RT Journal Article SR Electronic T1 Functional inhibition of acid sphingomyelinase disrupts infection by intracellular bacterial pathogens JF Life Science Alliance JO Life Sci. Alliance FD Life Science Alliance LLC SP e201800292 DO 10.26508/lsa.201800292 VO 2 IS 2 A1 Chelsea L Cockburn A1 Ryan S Green A1 Sheela R Damle A1 Rebecca K Martin A1 Naomi N Ghahrai A1 Punsiri M Colonne A1 Marissa S Fullerton A1 Daniel H Conrad A1 Charles E Chalfant A1 Daniel E Voth A1 Elizabeth A Rucks A1 Stacey D Gilk A1 Jason A Carlyon YR 2019 UL https://www.life-science-alliance.org/content/2/2/e201800292.abstract AB Intracellular bacteria that live in host cell–derived vacuoles are significant causes of human disease. Parasitism of low-density lipoprotein (LDL) cholesterol is essential for many vacuole-adapted bacteria. Acid sphingomyelinase (ASM) influences LDL cholesterol egress from the lysosome. Using functional inhibitors of ASM (FIASMAs), we show that ASM activity is key for infection cycles of vacuole-adapted bacteria that target cholesterol trafficking—Anaplasma phagocytophilum, Coxiella burnetii, Chlamydia trachomatis, and Chlamydia pneumoniae. Vacuole maturation, replication, and infectious progeny generation by A. phagocytophilum, which exclusively hijacks LDL cholesterol, are halted and C. burnetii, for which lysosomal cholesterol accumulation is bactericidal, is killed by FIASMAs. Infection cycles of Chlamydiae, which hijack LDL cholesterol and other lipid sources, are suppressed but less so than A. phagocytophilum or C. burnetii. A. phagocytophilum fails to productively infect ASM−/− or FIASMA-treated mice. These findings establish the importance of ASM for infection by intracellular bacteria and identify FIASMAs as potential host-directed therapies for diseases caused by pathogens that manipulate LDL cholesterol.