# Identifying the contribution of zinc limitation to antibiotic tolerance during S. aureus infection

> **NIH NIH R21** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2022 · $190,073

## Abstract

Abstract
 Staphylococcus aureus is a major human pathogen responsible for numerous chronic and relapsing
infections. These infections often do not respond to treatment, leading to approximately 20,000 annual deaths
in the US alone. Paradoxically, during in vitro susceptibility testing, isolates from these infections frequently
exhibit full sensitivity to administered antibiotics, suggesting that environmental factors present in the host may
influence S. aureus antibiotic susceptibility. Understanding how these factors control antibiotic susceptibility will
improve the resolution of recalcitrant S. aureus infection, and slow the evolution of resistance.
 We have previously shown that extrinsic stressors within the host including exposure to reactive oxygen
species (ROS) produced by the host innate immune system inadvertently render subpopulations of S. aureus
tolerant to antibiotic killing by suppressing S. aureus metabolic activity. However, ROS exposure cannot fully
account for the tolerant state of S. aureus in vivo, suggesting that other unidentified factors present within the
host reduce antibiotic efficacy against S. aureus. Here we propose that the host immune protein calprotectin
induces an antibiotic tolerant state in S. aureus by starving the pathogen of zinc. Zinc is an essential cofactor
required for the activity of numerous bacterial metalloenzymes that carry out the major host processes. Zinc-
starved populations of S. aureus demonstrate significantly reduced rates of DNA synthesis, transcription, and
translation, and these processes represent the primary targets of bactericidal antibiotic action. Host-mediated
zinc sequestration may therefore inadvertently render S. aureus tolerant to antibiotic killing by reducing the
activity of major antibiotic targets. Overall, we hypothesize that zinc limitation induces an antibiotic tolerant
state in S. aureus during infection and that altering zinc availability through diet or immune modulation will
influence antibiotic efficacy within the host.
 In AIM1 we will probe the role of target inactivation in driving S. aureus antibiotic tolerance by directly
reducing global DNA replication and translation rates, and measuring the impact on S. aureus antibiotic
susceptibility. We will then assess the contribution of host-mediated zinc sequestration in inducing this
phenotype. In AIM2 we will move into a mouse model of S. aureus sepsis to assess the relevance of altering
physiological zinc availability (through diet or genetic manipulation) to enhance or suppress antibiotic efficacy
against S. aureus. In all, we expect that our findings will help improve our understanding of SA antibiotic
susceptibility, and elucidate how such knowledge can be exploited to resolve currently unresolvable infections.

## Key facts

- **NIH application ID:** 10336491
- **Project number:** 5R21AI159369-02
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Brian Patrick Conlon
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $190,073
- **Award type:** 5
- **Project period:** 2021-02-01 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10336491

## Citation

> US National Institutes of Health, RePORTER application 10336491, Identifying the contribution of zinc limitation to antibiotic tolerance during S. aureus infection (5R21AI159369-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10336491. Licensed CC0.

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