Discovery of ARQ-501 as a potent PafA inhibitor that elevates KatG levels to potentiate isoniazid in mycobacteria

Abstract

The prokaryotic ubiquitin-like protein (Pup) conjugation system (PPS), which is essential for Mycobacterium tuberculosis (Mtb) virulence but absent in humans, presents an attractive drug target. Here, we report the discovery of ARQ-501, a quinone-based, covalent, substrate-competitive inhibitor of the Pup ligase PafA. ARQ-501 exhibited potent anti-mycobacterial activity against Mtb under host-mimicking stress conditions and within macrophages. We further identified the catalase-peroxidase KatG, essential for activation of the frontline prodrug isoniazid (INH), as a pupylation substrate. ARQ-501 inhibits KatG pupylation, causing its accumulation and creating a selective synergy with INH. This quantity over quality mechanism successfully rescued INH activation by the clinically prevalent KatG S315T mutant in enzymatic assays and enhanced INH efficacy against clinical S315T isolates to variable degrees. This work identifies a novel class of PafA inhibitors and a previously unrecognized role of pupylation in regulating KatG, offering a potential therapeutic avenue to combat drug-resistant tuberculosis.