1
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Zhao L, Luo S, Peng Z, Wang G. Studies on the inhibition mechanism of α-glucosidase by kaempferide: Enzyme kinetic, multi-spectroscopy and molecular docking techniques. Int J Biol Macromol 2025; 302:140637. [PMID: 39908884 DOI: 10.1016/j.ijbiomac.2025.140637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2024] [Revised: 01/13/2025] [Accepted: 02/01/2025] [Indexed: 02/07/2025]
Abstract
α-Glucosidase (α-Glu) is an enzyme that lowers postprandial blood glucose after breaking down complex carbohydrates. Kaempferide is the principal flavonoid active ingredient in plants and is widely found in fruits, vegetables, and beverages. This study found that kaempferide has the potential to inhibit α-Glu activity to treat type 2 diabetes. The results showed that kaempferide (IC50 = 55.35 ± 0.27 μM), serving as a mixed-type inhibitor for α-Glu, exhibited sensibly superior inhibition of α-Glu than acarbose (IC50 = 414.08 ± 10.73 μM). In addition, the outcomes from fluorescence quenching, 3D fluorescence, synchronous fluorescence, CD spectroscopy, and molecular docking analysis showed that kaempferide can not only chelate with α-Glu by hydrogen bonding and Van der Waals forces, but also affect the secondary structure and activity of the enzyme. After oral administration of sucrose in mice, kaempferide effectively reduces postprandial blood glucose (PBG) and without any other adverse symptoms. In summary, this study has the potential to contribute to the development of functional foods for the prevention and management of type 2 diabetes (T2DM).
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Affiliation(s)
- Li Zhao
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang, China; School of Pharmacy, Guizhou Medical University, Guiyang, China
| | - Shuang Luo
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang, China; School of Pharmacy, Guizhou Medical University, Guiyang, China
| | - Zhiyun Peng
- Clinical Trails Center, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
| | - Guangcheng Wang
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang, China.
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2
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Marinescu M. Bisindole Compounds-Synthesis and Medicinal Properties. Antibiotics (Basel) 2024; 13:1212. [PMID: 39766602 PMCID: PMC11727274 DOI: 10.3390/antibiotics13121212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Revised: 12/09/2024] [Accepted: 12/10/2024] [Indexed: 01/15/2025] Open
Abstract
The indole nucleus stands out as a pharmacophore, among other aromatic heterocyclic compounds with remarkable therapeutic properties, such as benzimidazole, pyridine, quinoline, benzothiazole, and others. Moreover, a series of recent studies refer to strategies for the synthesis of bisindole derivatives, with various medicinal properties, such as antimicrobial, antiviral, anticancer, anti-Alzheimer, anti-inflammatory, antioxidant, antidiabetic, etc. Also, a series of natural bisindole compounds are mentioned in the literature for their various biological properties and as a starting point in the synthesis of other related bisindoles. Drawing from these data, we have proposed in this review to provide an overview of the synthesis techniques and medicinal qualities of the bisindolic compounds that have been mentioned in recent literature from 2010 to 2024 as well as their numerous uses in the chemistry of materials, nanomaterials, dyes, polymers, and corrosion inhibitors.
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Affiliation(s)
- Maria Marinescu
- Department of Organic Chemistry, Biochemistry and Catalysis, Faculty of Chemistry, University of Bucharest, Soseaua Panduri, 030018 Bucharest, Romania
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3
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Mo X, Rao DP, Kaur K, Hassan R, Abdel-Samea AS, Farhan SM, Bräse S, Hashem H. Indole Derivatives: A Versatile Scaffold in Modern Drug Discovery-An Updated Review on Their Multifaceted Therapeutic Applications (2020-2024). Molecules 2024; 29:4770. [PMID: 39407697 PMCID: PMC11477627 DOI: 10.3390/molecules29194770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Revised: 10/03/2024] [Accepted: 10/07/2024] [Indexed: 10/20/2024] Open
Abstract
Indole derivatives have become an important class of compounds in medicinal chemistry, recognized for their wide-ranging biological activities and therapeutic potential. This review provides a comprehensive overview of recent advances in the evaluation of indole-based compounds in the last five years, highlighting their roles in cancer treatment, infectious disease management, anti-inflammatory therapies, metabolic disorder interventions, and neurodegenerative disease management. Indole derivatives have shown significant efficacy in targeting diverse biological pathways, making them valuable scaffolds in designing new drugs. Notably, these compounds have demonstrated the ability to combat drug-resistant cancer cells and pathogens, a significant breakthrough in the field, and offer promising therapeutic options for chronic diseases such as diabetes and hypertension. By summarizing recent key findings and exploring the underlying biological mechanisms, this review underscores the potential of indole derivatives in addressing major healthcare challenges, thereby instilling hope and optimism in the field of modern medicine.
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Affiliation(s)
- Xingyou Mo
- School of Engineering, Guangzhou College of Technology and Business, Guangzhou 510850, China
| | - Devendra Pratap Rao
- Coordination Chemistry Laboratory, Department of Chemistry, Dayanand Anglo-Vedic (PG) College, Kanpur 208001, Uttar Pradesh, India
| | - Kirandeep Kaur
- Department of Chemistry, Maharaja Ranjit Singh Punjab Technical University, Bathinda 151001, Punjab, India
| | - Roket Hassan
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Sohag University, Sohag 82524, Egypt
| | - Ahmed S. Abdel-Samea
- Pharmacology & Toxicology Department, Faculty of Pharmacy, Deraya University, New Minia 61768, Egypt
| | - Sara Mahmoud Farhan
- Department of Microbiology and Immunology, Faculty of Pharmacy, Deraya University, New Minia 61768, Egypt
| | - Stefan Bräse
- Institute of Biological and Chemical Systems—Functional Molecular Systems (IBCS-FMS), Karlsruhe Institute of Technology (KIT), Kaiserstrasse 12, 76131 Karlsruhe, Germany
| | - Hamada Hashem
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Sohag University, Sohag 82524, Egypt
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4
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Kothari M, Kannan K, Sahadevan R, Sadhukhan S. Novel molecular hybrids of EGCG and quinoxaline: Potent multi-targeting antidiabetic agents that inhibit α-glucosidase, α-amylase, and oxidative stress. Int J Biol Macromol 2024; 263:130175. [PMID: 38360242 DOI: 10.1016/j.ijbiomac.2024.130175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
Diabetes mellitus is a multifactorial disease and its effective therapy often demands several drugs with different modes of action. Herein, we report a rational design and synthesis of multi-targeting novel molecular hybrids comprised of EGCG and quinoxaline derivatives that can effectively inhibit α-glucosidase, α-amylase as well as control oxidative stress by scavenging ROS. The hybrids showed superior inhibition of α-glucosidase along with similar α-amylase inhibition as compared to standard drug, acarbose. Most potent compound, 15c showed an IC50 of 0.50 μM (IC50 of acarbose 190 μM) against α-glucosidase. Kinetics studies with 15c revealed a competitive inhibition against α-glucosidase. Binding affinity of 15c (-9.5 kcal/mol) towards α-glucosidase was significantly higher than acarbose (-7.7 kcal/mol). 15c exhibited remarkably high antioxidant activity (IC50 = 18.84 μM), much better than vitamin C (IC50 = 33.04 μM). Of note, acarbose shows no antioxidant activity. Furthermore, α-amylase activity was effectively inhibited by 15c with an IC50 value of 16.35 μM. No cytotoxicity was observed for 15c (up to 40 μM) in MCF-7 cells. Taken together, we report a series of multi-targeting molecular hybrids capable of inhibiting carbohydrate hydrolysing enzymes as well as reducing oxidative stress, thus representing an advancement towards effective and novel therapeutic approaches for diabetes.
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Affiliation(s)
- Manan Kothari
- Department of Chemistry, Indian Institute of Technology Palakkad, Kerala 678 623, India
| | - Karthika Kannan
- Department of Chemistry, Indian Institute of Technology Palakkad, Kerala 678 623, India
| | - Revathy Sahadevan
- Department of Chemistry, Indian Institute of Technology Palakkad, Kerala 678 623, India
| | - Sushabhan Sadhukhan
- Department of Chemistry, Indian Institute of Technology Palakkad, Kerala 678 623, India; Physical & Chemical Biology Laboratory and Department of Biological Sciences & Engineering, Indian Institute of Technology Palakkad, Kerala 678 623, India.
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5
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Muhammad MT, Beniddir MA, Phongphane L, Abu Bakar MH, Hussin MH, Awang K, Litaudon M, Supratman U, Azmi MN. Chemodiverse monoterpene indole alkaloids from Kopsia teoi, inhibitory potential against α-amylase, and their molecular docking studies. Fitoterapia 2024; 174:105873. [PMID: 38417682 DOI: 10.1016/j.fitote.2024.105873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 03/01/2024]
Abstract
Diabetes mellitus stands as a metabolic ailment marked by heightened blood glucose levels due to inadequate insulin secretion. The primary aims of this investigative inquiry encompassed the isolation of phytochemical components from the bark of Kopsia teoi, followed by the assessment of their α-amylase inhibition. The phytochemical composition of the K. teoi culminated in the discovery of a pair of new indole alkaloids; which are 16-epi-deacetylakuammiline N(4)-methylene chloride (akuammiline) (1), and N(1)-methoxycarbonyl-11-methoxy-12-hydroxy-Δ14-17-kopsinine (aspidofractinine) (2), together with five known compounds i.e. kopsiloscine G (aspidofractinine) (3), akuammidine (sarpagine) (4), leuconolam (aspidosperma) (5), N-methoxycarbonyl-12-methoxy-Δ16, 17-kopsinine (aspidofractinine) (6), and kopsininate (aspidofractinine) (7). All compounds were determined via spectroscopic analyses. The in vitro evaluation against α-amylase showed good inhibitory activities for compounds 5-7 with the inhibitory concentration (IC50) values of 21.7 ± 1.2, 34.1 ± 0.1, and 30.0 ± 0.8 μM, respectively compared with the reference acarbose (IC50 = 34.4 ± 0.1 μM). The molecular docking outputs underscored the binding interactions of compounds 5-7 ranging from -8.1 to -8.8 kcal/mol with the binding sites of α-amylase. Consequently, the outcomes highlighted the anti-hyperglycemic attributes of isolates from K. teoi.
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Affiliation(s)
- Muhammad Tahir Muhammad
- Natural Products and Synthesis Organic Research Laboratory (NPSO), School of Chemical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia; Nursing department, Darbandikhan Technical Institute (DATI), Sulaimani Polytechnic University, Kurdistan Region, Sulaimani 46001, Iraq
| | - Mehdi A Beniddir
- Équipe Chimie des Substances Naturelles, BioCIS, Centre National de la Recherche Scientifique (CNRS), Université Paris-Saclay, Orsay, France
| | - Lacksany Phongphane
- Natural Products and Synthesis Organic Research Laboratory (NPSO), School of Chemical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Mohamad Hafizi Abu Bakar
- Bioprocess Technology Division, School of Industrial Technology, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Mohd Hazwan Hussin
- Materials Technology Research Group (MaTReC), School of Chemical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Khalijah Awang
- Department of Chemistry, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Marc Litaudon
- Institut de Chimie des Substances Naturelles, CNRS-ICSN UPR 01, Univ. Paris-Sud 11, Av. de la Terrasse, 91198 Gif-sur-Yvette, France
| | - Unang Supratman
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, 45363 Jatinangor, Indonesia
| | - Mohamad Nurul Azmi
- Natural Products and Synthesis Organic Research Laboratory (NPSO), School of Chemical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia.
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6
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Liu H, Huang P, Wang X, Ma Y, Tong J, Li J, Ding H. Apigenin analogs as α-glucosidase inhibitors with antidiabetic activity. Bioorg Chem 2024; 143:107059. [PMID: 38154388 DOI: 10.1016/j.bioorg.2023.107059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/14/2023] [Accepted: 12/23/2023] [Indexed: 12/30/2023]
Abstract
This study investigated the inhibitory potential of a series of synthesized compounds (L1-L27) on α-glucosidase. Among them, compound L22 showed significant inhibitory effect. Through enzymatic kinetics studies, we demonstrated that L22 acts via a non-competitive inhibition mode with a Ki value of 2.61 μM, highlighting its high affinity for the enzyme. Molecular docking studies revealed the formation of hydrogen bonds between L22 and α-glucosidase and diverse interactions with neighboring amino acid residues. Furthermore, molecular dynamics simulations confirmed the stability of the L22-α-glucosidase complex. In a mouse model of type 2 diabetes, treatment with L22 significantly lowered fasting blood glucose levels, and reduced insulin resistance, suggesting its potential as a therapeutic agent for type 2 diabetes. Furthermore, L22 showed a protective effect against oxidative stress in the liver and alleviated liver and pancreatic abnormalities. These results provide valuable insights into the mechanism of action of L22 and its potential applications to treat type 2 diabetes, and improve liver health.
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Affiliation(s)
- Honghui Liu
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, Wuhan University School of Pharmaceutical Sciences, Wuhan University Hubei 430072, PR China
| | - Puxin Huang
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, Wuhan University School of Pharmaceutical Sciences, Wuhan University Hubei 430072, PR China
| | - Xingchen Wang
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, Wuhan University School of Pharmaceutical Sciences, Wuhan University Hubei 430072, PR China
| | - Yufang Ma
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, Wuhan University School of Pharmaceutical Sciences, Wuhan University Hubei 430072, PR China
| | - Jing Tong
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, Wuhan University School of Pharmaceutical Sciences, Wuhan University Hubei 430072, PR China.
| | - Jing Li
- School of Pharmaceutical Sciences, South-Central Minzu University, Wuhan 430074, PR China.
| | - Hong Ding
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, Wuhan University School of Pharmaceutical Sciences, Wuhan University Hubei 430072, PR China.
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7
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Mughal EU, Amjid S, Sadiq A, Naeem N, Nazir Y, Alrafai HA, Hassan AA, Al-Nami SY, Abdel Hafez AA, Ali Shah SW, Ghias M. Design and synthesis of 2-amino-4,6-diarylpyrimidine derivatives as potent α-glucosidase and α-amylase inhibitors: structure-activity relationship, in vitro, QSAR, molecular docking, MD simulations and drug-likeness studies. J Biomol Struct Dyn 2024; 42:244-260. [PMID: 37096830 DOI: 10.1080/07391102.2023.2198609] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/10/2023] [Indexed: 04/26/2023]
Abstract
In the present study, a series of 2-amino-4,6-diarylpyrimidine derivatives was designed, synthesized, characterized and evaluated for their in vitro α-glucosidase and α-amylase enzyme inhibition assays. The outcomes proved that this class of compounds exhibit considerable inhibitory activity against both enzymes. Among the target compounds, compounds 4p and 6p demonstrated the most potent dual inhibition with IC50 = 0.087 ± 0.01 μM for α-glucosidase; 0.189 ± 0.02 μM for α-amylase and IC50 = 0.095 ± 0.03 μM for α-glucosidase; 0.214 ± 0.03 μM for α-amylase, respectively as compared to the standard rutin (IC50 = 0.192 ± 0.02 μM for α-glucosidase and 0.224 ± 0.02 μM for α-amylase). Remarkably, the enzyme inhibition results indicate that test compounds have stronger inhibitory effect on the target enzymes than the positive control, with a significantly lower IC50 value. Moreover, these series of compounds were found to inhibit α-glucosidase activity in a reversible mixed-type manner with IC50 between 0.087 ± 0.01 μM to 1.952 ± 0.26 μM. Furthermore, molecular docking studies were performed to affirm the binding interactions of this scaffold to the active sites of α-glucosidase and α-amylase enzymes. The quantitative structure-activity relationship (QSAR) investigations showed a strong association between 1p-15p structures and their inhibitory actions (IC50) with a correlation value (R2) of 0.999916. Finally, molecular dynamic (MD) simulations were carried out to assess the dynamic behavior, stability of the protein-ligand complex, and binding affinity of the most active inhibitor 4p. The experimental and theoretical results therefore exposed a very good compatibility. Additionally, the drug-likeness assay revealed that some compounds exhibit a linear association with Lipinski's rule of five, indicating good drug-likeness and bioactivity scores for pharmacological targets.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
| | - Samreen Amjid
- Department of Chemistry, University of Gujrat, Gujrat, Pakistan
| | - Amina Sadiq
- Department of Chemistry, Govt. College Women University, Sialkot, Pakistan
| | - Nafeesa Naeem
- Department of Chemistry, University of Gujrat, Gujrat, Pakistan
| | - Yasir Nazir
- Department of Chemistry, Allama Iqbal Open University, Islamabad, Pakistan
| | - H A Alrafai
- Department of Chemistry, Faculty of Science, King Khalid University, Abraham, Saudi Arabia
| | - Abeer A Hassan
- Department of Chemistry, Faculty of Science, King Khalid University, Abraham, Saudi Arabia
| | - Samar Y Al-Nami
- Department of Chemistry, Faculty of Science, King Khalid University, Abraham, Saudi Arabia
| | - Amal A Abdel Hafez
- Department of Chemistry, Faculty of Science, King Khalid University, Abraham, Saudi Arabia
| | - Syed Wadood Ali Shah
- Department of Pharmacy, University of Malakand, Chakdara Dir, Khyber Pakhtunkhwa, Pakistan
| | - Mehreen Ghias
- Department of Pharmacy, University of Malakand, Chakdara Dir, Khyber Pakhtunkhwa, Pakistan
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8
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Kornicka A, Gzella K, Garbacz K, Jarosiewicz M, Gdaniec M, Fedorowicz J, Balewski Ł, Kokoszka J, Ordyszewska A. Indole-Acrylonitrile Derivatives as Potential Antitumor and Antimicrobial Agents-Synthesis, In Vitro and In Silico Studies. Pharmaceuticals (Basel) 2023; 16:918. [PMID: 37513830 PMCID: PMC10386429 DOI: 10.3390/ph16070918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
A series of 2-(1H-indol-2-yl)-3-acrylonitrile derivatives, 2a-x, 3, 4a-b, 5a-d, 6a-b, and 7, were synthesized as potential antitumor and antimicrobial agents. The structures of the prepared compounds were evaluated based on elemental analysis, IR, 1H- and 13NMR, as well as MS spectra. X-ray crystal analysis of the representative 2-(1H-indol-2-yl)-3-acrylonitrile 2l showed that the acrylonitrile double bond was Z-configured. All compounds were screened at the National Cancer Institute (USA) for their activities against a panel of approximately 60 human tumor cell lines and the relationship between structure and in vitro antitumor activity is discussed. Compounds of interest 2l and 5a-d showed significant growth inhibition potency against various tumor cell lines with the mean midpoint GI50 values of all tests in the range of 0.38-7.91 μM. The prominent compound with remarkable activity (GI50 = 0.0244-5.06 μM) and high potency (TGI = 0.0866-0.938 μM) against some cell lines of leukemia (HL-60(TB)), non-small cell lung cancer (NCI-H522), colon cancer (COLO 205), CNS cancer (SF-539, SNB-75), ovarian cancer ((OVCAR-3), renal cancer (A498, RXF 393), and breast cancer (MDA-MB-468) was 3-[4-(dimethylamino)phenyl]-2-(1-methyl-1H-indol-2-yl)acrylonitrile (5c). Moreover, the selected 2-(1H-indol-2-yl)-3-acrylonitriles 2a-c and 2e-x were evaluated for their antibacterial and antifungal activities against Gram-positive and Gram-negative pathogens as well as Candida albicans. Among them, 2-(1H-indol-2-yl)-3-(1H-pyrrol-2-yl)acrylonitrile (2x) showed the most potent antimicrobial activity and therefore it can be considered as a lead structure for further development of antimicrobial agents. Finally, molecular docking studies as well as drug-likeness and ADME profile prediction were carried out.
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Affiliation(s)
- Anita Kornicka
- Department of Chemical Technology of Drugs, Faculty of Pharmacy, Medical University of Gdansk, 80-416 Gdansk, Poland
| | - Karol Gzella
- Department of Chemical Technology of Drugs, Faculty of Pharmacy, Medical University of Gdansk, 80-416 Gdansk, Poland
| | - Katarzyna Garbacz
- Department of Oral Microbiology, Medical Faculty, Medical University of Gdansk, 80-204 Gdansk, Poland
| | - Małgorzata Jarosiewicz
- Department of Oral Microbiology, Medical Faculty, Medical University of Gdansk, 80-204 Gdansk, Poland
| | - Maria Gdaniec
- Faculty of Chemistry, Adam Mickiewicz University, 61-614 Poznań, Poland
| | - Joanna Fedorowicz
- Department of Chemical Technology of Drugs, Faculty of Pharmacy, Medical University of Gdansk, 80-416 Gdansk, Poland
| | - Łukasz Balewski
- Department of Chemical Technology of Drugs, Faculty of Pharmacy, Medical University of Gdansk, 80-416 Gdansk, Poland
| | - Jakub Kokoszka
- Department of Chemical Technology of Drugs, Faculty of Pharmacy, Medical University of Gdansk, 80-416 Gdansk, Poland
| | - Anna Ordyszewska
- Department of Inorganic Chemistry, Faculty of Chemistry and Advanced Materials Centers, Gdańsk University of Technology, Narutowicza 11/12, 80-233 Gdansk, Poland
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9
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Mushtaq A, Azam U, Mehreen S, Naseer MM. Synthetic α-glucosidase inhibitors as promising anti-diabetic agents: Recent developments and future challenges. Eur J Med Chem 2023; 249:115119. [PMID: 36680985 DOI: 10.1016/j.ejmech.2023.115119] [Citation(s) in RCA: 69] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023]
Abstract
Diabetes mellitus is one of the biggest challenges for the scientific community in the 21st century. It is a well-recognized multifactorial health problem contributes significantly to high mortality rates by causing serious health complications mainly related to cardiovascular diseases, kidney damage and neuropathy. The inhibition of α-glucosidase (enzyme that catalyses starch hydrolysis in the intestine) is an effective therapeutic approach for controlling hyperglycemia associated with type-2 diabetes. However, the presently approved drugs/inhibitors such as acarbose, miglitol and voglibose have several undesirable gastrointestinal side effects impeding their applications. Therefore, search for novel and more effective inhibitors with reduced side effects and less cost remains a fascinating area of research. In this context, a large variety of α-glucosidase inhibitors have been identified in recent years that demands attention from drug development community. This review is therefore an effort to summarize and highlight the promising α-glucosidase inhibitors especially those which are primarily based on aromatic heterocyclic scaffolds such as coumarin, imidazole, isatin, pyrimidine, quinazoline, triazine, thiazole etc, having improved safety and pharmacological profiles.
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Affiliation(s)
- Alia Mushtaq
- Department of Chemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Uzma Azam
- Department of Chemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan
| | - Saba Mehreen
- Department of Chemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan
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10
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Synthesis, α-glucosidase inhibitory activity, and molecular docking of cinnamamides. Med Chem Res 2023. [DOI: 10.1007/s00044-023-03032-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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11
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N-Derivatives of ( Z)-Methyl 3-(4-Oxo-2-thioxothiazolidin-5-ylidene)methyl)-1 H-indole-2-carboxylates as Antimicrobial Agents-In Silico and In Vitro Evaluation. Pharmaceuticals (Basel) 2023; 16:ph16010131. [PMID: 36678628 PMCID: PMC9865890 DOI: 10.3390/ph16010131] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
Herein, we report the experimental evaluation of the antimicrobial activity of seventeen new (Z)-methyl 3-(4-oxo-2-thioxothiazolidin-5-ylidene)methyl)-1H-indole-2-carboxylate derivatives. All tested compounds exhibited antibacterial activity against eight Gram-positive and Gram-negative bacteria. Their activity exceeded those of ampicillin as well as streptomycin by 10-50 fold. The most sensitive bacterium was En. Cloacae, while E. coli was the most resistant one, followed by M. flavus. The most active compound appeared to be compound 8 with MIC at 0.004-0.03 mg/mL and MBC at 0.008-0.06 mg/mL. The antifungal activity of tested compounds was good to excellent with MIC in the range of 0.004-0.06 mg/mL, with compound 15 being the most potent. T. viride was the most sensitive fungal, while A. fumigatus was the most resistant one. Docking studies revealed that the inhibition of E. coli MurB is probably responsible for their antibacterial activity, while 14a-lanosterol demethylase of CYP51Ca is involved in the mechanism of antifungal activity. Furthermore, drug-likeness and ADMET profile prediction were performed. Finally, the cytotoxicity studies were performed for the most active compounds using MTT assay against normal MRC5 cells.
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12
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Kumar R, Maurya SK. Synthesis of
γ
‐Butyrolactone Derivatives from Dihydrotagetone and Evaluation of Their Antidiabetic Activity. ChemistrySelect 2022. [DOI: 10.1002/slct.202203064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Rahul Kumar
- Chemical Technology Division CSIR-Institute of Himalayan Bioresource Technology Palampur Himachal Pradesh 176061 India
- Academy of Scientific and Innovative Research (AcSIR) Ghaziabad 201002 India
| | - Sushil K. Maurya
- Chemical Technology Division CSIR-Institute of Himalayan Bioresource Technology Palampur Himachal Pradesh 176061 India
- Academy of Scientific and Innovative Research (AcSIR) Ghaziabad 201002 India
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13
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Khalid Z, Alnuwaiser MA, Ahmad HA, Shafqat SS, Munawar MA, Kamran K, Abbas MM, Kalam MA, Ewida MA. Experimental and Computational Analysis of Newly Synthesized Benzotriazinone Sulfonamides as Alpha-Glucosidase Inhibitors. Molecules 2022; 27:molecules27206783. [PMID: 36296403 PMCID: PMC9612054 DOI: 10.3390/molecules27206783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/18/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
Diabetes mellitus is a chronic metabolic disorder in which the pancreas secretes insulin but the body cells do not recognize it. As a result, carbohydrate metabolism causes hyperglycemia, which may be fatal for various organs. This disease is increasing day by day and it is prevalent among people of all ages, including young adults and children. Acarbose and miglitol are famous alpha-glucosidase inhibitors but they complicate patients with the problems of flatulence, pain, bloating, diarrhea, and loss of appetite. To overcome these challenges, it is crucial to discover new anti-diabetic drugs with minimal side effects. For this purpose, benzotriazinone sulfonamides were synthesized and their structures were characterized by FT-IR, 1H-NMR and 13C-NMR spectroscopy. In vitro alpha-glucosidase inhibition studies of all synthesized hybrids were conducted using the spectrophotometric method. The synthesized compounds revealed moderate-to-good inhibition activity; in particular, nitro derivatives 12e and 12f were found to be the most effective inhibitors against this enzyme, with IC50 values of 32.37 ± 0.15 µM and 37.75 ± 0.11 µM. In silico studies, including molecular docking as well as DFT analysis, also strengthened the experimental findings. Both leading compounds 12e and 12f showed strong hydrogen bonding interactions within the enzyme cavity. DFT studies also reinforced the strong binding interactions of these derivatives with biological molecules due to their lowest chemical hardness values and lowest orbital energy gap values.
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Affiliation(s)
- Zunera Khalid
- Department of Chemistry, Kinnaird College for Women, Lahore 54000, Pakistan
| | - Maha Abdallah Alnuwaiser
- Department of Chemistry, College of Science, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Hafiz Adnan Ahmad
- School of Chemistry, University of the Punjab, Lahore 54590, Pakistan
| | - Syed Salman Shafqat
- Department of Chemistry, Division of Science and Technology, University of Education, Lahore 54770, Pakistan
- Correspondence: ; Tel.: +92-331-413-9585
| | - Munawar Ali Munawar
- School of Chemistry, University of the Punjab, Lahore 54590, Pakistan
- Department of Basic and Applied Chemistry, FAST, University of Central Punjab, Lahore 54000, Pakistan
| | - Kashif Kamran
- Department of Physics, University of Agriculture, Faisalabad 38040, Pakistan
| | - Muhammad Mujtaba Abbas
- Department of Mechanical Engineering, University of Engineering and Technology (New Campus), Lahore 54890, Pakistan
| | - M. A. Kalam
- Faculty of Engineering and IT, University of Technology, Sydney 2007, Australia
| | - Menna A. Ewida
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Future University in Egypt, New Cairo 11835, Egypt
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14
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Synthesis of Benzofuran–based Schiff bases as anti-diabetic compounds and their molecular docking studies. J Mol Struct 2022. [DOI: 10.1016/j.molstruc.2022.133287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Solangi M, Kanwal, Khan KM, Chigurupati S, Saleem F, Qureshi U, Ul-Haq Z, Jabeen A, Felemban SG, Zafar F, Perveen S, Taha M, Bhatia S. Isatin thiazoles as antidiabetic: Synthesis, in vitro enzyme inhibitory activities, kinetics, and in silico studies. Arch Pharm (Weinheim) 2022; 355:e2100481. [PMID: 35355329 DOI: 10.1002/ardp.202100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 11/11/2022]
Abstract
Diabetes mellitus is one of the most prevalent diseases nowadays. Several marketed drugs are available for the cure and treatment of diabetes, but there is still a dire need of introducing compatible drug molecules with lesser side effects. The current study is based on the synthesis of isatin thiazole derivatives 4-30 via the Hantzsch reaction. The synthetic compounds were characterized using different spectroscopic techniques and evaluated for their α-amylase and α-glucosidase inhibition potential. Of 27 isatin thiazoles, five (4, 5, 10, 12, and 16) displayed good activities against the α-amylase enzyme with IC50 values in the range of 22.22 ± 0.02-27.01 ± 0.06 µM, and for α-glucosidase, the IC50 values of these compounds were in the range of 20.76 ± 0.17-27.76 ± 0.17 µM, respectively. The binding interactions of the active molecules within the active site of enzymes were studied with the help of molecular docking studies. In addition, kinetic studies were carried out to examine the mechanism of action of the synthetic molecules as well. Compounds 3a, 4, 5, 10, 12, and 16 were also examined for their cytotoxic effect and were found to be noncytotoxic. Thus, several molecules were identified as good antihyperglycemic agents, which can be further modified to enhance inhibition ability and to find the lead molecule that can act as a potential antidiabetic agent.
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Affiliation(s)
- Mehwish Solangi
- International Center for Chemical and Biological Sciences, H. E. J. Research Institute of Chemistry, University of Karachi, Karachi, Pakistan
| | - Kanwal
- International Center for Chemical and Biological Sciences, H. E. J. Research Institute of Chemistry, University of Karachi, Karachi, Pakistan
- Institute of Marine Biotechnology, Universiti Malaysia Terengannu, Kuala Terengganu, Terengganu, Malaysia
| | - Khalid M Khan
- International Center for Chemical and Biological Sciences, H. E. J. Research Institute of Chemistry, University of Karachi, Karachi, Pakistan
- Department of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sridevi Chigurupati
- Department of Medicinal Chemistry and Pharmacognosy, Qassim University, Buraydah, Saudi Arabia
| | - Faiza Saleem
- International Center for Chemical and Biological Sciences, H. E. J. Research Institute of Chemistry, University of Karachi, Karachi, Pakistan
| | - Urooj Qureshi
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Zaheer Ul-Haq
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Almas Jabeen
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Shatha G Felemban
- Department of Medical Laboratory Science, Fakeeh College for Medical Sciences, Jeddah, Kingdom of Saudi Arabia
| | - Fatima Zafar
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Shahnaz Perveen
- PCSIR Laboratories Complex, Shahrah-e-Dr. Salimuzzaman Siddiqui, Karachi, Pakistan
| | - Muhammad Taha
- Department of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saurabh Bhatia
- Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, Oman
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16
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Mugaranja KP, Kulal A. Investigation of effective natural inhibitors for starch hydrolysing enzymes from Simaroubaceae plants by molecular docking analysis and comparison with in-vitro studies. Heliyon 2022; 8:e09360. [PMID: 35600433 PMCID: PMC9118686 DOI: 10.1016/j.heliyon.2022.e09360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/22/2021] [Accepted: 04/27/2022] [Indexed: 11/25/2022] Open
Abstract
The present study aims to find the effective natural enzyme inhibitors against alpha-amylase and alpha-glucosidase from the array of compounds identified in plants of the Simaroubaceae family using molecular docking and ADME/Toxicity studies. Among the 218 compounds docked against seven enzymes, buddlenol-A and citrusin-B showed the best binding energies (kcal/mol) of -7.830 and -7.383 against human salivary alpha-amylase and pancreatic alpha-amylase respectively. The other two compounds 9-hydroxycanthin-6-one and bruceolline-B had the best binding energy of -6.461 and -7.576 against N-terminal and C-terminal maltase glucoamylase respectively. Whereas the binding energy of prosopine (-6.499) and fisetinidol (-7.575) was considered as the best against N-terminal and C-terminal sucrase-isomaltase respectively. Picrasidine-X showed the best binding energy (-7.592) against yeast alpha-glucosidase. The study revealed that the seven compounds which showed the best binding energy against respective enzymes are considered as the 'lead hit compounds'. Even though the 'lead hit compounds' are not obeying all the laws of ADMET, the drug-likeness properties of 9-hydroxycanthin-6-one, fisetinidol, picrasidine-X, and prosopine were considerable. Also, kaempferol-3-O-pentoside was the recent compound identified from the Simarouba glauca plant extract found to be one among the top five lead hit compounds against four enzymes. This study provides valuable insight into the direction of developing natural compounds as potential starch hydrolysing enzyme inhibitors for managing type 2 diabetes.
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Affiliation(s)
- Kirana P. Mugaranja
- Biological Sciences Division, Poornaprajna Institute of Scientific Research, Bidalur Post, Devanahalli, Bangalore Rural, 562110, India
- Manipal Academy of Higher Education, Manipal, 576104, India
| | - Ananda Kulal
- Biological Sciences Division, Poornaprajna Institute of Scientific Research, Bidalur Post, Devanahalli, Bangalore Rural, 562110, India
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17
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Khalid Z, Shafqat SS, Ahmad HA, Rehman HM, Munawar MA, Ahmad M, Asiri AM, Ashraf M. Synthesis of 1,2,3-benzotriazin-4(3H)-one derivatives as α-glucosidase inhibitor and their in-silico study. Med Chem Res 2022. [DOI: 10.1007/s00044-022-02883-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Mehmood R, Sadiq A, Alsantali RI, Mughal EU, Alsharif MA, Naeem N, Javid A, Al-Rooqi MM, Chaudhry GES, Ahmed SA. Synthesis and Evaluation of 1,3,5-Triaryl-2-Pyrazoline Derivatives as Potent Dual Inhibitors of Urease and α-Glucosidase Together with Their Cytotoxic, Molecular Modeling and Drug-Likeness Studies. ACS OMEGA 2022; 7:3775-3795. [PMID: 35128286 PMCID: PMC8811919 DOI: 10.1021/acsomega.1c06694] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 01/11/2022] [Indexed: 05/04/2023]
Abstract
In the present work, a concise library of 1,3,5-triaryl-2-pyrazolines (2a-2q) was designed and synthesized by employing a multistep strategy, and the newly synthesized compounds were screened for their urease and α-glucosidase inhibitory activities. The compounds (2a-2q) were characterized using a combination of several spectroscopic techniques including FT-IR, 1H NMR, 13C NMR, and EI-MS. All the synthesized compounds, except compound 2i, were potent against urease as compared to the standard inhibitor thiourea (IC50 = 21.37 ± 0.26 μM). These analogs disclosed varying degrees of urease inhibitory activities ranging from 9.13 ± 0.25 to 18.42 ± 0.42 μM. Compounds 2b, 2g, 2m, and 2q having IC50 values of 9.36 ± 0.27, 9.13 ± 0.25, 9.18 ± 0.35, and 9.35 ± 0.35 μM, respectively, showed excellent inhibitory activity as compared to standard thiourea (IC50 = 21.37 ± 0.26 μM). A kinetic study of compound 2g revealed that compound 2g inhibited urease in a competitive mode. Among the synthesized pyrazolines, the compounds 2c, 2k, 2m, and 2o exhibited excellent α-glucosidase inhibitory activity with the lowest IC50 values of 212.52 ± 1.31, 237.26 ± 1.28, 138.35 ± 1.32, and 114.57 ± 1.35 μM, respectively, as compared to the standard acarbose (IC50 = 375.82 ± 1.76 μM). The compounds (2a-2q) showed α-glucosidase IC50 values in the range of 114.57 ± 1.35 to 462.94 ± 1.23 μM. Structure-activity relationship revealed that the size and electron-donating or -withdrawing effects of substituents influenced the activities, which led to the urease and α-glucosidase inhibiting properties. Compound 2m was a dual potent inhibitor against urease and α-glucosidase due to the presence of 2-CF3 electron-withdrawing functionality on the phenyl ring. To the best of our knowledge, these synthetic compounds were found to be the most potent dual inhibitors of urease and α-glucosidase with minimum IC50 values. The cytotoxicity of the compounds (2a-2q) was also investigated against human cell lines MCF-7 and HeLa. Compound 2l showed moderate cytotoxic activity against MCF-7 and HeLa cell lines. Moreover, in silico studies on most active compounds were also performed to understand the binding interaction of most active compounds with active sites of urease and α-glucosidase enzymes. Some compounds exhibited drug-like characteristics due to their lower cytotoxic and good ADME profiles.
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Affiliation(s)
- Rabia Mehmood
- Department
of Chemistry, Govt. College Women University, Sialkot 51300, Pakistan
| | - Amina Sadiq
- Department
of Chemistry, Govt. College Women University, Sialkot 51300, Pakistan
| | - Reem I. Alsantali
- Department
of Pharmaceutical Chemistry, College of Pharmacy, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | | | - Meshari A. Alsharif
- Department
of Chemistry, Faculty of Applied Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Nafeesa Naeem
- Department
of Chemistry, University of Gujrat, Gujrat 50700, Pakistan
| | - Asif Javid
- Department
of Chemistry, University of Gujrat, Gujrat 50700, Pakistan
| | - Munirah M. Al-Rooqi
- Department
of Chemistry, Faculty of Applied Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Gul-e-Saba Chaudhry
- Institute
of Marine Biotechnology, Universiti Malaysia
Terengganu, Kuala Nerus 21030, Terengganu, Malaysia
- Microbiology
and Biotechnology Research Lab, Fatima Jinnah
Women University, Rawalpindi 23451, Pakistan
| | - Saleh A. Ahmed
- Department
of Chemistry, Faculty of Applied Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia
- Department
of Chemistry, Faculty of Science, Assiut
University, Assiut 71516, Egypt
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19
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Karrouchi K, Fettach S, Anouar EH, Bayach I, Albalwi H, Arshad S, Sebbar NK, Tachalait H, Bougrin K, Faouzi MEA, Himmi B. Synthesis, Spectroscopic Characterization, DFT, Molecular Docking and Antidiabetic Activity of N-Isonicotinoyl Arylaldehyde Hydrazones. Polycycl Aromat Compd 2022. [DOI: 10.1080/10406638.2022.2028870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Khalid Karrouchi
- Laboratory of Analytical Chemistry and Bromatology, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco
| | - Saad Fettach
- Laboratory of Pharmacology and Toxicology, Biopharmaceutical and Toxicological Analysis Research Team, Faculty of Medicine and Pharmacy, Mohammed University V in Rabat, Morocco
| | - El Hassane Anouar
- Department of Chemistry, College of Science and Humanities in Al-Kharj, Prince Sattam Bin Abdulaziz University, Saudi Arabia
| | - Imene Bayach
- Chemistry Department, College of Science, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Hanan Albalwi
- Department of Chemistry, College of Science and Humanities in Al-Kharj, Prince Sattam Bin Abdulaziz University, Saudi Arabia
| | - Suhana Arshad
- X-Ray Crystallography Unit, School of Physics, Universiti Sains Malaysia, Penang, Malaysia
| | - Nada Kheira Sebbar
- Laboratoire de Chimie Bioorganique Appliquée, Faculte ́Des Sciences, Universite ́IbnZohr, Agadir, Morocco
| | - Hamza Tachalait
- Equipe de Chimie Des Plantes et de Synthèse Organique et Bioorganique, URAC23, Faculty of Science, B.P. 1014, Geophysics, Natural Patrimony and Green Chemistry (GEOPAC) Research Center, Mohammed V University in Rabat, Morocco
| | - Khalid Bougrin
- Equipe de Chimie Des Plantes et de Synthèse Organique et Bioorganique, URAC23, Faculty of Science, B.P. 1014, Geophysics, Natural Patrimony and Green Chemistry (GEOPAC) Research Center, Mohammed V University in Rabat, Morocco
- Chemical and Biochemical Sciences Green Process Engineering (CBS), Mohammed VI Polytechnic University (UM6P), Benguerir, Morocco
| | - My El Abbes Faouzi
- Laboratory of Pharmacology and Toxicology, Biopharmaceutical and Toxicological Analysis Research Team, Faculty of Medicine and Pharmacy, Mohammed University V in Rabat, Morocco
| | - Benacer Himmi
- Filière Techniques de Santé, Institut Supérieur Des Professions Infirmières et Techniques de Santé de Rabat, Ministère de la Santé, Morocco
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