The first response of bacteria to a noxious agent such as an antibiotic is the induced over expression of efflux pumps. Once the threat of the noxious agent passes, the level of efflux pump expression returns to its normal baseline.

Material secreted by bacteria such as those involved in quorum sensing (QS) and biofilm take place via the efflux pump system of the bacterium (Varga ZG, Armada A, Cerca P, Amaral L, Mior Ahmad Subki MA, Savka MA, Szegedi E, Kawase M, Motohashi N, Molnár J. Inhibition of quorum sensing and efflux pump system by trifluoromethyl ketone proton pump inhibitors. In Vivo. 2012). Because diffusion of other materials does not take place readily across the plasma membrane or outer membrane of bacteria, the means by which these materials (toxins, inducers, inhibitors, etc) are secreted may represent targets that may be exploited for the therapy of infections whose success lies in the materials secreted.

I would like for the members of RG to present their views on this subject for the purpose of expanding the possibility of new targets to be exploited, especially for the therapy of Gram-negative infections.

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