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Khan W, Wang YH, Chaurasiya ND, Nanayakkara NPD, Herath HMB, Harrison KA, Dale G, Stanford DA, Dahl EP, McChesney JD, Gul W, ElSohly MA, Khan SI, Fasinu PS, Khan IA, Tekwani BL, Walker LA. Comparative single dose pharmacokinetics and metabolism of racemic primaquine and its enantiomers in human volunteers. Drug Metab Pharmacokinet 2022; 45:100463. [PMID: 35709685 PMCID: PMC9789533 DOI: 10.1016/j.dmpk.2022.100463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/14/2022] [Accepted: 04/25/2022] [Indexed: 12/26/2022]
Abstract
Primaquine (PQ) is a racemic drug used in treatment of malaria for six decades. Recent studies suggest that the two enantiomers of PQ are differentially metabolized in animals, and this results in different pharmacological and toxicological profiles. The current study characterizes the pharmacokinetic (PK) properties, metabolism and tolerability of the individual enantiomers of PQ in healthy human volunteers with normal glucose-6-phosphate dehydrogenase (G6PD) activity. Two cohorts (at two dose levels), each with 18 subjects, participated in three study arms in a crossover fashion: a single dose of the (-)-R enantiomer (RPQ), a single dose of the (+)-S enantiomer (SPQ), and a single dose of racemic PQ (RSPQ). PQ and its key metabolites carboxyprimaquine (cPQ) and PQ-N-carbamoyl glucuronide (PQ-N-CG) were analyzed. Clear differences were observed in PK and metabolism of the two enantiomers. Relative PQ exposure was higher with SPQ as compared to RPQ. PQ maximum plasma concentration (Cmax) and area under the plasma concentration-time curve were higher for SPQ, while the apparent volume of distribution and total body clearance were higher for RPQ. Metabolism of the two enantiomers showed dramatic differences: plasma PQ-N-CG was derived solely from SPQ, while RPQ was much more efficiently converted to cPQ than was SPQ. Cmax of cPQ and PQ-N-CG were 10 and 2 times higher, respectively, than the parent drugs. The study demonstrates that the PK properties of PQ enantiomers show clear differences, and metabolism is highly enantioselective. Such differences in metabolism suggest potentially distinct toxicity profiles in multi-dose regimens, especially in G6PD-deficient subjects.
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Affiliation(s)
- Washim Khan
- National Center for Natural Products Research, The University of Mississippi, University, MS, 38677, USA
| | - Yan-Hong Wang
- National Center for Natural Products Research, The University of Mississippi, University, MS, 38677, USA
| | - Narayan D. Chaurasiya
- Department of Infectious Diseases, Division of Drug Discovery, Southern Research Institute, Birmingham, AL, 35205, USA
| | - NP Dhammika Nanayakkara
- National Center for Natural Products Research, The University of Mississippi, University, MS, 38677, USA
| | - HM Bandara Herath
- National Center for Natural Products Research, The University of Mississippi, University, MS, 38677, USA
| | - Kerri A. Harrison
- National Center for Natural Products Research, The University of Mississippi, University, MS, 38677, USA
| | - Gray Dale
- National Center for Natural Products Research, The University of Mississippi, University, MS, 38677, USA
| | - Donald A. Stanford
- National Center for Natural Products Research, The University of Mississippi, University, MS, 38677, USA
| | - Eric P. Dahl
- National Center for Natural Products Research, The University of Mississippi, University, MS, 38677, USA
| | | | - Waseem Gul
- ElSohly Laboratories, Inc., Oxford, MS, 38655, USA
| | - Mahmoud A. ElSohly
- National Center for Natural Products Research, The University of Mississippi, University, MS, 38677, USA,Pharmaceutics and Drug Delivery, School of Pharmacy, The University of Mississippi, University, MS, 38677, USA,ElSohly Laboratories, Inc., Oxford, MS, 38655, USA
| | - Shabana I. Khan
- National Center for Natural Products Research, The University of Mississippi, University, MS, 38677, USA
| | - Pius S. Fasinu
- Department of Pharmacology & Toxicology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Ikhlas A. Khan
- National Center for Natural Products Research, The University of Mississippi, University, MS, 38677, USA,Departments of BioMolecular Sciences, School of Pharmacy, The University of Mississippi, University, MS, 38677, USA
| | - Babu L. Tekwani
- Department of Infectious Diseases, Division of Drug Discovery, Southern Research Institute, Birmingham, AL, 35205, USA,Corresponding author. (B.L. Tekwani)
| | - Larry A. Walker
- National Center for Natural Products Research, The University of Mississippi, University, MS, 38677, USA,Corresponding author. (L.A. Walker)
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2
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Maier JD, Siegfried S, Gültekin N, Stanga Z, Baird JK, Grobusch MP, Schlagenhauf P. Efficacy and safety of tafenoquine for malaria chemoprophylaxis (1998-2020): A systematic review and meta-analysis. Travel Med Infect Dis 2020; 39:101908. [PMID: 33227500 DOI: 10.1016/j.tmaid.2020.101908] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND In 2018, tafenoquine was approved for malaria chemoprophylaxis. We evaluated all available data on the safety and efficacy of tafenoquine chemoprophylaxis. METHODS This systematic review followed the PRISMA guidelines and was registered on PROSPERO (CRD42019123839). We searched PubMed, Embase, Scopus, CINAHL and Cochrane databases. Two authors (JDM, PS) screened all papers. RESULTS We included 44 papers in the qualitative and 9 in the quantitative analyses. These 9 randomized, controlled trials included 2495 participants, aged 12-60 years with 27.3% women. Six studies were conducted in Plasmodium spp.-endemic regions; two were human infection studies. 200 mg weekly tafenoquine and higher dosages lead to a significant reduction of Plasmodium spp. infection compared to placebo and were comparable to 250 mg mefloquine weekly with a protective efficacy between 77.9 and 100% or a total risk ratio of 0.22 (95%-CI: 0.07-0.73; p = 0.013) in favour of tafenoquine. Adverse events (AE) were comparable in frequency and severity between tafenoquine and comparator arms. One study reported significantly more gastrointestinal events in tafenoquine users (p ≤ 0.001). Evidence of increased, reversible, asymptomatic vortex keratopathy in subjects with prolonged tafenoquine exposures was found. A single, serious event of decreased macular sensitivity occurred. CONCLUSION This systematic review and meta-analysis of trials of G6PD-normal adults show that weekly tafenoquine 200 mg is well tolerated and effective as malaria chemoprophylaxis focusing primarily on Plasmodium falciparum but also on Plasmodium vivax. Our safety analysis is limited by heterogenous methods of adverse events reporting. Further research is indicated on the use of tafenoquine in diverse traveller populations.
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Affiliation(s)
- Julian D Maier
- University of Zurich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Department of Public and Global Health, MilMedBiol Competence Centre, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland
| | - Sandra Siegfried
- University of Zurich, Biostatistics Department at Epidemiology, Biostatistics and Prevention Institute, Switzerland
| | - Nejla Gültekin
- Centre of Competence for Military and Disaster Medicine, Federal Department of Defence, Civil Protection and Sport DDPS, Swiss Armed Forces, Medical Services, Ittigen, Switzerland
| | - Zeno Stanga
- Centre of Competence for Military and Disaster Medicine, Federal Department of Defence, Civil Protection and Sport DDPS, Swiss Armed Forces, Medical Services, Ittigen, Switzerland
| | - J Kevin Baird
- Eijkman-Oxford Clinical Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Martin P Grobusch
- Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centres, Amsterdam Public Health, Amsterdam Infection & Immunity, University of Amsterdam, Amsterdam, the Netherlands
| | - Patricia Schlagenhauf
- University of Zurich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Department of Public and Global Health, MilMedBiol Competence Centre, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland.
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3
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Duparc S, Chalon S, Miller S, Richardson N, Toovey S. Neurological and psychiatric safety of tafenoquine in Plasmodium vivax relapse prevention: a review. Malar J 2020; 19:111. [PMID: 32169086 PMCID: PMC7071640 DOI: 10.1186/s12936-020-03184-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/06/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Tafenoquine is an 8-aminoquinoline anti-malarial drug recently approved as a single-dose (300 mg) therapy for Plasmodium vivax relapse prevention, when co-administered with 3-days of chloroquine or other blood schizonticide. Tafenoquine 200 mg weekly after a loading dose is also approved as travellers' prophylaxis. The development of tafenoquine has been conducted over many years, using various dosing regimens in diverse populations. METHODS This review brings together all the preclinical and clinical data concerning tafenoquine central nervous system safety. Data were assembled from published sources. The risk of neuropsychiatric adverse events (NPAEs) with single-dose tafenoquine (300 mg) in combination with chloroquine to achieve P. vivax relapse prevention is particularly examined. RESULTS There was no evidence of neurotoxicity with tafenoquine in preclinical animal models. In clinical studies in P. vivax relapse prevention, nervous system adverse events, mainly headache and dizziness, occurred in 11.4% (36/317) of patients with tafenoquine (300 mg)/chloroquine versus 10.2% (19/187) with placebo/chloroquine; and in 15.5% (75/483) of patients with tafenoquine/chloroquine versus 13.3% (35/264) with primaquine (15 mg/day for 14 days)/chloroquine. Psychiatric adverse events, mainly insomnia, occurred in 3.8% (12/317) of patients with tafenoquine/chloroquine versus 2.7% (5/187) with placebo/chloroquine; and in 2.9% (14/483) of patients with tafenoquine/chloroquine versus 3.4% (9/264) for primaquine/chloroquine. There were no serious or severe NPAEs observed with tafenoquine (300 mg)/chloroquine in these studies. CONCLUSIONS The risk:benefit of single-dose tafenoquine/chloroquine in P. vivax relapse prevention is favourable in the presence of malaria, with a low risk of NPAEs, similar to that seen with chloroquine alone or primaquine/chloroquine.
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Affiliation(s)
- Stephan Duparc
- Medicines for Malaria Venture, Route de Pré-Bois 20, 1215, Geneva 15, Switzerland.
| | - Stephan Chalon
- Medicines for Malaria Venture, Route de Pré-Bois 20, 1215, Geneva 15, Switzerland
| | | | | | - Stephen Toovey
- Medicines for Malaria Venture, Route de Pré-Bois 20, 1215, Geneva 15, Switzerland.,Pegasus Research, London, UK
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Berman J, Brown T, Dow G, Toovey S. Tafenoquine and primaquine do not exhibit clinical neurologic signs associated with central nervous system lesions in the same manner as earlier 8-aminoquinolines. Malar J 2018; 17:407. [PMID: 30400893 PMCID: PMC6219089 DOI: 10.1186/s12936-018-2555-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 10/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tafenoquine was recently approved for Plasmodium vivax radical cure (KRINTAFEL™) and malaria prevention (ARAKODA™). METHODS A review of the non-clinical and clinical literature was conducted to assess whether tafenoquine (and primaquine) exhibit the same neurologic lesions and associated clinical signs as earlier 8-aminoquinolines, as has been alleged in recent opinion pieces. RESULTS Plasmocid, pamaquine and pentaquine damage specific neuro-anatomical structures in Rhesus monkeys and humans leading to corresponding deficits in neurologic function. Neurologic therapeutic indices for these 3 drugs calculated based on monkey data were well correlated with human data. Despite 60 years of use, there is no evidence that primaquine exhibits similar neurotoxicity in humans. DISCUSSION/CONCLUSIONS Extrapolation of data from Rhesus monkeys to humans, and the available clinical data, suggest that tafenoquine also does not exhibit pamaquine, pentaquine or plasmocid-like clinical neurologic signs in humans.
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Affiliation(s)
| | - Tracey Brown
- Clinical Network Services Pty Ltd, 88/4 Jephson Road, Toowong, 4066 Queensland Australia
| | - Geoffrey Dow
- 60°Pharmaceuticals LLC, 1025 Connecticut Ave NW, Suite 1000, Washington, DC 20036 USA
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5
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Tarkang PA, Appiah-Opong R, Ofori MF, Ayong LS, Nyarko AK. Application of multi-target phytotherapeutic concept in malaria drug discovery: a systems biology approach in biomarker identification. Biomark Res 2016; 4:25. [PMID: 27999673 PMCID: PMC5154004 DOI: 10.1186/s40364-016-0077-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 11/29/2016] [Indexed: 01/20/2023] Open
Abstract
There is an urgent need for new anti-malaria drugs with broad therapeutic potential and novel mode of action, for effective treatment and to overcome emerging drug resistance. Plant-derived anti-malarials remain a significant source of bioactive molecules in this regard. The multicomponent formulation forms the basis of phytotherapy. Mechanistic reasons for the poly-pharmacological effects of plants constitute increased bioavailability, interference with cellular transport processes, activation of pro-drugs/deactivation of active compounds to inactive metabolites and action of synergistic partners at different points of the same signaling cascade. These effects are known as the multi-target concept. However, due to the intrinsic complexity of natural products-based drug discovery, there is need to rethink the approaches toward understanding their therapeutic effect. This review discusses the multi-target phytotherapeutic concept and its application in biomarker identification using the modified reverse pharmacology - systems biology approach. Considerations include the generation of a product library, high throughput screening (HTS) techniques for efficacy and interaction assessment, High Performance Liquid Chromatography (HPLC)-based anti-malarial profiling and animal pharmacology. This approach is an integrated interdisciplinary implementation of tailored technology platforms coupled to miniaturized biological assays, to track and characterize the multi-target bioactive components of botanicals as well as identify potential biomarkers. While preserving biodiversity, this will serve as a primary step towards the development of standardized phytomedicines, as well as facilitate lead discovery for chemical prioritization and downstream clinical development.
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Affiliation(s)
- Protus Arrey Tarkang
- Centre for Research on Medicinal Plants and Traditional Medicine, Institute of Medical Research and Medicinal Plants Studies (IMPM), P. O. Box 8013, Yaoundé, Cameroon
- Department of Clinical Pathology, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box LG 581, Legon, Accra Ghana
| | - Regina Appiah-Opong
- Department of Clinical Pathology, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box LG 581, Legon, Accra Ghana
| | - Michael F. Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box LG581, Legon, Accra Ghana
| | - Lawrence S. Ayong
- Malaria Research Laboratory, Centre Pasteur Cameroon, BP 1274 Yaoundé, Cameroon
| | - Alexander K. Nyarko
- Department of Clinical Pathology, Noguchi Memorial Institute for Medical Research, University of Ghana, P. O. Box LG 581, Legon, Accra Ghana
- School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra Ghana
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6
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Campo B, Vandal O, Wesche DL, Burrows JN. Killing the hypnozoite--drug discovery approaches to prevent relapse in Plasmodium vivax. Pathog Glob Health 2015; 109:107-22. [PMID: 25891812 PMCID: PMC4455353 DOI: 10.1179/2047773215y.0000000013] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The eradication of malaria will only be possible if effective, well-tolerated medicines kill hypnozoites in vivax and ovale malaria, and thus prevent relapses in patients. Despite progress in the 8-aminoquinoline series, with tafenoquine in Phase III showing clear benefits over primaquine, the drug discovery challenge to identify hypnozoiticidal or hypnozoite-activating compounds has been hampered by the dearth of biological tools and assays, which in turn has been limited by the immense scientific and logistical challenges associated with accessing relevant human tissue and sporozoites. This review summarises the existing drug discovery series and approaches concerning the goal to block relapse.
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Affiliation(s)
- Brice Campo
- Medicines for Malaria Venture, Geneva, Switzerland
| | - Omar Vandal
- The Bill and Melinda Gates Foundation, Seattle, WA, USA
| | - David L. Wesche
- The Bill and Melinda Gates Foundation, Seattle, WA, USA
- Great Lakes Drug Development/Certara, Princeton, NJ, USA
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7
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Kumar S, Kumari R, Pandey R. New insight-guided approaches to detect, cure, prevent and eliminate malaria. PROTOPLASMA 2015; 252:717-753. [PMID: 25323622 DOI: 10.1007/s00709-014-0697-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 09/01/2014] [Indexed: 06/04/2023]
Abstract
New challenges posed by the development of resistance against artemisinin-based combination therapies (ACTs) as well as previous first-line therapies, and the continuing absence of vaccine, have given impetus to research in all areas of malaria control. This review portrays the ongoing progress in several directions of malaria research. The variants of RTS,S and apical membrane antigen 1 (AMA1) are being developed and test adapted as multicomponent and multistage malaria control vaccines, while many other vaccine candidates and methodologies to produce antigens are under experimentation. To track and prevent the spread of artemisinin resistance from Southeast Asia to other parts of the world, rolling circle-enhanced enzyme activity detection (REEAD), a time- and cost-effective malaria diagnosis in field conditions, and a DNA marker associated with artemisinin resistance have become available. Novel mosquito repellents and mosquito trapping and killing techniques much more effective than the prevalent ones are undergoing field testing. Mosquito lines stably infected with their symbiotic wild-type or genetically engineered bacteria that kill sympatric malaria parasites are being constructed and field tested for stopping malaria transmission. A complementary approach being pursued is the addition of ivermectin-like drug molecules to ACTs to cure malaria and kill mosquitoes. Experiments are in progress to eradicate malaria mosquito by making it genetically male sterile. High-throughput screening procedures are being developed and used to discover molecules that possess long in vivo half life and are active against liver and blood stages for the fast cure of malaria symptoms caused by simple or relapsing and drug-sensitive and drug-resistant types of varied malaria parasites, can stop gametocytogenesis and sporogony and could be given in one dose. Target-based antimalarial drug designing has begun. Some of the putative next-generation antimalarials that possess in their scaffold structure several of the desired properties of malaria cure and control are exemplified by OZ439, NITD609, ELQ300 and tafenoquine that are already undergoing clinical trials, and decoquinate, usnic acid, torin-2, ferroquine, WEHI-916, MMV396749 and benzothiophene-type N-myristoyltransferase (NMT) inhibitors, which are candidates for future clinical usage. Among these, NITD609, ELQ300, decoquinate, usnic acid, torin-2 and NMT inhibitors not only cure simple malaria and are prophylactic against simple malaria, but they also cure relapsing malaria.
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Affiliation(s)
- Sushil Kumar
- SKA Institution for Research, Education and Development (SKAIRED), 4/11 SarvPriya Vihar, New Delhi, 110016, India,
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8
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Lewis MD, Behrends J, Sá E Cunha C, Mendes AM, Lasitschka F, Sattler JM, Heiss K, Kooij TWA, Prudêncio M, Bringmann G, Frischknecht F, Mueller AK. Chemical attenuation of Plasmodium in the liver modulates severe malaria disease progression. THE JOURNAL OF IMMUNOLOGY 2015; 194:4860-70. [PMID: 25862814 DOI: 10.4049/jimmunol.1400863] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 03/11/2015] [Indexed: 11/19/2022]
Abstract
Cerebral malaria is one of the most severe complications of malaria disease, attributed to a complicated series of immune reactions in the host. The syndrome is marked by inflammatory immune responses, margination of leukocytes, and parasitized erythrocytes in cerebral vessels leading to breakdown of the blood-brain barrier. We show that chemical attenuation of the parasite at the very early, clinically silent liver stage suppresses parasite development, delays the time until parasites establish blood-stage infection, and provokes an altered host immune response, modifying immunopathogenesis and protecting from cerebral disease. The early response is proinflammatory and cell mediated, with increased T cell activation in the liver and spleen, and greater numbers of effector T cells, cytokine-secreting T cells, and proliferating, proinflammatory cytokine-producing T cells. Dendritic cell numbers, T cell activation, and infiltration of CD8(+) T cells to the brain are decreased later in infection, possibly mediated by the anti-inflammatory cytokine IL-10. Strikingly, protection can be transferred to naive animals by adoptive transfer of lymphocytes from the spleen at very early times of infection. Our data suggest that a subpopulation belonging to CD8(+) T cells as early as day 2 postinfection is responsible for protection. These data indicate that liver stage-directed early immune responses can moderate the overall downstream host immune response and modulate severe malaria outcome.
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Affiliation(s)
- Matthew D Lewis
- Centre for Infectious Diseases, Parasitology Unit, Heidelberg University Hospital, D 69120 Heidelberg, Germany; German Centre for Infection Research, D 69120 Heidelberg, Germany
| | - Jochen Behrends
- Core Facility Fluorescence Cytometry, Research Center Borstel, D 23845 Borstel, Germany
| | - Cláudia Sá E Cunha
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - António M Mendes
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Felix Lasitschka
- German Centre for Infection Research, D 69120 Heidelberg, Germany; Institute of Pathology, Heidelberg University Hospital, D 69120 Heidelberg, Germany
| | - Julia M Sattler
- Centre for Infectious Diseases, Parasitology Unit, Heidelberg University Hospital, D 69120 Heidelberg, Germany
| | - Kirsten Heiss
- Centre for Infectious Diseases, Parasitology Unit, Heidelberg University Hospital, D 69120 Heidelberg, Germany; MalVa GmbH, D 69121 Heidelberg, Germany
| | - Taco W A Kooij
- Department of Medical Microbiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Centre, 6500 HB Nijmegen, the Netherlands; Centre for Molecular and Biomolecular Informatics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Centre, 6500 HB Nijmegen, the Netherlands; and
| | - Miguel Prudêncio
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Gerhard Bringmann
- Institute for Organic Chemistry, University of Würzburg, 97074 Würzburg, Germany
| | - Friedrich Frischknecht
- Centre for Infectious Diseases, Parasitology Unit, Heidelberg University Hospital, D 69120 Heidelberg, Germany
| | - Ann-Kristin Mueller
- Centre for Infectious Diseases, Parasitology Unit, Heidelberg University Hospital, D 69120 Heidelberg, Germany; German Centre for Infection Research, D 69120 Heidelberg, Germany;
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Tekwani BL, Avula B, Sahu R, Chaurasiya ND, Khan SI, Jain S, Fasinu PS, Herath HMTB, Stanford D, Nanayakkara NPD, McChesney JD, Yates TW, ElSohly MA, Khan IA, Walker LA. Enantioselective pharmacokinetics of primaquine in healthy human volunteers. Drug Metab Dispos 2015; 43:571-7. [PMID: 25637634 DOI: 10.1124/dmd.114.061127] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Primaquine (PQ), a racemic drug, is the only treatment available for radical cure of relapsing Plasmodium vivax malaria and blocking transmission of P. falciparum malaria. Recent studies have shown differential pharmacologic and toxicologic profiles of individual PQ enantiomers in rodent, dog, and primate animal models. This study was conducted in six healthy adult human volunteers to determine the plasma pharmacokinetic profile of enantiomers of PQ and carboxyprimaquine (cPQ), the major plasma metabolite. The individuals were orally administered PQ diphosphate, equivalent to 45-mg base, 30 minutes after a normal breakfast. Blood samples were collected at different time intervals, and plasma samples were analyzed for enantiomers of PQ and cPQ. Plasma PQ concentrations were low and variable for both parent enantiomers and peaked around 2-4 hours. Peak (-)-(R)-PQ concentrations ranged from 121 ng/ml to 221 ng/ml, and peak (+)-(S)-PQ concentrations ranged from 168 ng/ml to 299 ng/ml. The cPQ concentrations were much higher and were surprisingly consistent from subject to subject. Essentially all the cPQ detected in plasma was (-)-cPQ. The peak concentrations of (-)-cPQ were observed at 8 hours (range: 1104-1756 ng/ml); however, very high concentrations were sustained through 24 hours. (+)-cPQ was two orders of magnitude lower than (-)-cPQ, and in a few subjects it was detected but only under the limit of quantification. In vitro studies with primary human hepatocytes also suggested more rapid metabolism of (-)-PQ compared with (+)-PQ. The results suggest more rapid metabolism of (-)-PQ to (-) cPQ compared with (+)-PQ. Alternatively, (+)-PQ or (+)-cPQ could be rapidly converted to another metabolite(s) or distributed to tissues. This is the first clinical report on enantioselective pharmacokinetic profiles of PQ and cPQ and supports further clinical evaluation of individual PQ enantiomers.
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Affiliation(s)
- Babu L Tekwani
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - Bharathi Avula
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - Rajnish Sahu
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - Narayan D Chaurasiya
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - Shabana I Khan
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - Surendra Jain
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - Pius S Fasinu
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - H M T Bandara Herath
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - Donald Stanford
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - N P Dhammika Nanayakkara
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - James D McChesney
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - Travis W Yates
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - Mahmoud A ElSohly
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - Ikhlas A Khan
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
| | - Larry A Walker
- National Center for Natural Products Research (B.L.T., B.A., R.S., N.D.C., S.I.K., S.J., P.S.F., H.M.T.B.H., D.S., N.P.D.N., M.A.E., I.A.K., L.A.W.), Departments of BioMolecular Sciences (B.L.T., S.I.K., S.J., I.A.K., L.A.W.) and Pharmaceutics (M.A.E.), School of Pharmacy, and Department of Student Health Services (T.W.Y.), University of Mississippi, University; Ironstone Separations, Inc., Etta (J.D.M.); ElSohly Laboratories, Inc., Oxford (M.A.E.), Mississippi
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10
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Lu J, Maezawa I, Weerasekara S, Erenler R, Nguyen TDT, Nguyen J, Swisher LZ, Li J, Jin LW, Ranjan A, Srivastava SK, Hua DH. Syntheses, neural protective activities, and inhibition of glycogen synthase kinase-3β of substituted quinolines. Bioorg Med Chem Lett 2014; 24:3392-7. [PMID: 24951331 PMCID: PMC4110911 DOI: 10.1016/j.bmcl.2014.05.085] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 05/20/2014] [Accepted: 05/22/2014] [Indexed: 01/13/2023]
Abstract
A new series of fifteen 5-, 6-, and 8-appended 4-methylquinolines were synthesized and evaluated for their neural protective activities. Selected compounds were further examined for their inhibition of glycogen synthase kinase-3β (GSK-3β) and protein kinase C (PKC). Two most potent analogs, compounds 3 and 10, show nanomolar protective activities in amyloid β-induced MC65 cells and enzymatic inhibitory activities against GSK-3β, but poor PKC inhibitory activities. Using normal mouse model, the distribution of the most potent analog 3 in various tissues and possible toxic effects in the locomotors and inhibition of liver transaminases activities were carried out. No apparent decline of locomotor activity and no inhibition of liver transaminases were found. The compound appears to be safe for long-term use in Alzheimer's disease mouse model.
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Affiliation(s)
- Jianyu Lu
- Department of Chemistry, 213 CBC Building, Kansas State University, Manhattan, KS 66506, United States
| | - Izumi Maezawa
- M.I.N.D. Institute and Department of Pathology, 2825 50th Street, UC Davis Health System, Sacramento, CA 95817, United States
| | - Sahani Weerasekara
- Department of Chemistry, 213 CBC Building, Kansas State University, Manhattan, KS 66506, United States
| | - Ramazan Erenler
- Department of Chemistry, 213 CBC Building, Kansas State University, Manhattan, KS 66506, United States
| | - Tuyen D T Nguyen
- Department of Chemistry, 213 CBC Building, Kansas State University, Manhattan, KS 66506, United States
| | - James Nguyen
- Department of Chemistry, 213 CBC Building, Kansas State University, Manhattan, KS 66506, United States
| | - Luxi Z Swisher
- Department of Chemistry, 213 CBC Building, Kansas State University, Manhattan, KS 66506, United States
| | - Jun Li
- Department of Chemistry, 213 CBC Building, Kansas State University, Manhattan, KS 66506, United States
| | - Lee-Way Jin
- M.I.N.D. Institute and Department of Pathology, 2825 50th Street, UC Davis Health System, Sacramento, CA 95817, United States
| | - Alok Ranjan
- Department of Biomedical Sciences and Cancer Biology Center, Texas Tech University Health Sciences Center, Amarillo, TX 79106, United States
| | - Sanjay K Srivastava
- Department of Biomedical Sciences and Cancer Biology Center, Texas Tech University Health Sciences Center, Amarillo, TX 79106, United States
| | - Duy H Hua
- Department of Chemistry, 213 CBC Building, Kansas State University, Manhattan, KS 66506, United States.
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11
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Nevin RL. Idiosyncratic quinoline central nervous system toxicity: Historical insights into the chronic neurological sequelae of mefloquine. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE 2014; 4:118-25. [PMID: 25057461 PMCID: PMC4095041 DOI: 10.1016/j.ijpddr.2014.03.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 03/17/2014] [Accepted: 03/19/2014] [Indexed: 12/04/2022]
Abstract
Regulators now warn adverse neurological effects from mefloquine may be irreversible. Many neurological effects resemble those of a common quinoline CNS toxidrome. The quinoline toxidrome is associated with a risk of CNS neuronal degeneration. CNS neuronal degeneration may underlie some neurological effects from mefloquine.
Mefloquine is a quinoline derivative antimalarial which demonstrates promise for the treatment of schistosomiasis. Traditionally employed in prophylaxis and treatment of chloroquine-resistant Plasmodium falciparum malaria, recent changes to the approved European and U.S. product labeling for mefloquine now warn of a risk of permanent and irreversible neurological sequelae including vertigo, loss of balance and symptoms of polyneuropathy. The newly described permanent nature of certain of these neurological effects challenges the conventional belief that they are due merely to the long half-life of mefloquine and its continued presence in the body, and raises new considerations for the rational use of the drug against parasitic disease. In this opinion, it is proposed that many of the reported lasting adverse neurological effects of mefloquine are consistent with the chronic sequelae of a well characterized but idiosyncratic central nervous system (CNS) toxicity syndrome (or toxidrome) common to certain historical antimalarial and antiparasitic quinolines and associated with a risk of permanent neuronal degeneration within specific CNS regions including the brainstem. Issues in the development and licensing of mefloquine are then considered in the context of historical awareness of the idiosyncratic CNS toxicity of related quinoline drugs. It is anticipated that the information presented in this opinion will aid in the future clinical recognition of the mefloquine toxidrome and its chronic sequelae, and in informing improved regulatory evaluation of mefloquine and related quinoline drugs as they are explored for expanded antiparasitic use and for other indications.
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Affiliation(s)
- Remington L Nevin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 782, Baltimore, MD 21205, United States
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12
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Abstract
Malaria elimination has recently been reinstated as a global health priority but current therapies seem to be insufficient for the task. Elimination efforts require new drug classes that alleviate symptoms, prevent transmission and provide a radical cure. To develop these next-generation medicines, public-private partnerships are funding innovative approaches to identify compounds that target multiple parasite species at multiple stages of the parasite life cycle. In this Review, we discuss the cell-, chemistry- and target-based approaches used to discover new drug candidates that are currently in clinical trials or undergoing preclinical testing.
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13
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Burrows JN, van Huijsduijnen RH, Möhrle JJ, Oeuvray C, Wells TNC. Designing the next generation of medicines for malaria control and eradication. Malar J 2013; 12:187. [PMID: 23742293 PMCID: PMC3685552 DOI: 10.1186/1475-2875-12-187] [Citation(s) in RCA: 207] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 05/29/2013] [Indexed: 11/10/2022] Open
Abstract
In the fight against malaria new medicines are an essential weapon. For the parts of the world where the current gold standard artemisinin combination therapies are active, significant improvements can still be made: for example combination medicines which allow for single dose regimens, cheaper, safer and more effective medicines, or improved stability under field conditions. For those parts of the world where the existing combinations show less than optimal activity, the priority is to have activity against emerging resistant strains, and other criteria take a secondary role. For new medicines to be optimal in malaria control they must also be able to reduce transmission and prevent relapse of dormant forms: additional constraints on a combination medicine. In the absence of a highly effective vaccine, new medicines are also needed to protect patient populations. In this paper, an outline definition of the ideal and minimally acceptable characteristics of the types of clinical candidate molecule which are needed (target candidate profiles) is suggested. In addition, the optimal and minimally acceptable characteristics of combination medicines are outlined (target product profiles). MMV presents now a suggested framework for combining the new candidates to produce the new medicines. Sustained investment over the next decade in discovery and development of new molecules is essential to enable the long-term delivery of the medicines needed to combat malaria.
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Affiliation(s)
- Jeremy N Burrows
- Medicines for Malaria Venture-MMV, PO Box 1826, Route de Pré-Bois 20, Geneva 151215, Switzerland
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14
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Galinski MR, Meyer EVS, Barnwell JW. Plasmodium vivax: modern strategies to study a persistent parasite's life cycle. ADVANCES IN PARASITOLOGY 2013; 81:1-26. [PMID: 23384620 DOI: 10.1016/b978-0-12-407826-0.00001-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Plasmodium vivax has unique attributes to support its survival in varying ecologies and climates. These include hypnozoite forms in the liver, an invasion preference for reticulocytes, caveola-vesicle complex structures in the infected erythrocyte membrane and rapidly forming and circulating gametocytes. These characteristics make this species very different from P. falciparum. Plasmodium cynomolgi and other related simian species have identical biology and can serve as informative models of P. vivax infections. Plasmodium vivax and its model parasites can be grown in non-human primates (NHP), and in short-term ex vivo cultures. For P. vivax, in the absence of in vitro culture systems, these models remain highly relevant side by side with human clinical studies. While post-genomic technologies allow for greater exploration of P. vivax-infected blood samples from humans, these come with restrictions. Two advantages of NHP models are that infections can be experimentally tailored to address hypotheses, including genetic manipulation. Also, systems biology approaches can capitalise on computational biology combined with set experimental infection periods and protocols, which may include multiple sampling times, different types of samples, and the broad use of "omics" technologies. Opportunities for research on vivax malaria are increasing with the use of existing and new methodological strategies in combination with modern technologies.
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Affiliation(s)
- Mary R Galinski
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.
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15
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Nilsen A, LaCrue AN, White KL, Forquer IP, Cross RM, Marfurt J, Mather MW, Delves MJ, Shackleford DM, Saenz FE, Morrisey JM, Steuten J, Mutka T, Li Y, Wirjanata G, Ryan E, Duffy S, Kelly JX, Sebayang BF, Zeeman AM, Noviyanti R, Sinden RE, Kocken CHM, Price RN, Avery VM, Angulo-Barturen I, Jiménez-Díaz MB, Ferrer S, Herreros E, Sanz LM, Gamo FJ, Bathurst I, Burrows JN, Siegl P, Guy RK, Winter RW, Vaidya AB, Charman SA, Kyle DE, Manetsch R, Riscoe MK. Quinolone-3-diarylethers: a new class of antimalarial drug. Sci Transl Med 2013; 5:177ra37. [PMID: 23515079 PMCID: PMC4227885 DOI: 10.1126/scitranslmed.3005029] [Citation(s) in RCA: 164] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The goal for developing new antimalarial drugs is to find a molecule that can target multiple stages of the parasite's life cycle, thus impacting prevention, treatment, and transmission of the disease. The 4(1H)-quinolone-3-diarylethers are selective potent inhibitors of the parasite's mitochondrial cytochrome bc1 complex. These compounds are highly active against the human malaria parasites Plasmodium falciparum and Plasmodium vivax. They target both the liver and blood stages of the parasite as well as the forms that are crucial for disease transmission, that is, the gametocytes, the zygote, the ookinete, and the oocyst. Selected as a preclinical candidate, ELQ-300 has good oral bioavailability at efficacious doses in mice, is metabolically stable, and is highly active in blocking transmission in rodent models of malaria. Given its predicted low dose in patients and its predicted long half-life, ELQ-300 has potential as a new drug for the treatment, prevention, and, ultimately, eradication of human malaria.
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Affiliation(s)
- Aaron Nilsen
- VA Medical Center, 3710 SW US Veterans Hospital Road, Portland, Oregon 97239, USA
| | - Alexis N. LaCrue
- Department of Global Health, College of Public Health, 3720 Spectrum Blvd. (Ste 304), Tampa, FL 33612, USA
| | - Karen L. White
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Isaac P. Forquer
- VA Medical Center, 3710 SW US Veterans Hospital Road, Portland, Oregon 97239, USA
| | - Richard M. Cross
- Department of Chemistry, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620-5250, USA
| | - Jutta Marfurt
- Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia
| | - Michael W. Mather
- Department of Microbiology and Immunology, Drexel University College of Medicine, 2900 Queen Lane, Philadelphia, PA 19129, USA
| | - Michael J. Delves
- Department of Life Sciences, Imperial College London, London SW7 2AZ, United Kingdom
| | - David M. Shackleford
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Fabian E. Saenz
- Department of Global Health, College of Public Health, 3720 Spectrum Blvd. (Ste 304), Tampa, FL 33612, USA
| | - Joanne M. Morrisey
- Department of Microbiology and Immunology, Drexel University College of Medicine, 2900 Queen Lane, Philadelphia, PA 19129, USA
| | - Jessica Steuten
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Tina Mutka
- Department of Global Health, College of Public Health, 3720 Spectrum Blvd. (Ste 304), Tampa, FL 33612, USA
| | - Yuexin Li
- VA Medical Center, 3710 SW US Veterans Hospital Road, Portland, Oregon 97239, USA
| | - Grennady Wirjanata
- Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia
| | - Eileen Ryan
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Sandra Duffy
- Eskitis Institute for Cell & Molecular Therapies, Brisbane Innovation Park, Nathan campus, Griffith University, QLD 4111, Australia
| | - Jane Xu Kelly
- VA Medical Center, 3710 SW US Veterans Hospital Road, Portland, Oregon 97239, USA
| | - Boni F. Sebayang
- Eijkman Institute for Molecular Biology, Jl. Diponegoro 69, Jakarta 10430, Indonesia
| | - Anne-Marie Zeeman
- Department of Parasitology, Biomedical Primate Research Centre, P.O. Box 3306, 2280 GH Rijswijk, The Netherlands
| | - Rintis Noviyanti
- Eijkman Institute for Molecular Biology, Jl. Diponegoro 69, Jakarta 10430, Indonesia
| | - Robert E. Sinden
- Department of Life Sciences, Imperial College London, London SW7 2AZ, United Kingdom
| | - Clemens H. M. Kocken
- Department of Parasitology, Biomedical Primate Research Centre, P.O. Box 3306, 2280 GH Rijswijk, The Netherlands
| | - Ric N. Price
- Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7LJ, UK
| | - Vicky M. Avery
- Eskitis Institute for Cell & Molecular Therapies, Brisbane Innovation Park, Nathan campus, Griffith University, QLD 4111, Australia
| | - Iñigo Angulo-Barturen
- GlaxoSmithKline, Medicines Development Campus, Diseases of the Developing World, Severo Ochoa 2, Tres Cantos 28760, Madrid, Spain
| | - María Belén Jiménez-Díaz
- GlaxoSmithKline, Medicines Development Campus, Diseases of the Developing World, Severo Ochoa 2, Tres Cantos 28760, Madrid, Spain
| | - Santiago Ferrer
- GlaxoSmithKline, Medicines Development Campus, Diseases of the Developing World, Severo Ochoa 2, Tres Cantos 28760, Madrid, Spain
| | - Esperanza Herreros
- GlaxoSmithKline, Medicines Development Campus, Diseases of the Developing World, Severo Ochoa 2, Tres Cantos 28760, Madrid, Spain
| | - Laura M. Sanz
- GlaxoSmithKline, Medicines Development Campus, Diseases of the Developing World, Severo Ochoa 2, Tres Cantos 28760, Madrid, Spain
| | - Francisco-Javier Gamo
- GlaxoSmithKline, Medicines Development Campus, Diseases of the Developing World, Severo Ochoa 2, Tres Cantos 28760, Madrid, Spain
| | - Ian Bathurst
- Medicines for Malaria Venture, 20, route de Pré-Bois, PO Box 1826, 1215 Geneva 15, Switzerland
| | - Jeremy N. Burrows
- Medicines for Malaria Venture, 20, route de Pré-Bois, PO Box 1826, 1215 Geneva 15, Switzerland
| | - Peter Siegl
- Siegl Pharma Consulting LLC, Blue Bell, PA, USA
| | - R. Kiplin Guy
- Chemical Biology & Therapeutics, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105-3678 USA
| | - Rolf W. Winter
- VA Medical Center, 3710 SW US Veterans Hospital Road, Portland, Oregon 97239, USA
| | - Akhil B. Vaidya
- Department of Microbiology and Immunology, Drexel University College of Medicine, 2900 Queen Lane, Philadelphia, PA 19129, USA
| | - Susan A. Charman
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Dennis E. Kyle
- Department of Global Health, College of Public Health, 3720 Spectrum Blvd. (Ste 304), Tampa, FL 33612, USA
| | - Roman Manetsch
- Department of Chemistry, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620-5250, USA
| | - Michael K. Riscoe
- VA Medical Center, 3710 SW US Veterans Hospital Road, Portland, Oregon 97239, USA
- Department of Molecular Microbiology and Immunology, 3181 Sam Jackson Blvd., Portland, Oregon 97239, USA
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16
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Abstract
Malaria is one of the most devastating diseases in the world, affecting almost 225 million people a year, and causing over 780,000 deaths, most of which are children under the age of 5 years. Following the recent call for the eradication of the disease, supported by the WHO, there has been increasing investment into antimalarial drug-discovery projects. These activities are aimed at generating the next generation of molecules focused on the treatment and transmission-blocking of Plasmodium falciparum and Plasmodium vivax endo- and exo-erythrocytic stages of the parasite. This article summarizes the current top-level thinking regarding the prosecution of such endeavors and the disease-specific considerations in project planning.
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17
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Rodrigues T, Prudêncio M, Moreira R, Mota MM, Lopes F. Targeting the liver stage of malaria parasites: a yet unmet goal. J Med Chem 2011; 55:995-1012. [PMID: 22122518 DOI: 10.1021/jm201095h] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Tiago Rodrigues
- Research Institute for Medicines and Pharmaceutical Sciences (iMed.UL), Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-019 Lisbon, Portugal
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18
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Wells TNC, Burrows JN, Baird JK. Targeting the hypnozoite reservoir of Plasmodium vivax: the hidden obstacle to malaria elimination. Trends Parasitol 2010; 26:145-51. [PMID: 20133198 DOI: 10.1016/j.pt.2009.12.005] [Citation(s) in RCA: 206] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 11/17/2009] [Accepted: 12/21/2009] [Indexed: 02/03/2023]
Abstract
Plasmodium vivax is the major species of malaria parasite outside Africa. It is especially problematic in that the infection can relapse in the absence of mosquitoes by activation of dormant hypnozoites in the liver. Medicines that target the erythrocytic stages of Plasmodium falciparum are also active against P. vivax, except where these have been compromised by resistance. However, the only clinical therapy against relapse of vivax malaria is the 8-aminoquinoline, primaquine. This molecule has the drawback of causing haemolysis in genetically sensitive patients and requires 14 days of treatment. New, safer and more-easily administered drugs are urgently needed, and this is a crucial gap in the broader malaria-elimination agenda. New developments in cell biology are starting to open ways to the next generation of drugs against hypnozoites. This search is urgent, given the time needed to develop a new medication.
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Vale N, Prudêncio M, Marques CA, Collins MS, Gut J, Nogueira F, Matos J, Rosenthal PJ, Cushion MT, do Rosário VE, Mota MM, Moreira R, Gomes P. Imidazoquines as antimalarial and antipneumocystis agents. J Med Chem 2009; 52:7800-7. [PMID: 19799426 PMCID: PMC2788672 DOI: 10.1021/jm900738c] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Peptidomimetic imidazolidin-4-one derivatives of primaquine (imidazoquines) recently displayed in vitro activity against blood schizonts of a chloroquine-resistant strain of Plasmodium falciparum. Preliminary studies with a subset of such imidazoquines showed them to both block transmission of P. berghei malaria from mouse to mosquito and be highly stable toward hydrolysis at physiological conditions. This prompted us to have deeper insight into the activity of imidazoquines against both Plasmodia and Pneumocystis carinii, on which primaquine is also active. Full assessment of the in vivo transmission-blocking activity of imidazoquines, in vitro tissue-schizontocidal activity on P. berghei-infected hepatocytes, and in vitro anti-P. carinii activity is now reported. All compounds were active in these biological assays, with generally lower activity than the parent drug. However, imidazoquines' stability against both oxidative deamination and proteolytic degradation suggest that they will probably have higher oral bioavailability and lower hematotoxicity than primaquine, which might translate into higher therapeutic indexes.
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Affiliation(s)
- Nuno Vale
- CIQUP – Centro de Investigação em Química da Universidade do Porto, Departamento de Química, Faculdade de Ciências, Universidade do Porto, P-4169-007 Porto, Portugal
| | - Miguel Prudêncio
- Unidade de Malária, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, P-1649-028 Lisboa, Portugal
| | - Catarina A. Marques
- Unidade de Malária, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, P-1649-028 Lisboa, Portugal
| | - Margaret S. Collins
- Research Services, Veterans Affairs Medical Center, Cincinnati, OH 45220, USA
- Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati, OH 45267-0560, USA
| | - Jiri Gut
- Department of Medicine, San Francisco General Hospital, University of California, CA 94143-0811, USA
| | - Fátima Nogueira
- Centro de Malária e Outras Doenças Tropicais, IHMT - Universidade Nova de Lisboa, P-1349-008 Lisboa, Portugal
| | - Joana Matos
- CIQUP – Centro de Investigação em Química da Universidade do Porto, Departamento de Química, Faculdade de Ciências, Universidade do Porto, P-4169-007 Porto, Portugal
| | - Philip J. Rosenthal
- Department of Medicine, San Francisco General Hospital, University of California, CA 94143-0811, USA
| | - Melanie T. Cushion
- Research Services, Veterans Affairs Medical Center, Cincinnati, OH 45220, USA
- Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati, OH 45267-0560, USA
| | - Virgílio E. do Rosário
- Centro de Malária e Outras Doenças Tropicais, IHMT - Universidade Nova de Lisboa, P-1349-008 Lisboa, Portugal
| | - Maria M. Mota
- Unidade de Malária, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, P-1649-028 Lisboa, Portugal
| | - Rui Moreira
- iMed.UL, CECF, Faculdade de Farmácia, Universidade de Lisboa, P-1600-083 Lisboa, Portugal
| | - Paula Gomes
- CIQUP – Centro de Investigação em Química da Universidade do Porto, Departamento de Química, Faculdade de Ciências, Universidade do Porto, P-4169-007 Porto, Portugal
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Abstract
More attention is being focused on malaria today than any time since the world's last efforts to achieve eradication over 40 years ago. The global community is now discussing strategies aimed at dramatically reducing malarial disease burden and the eventual eradication of all types of malaria, everywhere. As a consequence, Plasmodium vivax, which has long been neglected and mistakenly considered inconsequential, is now entering into the strategic debates taking place on malaria epidemiology and control, drug resistance, pathogenesis and vaccines. Thus, contrary to the past, the malaria research community is becoming more aware and concerned about the widespread spectrum of illness and death caused by up to a couple of hundred million cases of vivax malaria each year. This review brings these issues to light and provides an overview of P. vivax vaccine development, then and now. Progress had been slow, given inherent research challenges and minimal support in the past, but prospects are looking better for making headway in the next few years. P. vivax, known to invade the youngest red blood cells, the reticulocytes, presents a strong challenge towards developing a reliable long-term culture system to facilitate needed research. The P. vivax genome was published recently, and vivax researchers now need to coordinate efforts to discover new vaccine candidates, establish new vaccine approaches, capitalize on non-human primate models for testing, and investigate the unique biological features of P. vivax, including the elusive P. vivax hypnozoites. Comparative studies on both P. falciparum and P. vivax in many areas of research will be essential to eradicate malaria. And to this end, the education and training of future generations of dedicated "malariologists" to advance our knowledge, understanding and the development of new interventions against each of the malaria species infecting humans also will be essential.
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Affiliation(s)
- Mary R Galinski
- Emory Vaccine Center and Yerkes National Primate Research Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - John W Barnwell
- Malaria Branch, Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, the Centers for Disease Control and Prevention, Atlanta, GA, USA
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21
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Rockwood G, Duniho S, Briscoe C, Gold M, Armstrong K, Kahler D, Moran A, Baskin S. Toxicity in rhesus monkeys following administration of the 8-aminoquinoline 8-[(4-amino-l-methylbutyl)amino]- 5-(l-hexyloxy)-6-methoxy-4-methylquinoline (WR242511). J Med Toxicol 2008; 4:157-66. [PMID: 18821488 DOI: 10.1007/bf03161194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Many substances that form methemoglobin (MHb) effectively counter cyanide (CN) toxicity. Although MHb formers are generally applied as treatments for CN poisoning, it has been proposed that a stable, long-acting MHb former could serve as a CN pretreatment. Using this rationale, the 8-aminoquinoline WR242511, a potent long-lasting MHb former in rodents and beagle dogs, was studied in the rhesus monkey for advanced development as a potential CN pretreatment. METHODS In this study, WR242511 was administered intravenously (IV) in 2 female and 4 male rhesus monkeys in doses of 3.5 and/or 7.0 mg/kg; a single male also received WR242511 orally (PO) at 7.0 mg/kg. Health status and MHb levels were monitored following exposure. RESULTS The selected doses of WR242511, which produced significant methemoglobinemia in beagle dogs in earlier studies conducted elsewhere, produced very little MHb (mean < 2.0%) in the rhesus monkey. Furthermore, transient hemoglobinuria was noted approximately 60 minutes postinjection of WR242511 (3.5 or 7.0 mg/kg), and 2 lethalities occurred (one IV and one PO) following the 7.0 mg/kg dose. Myoglobinuria was also observed following the 7.0 mg/kg dose. Histopathology analyses in the 2 animals that died revealed liver and kidney toxicity, with greater severity in the orally-treated animal. CONCLUSIONS These data demonstrate direct and/or indirect drug-induced toxicity. It is concluded that WR242511 should not be pursued as a pretreatment for CN poisoning unless the anti-CN characteristics of this compound can be successfully dissociated from those producing undesirable toxicity.
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Affiliation(s)
- Gary Rockwood
- Analytical Toxicology Division, United States Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD 21010-5400, USA.
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22
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Abstract
PURPOSE OF REVIEW This review focuses on recent developments on evaluation of 8-aminoquinoline analogs with broader efficacy and reduced toxicity, which would provide better drugs for treatment of protozoal infections. RECENT FINDINGS The earlier efforts towards development of 8-aminoquinoline analogs have been directed to extensive derivatization programs. This has led to discovery of tafenoquine for prophylaxis against malaria infections and sitamaquine with utility for treatment of visceral leishmaniasis. Bulaquine, a primaquine pro-drug, has shown reduced methemoglobin toxicity and better malaria-transmission-blocking activity than primaquine. Stereoselective pharmacologic and toxicologic characteristics of chiral 8-aminoquinolines provided the lead for enantiomeric separation of an 8-aminoquinoline analog NPC1161B, with greatly reduced toxicity and potent antimalarial action against blood as well as tissue stages of the parasite. NPC1161B has also shown promising use as an antileishmanial agent. Better understanding of the mechanisms of toxicity and efficacy may help in development of 8-aminoquinoline analogs with superior therapeutic actions, reduced toxicity and broader utility. SUMMARY Extensive derivatization approaches followed by better understanding of structure-activity relationships and biotransformation mechanisms of toxicity have provided 8-aminoquinoline analogs with better pharmacologic and reduced toxicologic profiles. The novel 8-aminoquinoline analogs may have broader utility in public health as future antiprotozoals.
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Affiliation(s)
- Babu L Tekwani
- National Center for Natural Products Research and Department of Pharmacology, University of Mississippi, University, Mississippi 38677, USA.
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23
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Wang TST, Fawwaz RA, van Heertum RH. Preparation of 1,2-dimethoxy-4-(bis-diethylaminoethyl-[14C]-amino)-5-bromobenzene. J Labelled Comp Radiopharm 2006. [DOI: 10.1002/jlcr.2580331103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Bray PG, Deed S, Fox E, Kalkanidis M, Mungthin M, Deady LW, Tilley L. Primaquine synergises the activity of chloroquine against chloroquine-resistant P. falciparum. Biochem Pharmacol 2005; 70:1158-66. [PMID: 16139253 DOI: 10.1016/j.bcp.2005.07.021] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2005] [Revised: 07/20/2005] [Accepted: 07/25/2005] [Indexed: 11/26/2022]
Abstract
In recent years, resistance to the antimalarial drug, chloroquine, has become widespread. It is, therefore, imperative to find compounds that could replace chloroquine or work synergistically with this drug to overcome chloroquine resistance. We have examined the interaction between chloroquine, a 4-aminoquinoline, and a number of 8-aminoquinolines, including primaquine, a drug that is widely used to treat Plasmodium vivax infections. We find that primaquine is a potent synergiser of the activity of chloroquine against chloroquine-resistant Plasmodium falciparum. Analysis of matched transfectants expressing mutant and wild-type alleles of the P. falciparum chloroquine resistance transporter (PfCRT) indicate that primaquine exerts its activity by blocking PfCRT, and thus enhancing chloroquine accumulation. Our data suggest that a novel formulation of two antimalarial drugs already licensed for use in humans could be used to treat chloroquine-resistant parasites.
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Affiliation(s)
- Patrick G Bray
- Molecular and Biochemical Parasitology Group, Liverpool School of Tropical Medicine, UK
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Jain M, Vangapandu S, Sachdeva S, Singh S, Singh PP, Jena GB, Tikoo K, Ramarao P, Kaul CL, Jain R. Discovery of a Bulky 2-tert-Butyl Group Containing Primaquine Analogue That Exhibits Potent Blood-Schizontocidal Antimalarial Activities and Complete Elimination of Methemoglobin Toxicity. J Med Chem 2003; 47:285-7. [PMID: 14711300 DOI: 10.1021/jm0304562] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To eliminate an unwarranted metabolic pathway of the quinoline ring, a set of two compounds, where C-2 position of the antimalarial drug primaquine is blocked by metabolically stable bulky alkyl group are synthesized. Compound 2 [R = C(CH(3))(3)] of the series has produced excellent antimalarial efficacy against P. berghei and highly virulent multidrug-resistant P. yoelii nigeriensis strain in vivo. Compound 2 was also evaluated for methemoglobin (MetHb) toxicity. This study describes the discovery of a highly potent blood-schizontocidal antimalarial analogue 2, completely devoid of MetHb toxicity.
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Affiliation(s)
- Meenakshi Jain
- National Institute of Pharmaceutical Education and Research, Sector 67, S.A.S. Nagar, Punjab 160 062, India
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Goodwin TE, Boylan CJ, Current WL, Byrd JC, Edwards CB, Fuller DA, Green JL, Larocca CD, Raney KD, Ross AS, Tucker WA. Enhanced pneumocystis carinii activity of new primaquine analogues. Bioorg Med Chem Lett 2000; 10:2205-8. [PMID: 11012030 DOI: 10.1016/s0960-894x(00)00436-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
New analogues of the venerable antimalarial drug primaquine have been synthesized and bioassayed in vivo against Pneumocystis carinii, a life-threatening infection common among immunosuppressed patients. Two of these new compounds are significantly more active than primaquine itself, and provide new information for future drug design and development in this area.
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Affiliation(s)
- T E Goodwin
- Department of Chemistry, Hendrix College, Conway, AR 72032, USA.
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27
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Portela MJ, Moreira R, Valente E, Constantino L, Iley J, Pinto J, Rosa R, Cravo P, do Rosário VE. Dipeptide derivatives of primaquine as transmission-blocking antimalarials: effect of aliphatic side-chain acylation on the gametocytocidal activity and on the formation of carboxyprimaquine in rat liver homogenates. Pharm Res 1999; 16:949-55. [PMID: 10397619 DOI: 10.1023/a:1018922425551] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE Dipeptide derivatives of primaquine (PQ) with reduced oxidative deamination to the inactive metabolite carboxyprimaquine were synthesized and evaluated as a novel class of transmission-blocking antimalarials. METHODS; Antimalarial activity was studied using a model consisting of mefloquine-resistant Plasmodium berghei ANKA 25R/10, Balb C mice, and Anopheles stephensi mosquitoes. Metabolic studies were performed with rat liver homogenates, and the incubates were analyzed by HPLC. RESULTS All dipeptide derivatives and glycyl-PQ completely inhibited the appearance of oocysts in the midguts of the mosquitoes at 15 mg/ kg, while N-acetylprimaquine was not active at this dose. However, none of the title compounds were able to block oocyst production at 3.75 mg/kg, in contrast with primaquine. Exception for sarc-gly-PQ, all remaining compounds prevented sporozoite formation in the salivary glands of mosquitoes at a dose of 3.75 mg/kg. Simultaneous hydrolysis to primaquine and gly-PQ ocurred with the following order of Vmax/Km: for primaquine formation. L-ala-gly-PQ > L-phe-gly-PQ > gly-gly-PQ; and for gly-PQ formation, L-phe-gly-PQ > L-ala-gly-PQ > gly-gly-PQ. In contrast, primaquine was not released from D-phe-gly-PQ, sarc-gly-PQ, and N-acetylprimaquine. Neither carboxyprimaquine nor 8-amino-6-methoxyquinoline were detected in any of the incubation mixtures. CONCLUSIONS The title compounds prevent the development of the sporogonic cycle of Plasmodium berghei. Gametocytocidal activity is independent of the rate and pathway of primaquine formation. Acylation of the aliphatic side-chain effectively prevents the formation of carboxyprimaquine, but the presence of a terminal amino group appears to be essential for the gametocytocidal activity.
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Affiliation(s)
- M J Portela
- CECF, Facudade de Farmácia, Universidade of Lisboa, Portugal
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28
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Nodiff EA, Chatterjee S, Musallam HA. Antimalarial activity of the 8-aminoquinolines. PROGRESS IN MEDICINAL CHEMISTRY 1991; 28:1-40. [PMID: 1843545 DOI: 10.1016/s0079-6468(08)70362-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- E A Nodiff
- Franklin Research Center, Arvin Calspan Corporation, Norristown, PA 19403
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29
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Schmidt LH, Rossan RN, Fradkin R, Sullivan R, Schulemann W, Kratz L. Antimalarial activities and subacute toxicity of RC-12, a 4-amino-substituted pyrocatechol. Antimicrob Agents Chemother 1985; 28:612-25. [PMID: 4091527 PMCID: PMC176344 DOI: 10.1128/aac.28.5.612] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
RC-12 [1,2-dimethoxy-4-(bis-diethylaminoethyl)-amino-5-bromobenzene] was evaluated for prophylactic, radical curative, and suppressive activities against infections with Plasmodium cynomolgi and subacute toxicity in rhesus monkeys. Applied as a prophylactic agent, RC-12, administered in doses of 6.25 to 25.0 mg/kg daily throughout the incubation period, provided near-complete to complete protection against 10(5) to 10(6) times the minimum infective dose of sporozoites. Applied as a suppressive agent, daily doses of 100.0 mg of RC-12 per kg did not eradicate blood schizonts regularly; hence, the need for concomitant administration of a blood schizonticide, such as chloroquine, in assessments of radical curative activity. In such appraisals, daily doses of 6.25 to 25.0 mg of RC-12 per kg for 14 days, in combination with 2.5 mg of chloroquine per kg daily for 7 days, effected cure of 69 and 93% of established infections, respectively. The curative activity of RC-12 was related to the total dose and could be achieved with a regimen as brief as 4 days. With respect to outward expressions of toxicity, daily doses of 50.0 mg/kg or lower for 15 to 225 days evoked no reactions. Doses of 100.0 or 200.0 mg/kg, scheduled for 15 days, evoked convulsions and depression and were, respectively, lethal to 4 of 17 and 7 of 7 recipients. Doses of 25.0 mg/kg or lower evoked no discrete reactions. Doses of 50.0 mg/kg and higher evoked hepatomegaly, vacuolation of hepatocytes, and elevations of glutamic oxalacetic and glutamic pyruvic transferase activities in serum, reactions related in intensity to dose but not duration of dosage.
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Johnson JL, Werbel LM. Synthesis ofN4-(5-methoxy-7-benzofuranyl)-1,4-pentanediamine, an oxygen isostere of primaquine. J Heterocycl Chem 1985. [DOI: 10.1002/jhet.5570220549] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Schmidt LH. Enhancement of the curative activity of primaquine by concomitant administration of mirincamycin. Antimicrob Agents Chemother 1985; 27:151-7. [PMID: 3885847 PMCID: PMC176228 DOI: 10.1128/aac.27.2.151] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Mirincamycin, a lincomycin derivative with unequivocal but limited activity against the pre-erythrocytic and persisting exoerythrocytic stages of Plasmodium cynomolgi, has been evaluated for capacity to enhance the radical curative potential of the conventional primaquine-chloroquine combination. Established infections with sporozoites of the above plasmodium in rhesus monkeys served this evaluation. The results showed that the dose of primaquine required for cure of 50% of active infections was reduced by one-half to two-thirds by coadministration with 2.5 mg of mirincamycin per kg, 1/16 the 50% curative dose of this lincomycin derivative when used in a mono-drug regimen. The dimensions of the enhancement of the curative activity of primaquine were inversely related to the size of the sporozoite inoculum. The smallest dose of mirincamycin productive of enhancement was 2.5 mg/kg; whether doses larger than 2.5 mg/kg would have been more effective was not determined. There is much to be done before it is known whether a mirincamycin-primaquine combination is useful for suppressive cure or radical cure of the human malarias. Irrespective of that result, the current study serves to focus attention on a somewhat novel approach to the development of more effective and better-tolerated regimens for radical cure, an alternative to the empirical chemical synthesis and screening approach that has dominated searches heretofore.
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Kinnamon KE, Davidson DE, Rane DS. Screening procedure using chicks infected with the sporozoites of Plasmodium gallinaceum in an antimalarial drug development programme. Bull World Health Organ 1985; 63:119-23. [PMID: 3872730 PMCID: PMC2536355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Of 10 000 compounds tested for tissue schizontocidal activity in a Plasmodium gallinaceum-chick model, 157 were also tested in a definitive mouse test (DMT) and 277 in a rhesus monkey test (RMT). The results in the avian model were 78% and 55% in agreement with those of the DMT and RMT, respectively. This result is not as good as that for a tissue schizontocidal mouse screen previously reported, which showed 93% and 80% agreement with DMT and RMT, respectively. More than three-quarters of the compounds tested in DMT and RMT were 8-aminoquinolines, a chemical class known to have tissue schizontocidal activity.
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Schmidt LH, Rossan RN. Activities of respository preparations of cycloguanil pamoate and 4,4'-diacetyldiaminodiphenylsulfone, alone and in combination, against infections with Plasmodium cynomolgi in rhesus monkeys. Antimicrob Agents Chemother 1984; 26:611-42. [PMID: 6393864 PMCID: PMC179984 DOI: 10.1128/aac.26.5.611] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The studies summarized in this report were concerned with the capacities of repository preparations of cycloguanil pamoate (CGT-P) to protect rhesus monkeys against infections with drug-susceptible and pyrimethamine-resistant strains of Plasmodium cynomolgi. Administered intramuscularly as a suspension in an oleaginous vehicle, CGT-P (i) provided long-term protection against single and repetitive challenges of rhesus monkeys with sporozoites of the drug-susceptible B and Ro strains, (ii) effected prompt clearance of parasitemia in established infections, and (iii) delayed relapse. Protection was equated to absence of parasites on thick blood films, negative results when blood was transferred to susceptible recipients, and inability to activate infection by splenectomy. Eventual loss of protection was not related to emergence of parasites resistant to cycloguanil (CGT). Although protection varied from monkey to monkey, its mean duration was related directly to size of CGT-P dose and size of particles in the suspension. Urinary excretion studies indicated that protection persisted as long as the daily output of CGT did not fall below that attained with the parenterally administered hydrochloride salt at a dose equivalent to 0.015 mg of CGT per kg. Studies on infections with the resistant Ro/PM strain showed that the activity of CGT-P was compromised severely by resistance to pyrimethamine. Attempts to minimize this liability by concomitant administration of 4,4'-diacetyldiaminodiphenylsulfone met with limited success. These results suggest that even the best of the repository preparations of CGT-P, with or without 4,4'-diacetyldiaminodiphenylsulfone, would be useful only in areas where Plasmodium falciparum and Plasmodium vivax are fully susceptible to chlorguanide and pyrimethamine.
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