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While the excessive use of broad-spectrum antibiotics is a major driver of the global antibiotic resistance crisis, more selective therapies remain unavailable for the majority of bacterial pathogens. This includes the obligate intracellular bacterial pathogens of the genus Chlamydia, which cause millions of urogenital, ocular, and respiratory infections each year. Conducting a comprehensive search of the chemical space for novel antichlamydial activities, we identified over 60 compounds that are chemically diverse, structurally distinct from known antibiotics, non-toxic to human cells, and highly potent in preventing the growth of Chlamydia trachomatis in cell cultures. Some blocked C. trachomatis development reversibly, while others eradicated both established and persistent infections in a bactericidal manner. The top molecules displayed compelling selectivity, yet broad activity against diverse Chlamydia strains and species, including both urogenital and ocular serovars of C. trachomatis, as well as Chlamydia muridarum and Chlamydia caviae. Some compounds also displayed synergies with clinically used antibiotics. Critically, we found the most potent antichlamydial compound to inhibit fatty acid biosynthesis via covalent binding to the active site of Chlamydia FabH, identifying a new mechanism of FabH inhibition and highlighting a possible way to selectively treat Chlamydia infections.

Chlamydia trachomatis is the most common infectious cause of blindness and a prevalent bacterial agent of sexually transmitted infections, with an annual incidence exceeding 130 million cases. The current therapeutic approach to Chlamydia infections relies on broad-spectrum antibiotics. However, while generally effective, these antibiotics carry the risk of substantial collateral damage, for instance by promoting resistance in bystander pathogens and by adversely affecting commensal microbes. Hence, the development of a more sustainable, narrow-spectrum treatment would be advantageous. In this context, the bacterium’s highly specialized obligate intracellular lifestyle could offer a wealth of unique targets for intervention. This thesis specifically investigates the potential of harnessing the protective power of cell-autonomous immunity in our battle against Chlamydia.

It is envisaged that the therapeutic exploitation of cell-autonomous immunity will initially necessitate three pivotal steps. Firstly, it will require identifying protective host cellular defense programs and counteracting virulence factors, which could serve as potential molecular targets. Secondly, it will be crucial to determine the molecular mechanisms by which the pathogen’s virulence factors suppress the host cellular defenses. Thirdly, pharmacological means to target the identified virulence factors or host cellular defense programs will need to be identified. This thesis outlines three independent projects, executed concurrently, to advance our knowledge at these three steps.

The first project involved the implementation of an innovative molecular genetic screening approach, which was devised to reveal host cellular defense mechanisms that could effectively restrict the growth of C. trachomatis provided they were not actively suppressed by the pathogen. This investigation culminated in the discovery of a mutant C. trachomatis strain that lacks the ability to effectively evade xenophagy. Overall, this finding highlighted Chlamydia’s ability to evade this defense mechanism as a potential novel target for therapeutic intervention.

The second project encompassed the molecular characterization of CpoS, a C. trachomatis virulence factor previously identified to counteract cell-autonomous immunity by inhibiting induction of type-I interferon responses and premature host cell death. The analyses revealed that CpoS manipulates host cellular membrane trafficking and suppresses host cellular type-Iinterferon responses through its interactions with the host factor Rab35.

The third project involved a compound screening campaign that identified several novel selective anti-chlamydial compounds. Interestingly, one molecule exhibited reduced activity in xenophagy-deficient cells, implying a potential involvement of xenophagy in its mechanism of action.

In summary, this research pinpointed xenophagy as a potential defensive mechanism against C. trachomatis, offered in-depth understanding of the operational mode of the virulence factor CpoS, and discovered new selective therapeutic alternatives, which in part utilize xenophagyin their mechanism of action. Consequently, this thesis provides a comprehensive overview of the transition from fundamental research to the more application-oriented domain of drug discovery and may inspire the development of more sustainable therapeutic strategies for the clinical handling of Chlamydia infections.

The obligate intracellular bacterium Chlamydia trachomatis inserts a family of inclusion membrane (Inc) proteins into the membrane of its vacuole (the inclusion). The Inc CpoS is a critical suppressor of host cellular immune surveillance, but the underlying mechanism remained elusive. By complementing a cpoS mutant with various natural orthologs and variants of CpoS, we linked distinct molecular interactions of CpoS to distinct functions. Unexpectedly, we found CpoS to be essential for the formation of inclusion membrane microdomains that control the spatial organization of multiple Incs involved in signaling and modulation of the host cellular cytoskeleton. While the function of CpoS in microdomains was uncoupled from its role in the suppression of host cellular defenses, we found the ability of CpoS to interact with Rab GTPases to be required not only for the manipulation of membrane trafficking, such as to mediate transport of ceramide-derived lipids (sphingolipids) to the inclusion, but also for the inhibition of Stimulator of interferon genes (STING)-dependent type I interferon responses. Indeed, depletion of Rab35 phenocopied the exacerbated interferon responses observed during infection with CpoS-deficient mutants. Overall, our findings highlight the role of Inc-Inc interactions in shaping the inclusion microenvironment and the modulation of membrane trafficking as a pathogenic immune evasion strategy.

IMPORTANCE: Chlamydia trachomatis is a prevalent bacterial pathogen that causes blinding ocular scarring and urogenital infections that can lead to infertility and pregnancy complications. Because Chlamydia can only grow within its host cell, boosting the intrinsic defenses of human cells may represent a novel strategy to fight pathogen replication and survival. Hence, CpoS, a Chlamydia protein known to block host cellular defenses, or processes regulated by CpoS, could provide new opportunities for therapeutic intervention. By revealing CpoS as a multifunctional virulence factor and by linking its ability to block host cellular immune signaling to the modulation of membrane trafficking, the present work may provide a foundation for such rationale targeting and advances our understanding of how intracellular bacteria can shape and protect their growth niche.