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Sikulu-Lord MT, Edstein MD, Goh B, Lord AR, Travis JA, Dowell FE, Birrell GW, Chavchich M. Rapid and non-invasive detection of malaria parasites using near-infrared spectroscopy and machine learning. PLoS One 2024; 19:e0289232. [PMID: 38527002 PMCID: PMC10962802 DOI: 10.1371/journal.pone.0289232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/26/2023] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Novel and highly sensitive point-of-care malaria diagnostic and surveillance tools that are rapid and affordable are urgently needed to support malaria control and elimination. METHODS We demonstrated the potential of near-infrared spectroscopy (NIRS) technique to detect malaria parasites both, in vitro, using dilutions of infected red blood cells obtained from Plasmodium falciparum cultures and in vivo, in mice infected with P. berghei using blood spotted on slides and non-invasively, by simply scanning various body areas (e.g., feet, groin and ears). The spectra were analysed using machine learning to develop predictive models for infection. FINDINGS Using NIRS spectra of in vitro cultures and machine learning algorithms, we successfully detected low densities (<10-7 parasites/μL) of P. falciparum parasites with a sensitivity of 96% (n = 1041), a specificity of 93% (n = 130) and an accuracy of 96% (n = 1171) and differentiated ring, trophozoite and schizont stages with an accuracy of 98% (n = 820). Furthermore, when the feet of mice infected with P. berghei with parasitaemia ≥3% were scanned non-invasively, the sensitivity and specificity of NIRS were 94% (n = 66) and 86% (n = 342), respectively. INTERPRETATION These data highlights the potential of NIRS technique as rapid, non-invasive and affordable tool for surveillance of malaria cases. Further work to determine the potential of NIRS to detect malaria in symptomatic and asymptomatic malaria cases in the field is recommended including its capacity to guide current malaria elimination strategies.
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Affiliation(s)
- Maggy T. Sikulu-Lord
- School of the Environment, Faculty of Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Michael D. Edstein
- Department of Drug Evaluation, Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Queensland, Australia
| | - Brendon Goh
- School of the Environment, Faculty of Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Anton R. Lord
- Centre for Data Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jye A. Travis
- Department of Drug Evaluation, Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Queensland, Australia
| | - Floyd E. Dowell
- Center for Grain and Animal Health Research, USDA Agricultural Research Service, Manhattan, Kansas, United States of America
| | - Geoffrey W. Birrell
- Department of Drug Evaluation, Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Queensland, Australia
| | - Marina Chavchich
- Department of Drug Evaluation, Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Queensland, Australia
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San NN, Kien NX, Manh ND, Van Thanh N, Chavchich M, Binh NTH, Long TK, Edgel KA, Rovira-Vallbona E, Edstein MD, Martin NJ. Cross-sectional study of asymptomatic malaria and seroepidemiological surveillance of seven districts in Gia Lai province, Vietnam. Malar J 2022; 21:40. [PMID: 35135536 PMCID: PMC8822839 DOI: 10.1186/s12936-022-04060-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/23/2022] [Indexed: 11/12/2022] Open
Abstract
Background Malaria elimination by 2030 is an aim of many countries in the Greater Mekong Sub-region, including Vietnam. However, to achieve this goal and accelerate towards malaria elimination, countries need to determine the extent and prevalence of asymptomatic malaria as a potential reservoir for malaria transmission and the intensity of malaria transmission. The purpose of this study was to determine the prevalence of asymptomatic malaria and seropositivity rate in several districts of Gia Lai province in the Central Highlands of Vietnam. Methods A cross-sectional survey of asymptomatic malaria and serological testing was conducted in 3283 people living at 14 communes across seven districts in Gia Lai province in December 2016 to January 2017. Finger prick capillary blood samples were tested for malaria using rapid diagnostic testing and polymerase chain reaction (PCR), as well as detecting antibodies against 3 Plasmodium falciparum and 4 Plasmodium vivax antigens by indirect enzyme-linked immunosorbent assay (ELISA). Age-seroprevalence curves were fitted using reverse catalytic models with maximum likelihood. Results The study population was predominantly male (65.9%, 2165/3283), adults (88.7%, 2911/3283) and of a minority ethnicity (72.2%, 2371/3283), with most participants being farmers and outdoor government workers (90.2%, 2960/3283). Using a small volume of blood (≈ 10 µL) the PCR assay revealed that 1.74% (57/3283) of the participants had asymptomatic malaria (P. falciparum 1.07%, P. vivax 0.40%, Plasmodium malariae 0.15% and mixed infections 0.12%). In contrast, the annual malaria prevalence rates for clinical malaria in the communities where the participants lived were 0.12% (108/90,395) in 2016 and 0.22% (201/93,184) in 2017. Seropositivity for at least one P. falciparum or one P. vivax antigen was 38.5% (1257/3262) and 31.1% (1022/3282), respectively. Age-dependent trends in the proportion of seropositive individuals in five of the districts discriminated the three districts with sustained low malaria prevalence from the two districts with higher transmission. Conclusions Asymptomatic Plasmodium carriers were found to be substantially more prevalent than clinical cases in seven districts of Gia Lai province, and a third of the population had serological evidence of previous malaria exposure. The findings add knowledge on the extent of asymptomatic malaria and transmission for developing malaria elimination strategies for Vietnam. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04060-6.
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Affiliation(s)
| | - Nguyen Xuan Kien
- Vietnam People's Army Military Medical Department, Hanoi, Vietnam
| | - Nguyen Duc Manh
- Vietnam People's Army Military Institute of Preventive Medicine, Hanoi, Vietnam
| | - Nguyen Van Thanh
- Vietnam People's Army Military Institute of Preventive Medicine, Hanoi, Vietnam
| | - Marina Chavchich
- Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia
| | | | | | | | | | - Michael D Edstein
- Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia
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Quang HH, Chavchich M, Trinh NTM, Manh ND, Edstein MD, Martin NJ, Edgel KA. Cross-sectional survey of asymptomatic malaria in Dak Nong province in the Central Highlands of Vietnam for the malaria elimination roadmap. PLoS One 2021; 16:e0258580. [PMID: 34669697 PMCID: PMC8528296 DOI: 10.1371/journal.pone.0258580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 09/30/2021] [Indexed: 12/25/2022] Open
Abstract
Asymptomatic parasite carriers represent a “silent” infective reservoir for malaria transmission and contributes to malaria persistence. However, limited data are available on asymptomatic malaria in Vietnam. Between November 2018 and March 2019, we conducted a malaria epidemiological survey of asymptomatic people (children ≥ 10 years old and adults ≥18 years old, n = 2,809) residing in three communes in Tuy Duc district, Dak Nong province in the Central Highlands of Vietnam. Based on the national stratification of malaria risk, Dak Buk So, Dak Ngo and Quang Truc communes were classified by the National Malaria Control Programme as low, moderate and high malaria endemic areas, respectively. Using participants’ finger prick blood samples, malaria parasites were detected by one-step reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The median age (Interquartile Range) for adults and children were 35 years (26–50) and 12 years (11–14), respectively. The prevalence of asymptomatic malaria was 1.7% (22/1,328), 3.5% (31/890) and 12.2% (72/591) for participants from Dak Buk So, Dak Ngo and Quang Truc, respectively. The prevalence of asymptomatic malaria was lower in children compared to adults: 2.6% (9/352) versus 4.7% (116/2,457) (Odds Ratio 0.53, 95% Confidence Interval 0.28 to1.02). Ownership of long-lasting insecticide-treated bed nets and hammocks was 97.1%, 99.0% and 94.7% for participants in Dak Buk So, Dak Ngo and Quang Truc, respectively, however, only 66.0%, 57.3% and 42.8% of the participants reported using bed nets every night. Of the several risk factors examined, going to the forest two weeks prior to enrolment into the study and sleeping in the forest had a significant association with participants being infected with asymptomatic malaria in Quang Truc, but not in the other two communes. Knowledge of the prevalence and distribution of asymptomatic malaria will help design and evaluate future intervention strategies for malaria elimination in Vietnam.
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Affiliation(s)
- Huynh Hong Quang
- Institute of Malariology, Parasitology and Entomology, Quy Nhon, Vietnam
| | - Marina Chavchich
- Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia
- * E-mail:
| | | | | | - Michael D. Edstein
- Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia
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Priebbenow DL, Mathiew M, Shi DH, Harjani JR, Beveridge JG, Chavchich M, Edstein MD, Duffy S, Avery VM, Jacobs RT, Brand S, Shackleford DM, Wang W, Zhong L, Lee G, Tay E, Barker H, Crighton E, White KL, Charman SA, De Paoli A, Creek DJ, Baell JB. Discovery of Potent and Fast-Acting Antimalarial Bis-1,2,4-triazines. J Med Chem 2021; 64:4150-4162. [PMID: 33759519 DOI: 10.1021/acs.jmedchem.1c00044] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Novel 3,3'-disubstituted-5,5'-bi(1,2,4-triazine) compounds with potent in vitro activity against Plasmodium falciparum parasites were recently discovered. To improve the pharmacokinetic properties of the triazine derivatives, a new structure-activity relationship (SAR) investigation was initiated with a focus on enhancing the metabolic stability of lead compounds. These efforts led to the identification of second-generation highly potent antimalarial bis-triazines, exemplified by triazine 23, which exhibited significantly improved in vitro metabolic stability (8 and 42 μL/min/mg protein in human and mouse liver microsomes). The disubstituted triazine dimer 23 was also observed to suppress parasitemia in the Peters 4-day test with a mean ED50 value of 1.85 mg/kg/day and exhibited a fast-killing profile, revealing a new class of orally available antimalarial compounds of considerable interest.
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Affiliation(s)
- Daniel L Priebbenow
- School of Chemistry, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Mitch Mathiew
- Medicinal Chemistry, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Da-Hua Shi
- Medicinal Chemistry, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Jitendra R Harjani
- Medicinal Chemistry, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Julia G Beveridge
- Medicinal Chemistry, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Marina Chavchich
- The Department of Drug Evaluation, Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, QLD 4051, Australia
| | - Michael D Edstein
- The Department of Drug Evaluation, Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, QLD 4051, Australia
| | | | | | - Robert T Jacobs
- Medicines for Malaria Venture (MMV), P.O. Box 1826, Route de Pré-Bois 20, CH-1215 Geneva, Switzerland
| | - Stephen Brand
- Medicines for Malaria Venture (MMV), P.O. Box 1826, Route de Pré-Bois 20, CH-1215 Geneva, Switzerland
| | - David M Shackleford
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Wen Wang
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Longjin Zhong
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Given Lee
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Erin Tay
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Helena Barker
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Elly Crighton
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Karen L White
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Susan A Charman
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Amanda De Paoli
- Drug Delivery Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Darren J Creek
- Drug Delivery Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
| | - Jonathan B Baell
- Medicinal Chemistry, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
- ARC Centre for Fragment-Based Design, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia
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Frydrych J, Keough DT, Chavchich M, Travis J, Dračínský M, Edstein MD, Guddat LW, Hocková D, Janeba Z. Nucleotide analogues containing a pyrrolidine, piperidine or piperazine ring: Synthesis and evaluation of inhibition of plasmodial and human 6-oxopurine phosphoribosyltransferases and in vitro antimalarial activity. Eur J Med Chem 2021; 219:113416. [PMID: 33887682 DOI: 10.1016/j.ejmech.2021.113416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 01/27/2023]
Abstract
Parasites of the Plasmodium genus are unable to produce purine nucleotides de novo and depend completely on the salvage pathway. This fact makes plasmodial hypoxanthine-guanine-(xanthine) phosphoribosyltransferase [HG(X)PRT] a valuable target for development of antimalarial agents. A series of nucleotide analogues was designed, synthesized and evaluated as potential inhibitors of Plasmodium falciparum HGXPRT, P. vivax HGPRT and human HGPRT. These novel nucleoside phosphonates have a pyrrolidine, piperidine or piperazine ring incorporated into the linker connecting the purine base to a phosphonate group(s) and exhibited a broad range of Ki values between 0.15 and 72 μM. The corresponding phosphoramidate prodrugs, able to cross cell membranes, have been synthesized and evaluated in a P. falciparum infected human erythrocyte assay. Of the eight prodrugs evaluated seven exhibited in vitro antimalarial activity with IC50 values within the range of 2.5-12.1 μM. The bis-phosphoramidate prodrug 13a with a mean (SD) IC50 of 2.5 ± 0.7 μM against the chloroquine-resistant P. falciparum W2 strain exhibited low cytotoxicity in the human hepatocellular liver carcinoma (HepG2) and normal human dermal fibroblasts (NHDF) cell lines at a concentration of 100 μM suggesting good selectivity for further structure-activity relationship investigations.
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Affiliation(s)
- Jan Frydrych
- The Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, CZ-16610 Prague 6, Czech Republic
| | - Dianne T Keough
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, 4068, Australia
| | - Marina Chavchich
- Department of Drug Evaluation, Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Brisbane, Queensland 4051, Australia
| | - Jye Travis
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, 4068, Australia; Department of Drug Evaluation, Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Brisbane, Queensland 4051, Australia
| | - Martin Dračínský
- The Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, CZ-16610 Prague 6, Czech Republic
| | - Michael D Edstein
- Department of Drug Evaluation, Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Brisbane, Queensland 4051, Australia
| | - Luke W Guddat
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, 4068, Australia
| | - Dana Hocková
- The Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, CZ-16610 Prague 6, Czech Republic
| | - Zlatko Janeba
- The Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, CZ-16610 Prague 6, Czech Republic.
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Klejch T, Keough DT, Chavchich M, Travis J, Skácel J, Pohl R, Janeba Z, Edstein MD, Avery VM, Guddat LW, Hocková D. Sulfide, sulfoxide and sulfone bridged acyclic nucleoside phosphonates as inhibitors of the Plasmodium falciparum and human 6-oxopurine phosphoribosyltransferases: Synthesis and evaluation. Eur J Med Chem 2019; 183:111667. [DOI: 10.1016/j.ejmech.2019.111667] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 02/05/2023]
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Parkinson CJ, Birrell GW, Chavchich M, Mackenzie D, Haynes RK, de Kock C, Richardson DR, Edstein MD. Development of pyridyl thiosemicarbazones as highly potent agents for the treatment of malaria after oral administration. J Antimicrob Chemother 2019; 74:2965-2973. [DOI: 10.1093/jac/dkz290] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 06/04/2019] [Accepted: 06/05/2019] [Indexed: 01/22/2023] Open
Abstract
AbstractObjectivesDrug resistance exists to all current and investigational antimalarial drug classes. Consequently, we have set out to develop chemically and mechanistically discrete antimalarials. Here we report on the development of thiosemicarbazone (TSC) antimalarials, with TSC3 as the most advanced lead.MethodsThiosemicarbazones were generated through simple condensation reactions of thiosemicarbazides and ketones. TSC3 was selected and tested for in vitro antimalarial activities against MDR Plasmodium falciparum lines using the [3H]hypoxanthine growth assay, in vitro cytotoxicity against mammalian cell lines using the alamarBlue fluorescence cell viability assay, in vivo potency in the mouse–Plasmodium berghei model and blood exposure in mice measured by LC-MS for pharmacokinetic analysis.ResultsTSC3 showed potent in vitro activity against atovaquone-, dihydroartemisinin-, chloroquine- and mefloquine-resistant P. falciparum lines (EC50 <15 nM). The selectivity index (EC50 cells/EC50Pf W2 line) of TSC3 was >500 in two of three mammalian cell lines. In P. berghei-infected mice, TSC3 showed potent activity in the Peters 4 day suppression test (ED50 1.2 mg/kg/day) and was as potent as artesunate and chloroquine in the curative modified Thompson test. A single oral dose of TSC3 at 16 mg/kg in healthy mice achieved a mean maximum blood concentration of 1883 ng/mL at 1 h after dosing and an elimination half-life of 48.7 h in groups of five mice.ConclusionsTSC3 shows promise as a persistent, potent and orally effective antimalarial. This, coupled with the extremely low cost of synthesis, suggests that the further development of antimalarial thiosemicarbazones is clearly warranted.
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Affiliation(s)
| | - Geoffrey W Birrell
- Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia
| | - Marina Chavchich
- Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia
| | - Donna Mackenzie
- Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia
| | - Richard K Haynes
- Centre for Excellence in Pharmaceutical Discovery, North-West University, Potchefstroom, South Africa
| | - Carmen de Kock
- Division of Pharmacology, University of Cape Town, Observatory, South Africa
| | - Des R Richardson
- Molecular Pharmacology and Pathology Program, Department of Pathology and Bosch Institute, The University of Sydney, Sydney, Australia
| | - Michael D Edstein
- Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia
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Xue L, Shi DH, Harjani JR, Huang F, Beveridge JG, Dingjan T, Ban K, Diab S, Duffy S, Lucantoni L, Fletcher S, Chiu FCK, Blundell S, Ellis K, Ralph SA, Wirjanata G, Teguh S, Noviyanti R, Chavchich M, Creek D, Price RN, Marfurt J, Charman SA, Cuellar ME, Strasser JM, Dahlin JL, Walters MA, Edstein MD, Avery VM, Baell JB. 3,3'-Disubstituted 5,5'-Bi(1,2,4-triazine) Derivatives with Potent in Vitro and in Vivo Antimalarial Activity. J Med Chem 2019; 62:2485-2498. [PMID: 30715882 DOI: 10.1021/acs.jmedchem.8b01799] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
A series of 3,3'-disubstituted 5,5'-bi(1,2,4-triazine) derivatives was synthesized and screened against the erythrocytic stage of Plasmodium falciparum 3D7 line. The most potent dimer, 6k, with an IC50 (50% inhibitory concentration) of 0.008 μM, had high in vitro potency against P. falciparum lines resistant to chloroquine (W2, IC50 = 0.0047 ± 0.0011 μM) and artemisinin (MRA1240, IC50 = 0.0086 ± 0.0010 μM). Excellent ex vivo potency of 6k was shown against clinical field isolates of both P. falciparum (IC50 = 0.022-0.034 μM) and Plasmodium vivax (IC50 = 0.0093-0.031 μM) from the blood of outpatients with uncomplicated malaria. Despite 6k being cleared relatively rapidly in mice, it suppressed parasitemia in the Peters 4-day test, with a mean ED50 value (50% effective dose) of 1.47 mg kg-1 day-1 following oral administration. The disubstituted triazine dimer 6k represents a new class of orally available antimalarial compounds of considerable interest for further development.
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Affiliation(s)
- Lian Xue
- School of Pharmaceutical Sciences , Nanjing Tech University , No. 30 South Puzhu Road , Nanjing 211816 , People's Republic of China
| | - Da-Hua Shi
- Medicinal Chemistry , Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
| | - Jitendra R Harjani
- Medicinal Chemistry , Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
| | - Fei Huang
- School of Pharmaceutical Sciences , Nanjing Tech University , No. 30 South Puzhu Road , Nanjing 211816 , People's Republic of China
| | - Julia G Beveridge
- Medicinal Chemistry , Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
| | - Tamir Dingjan
- Medicinal Chemistry , Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
| | - Kung Ban
- Medicinal Chemistry , Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
| | - Sarah Diab
- Medicinal Chemistry , Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
| | - Sandra Duffy
- Discovery Biology, Griffith Institute for Drug Discovery , Griffith University , Brisbane Innovation Park , Nathan , Queensland 4111 , Australia
| | - Leonardo Lucantoni
- Discovery Biology, Griffith Institute for Drug Discovery , Griffith University , Brisbane Innovation Park , Nathan , Queensland 4111 , Australia
| | - Sabine Fletcher
- Discovery Biology, Griffith Institute for Drug Discovery , Griffith University , Brisbane Innovation Park , Nathan , Queensland 4111 , Australia
| | - Francis C K Chiu
- Centre for Drug Candidate Optimisation , Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
| | - Scott Blundell
- Centre for Drug Candidate Optimisation , Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
| | - Katherine Ellis
- Drug Delivery Disposition and Dynamics , Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
| | - Stuart A Ralph
- Bio21 Institute , The University of Melbourne , Parkville , Victoria 3052 , Australia
| | - Grennady Wirjanata
- Global and Tropical Health Division , Menzies School of Health Research and Charles Darwin University , Royal Darwin Hospital Campus, Rocklands Drive , Casuarina , Northern Territory 0810 , Australia
| | - Silvia Teguh
- Medicinal Chemistry , Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
| | - Rintis Noviyanti
- Eijkman Institute for Molecular Biology , Jalan Diponegoro 69 , Jakarta 10430 , Indonesia
| | - Marina Chavchich
- The Department of Drug Evaluation , Australian Defence Force Malaria and Infectious Disease Institute , Brisbane , Queensland 4052 , Australia
| | - Darren Creek
- Drug Delivery Disposition and Dynamics , Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
| | - Ric N Price
- Global and Tropical Health Division , Menzies School of Health Research and Charles Darwin University , Royal Darwin Hospital Campus, Rocklands Drive , Casuarina , Northern Territory 0810 , Australia.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine , University of Oxford , Oxford OX3 7LJ , U.K
| | - Jutta Marfurt
- Global and Tropical Health Division , Menzies School of Health Research and Charles Darwin University , Royal Darwin Hospital Campus, Rocklands Drive , Casuarina , Northern Territory 0810 , Australia
| | - Susan A Charman
- Centre for Drug Candidate Optimisation , Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
| | - Matthew E Cuellar
- Institute for Therapeutics Discovery and Development , University of Minnesota , 717 Delaware Street SE , Minneapolis , Minnesota , United States
| | - Jessica M Strasser
- Institute for Therapeutics Discovery and Development , University of Minnesota , 717 Delaware Street SE , Minneapolis , Minnesota , United States
| | - Jayme L Dahlin
- Department of Pathology , Brigham and Women's Hospital , 75 Francis Street , Boston , Massachusetts 02115 , United States
| | - Michael A Walters
- Institute for Therapeutics Discovery and Development , University of Minnesota , 717 Delaware Street SE , Minneapolis , Minnesota , United States
| | - Michael D Edstein
- The Department of Drug Evaluation , Australian Defence Force Malaria and Infectious Disease Institute , Brisbane , Queensland 4052 , Australia
| | - Vicky M Avery
- Discovery Biology, Griffith Institute for Drug Discovery , Griffith University , Brisbane Innovation Park , Nathan , Queensland 4111 , Australia
| | - Jonathan B Baell
- School of Pharmaceutical Sciences , Nanjing Tech University , No. 30 South Puzhu Road , Nanjing 211816 , People's Republic of China.,Medicinal Chemistry , Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus) , 381 Royal Parade , Parkville , Victoria 3052 , Australia
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Phong NC, Chavchich M, Quang HH, San NN, Birrell GW, Chuang I, Martin NJ, Manh ND, Edstein MD. Susceptibility of Plasmodium falciparum to artemisinins and Plasmodium vivax to chloroquine in Phuoc Chien Commune, Ninh Thuan Province, south-central Vietnam. Malar J 2019; 18:10. [PMID: 30654808 PMCID: PMC6335800 DOI: 10.1186/s12936-019-2640-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 01/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reduced artemisinin susceptibility and artemisinin-based combination therapy (ACT)-resistance against Plasmodium falciparum and chloroquine (CQ)-resistant P. vivax malaria has been reported in Vietnam. Two therapeutic efficacy studies were conducted in Thuan Bac District (Ninh Thuan Province, Vietnam) in 2015 and 2016 to determine the extent of reduced artemisinin susceptibility and ACT resistant falciparum malaria, and CQ-resistant vivax malaria were present. METHODS Twenty-seven patients with falciparum malaria were randomized to receive artesunate alone (AS ~ 4 mg/kg/day) for 4 days followed by dihydroartemisinin (DHA) (2.2 mg/kg)-piperaquine (PPQ) (18 mg/kg) daily for 3 days or artemether (AM) (1.7 mg/kg)-lumefantrine (LUM) (12 mg/kg) twice daily for 3 days. Sixteen subjects with vivax malaria received CQ (total 25 mg/kg over 3 days). The therapeutic efficacy study for treating falciparum malaria was complemented with molecular analysis for artemisinin and piperaquine resistance, and in vitro drug susceptibility testing. Patient's drug exposure following both falciparum and vivax treatment studies was determined. RESULTS Twenty-five of 27 patients treated with the artemisinin regimens completed the 42-day follow-up period. None had parasites present on day 3 after commencing treatment with no incidence of recrudescence (100% curative rate). One patient on AS + DHA-PPQ was lost to follow-up and one patient had Plasmodium falciparum and Plasmodium vivax infection on day 0 by PCR. Of the vivax patients, 15 of 16 completed CQ treatment and two had a recurrence of vivax malaria on day 28, a failure rate of 13.3% (2/15). No mutations in the Pfkelch-13 gene for artemisinin resistance or exo-E415G gene polymorphism and amplification in plasmepsins 2 and 3 for piperaquine resistance were observed. In vitro testing of patient's falciparum parasites indicated susceptibility (low IC50 nM values) to dihydroartemisinin, lumefantrine, piperaquine and pyronaridine. Patient's drug exposure to artesunate and lumefantrine was comparable to published data, however, blood CQ concentrations were lower. CONCLUSIONS Clinical findings, molecular analysis and in vitro testing revealed that the falciparum parasites at Phuoc Chien Commune were artemisinin susceptible. The clinical failure rate of the 15 vivax patients who completed CQ treatment was 13%. Further studies are required to determine whether CQ-resistant vivax malaria is present at the commune.
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Affiliation(s)
- Nguyen Chinh Phong
- Vietnam People's Army Military Institute of Preventive Medicine, Hanoi, Vietnam
| | - Marina Chavchich
- Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia
| | - Huynh Hong Quang
- Institute of Malariology, Parasitology and Entomology, Quy Nhon, Vietnam
| | - Nguyen Ngoc San
- Vietnam People's Army Military Institute of Preventive Medicine, Hanoi, Vietnam
| | - Geoffrey W Birrell
- Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia
| | - Ilin Chuang
- Naval Medical Research Center, Silver Spring, USA
| | | | - Nguyen Duc Manh
- Vietnam People's Army Military Institute of Preventive Medicine, Hanoi, Vietnam
| | - Michael D Edstein
- Australian Defence Force Malaria and Infectious Disease Institute, Brisbane, Australia.
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10
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Quang NN, Chavchich M, Anh CX, Birrell GW, van Breda K, Travers T, Rowcliffe K, Edstein MD. Comparison of the Pharmacokinetics and Ex Vivo Antimalarial Activities of Artesunate-Amodiaquine and Artemisinin-Piperaquine in Healthy Volunteers for Preselection Malaria Therapy. Am J Trop Med Hyg 2018; 99:65-72. [PMID: 29741150 DOI: 10.4269/ajtmh.17-0434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The pharmacokinetics (PK) and ex vivo activity (pharmacodynamics [PD]) of two artemisinin combination therapies (ACTs) (artemisinin-piperaquine [ARN-PPQ] [Artequick®] and artesunate-amodiaquine [ARS-AQ] [Coarsucam™]) in healthy Vietnamese volunteers were compared following 3-day courses of the ACTs for the preselection of the drugs for falciparum malaria therapy. For PK analysis, serial plasma samples were collected from two separate groups of 22 volunteers after ACT administration. Of these volunteers, ex vivo activity was assessed in plasma samples from seven volunteers who received both ACTs. The area under the concentration-time curve (AUC0-∞) was 3.6-fold higher for dihydroartemisinin (active metabolite of ARS) than that for ARN, whereas the AUC0-∞ of desethylamodiaquine (active metabolite of AQ) was 2.0-fold lower than that of PPQ. Based on the 50% inhibitory dilution values of the volunteers' plasma samples collected from 0.25 to 3 hours after the last dose, the ex vivo activity of ARS-AQ was 2.9- to 16.2-fold more potent than that of ARN-PPQ against the drug-sensitive D6 Plasmodium falciparum line. In addition, at 1.5, 4.0, and 24 hours after the last dose, the ex vivo activity of ARS-AQ was 20.8-, 3.5-, and 8.5-fold more potent than that of ARN-PPQ against the ARN-sensitive MRA1239 line. By contrast, at 1.5 hours, the ex vivo activity of ARS-AQ was 5.4-fold more active than that of ARN-PPQ but had similar activities at 4 and 24 hours against the ARN-resistant MRA1240 line. The PK-PD data suggest that ARS-AQ possesses superior antimalarial activity than that of ARN-PPQ and would be the preferred ACT for further in vivo efficacy testing in multidrug-resistant falciparum malaria areas.
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Affiliation(s)
- Nguyen Ngoc Quang
- Institute for Clinical Infectious Diseases, Central Military Hospital 108, Hanoi, Vietnam
| | - Marina Chavchich
- Department of Drug Evaluation, Australian Army Malaria Institute, Brisbane, Australia
| | - Chu Xuan Anh
- Institute for Clinical Infectious Diseases, Central Military Hospital 108, Hanoi, Vietnam
| | - Geoffrey W Birrell
- Department of Drug Evaluation, Australian Army Malaria Institute, Brisbane, Australia
| | - Karin van Breda
- Department of Drug Evaluation, Australian Army Malaria Institute, Brisbane, Australia
| | - Thomas Travers
- Department of Drug Evaluation, Australian Army Malaria Institute, Brisbane, Australia
| | - Kerryn Rowcliffe
- Department of Drug Evaluation, Australian Army Malaria Institute, Brisbane, Australia
| | - Michael D Edstein
- Department of Drug Evaluation, Australian Army Malaria Institute, Brisbane, Australia
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11
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Keough DT, Rejman D, Pohl R, Zborníková E, Hocková D, Croll T, Edstein MD, Birrell GW, Chavchich M, Naesens LMJ, Pierens GK, Brereton IM, Guddat LW. Design of Plasmodium vivax Hypoxanthine-Guanine Phosphoribosyltransferase Inhibitors as Potential Antimalarial Therapeutics. ACS Chem Biol 2018; 13:82-90. [PMID: 29161011 DOI: 10.1021/acschembio.7b00916] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Plasmodium falciparum (Pf) and Plasmodium vivax (Pv) are the foremost causative agents of malaria. Due to the development of resistance to current antimalarial medications, new drugs for this parasitic disease need to be discovered. The activity of hypoxanthine-guanine-[xanthine]-phosphoribosyltransferase, HG[X]PRT, is reported to be essential for the growth of both of these parasites, making it an excellent target for antimalarial drug discovery. Here, we have used rational structure-based methods to design an inhibitor, [3R,4R]-4-guanin-9-yl-3-((S)-2-hydroxy-2-phosphonoethyl)oxy-1-N-(phosphonopropionyl)pyrrolidine, of PvHGPRT and PfHGXPRT that has Ki values of 8 and 7 nM, respectively, for these two enzymes. The crystal structure of PvHGPRT in complex with this compound has been determined to 2.85 Å resolution. The corresponding complex with human HGPRT was also obtained to allow a direct comparison of the binding modes of this compound with the two enzymes. The tetra-(ethyl l-phenylalanine) tetraamide prodrug of this compound was synthesized, and it has an IC50 of 11.7 ± 3.2 μM against Pf lines grown in culture and a CC50 in human A549 cell lines of 102 ± 11 μM, thus giving it a ∼10-fold selectivity index.
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Affiliation(s)
- Dianne T. Keough
- School
of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane 4072, Australia
| | - Dominik Rejman
- Institute
of Organic Chemistry and Biochemistry, Czech Academy of Sciences, CZ-166
10 Prague 6, Czech Republic
| | - Radek Pohl
- Institute
of Organic Chemistry and Biochemistry, Czech Academy of Sciences, CZ-166
10 Prague 6, Czech Republic
| | - Eva Zborníková
- Institute
of Organic Chemistry and Biochemistry, Czech Academy of Sciences, CZ-166
10 Prague 6, Czech Republic
| | - Dana Hocková
- Institute
of Organic Chemistry and Biochemistry, Czech Academy of Sciences, CZ-166
10 Prague 6, Czech Republic
| | - Tristan Croll
- Institute
of Health and Biomedical Innovation, Queensland University of Technology, 2 George St, Brisbane 4000, Australia
| | - Michael D. Edstein
- Department
of Drug Evaluation, Australian Army Malaria Institute, Enoggera 4051, Australia
| | - Geoff W. Birrell
- Department
of Drug Evaluation, Australian Army Malaria Institute, Enoggera 4051, Australia
| | - Marina Chavchich
- Department
of Drug Evaluation, Australian Army Malaria Institute, Enoggera 4051, Australia
| | - Lieve M. J. Naesens
- Rega
Institute for Medical Research, Katholique University, Minderbroedersstraat 10, B-3000 Leuven, Belgium
| | - Gregory K. Pierens
- Centre for
Advanced Imaging, The University of Queensland, St Lucia 4072, Australia
| | - Ian M. Brereton
- Centre for
Advanced Imaging, The University of Queensland, St Lucia 4072, Australia
| | - Luke W. Guddat
- School
of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane 4072, Australia
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12
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Špaček P, Keough DT, Chavchich M, Dračínský M, Janeba Z, Naesens L, Edstein MD, Guddat LW, Hocková D. Synthesis and Evaluation of Asymmetric Acyclic Nucleoside Bisphosphonates as Inhibitors of Plasmodium falciparum and Human Hypoxanthine–Guanine–(Xanthine) Phosphoribosyltransferase. J Med Chem 2017; 60:7539-7554. [DOI: 10.1021/acs.jmedchem.7b00926] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Petr Špaček
- The Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Flemingovo
nám. 2, CZ-16610 Prague 6, Czech Republic
| | - Dianne T. Keough
- School
of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4068, Australia
| | - Marina Chavchich
- Department
of Drug Evaluation, Australian Army Malaria Institute, Enoggera, Brisbane, Queensland 4051, Australia
| | - Martin Dračínský
- The Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Flemingovo
nám. 2, CZ-16610 Prague 6, Czech Republic
| | - Zlatko Janeba
- The Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Flemingovo
nám. 2, CZ-16610 Prague 6, Czech Republic
| | - Lieve Naesens
- Laboratory
of Virology and Chemotherapy, Rega Institute for Medical Research—KU Leuven, Herestraat 49, B-3000 Leuven, Belgium
| | - Michael D. Edstein
- Department
of Drug Evaluation, Australian Army Malaria Institute, Enoggera, Brisbane, Queensland 4051, Australia
| | - Luke W. Guddat
- School
of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4068, Australia
| | - Dana Hocková
- The Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Flemingovo
nám. 2, CZ-16610 Prague 6, Czech Republic
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13
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Dembele L, Ang X, Chavchich M, Bonamy GMC, Selva JJ, Lim MYX, Bodenreider C, Yeung BKS, Nosten F, Russell BM, Edstein MD, Straimer J, Fidock DA, Diagana TT, Bifani P. The Plasmodium PI(4)K inhibitor KDU691 selectively inhibits dihydroartemisinin-pretreated Plasmodium falciparum ring-stage parasites. Sci Rep 2017; 7:2325. [PMID: 28539634 PMCID: PMC5443816 DOI: 10.1038/s41598-017-02440-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/11/2017] [Indexed: 11/23/2022] Open
Abstract
Malaria control and elimination are threatened by the emergence and spread of resistance to artemisinin-based combination therapies (ACTs). Experimental evidence suggests that when an artemisinin (ART)-sensitive (K13 wild-type) Plasmodium falciparum strain is exposed to ART derivatives such as dihydroartemisinin (DHA), a small population of the early ring-stage parasites can survive drug treatment by entering cell cycle arrest or dormancy. After drug removal, these parasites can resume growth. Dormancy has been hypothesized to be an adaptive physiological mechanism that has been linked to recrudescence of parasites after monotherapy with ART and, possibly contributes to ART resistance. Here, we evaluate the in vitro drug sensitivity profile of normally-developing P. falciparum ring stages and DHA-pretreated dormant rings (DP-rings) using a panel of antimalarial drugs, including the Plasmodium phosphatidylinositol-4-OH kinase (PI4K)-specific inhibitor KDU691. We report that while KDU691 shows no activity against rings, it is highly inhibitory against DP-rings; a drug effect opposite to that of ART. Moreover, we provide evidence that KDU691 also kills DP-rings of P. falciparum ART-resistant strains expressing mutant K13.
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Affiliation(s)
- L Dembele
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01 Chromos, 138670, Singapore, Singapore
| | - X Ang
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01 Chromos, 138670, Singapore, Singapore
| | - M Chavchich
- Department of Drug Evaluation, Australian Army Malaria Institute, Brisbane, QLD, 4051, Australia
| | - G M C Bonamy
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01 Chromos, 138670, Singapore, Singapore
| | - J J Selva
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01 Chromos, 138670, Singapore, Singapore
| | - M Yi-Xiu Lim
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01 Chromos, 138670, Singapore, Singapore
| | - C Bodenreider
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01 Chromos, 138670, Singapore, Singapore
| | - B K S Yeung
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01 Chromos, 138670, Singapore, Singapore
| | - F Nosten
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - B M Russell
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | - M D Edstein
- Department of Drug Evaluation, Australian Army Malaria Institute, Brisbane, QLD, 4051, Australia
| | - J Straimer
- Department of Microbiology and Immunology, Columbia University Medical Center, New York, NY, 10032, USA
| | - D A Fidock
- Department of Microbiology and Immunology, Columbia University Medical Center, New York, NY, 10032, USA.,Division of Infectious Diseases, Department of Medicine, Columbia University Medical Center, New York, NY, 10032, USA
| | - T T Diagana
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01 Chromos, 138670, Singapore, Singapore
| | - P Bifani
- Novartis Institute for Tropical Diseases, 10 Biopolis Road, #05-01 Chromos, 138670, Singapore, Singapore. .,Department of Microbiology and Immunology Program, Yong Loo Lin School of Medicine, Life Sciences Institute, National University of Singapore, 119077, Singapore, Singapore.
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14
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Phong NC, Quang HH, Thanh NX, Trung TN, Dai B, Shanks GD, Chavchich M, Edstein MD. In Vivo Efficacy and Tolerability of Artesunate-Azithromycin for the Treatment of Falciparum Malaria in Vietnam. Am J Trop Med Hyg 2016; 95:164-7. [PMID: 27215294 DOI: 10.4269/ajtmh.16-0144] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 04/04/2016] [Indexed: 11/07/2022] Open
Abstract
Safe and effective antimalarial drugs are required for the treatment of pregnant women. We report a 3-day regimen of artesunate (4 mg/kg/day)-azithromycin (25 mg/kg/day) (ASAZ) to be efficacious (polymerase chain reaction-corrected cure rate of 96.7%) and well tolerated in the treatment of Plasmodium falciparum malaria in children (N = 11) and adults (N = 19), in Vietnam in 2010. In comparison, the cure rate for artesunate (4 mg/kg on day 0, 2 mg/kg on days 1-6) was 90.0% in children (N = 7) and adults (N = 23). Because azithromycin is considered safe in pregnancy, our findings provide further evidence that ASAZ should be evaluated for the treatment of pregnant women with malaria.
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Affiliation(s)
- Nguyen Chinh Phong
- Malaria Department, Military Institute of Preventive Medicine, Hanoi, Vietnam
| | - Huynh Hong Quang
- Malaria Department, Institute of Malariology, Parasitology and Entomology, Quy Nhon, Vietnam
| | - Nguyen Xuan Thanh
- Malaria Department, Military Institute of Preventive Medicine, Hanoi, Vietnam
| | - Trieu Nguyen Trung
- Malaria Department, Institute of Malariology, Parasitology and Entomology, Quy Nhon, Vietnam
| | - Bui Dai
- Malaria Department, Military Institute of Preventive Medicine, Hanoi, Vietnam
| | - G Dennis Shanks
- Department of Drug Evaluation, Australian Army Malaria Institute, Brisbane, Australia
| | - Marina Chavchich
- Department of Drug Evaluation, Australian Army Malaria Institute, Brisbane, Australia
| | - Michael D Edstein
- Department of Drug Evaluation, Australian Army Malaria Institute, Brisbane, Australia.
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15
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Gray KA, Gresty KJ, Chen N, Zhang V, Gutteridge CE, Peatey CL, Chavchich M, Waters NC, Cheng Q. Correlation between Cyclin Dependent Kinases and Artemisinin-Induced Dormancy in Plasmodium falciparum In Vitro. PLoS One 2016; 11:e0157906. [PMID: 27326764 PMCID: PMC4915707 DOI: 10.1371/journal.pone.0157906] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 06/07/2016] [Indexed: 12/02/2022] Open
Abstract
Background Artemisinin-induced dormancy provides a plausible explanation for recrudescence following artemisinin monotherapy. This phenomenon shares similarities with cell cycle arrest where cyclin dependent kinases (CDKs) and cyclins play an important role. Methods Transcription profiles of Plasmodium falciparum CDKs and cyclins before and after dihydroartemisinin (DHA) treatment in three parasite lines, and the effect of CDK inhibitors on parasite recovery from DHA-induced dormancy were investigated. Results After DHA treatment, parasites enter a dormancy phase followed by a recovery phase. During the dormancy phase parasites up-regulate pfcrk1, pfcrk4, pfcyc2 and pfcyc4, and down-regulate pfmrk, pfpk5, pfpk6, pfcrk3, pfcyc1 and pfcyc3. When entering the recovery phase parasites immediately up-regulate all CDK and cyclin genes. Three CDK inhibitors, olomoucine, WR636638 and roscovitine, produced distinct effects on different phases of DHA-induced dormancy, blocking parasites recovery. Conclusions The up-regulation of PfCRK1 and PfCRK4, and down regulation of other CDKs and cyclins correlate with parasite survival in the dormant state. Changes in CDK expression are likely to negatively regulate parasite progression from G1 to S phase. These findings provide new insights into the mechanism of artemisinin-induced dormancy and cell cycle regulation of P. falciparum, opening new opportunities for preventing recrudescence following artemisinin treatment.
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Affiliation(s)
- Karen-Ann Gray
- Drug Resistance and Diagnostics, Australian Army Malaria Institute, Brisbane, Australia
- Clinical Tropical Medicine, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Karryn J. Gresty
- Drug Resistance and Diagnostics, Australian Army Malaria Institute, Brisbane, Australia
- Clinical Tropical Medicine, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Nanhua Chen
- Drug Resistance and Diagnostics, Australian Army Malaria Institute, Brisbane, Australia
| | - Veronica Zhang
- Drug Resistance and Diagnostics, Australian Army Malaria Institute, Brisbane, Australia
- School of Biochemistry, University of Queensland, Brisbane, Australia
| | | | - Christopher L. Peatey
- Drug Resistance and Diagnostics, Australian Army Malaria Institute, Brisbane, Australia
- Clinical Tropical Medicine, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Marina Chavchich
- Drug Resistance and Diagnostics, Australian Army Malaria Institute, Brisbane, Australia
| | - Norman C. Waters
- Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America
- * E-mail: (QC); (NW)
| | - Qin Cheng
- Drug Resistance and Diagnostics, Australian Army Malaria Institute, Brisbane, Australia
- Clinical Tropical Medicine, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- * E-mail: (QC); (NW)
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16
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Kaiser MM, Hocková D, Wang TH, Dračínský M, Poštová-Slavětínská L, Procházková E, Edstein MD, Chavchich M, Keough DT, Guddat LW, Janeba Z. Cover Picture: Synthesis and Evaluation of Novel Acyclic Nucleoside Phosphonates as Inhibitors of Plasmodium falciparumand Human 6-Oxopurine Phosphoribosyltransferases (ChemMedChem 10/2015). ChemMedChem 2015. [DOI: 10.1002/cmdc.201500388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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17
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Kaiser MM, Hocková D, Wang TH, Dračínský M, Poštová-Slavětínská L, Procházková E, Edstein MD, Chavchich M, Keough DT, Guddat LW, Janeba Z. Synthesis and Evaluation of Novel Acyclic Nucleoside Phosphonates as Inhibitors ofPlasmodium falciparumand Human 6-Oxopurine Phosphoribosyltransferases. ChemMedChem 2015; 10:1707-23. [DOI: 10.1002/cmdc.201500322] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Indexed: 11/09/2022]
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18
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Hocková D, Janeba Z, Naesens L, Edstein MD, Chavchich M, Keough DT, Guddat LW. Antimalarial activity of prodrugs of N-branched acyclic nucleoside phosphonate inhibitors of 6-oxopurine phosphoribosyltransferases. Bioorg Med Chem 2015; 23:5502-10. [PMID: 26275679 DOI: 10.1016/j.bmc.2015.07.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 07/17/2015] [Accepted: 07/19/2015] [Indexed: 11/25/2022]
Abstract
Acyclic nucleoside phosphonates (ANPs) that contain a 6-oxopurine base are good inhibitors of the human and Plasmodium falciparum 6-oxopurine phosphoribosyltransferases (PRTs), key enzymes of the purine salvage pathway. Chemical modifications, based on the crystal structures of several inhibitors in complex with the human PRTase, led to the design of a new class of inhibitors--the aza-ANPs. Because of the negative charges of the phosphonic acid moiety, their ability to cross cell membranes is, however, limited. Thus, phosphoramidate prodrugs of the aza-ANPs were prepared to improve permeability. These prodrugs arrest parasitemia with IC50 values in the micromolar range against Plasmodium falciparum-infected erythrocyte cultures (both chloroquine-sensitive and chloroquine-resistant Pf strains). The prodrugs exhibit low cytotoxicity in several human cell lines. Thus, they fulfill two essential criteria to qualify them as promising antimalarial drug leads.
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Affiliation(s)
- Dana Hocková
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, v.v.i. Flemingovo nám. 2, CZ-166 10 Prague 6, Czech Republic.
| | - Zlatko Janeba
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, v.v.i. Flemingovo nám. 2, CZ-166 10 Prague 6, Czech Republic
| | - Lieve Naesens
- Rega Institute for Medical Research, KU Leuven-University of Leuven, Minderbroedersstraat 10, B-3000 Leuven, Belgium
| | - Michael D Edstein
- Department of Drug Evaluation, Australian Army Malaria Institute, Enoggera, Brisbane, QLD 4051, Australia
| | - Marina Chavchich
- Department of Drug Evaluation, Australian Army Malaria Institute, Enoggera, Brisbane, QLD 4051, Australia
| | - Dianne T Keough
- The School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane 4072, QLD, Australia
| | - Luke W Guddat
- The School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane 4072, QLD, Australia.
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19
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Stanisic DI, Liu XQ, De SL, Batzloff MR, Forbes T, Davis CB, Sekuloski S, Chavchich M, Chung W, Trenholme K, McCarthy JS, Li T, Sim BKL, Hoffman SL, Good MF. Development of cultured Plasmodium falciparum blood-stage malaria cell banks for early phase in vivo clinical trial assessment of anti-malaria drugs and vaccines. Malar J 2015; 14:143. [PMID: 25890156 PMCID: PMC4392471 DOI: 10.1186/s12936-015-0663-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 03/24/2015] [Indexed: 11/18/2022] Open
Abstract
Background The ability to undertake controlled human malaria infection (CHMI) studies for preliminary evaluation of malaria vaccine candidates and anti-malaria drug efficacy has been limited by the need for access to sporozoite infected mosquitoes, aseptic, purified, cryopreserved sporozoites or blood-stage malaria parasites derived ex vivo from malaria infected individuals. Three different strategies are described for the manufacture of clinical grade cultured malaria cell banks suitable for use in CHMI studies. Methods Good Manufacturing Practices (GMP)-grade Plasmodium falciparum NF54, clinically isolated 3D7, and research-grade P. falciparum 7G8 blood-stage malaria parasites were cultured separately in GMP-compliant facilities using screened blood components and then cryopreserved to produce three P. falciparum blood-stage malaria cell banks. These cell banks were evaluated according to specific criteria (parasitaemia, identity, viability, sterility, presence of endotoxin, presence of mycoplasma or other viral agents and in vitro anti-malarial drug sensitivity of the cell bank malaria parasites) to ensure they met the criteria to permit product release according to GMP requirements. Results The P. falciparum NF54, 3D7 and 7G8 cell banks consisted of >78% ring stage parasites with a ring stage parasitaemia of >1.4%. Parasites were viable in vitro following thawing. The cell banks were free from contamination with bacteria, mycoplasma and a broad panel of viruses. The P. falciparum NF54, 3D7 and 7G8 parasites exhibited differential anti-malarial drug susceptibilities. The P. falciparum NF54 and 3D7 parasites were susceptible to all anti-malaria compounds tested, whereas the P. falciparum 7G8 parasites were resistant/had decreased susceptibility to four compounds. Following testing, all defined release criteria were met and the P. falciparum cell banks were deemed suitable for release. Ethical approval has been obtained for administration to human volunteers. Conclusions The production of cultured P. falciparum blood-stage malaria cell banks represents a suitable approach for the generation of material suitable for CHMI studies. A key feature of this culture-based approach is the ability to take research-grade material through to a product suitable for administration in clinical trials. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-0663-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Xue Q Liu
- Institute for Glycomics, Griffith University, Southport, QLD, Australia.
| | - Sai Lata De
- Institute for Glycomics, Griffith University, Southport, QLD, Australia.
| | - Michael R Batzloff
- Institute for Glycomics, Griffith University, Southport, QLD, Australia.
| | - Tanya Forbes
- Institute for Glycomics, Griffith University, Southport, QLD, Australia.
| | | | - Silvana Sekuloski
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, University of Queensland, Herston, Australia.
| | | | - Wendy Chung
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, University of Queensland, Herston, Australia.
| | - Katharine Trenholme
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, University of Queensland, Herston, Australia.
| | - James S McCarthy
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, University of Queensland, Herston, Australia.
| | - Tao Li
- Sanaria Inc, Rockville, MD, USA.
| | | | | | - Michael F Good
- Institute for Glycomics, Griffith University, Southport, QLD, Australia.
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Peatey CL, Chavchich M, Chen N, Gresty KJ, Gray KA, Gatton ML, Waters NC, Cheng Q. Mitochondrial Membrane Potential in a Small Subset of Artemisinin-Induced Dormant Plasmodium falciparum Parasites In Vitro. J Infect Dis 2015; 212:426-34. [PMID: 25635122 DOI: 10.1093/infdis/jiv048] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 01/20/2015] [Indexed: 11/12/2022] Open
Abstract
Artemisinin-induced dormancy is a proposed mechanism for failures of monotherapy and is linked with artemisinin resistance in Plasmodium falciparum. The biological characterization and dynamics of dormant parasites are not well understood. Here we report that after dihydroartemisinin treatment in vitro, a small subset of morphologically dormant parasites was stained with rhodamine 123 (RH), a mitochondrial membrane potential marker, and persisted to recovery. RH-positive parasites sorted with fluorescence-activated cell sorting resumed growth at 10,000/well whereas RH-negative parasites failed to recover at 5 million/well. Furthermore, transcriptional activity for mitochondrial enzymes was detected only in RH-positive dormant parasites. Importantly, after treatment of dormant parasites with different concentrations of atovaquone, a mitochondrial inhibitor, the recovery of dormant parasites was delayed or stopped. This demonstrates that mitochondrial activity is critical for survival and regrowth of dormant parasites and that RH staining provides a means of identifying these parasites. These findings provide novel paths for studying and eradicating this dormant stage.
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Affiliation(s)
- Christopher L Peatey
- Drug Resistance and Diagnostics, Australian Army Malaria Institute Clinical Tropical Medicine, QIMR Berghofer Medical Research Institute
| | - Marina Chavchich
- Drug Resistance and Diagnostics, Australian Army Malaria Institute
| | - Nanhua Chen
- Drug Resistance and Diagnostics, Australian Army Malaria Institute
| | - Karryn J Gresty
- Drug Resistance and Diagnostics, Australian Army Malaria Institute Clinical Tropical Medicine, QIMR Berghofer Medical Research Institute
| | - Karen-Ann Gray
- Drug Resistance and Diagnostics, Australian Army Malaria Institute Clinical Tropical Medicine, QIMR Berghofer Medical Research Institute
| | - Michelle L Gatton
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Norman C Waters
- Walter Reed Army Institute of Research, Malaria Vaccine Branch, Military Malaria Research Program, Silver Spring, Maryland
| | - Qin Cheng
- Drug Resistance and Diagnostics, Australian Army Malaria Institute Clinical Tropical Medicine, QIMR Berghofer Medical Research Institute
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Keough DT, Hocková D, Janeba Z, Wang TH, Naesens L, Edstein MD, Chavchich M, Guddat LW. Aza-acyclic Nucleoside Phosphonates Containing a Second Phosphonate Group As Inhibitors of the Human, Plasmodium falciparum and vivax 6-Oxopurine Phosphoribosyltransferases and Their Prodrugs As Antimalarial Agents. J Med Chem 2014; 58:827-46. [DOI: 10.1021/jm501416t] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Dianne T. Keough
- The School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane 4072, Queensland Australia
| | - Dana Hocková
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, v.v.i. Flemingovo nám. 2, CZ-166 10 Prague 6, Czech Republic
| | - Zlatko Janeba
- Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech Republic, v.v.i. Flemingovo nám. 2, CZ-166 10 Prague 6, Czech Republic
| | - Tzu-Hsuan Wang
- The School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane 4072, Queensland Australia
| | - Lieve Naesens
- Rega Institute for Medical Research, KU Leuven—University of Leuven, Minderbroedersstraat 10, B-3000 Leuven, Belgium
| | - Michael D. Edstein
- Department of Drug Evaluation, Australian Army Malaria Institute, Enoggera, Brisbane, Queensland 4051, Australia
| | - Marina Chavchich
- Department of Drug Evaluation, Australian Army Malaria Institute, Enoggera, Brisbane, Queensland 4051, Australia
| | - Luke W. Guddat
- The School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane 4072, Queensland Australia
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Keough D, Špaček P, Hocková D, Tichý T, Vrbková S, Slavětínská L, Janeba Z, Naesens L, Edstein M, Chavchich M, Wang T, de Jersey J, Guddat L. Acyclic nucleoside phosphonates containing a second phosphonate group are potent inhibitors of the 6-oxopurine phosphoribosyltransferases and have antimalarial activity. Malar J 2014. [PMCID: PMC4179476 DOI: 10.1186/1475-2875-13-s1-p91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Keough DT, Špaček P, Hocková D, Tichý T, Vrbková S, Slavětínská L, Janeba Z, Naesens L, Edstein MD, Chavchich M, Wang TH, de Jersey J, Guddat LW. Acyclic Nucleoside Phosphonates Containing a Second Phosphonate Group Are Potent Inhibitors of 6-Oxopurine Phosphoribosyltransferases and Have Antimalarial Activity. J Med Chem 2013; 56:2513-26. [DOI: 10.1021/jm301893b] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Dianne T. Keough
- The School of Chemistry and
Molecular Biosciences, The University of Queensland, Brisbane 4072, Queensland, Australia
| | - Petr Špaček
- Institute of Organic Chemistry
and Biochemistry, Academy of Sciences of the Czech Republic, v.v.i. Flemingovo nám. 2, CZ-166 10 Prague 6, Czech Republic
| | - Dana Hocková
- Institute of Organic Chemistry
and Biochemistry, Academy of Sciences of the Czech Republic, v.v.i. Flemingovo nám. 2, CZ-166 10 Prague 6, Czech Republic
| | - Tomáš Tichý
- Institute of Organic Chemistry
and Biochemistry, Academy of Sciences of the Czech Republic, v.v.i. Flemingovo nám. 2, CZ-166 10 Prague 6, Czech Republic
| | - Silvie Vrbková
- Institute of Organic Chemistry
and Biochemistry, Academy of Sciences of the Czech Republic, v.v.i. Flemingovo nám. 2, CZ-166 10 Prague 6, Czech Republic
| | - Lenka Slavětínská
- Institute of Organic Chemistry
and Biochemistry, Academy of Sciences of the Czech Republic, v.v.i. Flemingovo nám. 2, CZ-166 10 Prague 6, Czech Republic
| | - Zlatko Janeba
- Institute of Organic Chemistry
and Biochemistry, Academy of Sciences of the Czech Republic, v.v.i. Flemingovo nám. 2, CZ-166 10 Prague 6, Czech Republic
| | - Lieve Naesens
- Rega Institute for Medical Research, Katholieke Universiteit Leuven, Minderbroedersstraat
10, B-3000 Leuven, Belgium
| | - Michael D. Edstein
- Australian Army Malaria Institute, Enoggera, Brisbane, Queensland 4051,
Australia
| | - Marina Chavchich
- Australian Army Malaria Institute, Enoggera, Brisbane, Queensland 4051,
Australia
| | - Tzu-Hsuan Wang
- The School of Chemistry and
Molecular Biosciences, The University of Queensland, Brisbane 4072, Queensland, Australia
| | - John de Jersey
- The School of Chemistry and
Molecular Biosciences, The University of Queensland, Brisbane 4072, Queensland, Australia
| | - Luke W. Guddat
- The School of Chemistry and
Molecular Biosciences, The University of Queensland, Brisbane 4072, Queensland, Australia
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Thanh NX, Trung TN, Phong NC, Quang HH, Dai B, Shanks GD, Chavchich M, Edstein MD. The efficacy and tolerability of artemisinin-piperaquine (Artequick®) versus artesunate-amodiaquine (Coarsucam™) for the treatment of uncomplicated Plasmodium falciparum malaria in south-central Vietnam. Malar J 2012; 11:217. [PMID: 22741618 PMCID: PMC3411481 DOI: 10.1186/1475-2875-11-217] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 06/28/2012] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND In Vietnam, the artemisinin-based combination therapy (ACT) of dihydroartemisinin-piperaquine is currently used for first-line treatment of uncomplicated Plasmodium falciparum malaria. However, limited efficacy and tolerability data are available on alternative forms of ACT in Vietnam in case there is a reduction in the susceptibility of dihydroartemisinin-piperaquine. A study was conducted to compare the efficacy and tolerability of two fixed-dose formulations of ACT, artemisinin-piperaquine (Artequick®, ARPQ) and artesunate-amodiaquine (Coarsucam™, ASAQ) for the treatment of P. falciparum malaria in south-central Vietnam. METHODS A randomized, open-label trial was conducted comparing the efficacy of a two-day regimen of ARPQ (~2.8 mg/kg artemisinin plus ~17.1 mg/kg of piperaquine per day) and a three-day regimen of ASAQ (~4.7 mg/kg of artesunate plus ~12.6 mg/kg of amodiaquine per day) for the treatment of children and adults with uncomplicated falciparum malaria. Primary efficacy endpoint was day 42, PCR-corrected, parasitological cure rate. Secondary endpoints were parasite and fever clearance times and tolerability. RESULTS Of 128 patients enrolled, 63 were administered ARPQ and 65 ASAQ. Of the patients who completed the 42 days follow-up period or had a recurrence of malaria, 55 were on ARPQ (30 children, 25 adults) and 59 were on ASAQ (31 children, 28 adults). Recrudescent parasitaemia was PCR-confirmed for one patient in each treatment group, with cure rates at day 42 of 98% (95% CI: 88-100) for both forms of ACT. The median parasite clearance time was significantly slower in the ARPQ group compared with the ASAQ group (48 h vs. 36 h, P<0.001) and fever clearance times were shorter in the ASAQ group (12 h vs. 24 h, P=0.07). The two forms of ACT were well tolerated with no serious adverse events. CONCLUSION Both forms of ACT were highly efficacious in the treatment of uncomplicated P. falciparum malaria. Although the two-day course of ARPQ was equally as effective as the three-day course of ASAQ, parasite and fever clearance times were shorter with ASAQ. Further studies are warranted in different regions of Vietnam to determine the nationwide efficacy of ASAQ. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry Number, ACTRN12609000816257.
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M. Zhang V, Chavchich M, C. Waters N. Targeting Protein Kinases in the Malaria Parasite: Update of an Antimalarial Drug Target. Curr Top Med Chem 2012; 12:456-72. [DOI: 10.2174/156802612799362922] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 10/17/2011] [Accepted: 10/18/2011] [Indexed: 11/22/2022]
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Ovenden SPB, Cobbe M, Kissell R, Birrell GW, Chavchich M, Edstein MD. Phenolic glycosides with antimalarial activity from Grevillea "Poorinda Queen". J Nat Prod 2011; 74:74-78. [PMID: 21155593 DOI: 10.1021/np100737q] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In search of new antimalarial compounds, three new phenolic glycosides, robustasides E (1), F (2), and G (3), in addition to the known compounds robustaside D (4) and quercetin-7-O-[α-l-rhamnopyranosyl(1→6)-β-d-galactopyranoside] (5), were identified during chemical investigations of the MeOH extract from the leaves and twigs of Grevillea "Poorinda Queen". The chemical structures of the new compounds were elucidated through 2D NMR spectroscopy, while the absolute configuration of the sugar was elucidated through chemical degradation and comparison with an authentic standard. Discussed in detail are the isolation and structure elucidation of 1-3, as well as the associated in vitro anitmalarial activities for 1-5. Also discussed are the in vivo anitmalarial and in vitro cytotoxic activities for 1, 3, and 4.
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Affiliation(s)
- Simon P B Ovenden
- Defence Science and Technology Organisation, 506 Lorimer Street, Fishermans Bend, Victoria, 3207, Australia.
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27
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Kozlov S, Waters NC, Chavchich M. Leveraging cell cycle analysis in anticancer drug discovery to identify novel plasmodial drug targets. Infect Disord Drug Targets 2010; 10:165-90. [PMID: 20334621 DOI: 10.2174/187152610791163354] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Accepted: 02/12/2010] [Indexed: 11/22/2022]
Abstract
Cancer and malaria are life threatening diseases killing millions of people each year. In spite of our best efforts, both continue to resist full control and eradication. If untreated, both malaria and cancer can lead to death. Only a few antimalarial drugs have been developed over the last decades and new drugs are urgently needed to combat drug-resistant parasites. Significant progress has been made in understanding the molecular mechanisms of cancer and designing new anticancer therapies. However, similar to malaria, majority of cancers quickly develop resistance to single target-based therapy. Novel cancer therapeutics are being developed with the aim of targeting multiple signalling pathways in tumour cells, an approach that may be applicable to antimalarial therapy. In this review we compare cell signalling pathways targeted by cancer drugs with similar pathways in the malaria parasite. We placed particular emphasis on cell cycle regulation and cell cycle checkpoints since the associated molecular machinery controlling these processes are conserved in Plasmodium. Furthermore, a large number of cancer drugs target cell cycle control mechanisms and, therefore, these compounds may possess antimalarial activity. We tried to demonstrate that promising areas of anticancer drug development can be incorporated in the existing antimalarial drug discovery program as well as deepen our understanding of parasite biology.
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Affiliation(s)
- Sergei Kozlov
- Radiation Biology and Oncology, Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Queensland, 4029, Australia
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Thanh NX, Trung TN, Phong NC, Thien NX, Dai B, Dennis Shanks G, Chavchich M, Edstein MD. Open label randomized comparison of dihydroartemisinin-piperaquine and artesunate-amodiaquine for the treatment of uncomplicatedPlasmodium falciparummalaria in central Vietnam. Trop Med Int Health 2009; 14:504-11. [DOI: 10.1111/j.1365-3156.2009.02269.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Suwanarusk R, Chavchich M, Russell B, Jaidee A, Chalfein F, Barends M, Prasetyorini B, Kenangalem E, Piera KA, Lek-Uthai U, Anstey NM, Tjitra E, Nosten F, Cheng Q, Price RN. Amplification of pvmdr1 associated with multidrug-resistant Plasmodium vivax. J Infect Dis 2009; 198:1558-64. [PMID: 18808339 DOI: 10.1086/592451] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Multidrug-resistant strains of Plasmodium vivax are emerging in Southeast Asia. METHODS In vitro drug susceptibility and pvmdr1 genotype were determined in P. vivax field isolates from Indonesia and Thailand. RESULTS Increased pvmdr1 copy number was present in 21% of isolates from Thailand (15/71) and none from Indonesia (0/114; P < .001). Compared with Indonesian isolates, the median IC(50) of Thai isolates was lower for chloroquine (36 vs. 114 nmol/L; P < .001) but higher for amodiaquine (34 vs. 13.7 nmol/L; P = .032), artesunate (8.33 vs. 1.58 nmol/L; P < .001), and mefloquine (111 vs. 9.87 nmol/L; P < .001). In 11 cryopreserved Thai isolates, those with increased pvmdr1 copy number had a higher IC(50) for mefloquine (78.6 vs. 38 nmol/L for single-copy isolates; P = .006). Compared with isolates with the wild-type allele, the Y976F mutation of pvmdr1 was associated with reduced susceptibility to chloroquine (154 nmol/L [range, 4.6-3505] vs. 34 nmol/L [range, 6.7-149]; P < .001) but greater susceptibility to artesunate (1.8 vs. 9.5 nmol/L; P = .009) and mefloquine (14 vs. 121 nmol/L; P < .001). CONCLUSIONS Amplification of pvmdr1 and single-nucleotide polymorphisms are correlated with susceptibility of P. vivax to multiple antimalarial drugs. Chloroquine and mefloquine appear to exert competitive evolutionary pressure on pvmdr1, similar to that observed with pfmdr1 in Plasmodium falciparum.
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Affiliation(s)
- R Suwanarusk
- International Health Division, Menzies School of Health Research, Darwin, Australia
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Suwanarusk R, Russell B, Chavchich M, Chalfein F, Kenangalem E, Kosaisavee V, Prasetyorini B, Piera KA, Barends M, Brockman A, Lek-Uthai U, Anstey NM, Tjitra E, Nosten F, Cheng Q, Price RN. Chloroquine resistant Plasmodium vivax: in vitro characterisation and association with molecular polymorphisms. PLoS One 2007; 2:e1089. [PMID: 17971853 PMCID: PMC2034531 DOI: 10.1371/journal.pone.0001089] [Citation(s) in RCA: 162] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Accepted: 10/05/2007] [Indexed: 11/19/2022] Open
Abstract
Background Treatment failure of chloroquine for P. vivax infections has reached high levels in the eastern provinces of Indonesia, however, in vitro characterization of chloroquine resistance and its associated molecular profile have yet to be determined. Methods Using a modified schizont maturation assay we investigated the in vitro chloroquine susceptibility profile and molecular polymorphisms of P. vivax isolates collected from Papua, Indonesia, where high levels of clinical chloroquine treatment failure have been reported, and from Thailand, where chloroquine treatment is generally effective. Results The geometric mean chloroquine IC50 for P. vivax isolates from Papua (n = 145) was 312 nM [95%CI: 237–411 nM] compared to 46.8 nM [95%CI: 34.7–63.1 nM] from Thailand (n = 81); p<0.001. Correlating with the known clinical efficacy of the area, a cut off for chloroquine resistance was defined as 220nM, a level exceeded in 13.6% (11/81) of Thai isolates and 65% (94/145) of Papuan isolates; p<0.001. Several sequence polymorphisms in pvcrt-o and pvmdr1, and difference in pvmdr1 copy number were identified. A Y976F mutation in pvmdr1 was present in 96% (123/128) of Papuan isolates and 25% (17/69) of Thai isolates; p<0.001. Overall, the geometric mean chloroquine IC50 in isolates with the Y976F mutation was 283 nM [95%CI: 211–379], compared to 44.5 nM [95%CI: 31.3–63.4] in isolates with the wild type; p< 0.001. Pvmdr1 amplification occurred in 23% (15/66) of Thai isolates compared to none (0/104) of Indonesian isolates (p<0.001), but was not associated with increased chloroquine resistance after controlling for geographical location. Conclusions In vitro susceptibility testing of P. vivax discriminates between populations with differing levels of clinical efficacy of chloroquine. The pvmdr1 polymorphism at Y976F may provide a useful tool to highlight areas of emerging chloroquine resistance, although further studies defining its clinical correlates are needed.
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Affiliation(s)
- Rossarin Suwanarusk
- International Health Program, Infectious Diseases Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Bruce Russell
- International Health Program, Infectious Diseases Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Marina Chavchich
- Department of Drug Resistance and Diagnostics, Australian Army Malaria Institute, Brisbane, Australia
| | - Ferryanto Chalfein
- National Institute of Health Research and Development and Menzies School of Health Malaria Research Program, Timika, Indonesia
| | - Enny Kenangalem
- National Institute of Health Research and Development and Menzies School of Health Malaria Research Program, Timika, Indonesia
- District Ministry of Health, Timika, Papua, Indonesia
| | - Varakorn Kosaisavee
- Department of Parasitology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Budi Prasetyorini
- National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
| | - Kim A. Piera
- International Health Program, Infectious Diseases Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Marion Barends
- Shoklo Malaria Research Unit, Mae Sod, Tak Province, Thailand
| | - Alan Brockman
- International Health Program, Infectious Diseases Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Usa Lek-Uthai
- Department of Parasitology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Nicholas M. Anstey
- International Health Program, Infectious Diseases Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Emiliana Tjitra
- National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
| | - François Nosten
- Faculty of Tropical Medicine, Mahidol University, Bangkok Thailand
- Shoklo Malaria Research Unit, Mae Sod, Tak Province, Thailand
| | - Qin Cheng
- Department of Drug Resistance and Diagnostics, Australian Army Malaria Institute, Brisbane, Australia
| | - Ric N. Price
- International Health Program, Infectious Diseases Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia
- Centre for Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Oxford, United Kingdom
- * To whom correspondence should be addressed. E-mail:
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Dao NVH, Cuong BT, Ngoa ND, Thuy LTT, The ND, Duy DN, Dai B, Thanh NX, Chavchich M, Rieckmann KH, Edstein MD. Vivax malaria: preliminary observations following a shorter course of treatment with artesunate plus primaquine. Trans R Soc Trop Med Hyg 2007; 101:534-9. [PMID: 17368694 DOI: 10.1016/j.trstmh.2007.01.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2006] [Revised: 01/23/2007] [Accepted: 01/24/2007] [Indexed: 11/18/2022] Open
Abstract
The standard adult treatment regimen for Plasmodium vivax malaria is chloroquine (1500 mg over 3 d) plus primaquine (15 or 30 mg daily for 14 d), but patient compliance tends to be poor with the lengthy course. Preliminary observations are reported on the efficacy of a shorter treatment course - artesunate (200mg twice a day for 2 d) plus primaquine (22.5mg base twice a day for 7 d) - given to 28 adult patients infected with P. vivax in Viet Nam. All patients responded quickly to treatment with mean (SD) parasite and fever clearance times of 14.2 (4.0) and 18.6 (8.4) h, respectively. The high dose of primaquine was generally well tolerated, and only one patient (3.6%) had a recurrence of parasitaemia during 28 d of follow-up. As most patients infected with Southeast Asian strains of P. vivax have their first relapse within 28 d after treatment with rapidly eliminated blood schizonticides, the absence of parasitaemia in the remaining 27 patients suggests that this drug regimen was active against both blood and liver stages. Further studies are needed to confirm that this rapidly acting, short artesunate-primaquine regimen can result in better patient compliance and treatment outcomes than the chloroquine-primaquine regimen.
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Affiliation(s)
- Nguyen Van Hoang Dao
- Department of Infectious Diseases, Military Hospital 175, Ho Chi Minh City, Viet Nam
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Fowler EV, Chavchich M, Chen N, Peters JM, Kyle DE, Gatton ML, Cheng Q. Physical linkage to drug resistance genes results in conservation of var genes among West Pacific Plasmodium falciparum isolates. J Infect Dis 2006; 194:939-48. [PMID: 16960782 PMCID: PMC1564382 DOI: 10.1086/506619] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2006] [Accepted: 04/10/2006] [Indexed: 11/03/2022] Open
Abstract
The multicopy var gene family encoding the variant surface antigen Plasmodium falciparum erythrocyte membrane protein 1 is highly diverse, with little overlap between different P. falciparum isolates. We report 5 var genes (varS1-varS5) that are shared at relatively high frequency among 63 genetically diverse P. falciparum isolates collected from 5 islands in the West Pacific region. The varS1, varS2, and varS3 genes were localized to the internal region on chromosome 4, approximately 200 kb from pfdhfr-ts, whereas varS4 and varS5 were mapped to an internal region of chromosome 7, within 100 kb of pfcrt. The presence of varS2 and varS3 were significantly correlated with the pyrimethamine-resistant pfdhfr genotype, whereas varS4 was strongly correlated with the chloroquine-resistant pfcrt genotype. Thus, the conservation of these var genes is the result of their physical linkage with drug-resistant genes in combination with the antimalarial drug pressure in the region.
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Affiliation(s)
- Elizabeth V Fowler
- Drug Resistance and Diagnostics, Australian Army Malaria Institute, Brisbane, Australia
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Fischer K, Chavchich M, Huestis R, Wilson DW, Kemp DJ, Saul A. Ten families of variant genes encoded in subtelomeric regions of multiple chromosomes of Plasmodium chabaudi, a malaria species that undergoes antigenic variation in the laboratory mouse. Mol Microbiol 2003; 48:1209-23. [PMID: 12787350 DOI: 10.1046/j.1365-2958.2003.03491.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The chromosome ends of human malaria parasites harbour many genes encoding proteins that are exported to the surface of infected red cells, often being involved in host-parasite interactions and immune evasion. Unlike other murine malaria parasites Plasmodium chabaudi undergoes antigenic variation during passage in the laboratory mouse and hence is a model suitable for investigation of switching mechanisms. However, little is known about the subtelomeric regions of P. chabaudi chromosomes and its variable antigens. Here we report 80 kb of sequence from an end of one P. chabaudi chromosome. Hybridization of probes spanning this region to two dimensional pulsed field gels of the genome revealed 10 multicopy gene families located exclusively in subtelomeric regions of multiple P. chabaudi chromosomes, interspersed amongst multicopy intergenic regions. Hence all chromosomes share a common subtelomeric structure, presumably playing a similar role in spatial positioning as the P. falciparum Rep20 sequence. Expression in blood stages, domains characteristic of surface antigens and copy numbers between four and several hundred per genome, indicate a functional role in antigenic variation for some of these families. We identify members of the cir family, as well as novel genes, that although clearly homologous to cir have large low complexity regions in the predicted extracellular domains. Although all families have homologues in other rodent Plasmodium species, four were previously not known to be subtelomeric. Six have homologues in human and simian malarias.
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Affiliation(s)
- Katja Fischer
- The Queensland Institute of Medical Research, P. O. Royal Brisbane Hospital, Australia.
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