High-performance liquid chromatographic method for the enantioselective analysis of mefloquine in plasma and urine

Lysosomal disruption preferentially targets acute myeloid leukemia cells and progenitors

Despite efforts to understand and treat acute myeloid leukemia (AML), there remains a need for more comprehensive therapies to prevent AML-associated relapses. To identify new therapeutic strategies for AML, we screened a library of on- and off-patent drugs and identified the antimalarial agent mefloquine as a compound that selectively kills AML cells and AML stem cells in a panel of leukemia cell lines and in mice. Using a yeast genome-wide functional screen for mefloquine sensitizers, we identified genes associated with the yeast vacuole, the homolog of the mammalian lysosome. Consistent with this, we determined that mefloquine disrupts lysosomes, directly permeabilizes the lysosome membrane, and releases cathepsins into the cytosol. Knockdown of the lysosomal membrane proteins LAMP1 and LAMP2 resulted in decreased cell viability, as did treatment of AML cells with known lysosome disrupters. Highlighting a potential therapeutic rationale for this strategy, leukemic cells had significantly larger lysosomes compared with normal cells, and leukemia-initiating cells overexpressed lysosomal biogenesis genes. These results demonstrate that lysosomal disruption preferentially targets AML cells and AML progenitor cells, providing a rationale for testing lysosomal disruption as a novel therapeutic strategy for AML.

Liquid-phase microextraction combined with high-performance liquid chromatography for the enantioselective analysis of mefloquine in plasma samples

A simple and rapid method, which involves liquid-phase microextraction (LPME) followed by HPLC analysis using Chiralpak AD column and UV detection, was developed for the enantioselective determination of mefloquine in plasma samples. Several factors that influence the efficiency of three-phase LPME were investigated and optimized. Under the optimal extraction conditions, the mean recoveries were 33.2 and 35.0% for (-)-(SR-)-mefloquine and (+)-(RS)-mefloquine, respectively. The method was linear over 50-1500 ng/ml range. Within-day and between-day assay precision and accuracy were below 15% for both enantiomers at concentrations of 150, 600 and 1200 ng/ml. Furthermore, no racemization or degradation were seen with the method described.

An analytical method with a single extraction procedure and two separate high performance liquid chromatographic systems for the determination of artesunate, dihydroartemisinin and mefloquine in human plasma for application in clinical pharmacological studies of the drug combination

The combination of two sensitive, selective and reproducible reversed phase liquid chromatographic (RP-HPLC) methods was developed for the determination of artesunate (AS), its active metabolite dihydroartemisinin (DHA) and mefloquine (MQ) in human plasma. Solid phase extraction (SPE) of the plasma samples was carried out on Supelclean LC-18 extraction cartridges. Chromatographic separation of AS, DHA and the internal standard, artemisinin (QHS) was obtained on a Hypersil C4 column with mobile phase consisting of acetonitrile-0.05 M acetic acid adjusted to pH 5.2 with 1.0M NaOH (42:58, v/v) at the flow rate of 1.50 ml/min. The analytes were detected using an electrochemical detector operating in the reductive mode. Chromatography of MQ and the internal standard, chlorpromazine hydrochloride (CPM) was carried out on an Inertsil C8-3 column using methanol-acetonitrile-0.05 M potassium dihydrogen phosphate adjusted to pH 3.9 with 0.5% orthophosphoric acid (50:8:42, v/v/v) at a flow rate of 1.00 ml/min with ultraviolet detection at 284 nm. The mean recoveries of AS and DHA over a concentration range of 30-750 ng/0.5 ml plasma and MQ over a concentration of 75-1500 ng/0.5 ml plasma were above 80% and the accuracy ranged from 91.1 to 103.5%. The within-day coefficients of variation were 1.0-1.4% for AS, 0.4-3.4% for DHA and 0.7-1.5% for MQ. The day-to-day coefficients of variation were 1.3-7.6%, 1.8-7.8% and 2.0-3.4%, respectively. Both the lower limit of quantifications for AS and DHA were at 10 ng/0.5 ml and the lower limit of quantification for MQ was at 25 ng/0.5 ml. The limit of detections were 4 ng/0.5 ml for AS and DHA and 15 ng/0.5 ml for MQ. The method was found to be suitable for use in clinical pharmacological studies.

Simultaneous enantiomer determination of 20 (R)- and 20 (S)-ginsenoside-Rg2 in rat plasma after intravenous administration using HPLC method

20 (R,S)-Ginsenoside-Rg2, an anti-shock agent, is prescribed as a racemate. To analyze simultaneously the enantiomers of 20 (R)-ginsenoside-Rg2 and 20 (S)-ginsenoside-Rg2 in plasma, a simple and reproducible high-performance liquid chromatographic (HPLC) method has been developed. The enantiomeric separation and determination were successfully achieved using a Diamonsil ODS C18 reversed-phase column (5 microm, 250 mm x 4.6 mm) with an RP18 (5 microm) guard column and a mobile phase of MeOH-aq. 4% H3PO4 (65:35, v/v, pH 5.1) with UV detection at 203 nm. Both enantiomers, 20 (R)-ginsenoside-Rg2 and 20 (S)-ginsenoside-Rg2, were well separated at 14.5 min and 13.6 min, respectively. The linear ranges of the standard curves were 2.0-250 microg/ml. The intra- and inter-day precision (R.S.D.) were <or=1.59% and <or=0.54% and the mean extraction recoveries were 95.8% and 96.5% for 20 (R)-ginsenoside-Rg2 and 20 (S)-ginsenoside-Rg2 in rat plasma, respectively. The limits of detection and quantification were 2.0 microg/ml and 7.8 microg/ml (S/N=3:1) for 20 (R)-ginsenoside-Rg2, and 2.0 microg/ml and 3.9 microg/ml (S/N=3:1) for 20 (S)-ginsenoside-Rg2, respectively. This validated method was applicable to pharmacokinetic studies in rat plasma after intravenous administration of 20 (R,S)-ginsenoside-Rg2. A pharmacokinetic study in rat plasma indicated that the enantiomers were rapidly absorbed and eliminated. These assay results are necessary for the evaluation of the metabolism of ginsenoside-Rg2 in vivo.

Stereoselectivity in the pharmacodynamics and pharmacokinetics of the chiral antimalarial drugs

Several of the antimalarial drugs are chiral and administered as the racemate. These drugs include chloroquine, hydroxychloroquine, quinacrine, primaquine, mefloquine, halofantrine, lumefantrine and tafenoquine. Quinine and quinidine are also stereoisomers, although they are given separately rather than in combination. From the perspective of antimalarial activity, most of these agents demonstrate little stereoselectivity in their effects in vitro. Mefloquine, on the other hand, displays in vitro stereoselectivity against some strains of P. falciparum, with a eudismic ratio of almost 2 : 1 in favour of the (+)-enantiomer. Additionally, for some of these agents (e.g. halofantrine, primaquine, chloroquine), stereoselectivity has been noted in the ability of the enantiomers to cause certain adverse effects. In recent years, stereospecific analytical methods capable of measuring the individual enantiomers after the administration of racemic drugs have been reported for a number of chiral antimalarial drugs. These assays have revealed that almost all the studied antimalarial drugs display stereoselectivity in their pharmacokinetics, leading to enantioselectivity in their plasma concentrations. Whereas the oral absorption of these agents appears to be non-stereoselective, stereoselectivity is often seen in their volume of distribution and/or clearance. With regard to distribution, plasma protein binding of some chiral antimalarial drugs exhibits a significant degree of stereoselectivity, leading to stereoselective distribution to blood cells and other tissues. Because of their low hepatic extraction ratios, stereoselective plasma protein binding also contributes to the stereoselectivity in the metabolism of these drugs. Chiral metabolites are formed from some parent antimalarial drugs, although stereoselective aspects of the pharmacokinetics of the metabolites are not well understood. It is concluded that knowledge of the stereoselective aspects of these agents may be helpful in better understanding their mechanisms of action and possibly optimising their clinical safety and/or effectiveness.

Enantioseparation of erythro-mefloquine and its analogues in capillary electrophoresis

The enantioseparations of the chiral antimalaria drug (R,S)-erythro-alpha-(2-piperidyl)-2,8-bis(trifluoromethyl)4-quinolinemethanol (erythro-mefloquine, erythro-MQ) and its analogues were studied by capillary electrophoresis (CE) using cyclodextrins (CDs) as chiral selectors. The emphasis was put on the enantiomer affinity pattern of MQ towards different CDs as well as on simultaneous enantioseparations of erythro-MQ and its structural analogues. All three native CDs resolved the enantiomers of erythro-MQ and the enantiomer affinity pattern was the same, i.e. (+)-erythro-MQ was the more tightly bond enantiomer. However, the affinity pattern of erythro-MQ enantiomers was opposite in the case of heptakis-(2,3,6-tri-O-methyl)-beta-CD (TM-beta-CD), heptakis-(2,3-di-O-methyl-6-sulfo)-beta-CD (HDMS-beta-CD), heptakis-(3-O-methyl-2,6-di-O-sulfo)-beta-CD (HMdiSu-beta-CD) and randomly sulfated beta-CD (SU-beta-CD). Randomly hydroxyalkylated and acetylated derivatives of CDs appeared to be suitable chiral selectors for simultaneous enantioseparation of erythro-MQ and its analogues.

Crystal structure of (-)-mefloquine hydrochloride reveals consistency of configuration with biological activity

The absolute configuration of (-)-mefloquine has been established as 11R,12S by X-ray crystallography of the hydrochloride salt, thus allowing comparison of the configuration of mefloquine's optical isomers to those of quinine and quinidine. (-)-Mefloquine has the same stereochemistry as quinine, and (+)-mefloquine has the same stereochemistry as quinidine. Since (+)-mefloquine is more potent than (-)-mefloquine in vitro against the D6 and W2 strains of Plasmodium falciparum and quinidine is more potent than quinine, a common stereochemical component for antimalarial activity is implicated. The crystal of (-)-mefloquine hydrochloride contained four different conformations which mainly differ in a small rotation of the piperidine ring. These conformations are essentially the same as the crystalline conformations of racemic mefloquine methylsulfonate monohydrate, mefloquine hydrochloride, and mefloquine free base. The crystallographic parameters for (-)-mefloquine hydrochloride hydrate were as follows: C17H17F (6)N(2)O(+)Cl(-) .0.25 H2O; M(r), 419.3; symmetry of unit cell, orthorhombic; space group, P2(1)2(1)2(1); parameters of unit cell, a = 12.6890 +/- 0.0006 A (1 A = 0.1 nm), b = 18.9720 +/- 0.0009 A, c = 32.189 +/- 0.017 A; volume of unit cell, 7,749 +/- 4 A(3); number of molecules per unit cell, 16; calculated density, 1.44 g cm(-3); source of radiation, Cu Kalpha (lambda = 1.54178 A); mu (absorption coefficient), 2.373 mm(-1); room temperature was used; final R(1) (residual index), 0.0874 for 3,692 reflections with intensities greater than 2sigma. All of the hydroxyl and amine hydrogen atoms participate in intermolecular hydrogen bonds with chloride ions. The orientation of the amine and hydroxyl groups in (+)-mefloquine may define the optimal geometry for hydrogen bonding with cellular constituents.

A rapid spectrophotometric method for the determination of mefloquine hydrochloride

A simple ultraviolet spectrophotometric method for the estimation of mefloquine hydrochloride in methanol (ME(2)) has been developed and has been compared with the reported ultraviolet spectrophotometric method in 0.1 N hydrochloric acid (ME(1)). Analytical parameters such as stability, selectivity, accuracy and precision have been established for both the methods and evaluated statistically to assess the application of the individual methods. Both the methods were compared with the existing pharmacopoeial method for estimation of the drug. Both the methods were found to have the advantages for simplicity, stability, sensitivity, reproducibility and accuracy for using as an alternate to the existing non-spectrophotometric methods for the routine analysis of the drug in pharmaceutical formulations and also in pharmaceutical investigations involving mefloquine hydrochloride.

Stereospecific determination of mefloquine in biological fluids by high-performance liquid chromatography

A sensitive stereoselective HPLC method was developed for determination of mefloquine (MFQ) enantiomers in plasma, urine and whole blood. The assay involved liquid-liquid extraction of MFQ from biological fluids with a mixture of hexane and isopropanol in the presence of sodium hydroxide and derivatization of the residue by (+)-(S)-naphthylethylisocyanate (NEIC) as chiral derivatizing reagent. Separation of the resulting diastereomers was performed on a silica normal-phase column using chloroform-hexane-methanol (25:74:1) as the mobile phase with a flow-rate of 1 ml/min. Using 200 microl of plasma or whole blood, the limit of determination was 0.2 microg/ml with UV detection for both enantiomers. The limit of determination in 500 microl of urine was 0.08 microg/ml with UV detection.

Simultaneous enantiomeric determination of a gastroprokinetic agent mosapride citrate and its metabolite in plasma using alpha 1-acid glycoprotein HPLC column

Mosapride citrate, a novel benzamide-type gastroprokinetic agent, is clinically prescribed as a racemate and is metabolized to its des-4-fluorobenzyl structure (M-1). In order to analyze simultaneously the enantiomers of mosapride and M-1 in plasma, a simple and reproducible high-performance liquid chromatographic (HPLC) method has been developed. The enantiomeric separation and determination were successfully achieved using an alpha 1-acid glycoprotein column and gradient elution with a fluorimetric detection (excitation 314 nm/emission 352 nm). Both enantiomers of mosapride and M-1 were well separated between 20 and 22 min at pH 4.4 and between 4 and 7 min at pH 5.0, respectively. Accurate determinations are possible in the concentration ranges of 10-5000 ng ml-1 for mosapride enantiomers and 50-5000 ng ml-1 for M-1 enantiomers. The intra- and inter-day coefficients of variation are satisfactory for the pharmacokinetic study of mosapride.

Mefloquine tolerability during chemoprophylaxis: focus on adverse event assessments, stereochemistry and compliance

This longitudinal study of travellers to Africa taking mefloquine (MQ) chemoprophylaxis aimed to quantify and assess non-serious adverse events (AE) occurring during short-term prophylaxis and relate these to concentrations of racemic MQ, its enantiomers and metabolite. A total of 420 volunteers (52% F) participated. AEs with some impact on activities were reported by 11.2% of participants including 7.9% of neurological/psychiatric symptoms. Women were more likely to report AEs (P = 0.02). The standardized questionnaires used showed more pathological indicators in travellers who reported subjective AE with significantly more dizziness, distress, sleep disturbances and a high total mood disturbance (TMD) in the AE group. There was, however, no significant performance deficit in computerized psychomotor tests in those experiencing AE. Furthermore, no significant differences were observed in enantiomer ratios, metabolite concentrations, or racemic MQ levels in participants with or without AEs suggesting that these factors are not the main predictors of mefloquine intolerability.