Target intelligence / Profile preview

Cytochrome bc1:aa3 oxidase supercomplex (bc1:aa3)

Target
bc1:aa3
Molecular classification
Enzyme, Oxidoreductase, Respiratory chain complex, Terminal oxidase
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Overview

The Cytochrome bc1:aa3 oxidase supercomplex is a critical component of the Mycobacterium tuberculosis respiratory chain, responsible for transferring electrons from menaquinol to oxygen and generating the proton motive force required for ATP synthesis (Current Molecular Pharmacology, 2022; PNAS, 2017). It consists of two main parts: the cytochrome bc1 complex (menaquinone:cytochrome c reductase) and the cytochrome aa3 oxidase (cytochrome c oxidase), which form an obligate supercomplex in mycobacteria (Nature Medicine, 2013; eLife, 2021). This supercomplex is a validated therapeutic target, with the QcrB subunit of the bc1 complex being the primary binding site for several novel antitubercular agents, most notably Telacebec (Q203) (Nature Medicine, 2013; Expert Opinion on Investigational Drugs, 2022). Inhibition of this target leads to a rapid collapse of intracellular ATP levels, although the presence of an alternative terminal oxidase, cytochrome bd, can provide respiratory flexibility and limit the bactericidal efficacy of bc1:aa3 inhibitors (PNAS, 2017; EMBO Molecular Medicine, 2020). Consequently, current research explores combining bc1:aa3 inhibitors with other agents to overcome this redundancy and achieve more effective sterilization of M. tuberculosis infections, including multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains (Antimicrobial Agents and Chemotherapy, 2022). The target's high specificity for mycobacterial enzymes over human mitochondrial homologs minimizes host toxicity, making it a promising focus for the development of shorter, safer treatment regimens for tuberculosis and other mycobacterial diseases like Buruli ulcer and leprosy (NEJM, 2020; Qurient, 2021).

Other names
Cytochrome bc1 complexCytochrome aa3 oxidaseQcrBCytochrome bcc:aa3 supercomplexMenaquinone:cytochrome c reductaseUbiquinol-cytochrome c reductase
02

Mechanism of action

Inhibition of the QcrB subunit (cytochrome b) of the cytochrome bc1 complex, which disrupts the electron transport chain and leads to a rapid depletion of intracellular ATP levels.

03

Biological functions

Oxidative phosphorylationElectron transportATP synthesisCellular respirationProton pumping
04

Disease associations

Infection
05

Safety considerations

Respiratory plasticity due to cytochrome bd oxidase redundancy (limiting bactericidal activity)Potential for cross-reactivity with human mitochondrial complexesPotential for QT interval prolongation (general class concern for antitubercular agents)
06

Interacting drugs

Telacebec (Q203)

4 more in the full profile.

07

Biomarkers

Time to culture positivity (TTP)Sputum bacterial loadColony-forming unit (CFU) count

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