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Franco CH, Warhurst DC, Bhattacharyya T, Au HYA, Le H, Giardini MA, Pascoalino BS, Torrecilhas AC, Romera LMD, Madeira RP, Schenkman S, Freitas-Junior LH, Chatelain E, Miles MA, Moraes CB. Novel structural CYP51 mutation in Trypanosoma cruzi associated with multidrug resistance to CYP51 inhibitors and reduced infectivity. Int J Parasitol Drugs Drug Resist 2020; 13:107-120. [PMID: 32688218 PMCID: PMC7369355 DOI: 10.1016/j.ijpddr.2020.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/29/2020] [Accepted: 06/04/2020] [Indexed: 12/31/2022]
Abstract
Ergosterol biosynthesis inhibitors, such as posaconazole and ravuconazole, have been proposed as drug candidates for Chagas disease, a neglected infectious tropical disease caused by the protozoan parasite Trypanosoma cruzi. To understand better the mechanism of action and resistance to these inhibitors, a clone of the T. cruzi Y strain was cultured under intermittent and increasing concentrations of ravuconazole until phenotypic stability was achieved. The ravuconazole-selected clone exhibited loss in fitness in vitro when compared to the wild-type parental clone, as observed in reduced invasion capacity and slowed population growth in both mammalian and insect stages of the parasite. In drug activity assays, the resistant clone was above 300-fold more tolerant to ravuconazole than the sensitive parental clone, when the half-maximum effective concentration (EC50) was considered. The resistant clones also showed reduced virulence in vivo, when compared to parental sensitive clones. Cross-resistance to posaconazole and other CYP51 inhibitors, but not to other antichagasic drugs that act independently of CYP51, such as benznidazole and nifurtimox, was also observed. A novel amino acid residue change, T297M, was found in the TcCYP51 gene in the resistant but not in the sensitive clones. The structural effects of the T297M, and of the previously described P355S residue changes, were modelled to understand their impact on interaction with CYP51 inhibitors. A ravuconazole-resistant T. cruzi clone presented reduced in vitro and in vivo fitness. The ravuconazole-resistant clone presented cross-resistance to other CYP51 inhibitors. There was no cross-resistance to benznidazole and nifurtimox. Resistance is associated with a novel structural mutation in the TcCYP51 protein.
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Affiliation(s)
- Caio H Franco
- Laboratório Nacional de Biociências (LNBio), Centro Nacional de Pesquisa em Energia e Materiais (CNPEM), Campinas, SP, Brazil; Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - David C Warhurst
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Tapan Bhattacharyya
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Ho Y A Au
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Hai Le
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Miriam A Giardini
- Institut Pasteur Korea, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Bruno S Pascoalino
- Laboratório Nacional de Biociências (LNBio), Centro Nacional de Pesquisa em Energia e Materiais (CNPEM), Campinas, SP, Brazil
| | - Ana Claudia Torrecilhas
- Department of Pharmaceutical Sciences, Federal University of São Paulo (UNIFESP), Diadema, SP, Brazil
| | - Lavinia M D Romera
- Department of Pharmaceutical Sciences, Federal University of São Paulo (UNIFESP), Diadema, SP, Brazil
| | - Rafael Pedro Madeira
- Department of Pharmaceutical Sciences, Federal University of São Paulo (UNIFESP), Diadema, SP, Brazil
| | - Sergio Schenkman
- Department of Microbiology, Immunology and Parasitology, UNIFESP, São Paulo, SP, Brazil
| | - Lucio H Freitas-Junior
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil; Institut Pasteur Korea, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Eric Chatelain
- Drugs for Neglected Diseases Initiative, Geneva, Switzerland
| | - Michael A Miles
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Carolina B Moraes
- Laboratório Nacional de Biociências (LNBio), Centro Nacional de Pesquisa em Energia e Materiais (CNPEM), Campinas, SP, Brazil; Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil; Institut Pasteur Korea, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea; Department of Pharmaceutical Sciences, Federal University of São Paulo (UNIFESP), Diadema, SP, Brazil.
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