Present and future of siderophore-based therapeutic and diagnostic approaches in infectious diseases

Gilda Tonziello, Emanuela Caraffa, Biagio Pinchera, Guido Granata, Nicola Petrosillo

Research output: Contribution to journalArticlepeer-review


Iron is an essential micronutrient required for the growth of almost all aerobic organisms; the iron uptake pathway in bacteria therefore represents a possible target for novel antimicrobials, including hybrids between antimicrobials and siderophores. Siderophores are low molecular weight iron chelators that bind to iron and are actively transported inside the cell through specific binding protein complexes. These binding protein complexes are present both in Gram negative bacteria, in their outer and inner membrane, and in Gram positive bacteria in their cytoplasmic membrane. Most bacteria have the ability to produce siderophores in order to survive in environments with limited concentrations of free iron, however some bacteria synthetize natural siderophore-antibiotic conjugates that exploit the siderophore-iron uptake pathway to deliver antibiotics into competing bacterial cells and gain a competitive advantage. This approach has been referred to as a Trojan Horse Strategy. To overcome the increasing global problem of antibiotic resistance in Gram negative bacteria, which often have reduced outer membrane permeability, siderophore-antibiotic hybrid conjugates have been synthetized in vitro. Cefiderocol is the first siderophore-antibiotic conjugate that progressed to late stage clinical development so far. In studies on murine models the iron-siderophore uptake pathway has been also exploited for diagnostic imaging of infectious diseases, in which labelled siderophores have been used as specific probes. The aim of this review is to describe the research progress in the field of siderophore-based therapeutic and diagnostic approaches in infectious diseases.

Original languageEnglish
Pages (from-to)30-36
Number of pages7
JournalInfectious Disease Reports
Issue number2
Publication statusPublished - Jan 1 2019


  • Cefiderocol
  • Iron uptake
  • Multidrug-resistant organisms
  • Siderophores

ASJC Scopus subject areas

  • Infectious Diseases


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