Plasmodium hemozoin formation mediated by histidine-rich proteins

Hemoglobin catabolism and iron utilization by malaria parasites

Erythrocytic malaria parasites transport large quantities of erythrocyte cytoplasm to an acidic food vacuole, where hemoglobin is degraded. Globin is hydrolysed to free amino acids, which are subsequently incorporated into parasite proteins. Potentially toxic heme moieties are polymerized to hemozoin and also probably provide necessary parasite iron. Our understanding of the precise mechanisms of hemoglobin processing is incomplete. However, it is clear that hemoglobin catabolism and related events in the malarial food vacuole are the likely targets of both important antimalarial drugs and of promising new compounds. Thus, a more precise characterization of the metabolism of hemoglobin and iron by malaria parasites should expedite the development of new modes of antimalarial chemotherapy.

On the molecular mechanism of chloroquine's antimalarial action

Chloroquine is thought to exert its antimalarial effect by preventing the polymerization of toxic heme released during proteolysis of hemoglobin in the Plasmodium digestive vacuole. The mechanism of this blockade has not been established. We incubated cultured parasites with subinhibitory doses of [3H]chloroquine and [3H] quinidine. These [3H]quinoline compounds became associated with hemozoin as assessed by electron microscope autoradiography and subcellular fractionation. In vitro, binding of [3H]quinoline inhibitors to the hemozoin chain depended on the addition of heme substrate. These data counter previous conclusions regarding the lack of quinoline association with hemozoin, explain the exaggerated accumulation of quinolines in the plasmodium digestive vacuole, and suggest that a quinoline heme complex incorporates into the growing polymer to terminate chain extension, blocking further sequestration of toxic heme.

Formation of haemozoin/beta-haematin under physiological conditions is not spontaneous

Malaria parasite detoxifies free haem, released as a result of haemoglobin digestion, by converting it into an stable, crystalline, black brown pigment known as 'malaria pigment' or 'haemozoin'. Earlier studies have demonstrated the involvement of a parasite-specific enzyme 'haem polymerase' in the formation of haemozoin. However, recently it has been proposed that the polymerization of haem may be a spontaneous process that could take place by incubation of haematin with carboxylic acids (pH 4.2-5.0) even without presence of any parasitic or biological component (FEBS Letters, 352, 54-57 (1994). Here we report that no spontaneous haem polymerization occurs at physiological conditions and the product described in the study mentioned above is not haemozoin/beta-haematin (haem polymer) as characterized by us on the basis of solubility characteristics and thin layer chromatography. The infra-red spectroscopic analysis of the product formed though exhibits the bands corresponding to formation of iron-carboxylate bond, similar to that in haemozoin/beta-haematin, but was identified as haem-acid adduct. Thus polymerization of haem may not occur spontaneously under the reaction conditions corresponding to food vacuoles of the malarial parasite, the physiological site of haemozoin formation.

Novel bisquinoline antimalarials. Synthesis, antimalarial activity, and inhibition of haem polymerisation

We report the synthesis of two series of novel bisquinoline compounds that inhibit the growth of both chloroquine-sensitive and chloroquine-resistant strains of Plasmodium falciparum. To study the molecular basis of the action of these novel antimalarial drugs, we examined their ability to inhibit haem polymerisation in the presence and absence of parasite extracts. The level of antimalarial potency was correlated with the level of inhibition of haem polymerisation, suggesting that these bisquinolines exert their antimalarial activity by antagonising the sequestration of toxic haem moieties.

The chemical mechanism of beta-haematin formation studied by Mössbauer spectroscopy

Spontaneous formation of beta-haematin (malaria pigment) from haematin in acetate solution follows pseudo-zero-order and not autocatalytic kinetics. Acetate appears to facilitate the reaction by solubilizing the haematin and acting as a phase-transfer catalyst, a role which, in vivo, could be fulfilled by carboxylic acids or amino acids.

4-aminoquinoline analogs of chloroquine with shortened side chains retain activity against chloroquine-resistant Plasmodium falciparum

We have synthesized several 4-aminoquinolines with shortened side chains that retain activity against chloroquine-resistant isolates of Plasmodium falciparum malaria (W. Hofheinz, C. Jaquet, and S. Jolidon, European patent 94116281.0, June 1995). We report here an assessment of the activities of four selected compounds containing ethyl, propyl, and isopropyl side chains. Reasonable in vitro activity (50% inhibitory concentration, < 100 nM) against chloroquine-resistant P. falciparum strains was consistently observed, and the compounds performed well in a variety of plasmodium berghei animal models. However, some potential drawbacks of these compounds became evident upon in-depth testing. In vitro analysis of more than 70 isolates of P. falciparum and studies with a mouse in vivo model suggested a degree of cross-resistance with chloroquine. In addition, pharmacokinetic analysis demonstrated the formation of N-dealkylated metabolites of these compounds. These metabolites are similarly active against chloroquine-susceptible strains but are much less active against chloroquine-resistant strains. Thus, the clinical dosing required for these compounds would probably be greater for chloroquine-resistant strains than for chloroquine-susceptible strains. The clinical potential of these compounds is discussed within the context of chloroquine's low therapeutic ratio and toxicity.

Is haemozoin a target for antimalarial drugs?

Malarial parasites utilize a unique pathway to degrade haemoglobin. Most of the haem which is released during haemoglobin degradation is incorporated into haemozoin. The mechanism of haemozoin synthesis and the structure of haemozoin are controversial. Neither chloroquine nor artemisinin appear to affect haemozoin synthesis in vivo. Artemisinin is activated by intraparasitic haem and iron into a free radical which then alkylates specific malarial proteins.