Cross-resistance
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Cross-resistance is when something develops resistance to several substances that have a similar mechanism of action. For example, if a certain type of bacteria develops resistance to one antibiotic, that bacteria will also have resistance to several other antibiotics that target the same protein or use the same route to get into the bacterium. A real example of cross-resistance occurred for
nalidixic acid Nalidixic acid (tradenames Nevigramon, NegGram, Wintomylon and WIN 18,320) is the first of the synthetic quinolone antibiotics. In a technical sense, it is a naphthyridone, not a quinolone: its ring structure is a 1,8-naphthyridine nucleus that ...
and
ciprofloxacin Ciprofloxacin is a fluoroquinolone antibiotic used to treat a number of bacterial infections. This includes bone and joint infections, intra abdominal infections, certain types of infectious diarrhea, respiratory tract infections, skin i ...
, which are both
quinolone antibiotic A quinolone antibiotic is a member of a large group of broad-spectrum bacteriocidals that share a bicyclic core structure related to the substance 4-quinolone. They are used in human and veterinary medicine to treat bacterial infections, as wel ...
s. When bacteria developed resistance to ciprofloxacin, they also developed resistance to nalidixic acid because both drugs inhibit
topoisomerase DNA topoisomerases (or topoisomerases) are enzymes that catalyze changes in the topological state of DNA, interconverting relaxed and supercoiled forms, linked (catenated) and unlinked species, and knotted and unknotted DNA. Topological issues i ...
, a key enzyme in DNA replication. Due to cross-resistance, antimicrobial treatments like
phage therapy Phage therapy, viral phage therapy, or phagotherapy is the therapeutic use of bacteriophages for the treatment of pathogenic bacterial infections. This therapeutic approach emerged at the beginning of the 20th century but was progressively re ...
can quickly lose their efficacy against bacteria. This makes cross-resistance an important consideration in designing evolutionary therapies.


Definition

Cross-resistance is the idea is that the development of resistance to one substance subsequently leads to resistance to one or more substances that can be resisted in a similar manner. It occurs when resistance is provided against multiple compounds through one single mechanism, like an
efflux pump In microbiology, efflux is the moving of a variety of different compounds out of cells, such as antibiotics, heavy metals, organic pollutants, plant-produced compounds, quorum sensing signals, bacterial metabolites and neurotransmitters. All micr ...
. Which can keep concentrations of a toxic substance at low levels and can do so for multiple compounds. Increasing the activity of such a mechanism in response to one compound then also has a similar effect on the others. The precise definition of cross-resistance depends on the field of interest.


Pest Management

In pest management, cross-resistance is defined as the development of resistance by pest populations to multiple pesticides within a chemical family. Similar to the case of microbes, this may occur due to sharing binding target sites. One such example occurs in the case of cadherin mutations may result in cross resistance in ''H. armigera'' to Cry1Aa and Cry1Ab. There also exists multiple resistance in which resistance to multiple pesticides occurs via different resistances mechanisms as opposed to the same mechanisms.


Microorganisms

In another case it is defined as the resistance of a virus to a new drug as a result of previous exposure to another drug. Or in the context of microbes as the resistance to multiple different antimicrobial agents as a result of a single molecular mechanism.


Antibiotic Resistance

Cross-resistance is highly involved in the widespread issue of antibiotic resistance; an area of clinical relevance. There is a continued increase in the development of multidrug resistance in bacteria. This is partially due to the widespread use of antimicrobial compounds in diverse environments. But resistance to antibiotics can arise in multiple ways. It is not necessarily the result of exposure to an antimicrobial compound.


Structural Similarity

Cross-resistance can take place between compounds that are chemically similar, like antibiotics within similar and different classes. That said, structural similarity is a weak predictor of antibiotic resistance, and does not predict antibiotic resistance at all when
aminoglycoside Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside (sugar). The term can also refer ...
s are disregarded in the comparison.


Target Similarity

Cross resistance will most commonly occur due to target similarity. This is possible when antimicrobial agents have the same target, initiate cell death in a similar manner or have a similar route of access. An example is cross-resistance between antibiotics and disinfectants. Exposure to certain disinfectants can lead to the increased expression of genes that encode for efflux pumps that are able to maintain low levels of antibiotics. So the same mechanism that is used to clear the disinfectant compound from the cell can also be used to clear antibiotics from the cell. Another example is cross-resistance between antibiotics and metals. As mentioned before compounds do not have to be similar in structure in order to lead to cross-resistance. It can also occur when the same mechanism is used to remove the compound from the cell. In the bacteria ''Listeria monocytogenes'' for instance a multi-drug efflux transporter was found that could export both metals and antibiotics. Experimental work has shown that exposure to Zinc can lead to increased levels of bacterial resistance to antibiotics. Several other studies have reported cross-resistance to various types of metals and antibiotics. These worked through several mechanisms, like drug efflux systems and
disulphide bond In biochemistry, a disulfide (or disulphide in British English) refers to a functional group with the structure . The linkage is also called an SS-bond or sometimes a disulfide bridge and is usually derived by the coupling of two thiol groups. I ...
formation systems. The possible implication of this is that not only the presence of antibacterial compounds can lead to the development of resistance against antibiotics, but also environmental factors like exposure to heavy metals.


Collateral Sensitivity

Collateral sensitivity occurs when developing multidrug resistance causes a bacteria to develop sensitivity to other drugs. Such developments can be exploited by researchers in effort to combat the harms created by cross resistance to commonly used antibiotics. Increased sensitivity to an antibiotic means that a lower concentration of antibiotic can be used to achieve adequate growth inhibition. Collateral sensitivity and antibiotic resistance exist as a trade off, in which the benefits gained by antibiotic resistance are balanced by the risks introduced by collateral sensitivity.


See also

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Drug resistance Drug resistance is the reduction in effectiveness of a medication such as an antimicrobial or an antineoplastic in treating a disease or condition. The term is used in the context of resistance that pathogens or cancers have "acquired", that is ...
*
Pesticide resistance Pesticide resistance describes the decreased susceptibility of a pest population to a pesticide that was previously effective at controlling the pest. Pest species evolve pesticide resistance via natural selection: the most resistant specimens su ...


References

{{Reflist Toxicology Pesticides Agricultural pests Evolutionary biology