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Duan Z, Zhang X, Liu Y, Wang J, Zhu H, Chen R, Xu W, Miao K. The impact of matched and mismatched donor-recipient genotypes for MDR1 polymorphisms (G2677TA, C1236T and C3435T) on the outcomes of patients after allogeneic haematopoietic stem cell transplantation. Br J Haematol 2024; 205:634-644. [PMID: 38924031 DOI: 10.1111/bjh.19588] [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: 03/14/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024]
Abstract
In this study, we investigated whether matched and mismatched multidrug resistance gene (MDR1) genotypes (G2677TA, C1236T and C3435T) were associated with prognosis in patients after allogeneic haematopoietic stem cell transplantation (allo-HSCT). One hundred patients after transplantation and their donors were enrolled. Matched MDR1 G2677TA donor-recipient was associated with an increased risk of non-relapse mortality (NRM) (29.5% vs. 6.2%, p = 0.002), poor overall survival (OS) (51.7% vs. 63.8%, p = 0.024) and disease-free survival (DFS) (38.6% vs. 67%, p = 0.005). There were no differences in OS, DFS or NRM between MDR1 C1236T- and C3435T-matched and -mismatched groups. Subgroup analysis suggested that within the matched MDR1 G2677TA group, male gender, haematopoietic cell transplantation-specific comorbidity index ≥1, serum creatinine >137.2 μmol/L and post-transplantation thrombocytopenia were associated with poor survival. Our results demonstrated that patients receiving matched MDR1 G2677TA allo-HSCT experienced a poorer prognosis compared with the mismatched group. The potential mechanism may involve increased expression of P-glycoprotein, leading to decreased accumulation of antimicrobial agents and ultimately contributing to the progression of inflammation. This identification of MDR1 G2677TA genotype compatibility holds promise as a valuable molecular tool for selecting donors for allo-HSCT.
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Affiliation(s)
- Ziwen Duan
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Xiao Zhang
- Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Suzhou, China
| | - Yanping Liu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Jiawen Wang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Han Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Ruize Chen
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Wei Xu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Kourong Miao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
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Shalaby NE, Shoheib ZS, Yassin NA, El-Kaliny HH, Hasby Saad MA. Pyroptosis Tuning in Intestinal Cryptosporidiosis via the Natural Histone Deacetylase Inhibitor Romidepsin. Parasite Immunol 2024; 46:e13032. [PMID: 38497997 DOI: 10.1111/pim.13032] [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: 09/04/2023] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 03/19/2024]
Abstract
Cryptosporidium is an opportunistic protozoan, with many species of cross-human infectivity. It causes life-threatening diarrhoea in children and CD4-defective patients. Despite its limited efficacy, nitazoxanide remains the primary anti-cryptosporidial drug. Cryptosporidium infects the intestinal brush border (intracellular-extracytoplasmic) and down-regulates pyroptosis to prevent expulsion. Romidepsin is a natural histone deacetylase inhibitor that triggers pyroptosis. Romidepsin's effect on cryptosporidiosis was assessed in immunocompromised mice via gasdermin-D (GSDM-D) immunohistochemical expression, IFN-γ, IL-1β and IL-18 blood levels by ELISA, and via parasite scanning by modified Ziehl-Neelsen staining and scanning electron microscopy (SEM). Oocyst deformity and local cytokines were also assessed in ex vivo ileal explants. Following intraperitoneal injection of romidepsin, oocyst shedding significantly reduced at the 9th, 12th and 15th d.p.i. compared with infected-control and drug-control (nitazoxanide-treated) mice. H&E staining of intestinal sections from romidepsin-treated mice showed significantly low intestinal scoring with marked reduction in epithelial hyperplasia, villous blunting and cellular infiltrate. SEM revealed marked oocyst blebbing and paucity (in vivo and ex vivo) after romidepsin compared with nitazoxanide. Regarding pyroptosis, romidepsin triggered significantly higher intestinal GSDM-D expression in vivo, and higher serum/culture IFN-γ, IL-1β and IL-18 levels in romidepsin-treated mice than in the control groups. Collectively, in cryptosporidiosis, romidepsin succeeded in enhancing pyroptosis in the oocysts and infected epithelium, reducing infection and shifting the brush border towards normalisation.
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Affiliation(s)
- Noha E Shalaby
- Medical Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Zeinab S Shoheib
- Medical Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Nabila A Yassin
- Medical Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Heba H El-Kaliny
- Histology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
- Anatomy and Histology Department, Mutah University, Mutah, Jordan
| | - Marwa A Hasby Saad
- Medical Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Oboh E, Schubert TJ, Teixeira JE, Stebbins EE, Miller P, Philo E, Thakellapalli H, Campbell SD, Griggs DW, Huston CD, Meyers MJ. Optimization of the Urea Linker of Triazolopyridazine MMV665917 Results in a New Anticryptosporidial Lead with Improved Potency and Predicted hERG Safety Margin. J Med Chem 2021; 64:11729-11745. [PMID: 34342443 DOI: 10.1021/acs.jmedchem.1c01136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Cryptosporidiosis is caused by infection of the small intestine by Cryptosporidium parasites, resulting in severe diarrhea, dehydration, malabsorption, and potentially death. The only FDA-approved therapeutic is only partially effective in young children and ineffective for immunocompromised patients. Triazolopyridazine MMV665917 is a previously reported anti-Cryptosporidium screening hit with in vivo efficacy but suffers from modest inhibition of the hERG ion channel, which could portend cardiotoxicity. Herein, we describe our initial development of structure-activity relationships of this novel lead series with a particular focus on optimization of the piperazine-urea linker. We have discovered that piperazine-acetamide is a superior linker resulting in identification of SLU-2633, which has an EC50 of 0.17 μM, an improved projected margin versus hERG, prolonged pharmacokinetic exposure in small intestine, and oral efficacy in vivo with minimal systemic exposure. SLU-2633 represents a significant advancement toward the identification of a new effective and safe treatment for cryptosporidiosis.
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Affiliation(s)
- Edmund Oboh
- Department of Chemistry, Saint Louis University, Saint Louis, Missouri 63103, United States
| | - Tanner J Schubert
- Department of Chemistry, Saint Louis University, Saint Louis, Missouri 63103, United States
| | - Jose E Teixeira
- Department of Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont 05401, United States
| | - Erin E Stebbins
- Department of Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont 05401, United States
| | - Peter Miller
- Department of Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont 05401, United States
| | - Emily Philo
- Department of Chemistry, Saint Louis University, Saint Louis, Missouri 63103, United States
| | - Haresh Thakellapalli
- Department of Chemistry, Saint Louis University, Saint Louis, Missouri 63103, United States
| | - Scott D Campbell
- Department of Molecular Microbiology and Immunology, Saint Louis University School of Medicine, Saint Louis, Missouri 63104, United States
| | - David W Griggs
- Department of Molecular Microbiology and Immunology, Saint Louis University School of Medicine, Saint Louis, Missouri 63104, United States.,Institute for Drug and Biotherapeutic Innovation, Saint Louis University, St. Louis, Missouri 63103, United States
| | - Christopher D Huston
- Department of Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont 05401, United States
| | - Marvin J Meyers
- Department of Chemistry, Saint Louis University, Saint Louis, Missouri 63103, United States.,Institute for Drug and Biotherapeutic Innovation, Saint Louis University, St. Louis, Missouri 63103, United States
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Wang B, Castellanos-Gonzalez A, White AC. Novel drug targets for treatment of cryptosporidiosis. Expert Opin Ther Targets 2020; 24:915-922. [PMID: 32552166 DOI: 10.1080/14728222.2020.1785432] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction Cryptosporidium species are protozoan parasites that are important causes of diarrheal disease including waterborne outbreaks, childhood diarrhea in resource-poor countries, and diarrhea in compromised hosts worldwide. Recent studies highlight the importance of cryptosporidiosis in childhood diarrhea, malnutrition, and death in resource-poor countries. Despite this, only a single drug, nitazoxanide, has demonstrated efficacy in human cryptosporidiosis and its efficacy is limited in malnourished children and patients with HIV. Areas covered In this review, we highlight work on potential targets for chemotherapy and review progress on drug development. A number of new targets have been identified for chemotherapy and progress has been made at developing drugs for these targets. Targets include parasite kinases, nucleic acid synthesis and processing, proteases, and lipid metabolism. Other groups have performed high-throughput screening to identify potential drugs. Several compounds have advanced to large animal studies. Expert opinion Development of drugs for cryptosporidiosis has been plagued by a lack of success. Barriers have included poor correlations between in vitro activity and clinical success as well as frequent unanticipated adverse effects. Without a clear pathway forward, it is wise to maintain a diverse development pipeline. Drug developers should also realize that success will likely require a sustained, methodical effort.
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Affiliation(s)
- Beilin Wang
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch , Galveston, TX, USA
| | | | - A Clinton White
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch , Galveston, TX, USA
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De Rycker M, Horn D, Aldridge B, Amewu RK, Barry CE, Buckner FS, Cook S, Ferguson MAJ, Gobeau N, Herrmann J, Herrling P, Hope W, Keiser J, Lafuente-Monasterio MJ, Leeson PD, Leroy D, Manjunatha UH, McCarthy J, Miles TJ, Mizrahi V, Moshynets O, Niles J, Overington JP, Pottage J, Rao SPS, Read KD, Ribeiro I, Silver LL, Southern J, Spangenberg T, Sundar S, Taylor C, Van Voorhis W, White NJ, Wyllie S, Wyatt PG, Gilbert IH. Setting Our Sights on Infectious Diseases. ACS Infect Dis 2020; 6:3-13. [PMID: 31808676 PMCID: PMC6958537 DOI: 10.1021/acsinfecdis.9b00371] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In
May 2019, the Wellcome Centre for Anti-Infectives Research (WCAIR) at the University of Dundee, UK, held an international
conference with the aim of discussing some key questions around discovering
new medicines for infectious diseases and a particular focus on diseases
affecting Low and Middle Income Countries. There is an urgent need
for new drugs to treat most infectious diseases. We were keen to see
if there were lessons that we could learn across different disease
areas and between the preclinical and clinical phases with the aim
of exploring how we can improve and speed up the drug discovery, translational,
and clinical development processes. We started with an introductory
session on the current situation and then worked backward from clinical
development to combination therapy, pharmacokinetic/pharmacodynamic
(PK/PD) studies, drug discovery pathways, and new starting points
and targets. This Viewpoint aims to capture some of the learnings.
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Affiliation(s)
- Manu De Rycker
- Wellcome Centre for Anti-Infectives Research, Division of Biological Chemistry and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
| | - David Horn
- Wellcome Centre for Anti-Infectives Research, Division of Biological Chemistry and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
| | - Bree Aldridge
- Tufts University School of Medicine, 136 Harrison Avenue, Boston, Massachusetts 02111, United States
| | - Richard K. Amewu
- Department of Chemistry, University of Ghana, P.O. Box LG56, Legon, Accra, Ghana
| | - Clifton E. Barry
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, Maryland 20892, United States
| | - Frederick S. Buckner
- Center for Emerging and Re-emerging Infectious Diseases (CERID), University of Washington, MS 358061, 750 Republican Street, Rm E-606, Seattle, Washington 98109-4766, United States
| | - Sarah Cook
- School of Humanities, University of Glasgow, 1 University Gardens, Glasgow G12 8QQ, United Kingdom
| | - Michael A. J. Ferguson
- Wellcome Centre for Anti-Infectives Research, Division of Biological Chemistry and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
| | - Nathalie Gobeau
- Medicines for Malaria Venture (MMV), PO Box 1826, 20 Route de Pré-Bois, 1215 Geneva 15, Switzerland
| | - Jennifer Herrmann
- Helmholtz Institute for Pharmaceutical Research Saarland, Department Microbial Natural Products, Saarland University, Campus E8.1, 66123 Saarbrücken, Germany
- German Centre for Infection Research, partner
site Hannover-Braunschweig, Germany
| | | | - William Hope
- Institute of Translational Medicine, University of Liverpool, Liverpool L69 3BX, United Kingdom
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Socinstrasse 57, CH-4051 Basel, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
| | | | | | - Didier Leroy
- Medicines for Malaria Venture (MMV), PO Box 1826, 20 Route de Pré-Bois, 1215 Geneva 15, Switzerland
| | - Ujjini H. Manjunatha
- Novartis Institute for Tropical Diseases (NITD), Novartis Institutes for BioMedical Research (NIBR), 5300 Chiron Way, Emeryville, California 94608, United States
| | - James McCarthy
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Hertson, Queensland 4006, Australia
| | - Timothy J. Miles
- Tres Cantos Medicines Development Campus, Diseases of the Developing World (DDW), GlaxoSmithKline, Tres Cantos, Spain
| | - Valerie Mizrahi
- SAMRC/NHLS/UCT Molecular Mycobacteriology Research Unit, Institute of Infectious Disease and Molecular Medicine and Wellcome Centre for Infectious Disease Research in Africa, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Olena Moshynets
- Biofilm Study Group, Institute of Molecular Biology and Genetics of National Academy of Sciences of Ukraine, 150 Zabolotnoho Street, Kiev 03143, Ukraine
| | - Jacquin Niles
- School of Engineering, Massachusetts Institute of Technology, Building 1-206, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139-4307, United States
| | - John P. Overington
- Medicines Discovery Catapult, Alderley
Park, Alderley Edge, Cheshire SK10 4TG, United Kingdom
| | - John Pottage
- ViiV Healthcare, 980 Great West Road, Brentford, Middlesex TW8 9GS, United Kingdom
| | - Srinivasa P. S. Rao
- Novartis Institute for Tropical Diseases (NITD), Novartis Institutes for BioMedical Research (NIBR), 5300 Chiron Way, Emeryville, California 94608, United States
| | - Kevin D. Read
- Wellcome Centre for Anti-Infectives Research, Division of Biological Chemistry and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
| | - Isabela Ribeiro
- Drugs for Neglected Diseases Initiative (DNDi), Chemin Louis-Dunant 15, 1202 Genève, Switzerland
| | | | - Jen Southern
- Lancaster Institute for the Contemporary Arts (LICA), The LICA Building, Lancaster University, Lancaster LA1 4YW, United Kingdom
| | - Thomas Spangenberg
- Global Health Institute of Merck, Ares Trading S.A., a subsidiary
of Merck KGaA Darmstadt Germany, Route de Crassier 1, 1262 Eysins, Switzerland
| | - Shyam Sundar
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Caitlin Taylor
- SAMRC/NHLS/UCT Molecular Mycobacteriology Research Unit, Institute of Infectious Disease and Molecular Medicine and Wellcome Centre for Infectious Disease Research in Africa, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Wes Van Voorhis
- Center for Emerging and Re-emerging Infectious Diseases (CERID), University of Washington, MS 358061, 750 Republican Street, Rm E-606, Seattle, Washington 98109-4766, United States
| | - Nicholas J. White
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok 10400, Thailand
| | - Susan Wyllie
- Wellcome Centre for Anti-Infectives Research, Division of Biological Chemistry and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
| | - Paul G. Wyatt
- Wellcome Centre for Anti-Infectives Research, Division of Biological Chemistry and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
| | - Ian H. Gilbert
- Wellcome Centre for Anti-Infectives Research, Division of Biological Chemistry and Drug Discovery, University of Dundee, Dundee DD1 5EH, United Kingdom
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