Identification and characterization of sirtuin enzymes in cestodes and evaluation of sirtuin inhibitors as new cestocidal molecules

Anti-parasitic treatment of neglected tropical diseases (NTDs) caused by cestodes such as echinococcosis and cysticercosis relies on a small number of approved anthelmintic drugs. Furthermore, the treatment is usually prolonged and often partially effective and not well tolerated by some patients. Therefore, the identification of novel drug targets and their associated compounds is critical. In this study, we identified and characterized sirtuin (SIRT) enzymes in cestodes and evaluated the cestocidal potential of SIRT inhibitors. SIRTs are a highly conserved family of nicotinamide-adenine dinucleotide (NAD⁺)-lysine deacylases involved in multiple cellular functions. Here, we described the full repertoire of SIRT-encoding genes in several cestode species. We identified six SIRT-encoding genes that were classified into SIRTs Class I (SIRT1, SIRT2, and SIRT3), Class III (SIRT5), and Class IV (SIRT6 and SIRT7). In Echinococcus spp., SIRT genes showed transcriptional expression throughout several developmental stages, SIRT2 being the most expressed. To evaluate the potential of SIRT inhibitors as new cestocidal molecules, we determined the in vitro effect of several Class I SIRT inhibitors by motility assay. Of those, the selective SIRT2 inhibitor Mz25 showed a strong cestocidal activity in Mesocestoides vogae (syn. Mesocestoides corti) tetrathyridia at various concentrations. The Mz25 cestocidal activity was time- and dose-dependent with a half-maximal inhibitory concentration (IC₅₀) value significantly lower than that of albendazole. Additionally, Mz25 induced extensive damage in the general morphology with marked alterations in the tegument and ultrastructural features. By homology modeling, we found that cestode SIRT2s showed a high conservation of the canonical SIRT structure as well as in the residues related to Mz25 binding. Interestingly, some non-conservative mutations were found on the selectivity pocket (an Mz25-induced structural rearrangement on the active site), which represent a promising lead for developing selective cestode SIRT2 inhibitors derived from Mz25. Nevertheless, the Mz25 molecular target in M. vogae is unknown and remains to be determined. This report provides the basis for further studies of SIRTs to understand their roles in cestode biology and to develop selective SIRT inhibitors to treat these parasitic NTDs.

The potential for histone deacetylase (HDAC) inhibitors as cestocidal drugs

Background

Echinococcosis and cysticercosis are neglected tropical diseases caused by cestode parasites (family Taeniidae). Not only there is a small number of approved anthelmintics for the treatment of these cestodiases, but also some of them are not highly effective against larval stages, such that identifying novel drug targets and their associated compounds is critical. Histone deacetylase (HDAC) enzymes are validated drug targets in cancers and other diseases, and have been gaining relevance for developing new potential anti-parasitic treatments in the last years. Here, we present the anthelmintic profile for a panel of recently developed HDAC inhibitors against the model cestode Mesocestoides vogae (syn. M. corti).

Methodology/Principal findings

Phenotypic screening was performed on M. vogae by motility measurements and optical microscopic observations. Some HDAC inhibitors showed potent anthelmintic activities; three of them -entinostat, TH65, and TH92- had pronounced anthelmintic effects, reducing parasite viability by ~100% at concentrations of ≤ 20 μM. These compounds were selected for further characterization and showed anthelmintic effects in the micromolar range and in a time- and dose-dependent manner. Moreover, these compounds induced major alterations on the morphology and ultrastructural features of M. vogae. The potencies of these compounds were higher than albendazole and the anthelmintic effects were irreversible. Additionally, we evaluated pairwise drug combinations of these HDAC inhibitors and albendazole. The results suggested a positive interaction in the anthelmintic effect for individual pairs of compounds. Due to the maximum dose approved for entinostat, adjustments in the dose regime and/or combinations with currently-used anthelmintic drugs are needed, and the selectivity of TH65 and TH92 towards parasite targets should be assessed.

Conclusion, significance

The results presented here suggest that HDAC inhibitors represent novel and potent drug candidates against cestodes and pave the way to understanding the roles of HDACs in these parasites.

Neglected tropical diseases, such as echinococcosis and cysticercosis, which are caused by taeniid cestodes (tapeworms), represent serious public health problems in many countries around the world. Given that there is only a small number of approved anthelmintics for the treatment of cestodiases, and that most of them are not highly effective against larval stages, identifying novel drug targets and their associated compounds is critical. Histone deacetylases (HDACs) are enzymes that produce epigenetic modifications of chromatin, thus modifying cellular gene expression. In this study, we evaluate and characterize a number of HDAC inhibitors on the model cestode Mesocestoides vogae and report the anthelmintic profile of these compounds. Some of the HDAC inhibitors tested showed potent anthelmintic effects, particularly entinostat, TH65 and TH92. These compounds were selected as the most promising candidates due to their high potencies, which were superior to the commercially-available anthelmintic drug albendazole. We also evaluated pairwise drug combinations of HDAC inhibitors and albendazole. The findings of this study provide a starting point for the development of new HDAC-based cestocidal compounds.

Diagnosis of histoplasmosis: current status and perspectives

Histoplasmosis is a worldwide-distributed systemic mycosis caused by the dimorphic fungus Histoplasma capsulatum. Its clinical manifestations range from subclinical or mild respiratory illness to progressive disseminated histoplasmosis (PDH), a life-threatening disease, whose accurate diagnosis is still challenging and limited in many countries, where this disease is highly endemic. In this regard, Histoplasma antigen testing is now included in the WHO Essential Diagnostics List. The final diagnosis of histoplasmosis is established by culture and/or visualization of the yeast cells by cytology or histopathology using specific stains. However, both procedures have limited sensitivity to detect the disease and cultures are time-consuming. Antibody detection assays are effective for the subacute and chronic clinical forms of histoplasmosis. However, their sensitivity is low in the immunocompromised host. Several molecular "in-house" tests were also developed and showed promising results, but none of these tests are commercially available and their standardization and validation are still pending. Antigen detection assays have high sensitivity in PDH cases and are of great value for the follow-up of patients with histoplasmosis; however, cross-reactivity with other related fungi are common. In addition, this assay is expensive and only performed in few laboratories. Novel protein antigen candidates have been recently identified and produced by DNA-recombinant techniques in order to obtain standardized and specific reagents for the diagnosis of histoplasmosis, as opposed to the unspecific antigens or crude extracts currently used. This review describes the currently available assays, highlighting their strengths and limitations and reports the latest approaches to achieve reliable and rapid diagnostic tests for histoplasmosis. KEY POINTS: • PDH causes thousands of deaths per year globally. • Rapid accurate diagnosis of PDH is unfeasible in many regions. • Fast, accurate, and low-cost diagnostic alternatives are currently under development.