Targeting cell membrane adaptation as a novel antimicrobial strategy

•The Lia system mediates response to cell membrane stressors in Gram-positive bacteria.•Disruption of the Lia system rendered bacteria susceptible to a variety of antibiotics.•LiaR and its homologs emerge as an appealing target for novel antimicrobial development.

Emergence of antibiotic resistance is an example of the incredible plasticity of bacteria to survive in all environments. The search for new antibiotics active against traditional targets is more challenging due not only to the lack of novel natural products to fulfill the current clinical needs against multidrug-resistant (MDR) bacteria, but also for the possible 'collateral' effects on the human microbiota. Thus, non-traditional approaches to combat MDR bacteria have been proposed. Here, we discuss the possibility of targeting the membrane response to the antibiotic attack (cell membrane adaptation) as a viable strategy to increase the activity of current antimicrobials, enhance the activity of the innate immune system and prevent development of resistance during therapy using the three-component regulatory system LiaFSR of enterococci as a model.