1
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Amorim JC, Carpio JM. Alpha-Naphthoflavone as a Novel Scaffold for the Design of Potential Inhibitors of the APH(3')-IIIa Nucleotide-Binding Site of Enterococcus faecalis. Microorganisms 2023; 11:2351. [PMID: 37764195 PMCID: PMC10535617 DOI: 10.3390/microorganisms11092351] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 09/29/2023] Open
Abstract
The spread of nosocomial infections caused by antibiotic-resistant Enterococcus faecalis is one of the major threats to global health at present. While aminoglycosides are often used to combat these infections, their effectiveness is reduced by various resistance mechanisms, including aminoglycoside modifying enzymes, and there are currently no drugs to inhibit these enzymes. To address this issue, this study was conducted to identify potential aminoglycoside adjuvants from a database of 462 flavones. The affinity of these molecules with the nucleotide-binding site (NBS) of aminoglycoside phosphotransferase type IIIa of E. faecalis (EfAPH(3')-IIIa) was evaluated, and the five molecules with the highest binding energies were identified. Of these, four were naphthoflavones, suggesting that their backbone could be useful in designing potential inhibitors. The highest-ranked naphthoflavone, 2-phenyl-4H-benzo[h]chromen-4-one, was modified to generate two new derivatives (ANF2OHC and ANF2OHCC) to interact with the NBS similarly to adenine in ATP. These derivatives showed higher binding free energies, better stability in molecular dynamics analysis and superior pharmacokinetic and toxicological profiles compared to the parent molecule. These findings suggest that these alpha-naphthoflavone derivatives are potential inhibitors of EfAPH(3')-IIIa and that this core may be a promising scaffold for developing adjuvants that restore the sensitivity of aminoglycosides.
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Affiliation(s)
| | - Juan Marcelo Carpio
- Unidad Académica de Salud y Bienestar, Universidad Católica de Cuenca, Av. Las Américas, Cuenca 010105, Ecuador;
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2
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Cattaneo D, Torre A, Schiuma M, Civati A, Lazzarin S, Rizzardini G, Gori A, Antinori S, Gervasoni C. Management of Polypharmacy and Potential Drug-Drug Interactions in Patients with Mycobacterial Infection: A 1-Year Experience of a Multidisciplinary Outpatient Clinic. Antibiotics (Basel) 2023; 12:1171. [PMID: 37508267 PMCID: PMC10375959 DOI: 10.3390/antibiotics12071171] [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: 06/09/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
In 2022, we opened an outpatient clinic for the management of polypharmacy and potential drug-drug interactions (pDDIs) in patients with mycobacterial infection (called GAP-MyTB). All patients who underwent a GAP-MyTB visit from March 2022 to March 2023 were included in this retrospective analysis. Fifty-two patients were included in the GAP-MyTB database. They were given 10.4 ± 3.7 drugs (2.8 ± 1.0 and 7.8 ± 3.9 were, respectively, antimycobacterial agents and co-medications). Overall, 262 pDDIs were identified and classified as red-flag (2%), orange-flag (72%), or yellow-flag (26%) types. The most frequent actions suggested after the GAP-MyTB assessment were to perform ECG (52%), therapeutic drug monitoring (TDM, 40%), and electrolyte monitoring (33%) among the diagnostic interventions and to reduce/stop proton pump inhibitors (37%), reduce/change statins (14%), and reduce anticholinergic burden (8%) among the pharmacologic interventions. The TDM of rifampicin revealed suboptimal exposure in 39% of patients that resulted in a TDM-guided dose increment (from 645 ± 101 to 793 ± 189 mg/day, p < 0.001). The high prevalence of polypharmacy and risk of pDDIs in patients with mycobacterial infection highlights the need for ongoing education on prescribing principles and the optimal management of individual patients. A multidisciplinary approach involving physicians and clinical pharmacologists could help achieve this goal.
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Affiliation(s)
- Dario Cattaneo
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, 20157 Milan, Italy
- Gestione Ambulatoriale Politerapie (GAP) Outpatient Clinic, ASST Fatebenefratelli-Sacco University Hospital, 20157 Milan, Italy
| | - Alessandro Torre
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, 20157 Milan, Italy
| | - Marco Schiuma
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, 20157 Milan, Italy
| | - Aurora Civati
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, 20157 Milan, Italy
| | - Samuel Lazzarin
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, 20157 Milan, Italy
| | - Giuliano Rizzardini
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, 20157 Milan, Italy
| | - Andrea Gori
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, 20157 Milan, Italy
| | - Spinello Antinori
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, 20157 Milan, Italy
| | - Cristina Gervasoni
- Department of Infectious Diseases, ASST Fatebenefratelli-Sacco University Hospital, 20157 Milan, Italy
- Gestione Ambulatoriale Politerapie (GAP) Outpatient Clinic, ASST Fatebenefratelli-Sacco University Hospital, 20157 Milan, Italy
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3
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Chamboko CR, Veldman W, Tata RB, Schoeberl B, Tastan Bishop Ö. Human Cytochrome P450 1, 2, 3 Families as Pharmacogenes with Emphases on Their Antimalarial and Antituberculosis Drugs and Prevalent African Alleles. Int J Mol Sci 2023; 24:ijms24043383. [PMID: 36834793 PMCID: PMC9961538 DOI: 10.3390/ijms24043383] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/30/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
Precision medicine gives individuals tailored medical treatment, with the genotype determining the therapeutic strategy, the appropriate dosage, and the likelihood of benefit or toxicity. Cytochrome P450 (CYP) enzyme families 1, 2, and 3 play a pivotal role in eliminating most drugs. Factors that affect CYP function and expression have a major impact on treatment outcomes. Therefore, polymorphisms of these enzymes result in alleles with diverse enzymatic activity and drug metabolism phenotypes. Africa has the highest CYP genetic diversity and also the highest burden of malaria and tuberculosis, and this review presents current general information on CYP enzymes together with variation data concerning antimalarial and antituberculosis drugs, while focusing on the first three CYP families. Afrocentric alleles such as CYP2A6*17, CYP2A6*23, CYP2A6*25, CYP2A6*28, CYP2B6*6, CYP2B6*18, CYP2C8*2, CYP2C9*5, CYP2C9*8, CYP2C9*9, CYP2C19*9, CYP2C19*13, CYP2C19*15, CYP2D6*2, CYP2D6*17, CYP2D6*29, and CYP3A4*15 are implicated in diverse metabolic phenotypes of different antimalarials such as artesunate, mefloquine, quinine, primaquine, and chloroquine. Moreover, CYP3A4, CYP1A1, CYP2C8, CYP2C18, CYP2C19, CYP2J2, and CYP1B1 are implicated in the metabolism of some second-line antituberculosis drugs such as bedaquiline and linezolid. Drug-drug interactions, induction/inhibition, and enzyme polymorphisms that influence the metabolism of antituberculosis, antimalarial, and other drugs, are explored. Moreover, a mapping of Afrocentric missense mutations to CYP structures and a documentation of their known effects provided structural insights, as understanding the mechanism of action of these enzymes and how the different alleles influence enzyme function is invaluable to the advancement of precision medicine.
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Affiliation(s)
- Chiratidzo R Chamboko
- Research Unit in Bioinformatics (RUBi), Department of Biochemistry and Microbiology, Rhodes University, Makhanda 6139, South Africa
| | - Wayde Veldman
- Research Unit in Bioinformatics (RUBi), Department of Biochemistry and Microbiology, Rhodes University, Makhanda 6139, South Africa
| | - Rolland Bantar Tata
- Research Unit in Bioinformatics (RUBi), Department of Biochemistry and Microbiology, Rhodes University, Makhanda 6139, South Africa
| | - Birgit Schoeberl
- Translational Medicine, Novartis Institutes for BioMedical Research, 220 Massachusetts Ave, Cambridge, MA 02139, USA
| | - Özlem Tastan Bishop
- Research Unit in Bioinformatics (RUBi), Department of Biochemistry and Microbiology, Rhodes University, Makhanda 6139, South Africa
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4
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Pooranagangadevi N, Padmapriyadarsini C. Treatment of Tuberculosis and the Drug Interactions Associated With HIV-TB Co-Infection Treatment. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.834013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Tuberculosis (TB) is a communicable disease that is a major source of illness, one of the ten causes of mortality worldwide, and the largest cause of death from a single infectious agent Mycobacterium tuberculosis. HIV infection and TB are a fatal combination, with each speeding up the progression of the other. Barriers to integrated treatment as well as safety concerns on the co-management of HIV- TB co-infection do exist. Many HIV TB co-infected people require concomitant anti-retroviral therapy (ART) and anti-TB medication, which increases survival but also introduces certain management issues, such as drug interactions, combined drug toxicities, and TB immune reconstitution inflammatory syndrome which has been reviewed here. In spite of considerable pharmacokinetic interactions between antiretrovirals and antitubercular drugs, when the pharmacological characteristics of drugs are known and appropriate combination regimens, dosing, and timing of initiation are used, adequate clinical response of both infections can be achieved with an acceptable safety profile. To avoid undesirable drug interactions and side effects in patients, anti TB treatment and ART must be closely monitored. To reduce TB-related mortality among HIV-TB co-infected patients, ART and ATT (Anti Tuberculosis Treatment) outcomes must improve. Clinical practise should prioritise strategies to promote adherence, such as reducing treatment duration, monitoring and treating adverse events, and improving treatment success rates, to reduce the mortality risk of HIV-TB co-infection.
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5
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Resende NHD, Miranda SSD, Ceccato MDGB, Reis AMM, Haddad JPA, Silva DID, Carvalho WDS. Assessment of factors associated with potential drug-drug interactions in patients with tuberculosis and HIV/AIDS. Rev Soc Bras Med Trop 2021; 54:e01032021. [PMID: 34320130 PMCID: PMC8313099 DOI: 10.1590/0037-8682-0103-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/17/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: The concomitant use of antituberculosis and antiretroviral drugs, as well as
drugs to treat other diseases, can cause drug-drug interactions. This study
aimed to describe potential drug-drug interactions (pDDI) in patients with
TB and HIV/AIDS co-infection, as well as to analyze possible associated
factors. METHODS: This study was performed in a reference hospital for infectious and
contagious diseases in the southeastern region of Brazil and evaluated adult
patients co-infected with tuberculosis and HIV/AIDS. A cross-sectional study
was conducted in which sociodemographic, clinical, and pharmacotherapeutic
characteristics were assessed. The pDDI were identified using the Drug-Reax
software. Association analysis was performed using either a chi-squared test
or a Fisher’s exact test. Correlation analysis was performed using the
Spearman’s coefficient. RESULTS: The study included 81 patients, of whom 77 (95.1%) were exposed to pDDI. The
most frequent interactions were between antituberculosis and antiretroviral
drugs, which can cause therapeutic ineffectiveness and major adverse
reactions. A positive correlation was established between the number of
associated diseases, the number of drugs used, and the number of pDDI. An
association was identified between contraindicated and moderate pDDI with
excessive polypharmacy and hospitalization. CONCLUSIONS: We found a high frequency of pDDI, especially among those hospitalized and
those with excessive polypharmacy. These findings highlight the importance
of pharmacists in the pharmacotherapeutic monitoring in these patients.
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Affiliation(s)
- Natália Helena de Resende
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Programa de Pós-Graduação Medicamentos e Assistência Farmacêutica, Departamento de Farmácia Social, Belo Horizonte, MG, Brasil
| | | | - Maria das Graças Braga Ceccato
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Programa de Pós-Graduação Medicamentos e Assistência Farmacêutica, Departamento de Farmácia Social, Belo Horizonte, MG, Brasil
| | - Adriano Max Moreira Reis
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Programa de Pós-Graduação Medicamentos e Assistência Farmacêutica, Departamento de Farmácia Social, Belo Horizonte, MG, Brasil
| | | | - Dirce Inês da Silva
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Programa de Pós-Graduação Medicamentos e Assistência Farmacêutica, Departamento de Farmácia Social, Belo Horizonte, MG, Brasil.,Fundação Hospitalar do Estado de Minas Gerais, Hospital Eduardo de Menezes, Belo Horizonte, MG, Brasil
| | - Wânia da Silva Carvalho
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Programa de Pós-Graduação Medicamentos e Assistência Farmacêutica, Departamento de Farmácia Social, Belo Horizonte, MG, Brasil
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6
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Gagandeep, Singh M, Kidawi S, Das US, Velpandian T, Singh R, Rawat DS. Monocarbonyl curcuminoids as antituberculosis agents with their moderate in-vitro metabolic stability on human liver microsomes. J Biochem Mol Toxicol 2021; 35:1-10. [PMID: 33751730 DOI: 10.1002/jbt.22754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/19/2021] [Accepted: 02/24/2021] [Indexed: 11/11/2022]
Abstract
Tuberculosis, an airborne infectious disease, results in a high morbidity and mortality rate. The continuous emergence of TB resistance strains including MDR (multidrug-resistant tuberculosis), XDR (extensive drug-resistant tuberculosis), and especially TDR (totally drug-resistant tuberculosis) is a major public health threat and has intensified the need to develop new antitubercular agents. A natural product, curcumin, possesses diverse biological activities but suffers due to a lack of water solubility and bioavailability. To overcome these limitations, a series of 17 water-soluble monocarbonyl curcuminoids was synthesized and evaluated for antimycobacterial activity. All compounds exhibited good to moderate anti-TB activity with MIC99 in the range of 3.12-25.0 µM, out of which 7c and 7p were found the most potent compounds with MIC99 in the range of 3.12-6.25 µM. Furthermore, these compounds were observed to be nonhaemolytic, nontoxic, and stable under both physiological as well as reducing conditions. In-vitro metabolic stability data of the representative compound 7p with the human liver microsome revealed that these compounds possess a moderate metabolism with a half-life of 1.2 h and an intrinsic clearance of 1.12 ml/h/mg.
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Affiliation(s)
- Gagandeep
- Department of Chemistry, University of Delhi, New Delhi, India
| | - Manisha Singh
- Tuberculosis Research Laboratory, Translational Health Science and Technology Institute, Faridabad, India
| | - Saqib Kidawi
- Tuberculosis Research Laboratory, Translational Health Science and Technology Institute, Faridabad, India
| | - Ujjalkumar S Das
- Department of Ocular Pharmacology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Thirumurthy Velpandian
- Department of Ocular Pharmacology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ramandeep Singh
- Tuberculosis Research Laboratory, Translational Health Science and Technology Institute, Faridabad, India
| | - Diwan S Rawat
- Department of Chemistry, University of Delhi, New Delhi, India
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7
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Fernandes GFS, Campos DL, Da Silva IC, Prates JLB, Pavan AR, Pavan FR, Dos Santos JL. Benzofuroxan Derivatives as Potent Agents against Multidrug-Resistant Mycobacterium tuberculosis. ChemMedChem 2021; 16:1268-1282. [PMID: 33410233 DOI: 10.1002/cmdc.202000899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/06/2021] [Indexed: 12/13/2022]
Abstract
Tuberculosis (TB) is currently the leading cause of death related to infectious diseases worldwide, as reported by the World Health Organization. Moreover, the increasing number of multidrug-resistant tuberculosis (MDR-TB) cases has alarmed health agencies, warranting extensive efforts to discover novel drugs that are effective and also safe. In this study, 23 new compounds were synthesized and evaluated in vitro against the drug-resistant strains of M. tuberculosis. The compound 6-((3-fluoro-4-thiomorpholinophenyl)carbamoyl)benzo[c][1,2,5]oxadiazole 1-N-oxide (5 b) was particularly remarkable in this regard as it demonstrated MIC90 values below 0.28 μM against all the MDR strains evaluated, thus suggesting that this compound might have a different mechanism of action. Benzofuroxans are an attractive new class of anti-TB agents, exemplified by compound 5 b, with excellent potency against the replicating and drug-resistant strains of M. tuberculosis.
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Affiliation(s)
- Guilherme F S Fernandes
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara Jaú Highway KM 01, 14800903, Araraquara, Brazil.,Institute of Chemistry, São Paulo State University (UNESP), Francisco Degni Street 55, 14800060, Araraquara, Brazil
| | - Débora L Campos
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara Jaú Highway KM 01, 14800903, Araraquara, Brazil
| | - Isabel C Da Silva
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara Jaú Highway KM 01, 14800903, Araraquara, Brazil
| | - João L B Prates
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara Jaú Highway KM 01, 14800903, Araraquara, Brazil.,Institute of Chemistry, São Paulo State University (UNESP), Francisco Degni Street 55, 14800060, Araraquara, Brazil
| | - Aline R Pavan
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara Jaú Highway KM 01, 14800903, Araraquara, Brazil.,Institute of Chemistry, São Paulo State University (UNESP), Francisco Degni Street 55, 14800060, Araraquara, Brazil
| | - Fernando R Pavan
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara Jaú Highway KM 01, 14800903, Araraquara, Brazil
| | - Jean L Dos Santos
- School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara Jaú Highway KM 01, 14800903, Araraquara, Brazil.,Institute of Chemistry, São Paulo State University (UNESP), Francisco Degni Street 55, 14800060, Araraquara, Brazil
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8
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Ooka M, Lynch C, Xia M. Application of In Vitro Metabolism Activation in High-Throughput Screening. Int J Mol Sci 2020; 21:ijms21218182. [PMID: 33142951 PMCID: PMC7663506 DOI: 10.3390/ijms21218182] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/25/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023] Open
Abstract
In vitro methods which incorporate metabolic capability into the assays allow us to assess the activity of metabolites from their parent compounds. These methods can be applied into high-throughput screening (HTS) platforms, thereby increasing the speed to identify compounds that become active via the metabolism process. HTS was originally used in the pharmaceutical industry and now is also used in academic settings to evaluate biological activity and/or toxicity of chemicals. Although most chemicals are metabolized in our body, many HTS assays lack the capability to determine compound activity via metabolism. To overcome this problem, several in vitro metabolic methods have been applied to an HTS format. In this review, we describe in vitro metabolism methods and their application in HTS assays, as well as discuss the future perspectives of HTS with metabolic activity. Each in vitro metabolism method has advantages and disadvantages. For instance, the S9 mix has a full set of liver metabolic enzymes, but it displays high cytotoxicity in cell-based assays. In vitro metabolism requires liver fractions or the use of other metabolically capable systems, including primary hepatocytes or recombinant enzymes. Several newly developed in vitro metabolic methods, including HepaRG cells, three-dimensional (3D) cell models, and organ-on-a-chip technology, will also be discussed. These newly developed in vitro metabolism approaches offer significant progress in dissecting biological processes, developing drugs, and making toxicology studies quicker and more efficient.
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9
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Dos Santos Fernandes GF, de Souza PC, Moreno-Viguri E, Santivañez-Veliz M, Paucar R, Pérez-Silanes S, Chegaev K, Guglielmo S, Lazzarato L, Fruttero R, Man Chin C, da Silva PB, Chorilli M, Solcia MC, Ribeiro CM, Silva CSP, Marino LB, Bosquesi PL, Hunt DM, de Carvalho LPS, de Souza Costa CA, Cho SH, Wang Y, Franzblau SG, Pavan FR, Dos Santos JL. Design, Synthesis, and Characterization of N-Oxide-Containing Heterocycles with in Vivo Sterilizing Antitubercular Activity. J Med Chem 2017; 60:8647-8660. [PMID: 28968083 PMCID: PMC5677254 DOI: 10.1021/acs.jmedchem.7b01332] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
![]()
Tuberculosis,
caused by Mycobacterium tuberculosis (Mtb), is the infectious disease responsible for
the highest number of deaths worldwide. Herein, 22 new N-oxide-containing
compounds were synthesized followed by in vitro and in vivo evaluation of their antitubercular potential against Mtb. Compound 8 was found to be the most promising
compound, with MIC90 values of 1.10 and 6.62 μM against
active and nonreplicating Mtb, respectively. Additionally,
we carried out in vivo experiments to confirm the
safety and efficacy of compound 8; the compound was found
to be orally bioavailable and highly effective, leading to a reduction
of Mtb to undetectable levels in a mouse model of
infection. Microarray-based initial studies on the mechanism of action
suggest that compound 8 blocks translation.
Altogether, these results indicate that benzofuroxan derivative 8 is a promising lead compound for the development of a novel
chemical class of antitubercular drugs.
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Affiliation(s)
- Guilherme Felipe Dos Santos Fernandes
- São Paulo State University (UNESP) , Institute of Chemistry, Araraquara 14800060, Brazil.,São Paulo State University (UNESP) , School of Pharmaceutical Sciences, Araraquara 14800903, Brazil.,Universidad de Navarra , Department of Organic and Pharmaceutical Chemistry, Instituto de Salud Tropical, Pamplona 31008, Spain
| | - Paula Carolina de Souza
- São Paulo State University (UNESP) , School of Pharmaceutical Sciences, Araraquara 14800903, Brazil.,Institute of Tuberculosis Research, University of Illinois at Chicago , Chicago, Illinois 60607, United States
| | - Elsa Moreno-Viguri
- Universidad de Navarra , Department of Organic and Pharmaceutical Chemistry, Instituto de Salud Tropical, Pamplona 31008, Spain
| | - Mery Santivañez-Veliz
- Universidad de Navarra , Department of Organic and Pharmaceutical Chemistry, Instituto de Salud Tropical, Pamplona 31008, Spain
| | - Rocio Paucar
- Universidad de Navarra , Department of Organic and Pharmaceutical Chemistry, Instituto de Salud Tropical, Pamplona 31008, Spain
| | - Silvia Pérez-Silanes
- Universidad de Navarra , Department of Organic and Pharmaceutical Chemistry, Instituto de Salud Tropical, Pamplona 31008, Spain
| | - Konstantin Chegaev
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino , Turin 10124, Italy
| | - Stefano Guglielmo
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino , Turin 10124, Italy
| | - Loretta Lazzarato
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino , Turin 10124, Italy
| | - Roberta Fruttero
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino , Turin 10124, Italy
| | - Chung Man Chin
- São Paulo State University (UNESP) , School of Pharmaceutical Sciences, Araraquara 14800903, Brazil
| | - Patricia Bento da Silva
- São Paulo State University (UNESP) , School of Pharmaceutical Sciences, Araraquara 14800903, Brazil
| | - Marlus Chorilli
- São Paulo State University (UNESP) , School of Pharmaceutical Sciences, Araraquara 14800903, Brazil
| | - Mariana Cristina Solcia
- São Paulo State University (UNESP) , School of Pharmaceutical Sciences, Araraquara 14800903, Brazil
| | - Camila Maríngolo Ribeiro
- São Paulo State University (UNESP) , School of Pharmaceutical Sciences, Araraquara 14800903, Brazil
| | - Caio Sander Paiva Silva
- São Paulo State University (UNESP) , School of Pharmaceutical Sciences, Araraquara 14800903, Brazil
| | | | | | - Debbie M Hunt
- Mycobacterial Metabolism and Antibiotic Research Laboratory, The Francis Crick Institute , 1 Midland Road, London NW1 1AT, United Kingdom
| | - Luiz Pedro S de Carvalho
- Mycobacterial Metabolism and Antibiotic Research Laboratory, The Francis Crick Institute , 1 Midland Road, London NW1 1AT, United Kingdom
| | | | - Sang Hyun Cho
- Institute of Tuberculosis Research, University of Illinois at Chicago , Chicago, Illinois 60607, United States
| | - Yuehong Wang
- Institute of Tuberculosis Research, University of Illinois at Chicago , Chicago, Illinois 60607, United States
| | - Scott Gary Franzblau
- Institute of Tuberculosis Research, University of Illinois at Chicago , Chicago, Illinois 60607, United States
| | - Fernando Rogério Pavan
- São Paulo State University (UNESP) , School of Pharmaceutical Sciences, Araraquara 14800903, Brazil
| | - Jean Leandro Dos Santos
- São Paulo State University (UNESP) , Institute of Chemistry, Araraquara 14800060, Brazil.,São Paulo State University (UNESP) , School of Pharmaceutical Sciences, Araraquara 14800903, Brazil
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10
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Kajubi R, Huang L, Jagannathan P, Chamankhah N, Were M, Ruel T, Koss CA, Kakuru A, Mwebaza N, Kamya M, Havlir D, Dorsey G, Rosenthal PJ, Aweeka FT. Antiretroviral Therapy With Efavirenz Accentuates Pregnancy-Associated Reduction of Dihydroartemisinin-Piperaquine Exposure During Malaria Chemoprevention. Clin Pharmacol Ther 2017; 102:520-528. [PMID: 28187497 PMCID: PMC5546920 DOI: 10.1002/cpt.664] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 02/02/2017] [Accepted: 02/03/2017] [Indexed: 11/08/2022]
Abstract
Dihydroartemisinin (DHA)-piperaquine is promising for malaria chemoprevention in pregnancy. We assessed the impacts of pregnancy and efavirenz-based antiretroviral therapy on exposure to DHA and piperaquine in pregnant Ugandan women. Intensive sampling was performed at 28 weeks gestation in 31 HIV-uninfected pregnant women, in 27 HIV-infected pregnant women receiving efavirenz, and in 30 HIV-uninfected nonpregnant women. DHA peak concentration and area under the concentration time curve (AUC0-8hr ) were 50% and 47% lower, respectively, and piperaquine AUC0-21d was 40% lower in pregnant women compared to nonpregnant women. DHA AUC0-8hr and piperaquine AUC0-21d were 27% and 38% lower, respectively, in pregnant women receiving efavirenz compared to HIV-uninfected pregnant women. Exposure to DHA and piperaquine were lower among pregnant women and particularly in women on efavirenz, suggesting a need for dose modifications. The study of modified dosing strategies for these populations is urgently needed.
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Affiliation(s)
- Richard Kajubi
- Infectious Disease Research Collaboration, Makerere University
College of Health Sciences- all in Kampala, Uganda
- Department of Pharmacology and Therapeutics, Makerere University
College of Health Sciences- all in Kampala, Uganda
| | - Liusheng Huang
- Department of Clinical Pharmacy, University of California, San
Francisco, San Francisco General Hospital, San Francisco, CA, USA
| | - Prasanna Jagannathan
- Department of Medicine, University of California, San Francisco, San
Francisco General Hospital, San Francisco, CA, USA
| | - Nona Chamankhah
- Department of Clinical Pharmacy, University of California, San
Francisco, San Francisco General Hospital, San Francisco, CA, USA
| | - Moses Were
- Infectious Disease Research Collaboration, Makerere University
College of Health Sciences- all in Kampala, Uganda
| | - Theodore. Ruel
- Department of Pediatrics, University of California, San Francisco,
San Francisco General Hospital, San Francisco, CA, USA
| | - Catherine A. Koss
- Department of Medicine, University of California, San Francisco, San
Francisco General Hospital, San Francisco, CA, USA
| | - Abel Kakuru
- Infectious Disease Research Collaboration, Makerere University
College of Health Sciences- all in Kampala, Uganda
| | - Norah Mwebaza
- Infectious Disease Research Collaboration, Makerere University
College of Health Sciences- all in Kampala, Uganda
- Department of Pharmacology and Therapeutics, Makerere University
College of Health Sciences- all in Kampala, Uganda
| | - Moses Kamya
- Infectious Disease Research Collaboration, Makerere University
College of Health Sciences- all in Kampala, Uganda
| | - Diane Havlir
- Department of Medicine, University of California, San Francisco, San
Francisco General Hospital, San Francisco, CA, USA
| | - Grant Dorsey
- Department of Medicine, University of California, San Francisco, San
Francisco General Hospital, San Francisco, CA, USA
| | - Philip J. Rosenthal
- Department of Medicine, University of California, San Francisco, San
Francisco General Hospital, San Francisco, CA, USA
| | - Francesca T. Aweeka
- Department of Clinical Pharmacy, University of California, San
Francisco, San Francisco General Hospital, San Francisco, CA, USA
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Shayakhmetova GM, Bondarenko LB, Voronina AK, Kovalenko VM. Comparative investigation of methionine and novel formulation Metovitan protective effects in Wistar rats with testicular and epididymal toxicity induced by anti-tuberculosis drugs co-administration. Food Chem Toxicol 2017; 99:222-230. [DOI: 10.1016/j.fct.2016.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/25/2016] [Accepted: 12/02/2016] [Indexed: 12/12/2022]
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Fernandes GFDS, de Souza PC, Marino LB, Chegaev K, Guglielmo S, Lazzarato L, Fruttero R, Chung MC, Pavan FR, Dos Santos JL. Synthesis and biological activity of furoxan derivatives against Mycobacterium tuberculosis. Eur J Med Chem 2016; 123:523-531. [PMID: 27508879 DOI: 10.1016/j.ejmech.2016.07.039] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 06/16/2016] [Accepted: 07/19/2016] [Indexed: 12/21/2022]
Abstract
Tuberculosis (TB) remains a serious health problem responsible to cause millions of deaths annually. The scenario becomes alarming when it is evaluated that the number of new drugs does not increase proportionally to the emergence of resistance to the current therapy. Furoxan derivatives, known as nitric oxide (NO) donors, have been described to exhibit antitubercular activity. Herein, a novel series of hybrid furoxan derivatives (1,2,5-oxadiazole 2-N-oxide) (compounds 4a-c, 8a-c and 14a-c) were designed, synthesized and evaluated in vitro against Mycobacterium tuberculosis (MTB) H37Rv (ATCC 27294) and a clinical isolate MDR-TB strain. The furoxan derivatives have exhibited MIC90 values ranging from 1.03 to 62 μM (H37Rv) and 7.0-50.0 μM (MDR-TB). For the most active compounds (8c, 14a, 14b and 14c) the selectivity index ranged from 3.78 to 52.74 (MRC-5 cells) and 1.25-34.78 (J774A.1 cells). In addition, it was characterized for those compounds logPo/w values between 2.1 and 2.9. All compounds were able to release NO at levels ranging from 0.16 to 44.23%. Among the series, the phenylsulfonyl furoxan derivatives (compounds 14a-c) were the best NO-donor with the lowest MIC90 values. The most active compound (14c) was also stable at different pHs (5.0 and 7.4). In conclusion, furoxan derivatives were identified as new promising compounds useful to treat tuberculosis.
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Affiliation(s)
| | - Paula Carolina de Souza
- School of Pharmaceutical Sciences, UNESP - Univ Estadual Paulista, Araraquara, 14800903, Brazil
| | | | - Konstantin Chegaev
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, Turin, 10124, Italy
| | - Stefano Guglielmo
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, Turin, 10124, Italy
| | - Loretta Lazzarato
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, Turin, 10124, Italy
| | - Roberta Fruttero
- Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, Turin, 10124, Italy
| | - Man Chin Chung
- School of Pharmaceutical Sciences, UNESP - Univ Estadual Paulista, Araraquara, 14800903, Brazil
| | - Fernando Rogério Pavan
- School of Pharmaceutical Sciences, UNESP - Univ Estadual Paulista, Araraquara, 14800903, Brazil
| | - Jean Leandro Dos Santos
- School of Pharmaceutical Sciences, UNESP - Univ Estadual Paulista, Araraquara, 14800903, Brazil.
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Preclinical Studies Evaluating Subacute Toxicity and Therapeutic Efficacy of LQB-118 in Experimental Visceral Leishmaniasis. Antimicrob Agents Chemother 2016; 60:3794-801. [PMID: 27067332 DOI: 10.1128/aac.01787-15] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 04/06/2016] [Indexed: 12/11/2022] Open
Abstract
Visceral leishmaniasis (VL) is the most severe form of leishmaniasis and is the second major cause of death by parasites, after malaria. The arsenal of drugs against leishmaniasis is small, and each has a disadvantage in terms of toxicity, efficacy, price, or treatment regimen. Our group has focused on studying new drug candidates as alternatives to current treatments. The pterocarpanquinone LQB-118 was designed and synthesized based on molecular hybridization, and it exhibited antiprotozoal and anti-leukemic cell line activities. Our previous work demonstrated that LQB-118 was an effective treatment for experimental cutaneous leishmaniasis. In this study, we observed that treatment with 10 mg/kg of body weight/day LQB-118 orally inhibited the development of hepatosplenomegaly with a 99% reduction in parasite load. An in vivo toxicological analysis showed no change in the clinical, biochemical, or hematological parameters. Histologically, all of the analyzed organs were normal, with the exception of the liver, where focal points of necrosis with leukocytic infiltration were observed at treatment doses 5 times higher than the therapeutic dose; however, these changes were not accompanied by an increase in transaminases. Our findings indicate that LQB-118 is effective at treating different clinical forms of leishmaniasis and presents no relevant signs of toxicity at therapeutic doses; thus, this framework is demonstrated suitable for developing promising drug candidates for the oral treatment of leishmaniasis.
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