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Zarfos SD, Deans BJ, Ho CC, Jordan GJ, Smith JA, Bissember AC. Distinctive Arbutin-Containing Markers: Chemotaxonomic Significance and Insights into the Evolution of Proteaceae Phytochemistry. Chem Biodivers 2023; 20:e202301112. [PMID: 37726205 DOI: 10.1002/cbdv.202301112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 09/21/2023]
Abstract
Natural products isolation studies of eight endemic Tasmanian Proteaceae species - Agastachys odorata, Persoonia juniperina, Hakea megadenia, Hakea epiglottis, Orites diversifolius, Orites acicularis, Orites revolutus, and Telopea truncata - and three endemic Australian Proteaceae species Banksia serrata, Banksia praemorsa, and Banksia marginata were undertaken. Two previously unreported glycoside-derived natural products were identified, in addition to four other tremendously rare arbutin esters. The results of this study provide further evidence consistent with the proposal that these distinctive arbutin esters represent markers that can provide valuable insights into the chemical evolution of plant species within the family Proteaceae.
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Affiliation(s)
- Samuel D Zarfos
- School of Natural Sciences - Chemistry, University of Tasmania, Hobart, Tasmania, 7001, Australia
| | - Bianca J Deans
- School of Natural Sciences - Chemistry, University of Tasmania, Hobart, Tasmania, 7001, Australia
| | - Curtis C Ho
- School of Natural Sciences - Chemistry, University of Tasmania, Hobart, Tasmania, 7001, Australia
| | - Gregory J Jordan
- School of Natural Sciences - Biological Sciences, University of Tasmania, Hobart, 7001, Tasmania, Australia
| | - Jason A Smith
- School of Natural Sciences - Chemistry, University of Tasmania, Hobart, Tasmania, 7001, Australia
| | - Alex C Bissember
- School of Natural Sciences - Chemistry, University of Tasmania, Hobart, Tasmania, 7001, Australia
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2
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Setshedi KJ, Beteck RM, Jesumoroti OJ, Ilbeigi K, Mabille D, Caljon G, Van der Kooy F, Legoabe LJ. 2-Aroyl quinazolinone: Synthesis and in vitro anti-parasitic activity. Chem Biol Drug Des 2023; 102:763-772. [PMID: 37353860 DOI: 10.1111/cbdd.14284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023]
Abstract
Trypanosomes and Leishmania are parasitic protozoans that affect millions of people globally. Herein we report the synthesis of 2-aroyl quinazolinones and their antiprotozoal efficacy against Trypanosoma brucei, Trypanosoma brucei rhodesiense, Trypanosoma cruzi, and Leishmania infantum. These compounds were counter-screened against a human cell line for cytotoxicity. Thirteen of the twenty target compounds in this study inhibited the growth of these parasites, with compounds KJ1, and KJ10 exhibiting IC50 values of 4.7 μM (T. b. brucei) and 1.1 μM (T. b. rhodesiense), respectively.
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Affiliation(s)
- Koketso J Setshedi
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa
| | - Richard M Beteck
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa
| | - Omobolanle J Jesumoroti
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa
| | - Kayhan Ilbeigi
- Laboratory of Microbiology, Parasitology and Hygiene, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Dorien Mabille
- Laboratory of Microbiology, Parasitology and Hygiene, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Guy Caljon
- Laboratory of Microbiology, Parasitology and Hygiene, Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Frank Van der Kooy
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa
| | - Lesetja J Legoabe
- Centre of Excellence for Pharmaceutical Sciences, North-West University, Potchefstroom, South Africa
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3
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Dong H, Yu P, Long B, Peng T, He Y, Xu B, Liao L, Lu L. Total Synthesis of Kuwanons A and B and Discovery of Their Antibacterial Mechanism. JOURNAL OF NATURAL PRODUCTS 2023; 86:2022-2030. [PMID: 37499116 DOI: 10.1021/acs.jnatprod.3c00466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Kuwanons A (1) and B (2) are two natural prenylated flavones isolated from the root bark of Morus alba L. In this study, the first total syntheses of kuwanons A (1) and B (2) were achieved from a common intermediate with overall yields of 6.6% and 11.6%, respectively. Kuwanon B (2) exhibited antibacterial activity against Gram-positive bacteria and concentration-dependent bactericidal activity against Staphylococcus aureus bacteria. Preliminary mechanism of action studies suggested that this compound killed bacteria rapidly by disrupting bacterial membrane integrity.
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Affiliation(s)
- Hongbo Dong
- Engineering Research Center for Pharmaceuticals and Equipment of Sichuan Province, School of Pharmacy, Chengdu University, Chengdu 610106, People's Republic of China
- Anti-infective Agent Creation Engineering Research Centre of Sichuan Province, School of Pharmacy, Chengdu University, Chengdu 610106, People's Republic of China
| | - Pei Yu
- Engineering Research Center for Pharmaceuticals and Equipment of Sichuan Province, School of Pharmacy, Chengdu University, Chengdu 610106, People's Republic of China
| | - Bin Long
- Engineering Research Center for Pharmaceuticals and Equipment of Sichuan Province, School of Pharmacy, Chengdu University, Chengdu 610106, People's Republic of China
| | - Ting Peng
- Anti-infective Agent Creation Engineering Research Centre of Sichuan Province, School of Pharmacy, Chengdu University, Chengdu 610106, People's Republic of China
| | - Yujiao He
- Anti-infective Agent Creation Engineering Research Centre of Sichuan Province, School of Pharmacy, Chengdu University, Chengdu 610106, People's Republic of China
| | - Bing Xu
- Department of Pediatric Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 610072, People's Republic of China
| | - Li Liao
- Anti-infective Agent Creation Engineering Research Centre of Sichuan Province, School of Pharmacy, Chengdu University, Chengdu 610106, People's Republic of China
| | - Lan Lu
- Anti-infective Agent Creation Engineering Research Centre of Sichuan Province, School of Pharmacy, Chengdu University, Chengdu 610106, People's Republic of China
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4
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Sun Y, Tang L, Wu C, Wang J, Wang C. RSK inhibitors as potential anticancer agents: Discovery, optimization, and challenges. Eur J Med Chem 2023; 251:115229. [PMID: 36898330 DOI: 10.1016/j.ejmech.2023.115229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 02/27/2023]
Abstract
Ribosomal S6 kinase (RSK) family is a group of serine/threonine kinases, including four isoforms (RSK1/2/3/4). As a downstream effector of the Ras-mitogen-activated protein kinase (Ras-MAPK) pathway, RSK participates in many physiological activities such as cell growth, proliferation, and migration, and is intimately involved in tumor occurrence and development. As a result, it is recognized as a potential target for anti-cancer and anti-resistance therapies. There have been several RSK inhibitors discovered or designed in recent decades, but only two have entered clinical trials. Low specificity, low selectivity, and poor pharmacokinetic properties in vivo limit their clinical translation. Published studies performed structure optimization by increasing interaction with RSK, avoiding hydrolysis of pharmacophores, eliminating chirality, adapting to binding site shape, and becoming prodrugs. Besides enhancing efficacy, the focus of further design will move towards selectivity since there are functional differences among RSK isoforms. This review summarized the types of cancers associated with RSK, along with the structural characteristics and optimization process of the reported RSK inhibitors. Furthermore, we addressed the importance of RSK inhibitors' selectivity and discussed future drug development directions. This review is expected to shed light on the emergence of RSK inhibitors with high potency, specificity, and selectivity.
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Affiliation(s)
- Ying Sun
- Department of Respiratory and Critical Care Medicine, Targeted Tracer Research and Development Laboratory, Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China; State Key Laboratory of Biotherapy and Cancer Center, Department of Respiratory and Critical Care Medicine, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China; Precision Medicine Key Laboratory of Sichuan Province & Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Lichao Tang
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, 60208, IL, United States
| | - Chengyong Wu
- Department of Respiratory and Critical Care Medicine, Targeted Tracer Research and Development Laboratory, Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China; Precision Medicine Key Laboratory of Sichuan Province & Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jiaxing Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, 38163, Tennessee, United States
| | - Chengdi Wang
- Department of Respiratory and Critical Care Medicine, Targeted Tracer Research and Development Laboratory, Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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5
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Larin ACR, Pfrunder MC, Mullen KM, Wiedbrauk S, Boase NR, Fairfull-Smith KE. Synergistic or antagonistic antioxidant combinations - a case study exploring flavonoid-nitroxide hybrids. Org Biomol Chem 2023; 21:1780-1792. [PMID: 36728689 DOI: 10.1039/d2ob02101c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Neurodegenerative diseases impose a considerable medical and public health burden on populations throughout the world. Oxidative stress, an imbalance in pro-oxidant/antioxidant homeostasis that leads to the generation of reactive oxygen species (ROS), has been implicated in the progression of a number of neurodegenerative diseases. The manipulation of ROS levels may represent a promising treatment option to slow down neurodegeneration, although adequate potency of treatments has not yet been achieved. Using a hybrid pharmacology approach, free radical nitroxide antioxidants were hybridised with a class of natural antioxidants, flavonoids, to form a potential multitargeted antioxidant. Modification of the Baker-Venkataraman reaction achieved the flavonoid-nitroxide hybrids (6-9) in modest yields. Antioxidant evaluation of the hybrids by cyclic voltammetry showed both redox functionalities were still active, with little influence on oxidation potential. Assessment of the peroxyl radical scavenging ability through an ORAC assay showed reduced antioxidant activity of the hybrids compared to their individual components. It was hypothesized that the presence of the phenol in the hybrids creates a more acidic medium which does not favour regeneration of the nitroxide from the corresponding oxammonium cation, disturbing the typical catalytic cycle of peroxyl radical scavenging by nitroxides. This work highlights the potential intricacies involved with drug hybridization as a strategy for new therapeutic development.
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Affiliation(s)
- Astrid C R Larin
- School of Chemistry and Physics, Faculty of Science, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.,Centre for Materials Science, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.
| | - Michael C Pfrunder
- School of Chemistry and Physics, Faculty of Science, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.,Centre for Materials Science, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.
| | - Kathleen M Mullen
- School of Chemistry and Physics, Faculty of Science, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.,Centre for Materials Science, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.
| | - Sandra Wiedbrauk
- School of Chemistry and Physics, Faculty of Science, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.,Centre for Materials Science, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.
| | - Nathan R Boase
- School of Chemistry and Physics, Faculty of Science, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.,Centre for Materials Science, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.
| | - Kathryn E Fairfull-Smith
- School of Chemistry and Physics, Faculty of Science, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.,Centre for Materials Science, Queensland University of Technology, Brisbane, Queensland, 4001, Australia.
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6
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Mori M, Quaglio D, Calcaterra A, Ghirga F, Sorrentino L, Cammarone S, Fracella M, D’Auria A, Frasca F, Criscuolo E, Clementi N, Mancini N, Botta B, Antonelli G, Pierangeli A, Scagnolari C. Natural Flavonoid Derivatives Have Pan-Coronavirus Antiviral Activity. Microorganisms 2023; 11:microorganisms11020314. [PMID: 36838279 PMCID: PMC9960971 DOI: 10.3390/microorganisms11020314] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/27/2023] Open
Abstract
The SARS-CoV-2 protease (3CLpro) is one of the key targets for the development of efficacious drugs for COVID-19 treatment due to its essential role in the life cycle of the virus and exhibits high conservation among coronaviruses. Recent studies have shown that flavonoids, which are small natural molecules, have antiviral activity against coronaviruses (CoVs), including SARS-CoV-2. In this study, we identified the docking sites and binding affinity of several natural compounds, similar to flavonoids, and investigated their inhibitory activity towards 3CLpro enzymatic activity. The selected compounds were then tested in vitro for their cytotoxicity, for antiviral activity against SARS-CoV-2, and the replication of other coronaviruses in different cell lines. Our results showed that Baicalein (100 μg/mL) exerted strong 3CLpro activity inhibition (>90%), whereas Hispidulin and Morin displayed partial inhibition. Moreover, Baicalein, up to 25 μg/mL, hindered >50% of SARS-CoV-2 replication in Vero E6 cultures. Lastly, Baicalein displayed antiviral activity against alphacoronavirus (Feline-CoV) and betacoronavirus (Bovine-CoV and HCoV-OC43) in the cell lines. Our study confirmed the antiviral activity of Baicalein against SARS-CoV-2 and demonstrated clear evidence of its pan-coronaviral activity.
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Affiliation(s)
- Mattia Mori
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Deborah Quaglio
- Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Calcaterra
- Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesca Ghirga
- Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Leonardo Sorrentino
- Laboratory of Virology, Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Silvia Cammarone
- Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Matteo Fracella
- Laboratory of Virology, Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Alessandra D’Auria
- Laboratory of Virology, Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Federica Frasca
- Laboratory of Virology, Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Elena Criscuolo
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Nicola Clementi
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Nicasio Mancini
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Laboratory of Medical Microbiology and Virology, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Bruno Botta
- Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Guido Antonelli
- Laboratory of Virology, Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Alessandra Pierangeli
- Laboratory of Virology, Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Carolina Scagnolari
- Laboratory of Virology, Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence:
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7
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Dong H, Wu M, Xiang S, Song T, Li Y, Long B, Feng C, Shi Z. Total Syntheses and Antibacterial Evaluations of Neocyclomorusin and Related Flavones. JOURNAL OF NATURAL PRODUCTS 2022; 85:2217-2225. [PMID: 36062892 DOI: 10.1021/acs.jnatprod.2c00658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Neocyclomorusin (1), a natural bioactive pyranoflavone mainly isolated from plants of the Moraceae family, was synthesized for the first time using a Friedel-Crafts reaction, a Baker-Venkataraman (BK-VK) rearrangement, a selective epoxidation, and a novel SN2-type cyclization as the key steps. The present protocol was also successfully applied for the total synthesis of oxyisocyclointegrin (2). Structurally related natural products morusin (23) and cudraflavone B (24) were also prepared. We investigated the antibacterial activities of these natural compounds against both Gram-negative and Gram-positive strains. The prenylated flavones, morusin (23) and cudraflavone B (24), showed comparable activity to ampicillin and kanacycin A against Staphylococcus aureus. Both morusin (23) and cudraflavone B (24) showed better antibacterial activities than ampicillin against the Gram-positive bacteria Staphylococcus epidermidis and Bacillus subtilis. Both neocyclomorusin (1) and oxyisocyclointegrin (2) displayed disappointing antimicrobial activities against Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, and Bacillus subtilis strains.
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Affiliation(s)
- Hongbo Dong
- Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu 610106, China
- School of Pharmacy, Chengdu University, Chengdu 610106, China
| | - Min Wu
- School of Pharmacy, Chengdu University, Chengdu 610106, China
- School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China
| | - Shengwei Xiang
- School of Pharmacy, Chengdu University, Chengdu 610106, China
- School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China
| | - Tao Song
- School of Pharmacy, Chengdu University, Chengdu 610106, China
| | - Ying Li
- School of Pharmacy, Chengdu University, Chengdu 610106, China
| | - Bin Long
- School of Pharmacy, Chengdu University, Chengdu 610106, China
| | - Chuanling Feng
- School of Pharmacy, Chengdu University, Chengdu 610106, China
| | - Zheng Shi
- Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu 610106, China
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8
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Dong H, Wu M, Li Y, Lu L, Qin J, He Y, Shi Z. Total Syntheses and Anti-inflammatory Evaluations of Pongamosides A-C, Natural Furanoflavonoid Glucosides from Fruit of Pongamia pinnata (L.) Pierre. JOURNAL OF NATURAL PRODUCTS 2022; 85:1118-1127. [PMID: 35352937 DOI: 10.1021/acs.jnatprod.2c00021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The syntheses of three natural furanoflavonoid glucosides, including two flavone glucosides, pongamosides A (1) and B (2), and a flavonol glucoside, pongamoside C (3), were achieved for the first time in 9-15 steps from commercially available materials in overall yields ranging from 2.9% to 29%. The synthetic sequence featured a NaH-promoted BK-VK rearrangement and acid-catalyzed intramolecular cyclization to furnish the furanoflavonoid aglycone. Meanwhile, phase-transfer-catalyzed glycosylation and Schmidt's trichloroacetimidate procedure were employed to establish the pivotal O-glycosidic linkage. The anti-inflammatory activities of compounds 1-3, as well as their aglycones 5a, 5b, and 23, were determined against NO production in the LPS-stimulated RAW264.7 cells. The results indicated that the O-glycosylation may reduce the anti-inflammatory activity of furanoflavonoid in vitro.
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Affiliation(s)
- Hongbo Dong
- Antibiotics Research and Re-evaluation Key Laboratory of Sichuan Province, School of Pharmacy & Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu 610106, China
- Engineering Research Center for Pharmaceuticals and Equipment of Sichuan Province, School of Pharmacy, Chengdu University, Chengdu 610106, China
| | - Min Wu
- Antibiotics Research and Re-evaluation Key Laboratory of Sichuan Province, School of Pharmacy & Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu 610106, China
- School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China
| | - Ying Li
- Antibiotics Research and Re-evaluation Key Laboratory of Sichuan Province, School of Pharmacy & Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu 610106, China
| | - Lan Lu
- Antibiotics Research and Re-evaluation Key Laboratory of Sichuan Province, School of Pharmacy & Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu 610106, China
| | - Jialan Qin
- Engineering Research Center for Pharmaceuticals and Equipment of Sichuan Province, School of Pharmacy, Chengdu University, Chengdu 610106, China
| | - Yujiao He
- Engineering Research Center for Pharmaceuticals and Equipment of Sichuan Province, School of Pharmacy, Chengdu University, Chengdu 610106, China
| | - Zheng Shi
- Antibiotics Research and Re-evaluation Key Laboratory of Sichuan Province, School of Pharmacy & Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu 610106, China
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