Evidence map›Paper›PMID 40390184›Full record

ArticleArchiv der Pharmazie2025

NorA Efflux Pump Inhibitors: Expanding SAR Knowledge of Pyrazolo[4,3-c][1,2]benzothiazine 5,5-Dioxide Derivatives.

Giada Cernicchi, Alessandra Di Gregorio, Tommaso Felicetti, Elisa Rampacci, Giulia Casari, Tatiana Armeni, Brenda Romaldi, Ermelinda Zefaj, Fabrizio Passamonti, Serena Massari and 5 more

Abstract read
In one paragraph

Article in Archiv der Pharmazie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Screening ofFrontiers in microbiology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Giada CernicchiDepartment of Pharmaceutical Sciences, Università degli Studi di Perugia, Perugia, Italy.ORCID https://orcid.org/0000-0002-3591-0210
Alessandra Di GregorioDepartment of Life and Environmental Science, Università Politecnica delle Marche, Ancona, Italy.ORCID https://orcid.org/0009-0002-2996-9571
Tommaso FelicettiDepartment of Pharmaceutical Sciences, Università degli Studi di Perugia, Perugia, Italy.ORCID http://orcid.org/0000-0001-9369-8564
Elisa RampacciDepartment of Veterinary Medicine, Università degli Studi di Perugia, Perugia, Italy.ORCID https://orcid.org/0000-0001-5023-2828
Giulia CasariDepartment of Specialized Clinical Sciences and Odontostomatology, Università Politecnica delle Marche, Torrette di Ancona, Italy.ORCID https://orcid.org/0009-0008-2881-3894
Tatiana ArmeniDepartment of Specialized Clinical Sciences and Odontostomatology, Università Politecnica delle Marche, Torrette di Ancona, Italy.ORCID https://orcid.org/0000-0003-0931-1342
Brenda RomaldiDepartment of Specialized Clinical Sciences and Odontostomatology, Università Politecnica delle Marche, Torrette di Ancona, Italy.ORCID https://orcid.org/0009-0001-6190-7605
Ermelinda ZefajDepartment of Pharmaceutical Sciences, Università degli Studi di Perugia, Perugia, Italy.
Fabrizio PassamontiDepartment of Veterinary Medicine, Università degli Studi di Perugia, Perugia, Italy.ORCID https://orcid.org/0000-0001-8773-838X
Serena MassariDepartment of Pharmaceutical Sciences, Università degli Studi di Perugia, Perugia, Italy.ORCID https://orcid.org/0000-0002-9992-6318
Giuseppe ManfroniDepartment of Pharmaceutical Sciences, Università degli Studi di Perugia, Perugia, Italy.ORCID https://orcid.org/0000-0003-0207-3927
Maria Letizia BarrecaDepartment of Pharmaceutical Sciences, Università degli Studi di Perugia, Perugia, Italy.ORCID https://orcid.org/0000-0003-3530-5042
Oriana TabarriniDepartment of Pharmaceutical Sciences, Università degli Studi di Perugia, Perugia, Italy.ORCID https://orcid.org/0000-0003-2693-5675
Carla VignaroliDepartment of Life and Environmental Science, Università Politecnica delle Marche, Ancona, Italy.ORCID https://orcid.org/0000-0002-0993-5967
Stefano SabatiniDepartment of Pharmaceutical Sciences, Università degli Studi di Perugia, Perugia, Italy.ORCID http://orcid.org/0000-0003-0971-3536

Funding

This study has been funded in part by the European Union NextGenerationEU under the Italian Ministry of University and Research (MUR) National Innovation Ecosystem grant ECS00000041-VITALITY-CUP J97G22000170005.
6 · The paper itself

Abstract

Antimicrobial resistance (AMR) represents a significant global concern, driven by the overuse of antibiotics. One of the principal mechanisms contributing to AMR is the activity of microbial efflux pumps (EPs), which expel diverse antibiotics out of bacterial cells, thereby rendering them ineffective. Our research aimed to expand the range of molecular classes that inhibit the Staphylococcus aureus EP NorA. In this study, starting from the hit compound pyrazolo[4,3-c][1,2]benzothiazine 5,5-dioxide 1, previously reported as a NorA efflux pump inhibitor (EPI), we undertook medicinal chemistry efforts, which involved the iterative combination of the design and synthesis of new analogues with data obtained through ethidium bromide efflux inhibition assays. Subsequent synergistic assays with ciprofloxacin (CPX) against the resistant strain SA-1199B led to the identification of three potent compounds (3, 10, and 19). The evaluation of these compounds in combination with CPX against NorA-overexpressing and NorA-knockout strains (SA-K2378 and SA-K1902, respectively) confirmed that the observed synergy with CPX is dependent on the presence of NorA. Additionally, the combination of NorA EPIs with CPX reduced biofilm production in NorA-overexpressing strains. These findings enhance our understanding of the structure-activity relationship of pyrazolobenzothiazine derivatives and support the use of EtBr efflux assays for rapid NorA inhibitors' identification.

Indexed as

Anti-Bacterial AgentsATP-Binding Cassette, Sub-Family C ProteinsBacterial ProteinsPyrazolesStaphylococcus aureusThiazinesCiprofloxacinDose-Response Relationship, DrugMicrobial Sensitivity TestsMolecular StructureStructure-Activity RelationshipAnti-Bacterial AgentsATP-Binding Cassette, Sub-Family C ProteinsBacterial ProteinsCiprofloxacinNorA protein, StaphylococcusPyrazolesThiazinesantibiotic resistance breakersciprofloxacinefflux pump inhibitorNorApyrazolobenzothiazine

Identifiers

PMID40390184
PMCPMC12089509

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.