1
|
Lisauskaitė M, Nixon GL, Woodley CM, Berry NG, Coninckx A, Qie LC, Leung SC, Taramelli D, Basilico N, Parapini S, Ward SA, Vadas O, Soldati-Favre D, Hong WD, O'Neill PM. Design, synthesis and modelling of photoreactive chemical probes for investigating target engagement of plasmepsin IX and X in Plasmodium falciparum. RSC Chem Biol 2024; 5:19-29. [PMID: 38179191 PMCID: PMC10763550 DOI: 10.1039/d3cb00109a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/27/2023] [Indexed: 01/06/2024] Open
Abstract
The emergence of Plasmodium parasite resistance to current front-line antimalarial treatments poses a serious threat to global malaria control and highlights the necessity for the development of therapeutics with novel targets and mechanisms of action. Plasmepsins IX and X (PMIX/PMX) have been recognised as highly promising targets in Plasmodium due to their contribution to parasite's pathogenicity. Recent research has demonstrated that dual PMIX/PMX inhibition results in the impairment of multiple parasite's life cycle stages, which is an important feature in drug resistance prevention. Herein we report novel hydroxyethylamine photoaffinity labelling (PAL) probes, designed for PMIX/PMX target engagement and proteomics experiments in Plasmodium parasites. The prepared probes have both a photoreactive group (diazirine or benzophenone) for covalent attachment to target proteins, and a terminal alkyne handle allowing their use in bioorthogonal ligation. One of the synthesised benzophenone probes was shown to be highly promising as demonstrated by its outstanding antimalarial potency (IC50 = 15 nM versus D10 P. falciparum) and its inhibitory effect against PfPMX in an enzymatic assay. Molecular docking and molecular dynamics studies show that the inclusion of the benzophenone and alkyne handle does not alter the binding mode compared to the parent compound. The photoaffinity probe can be used in future chemical proteomics studies to allow hydroxyethylamine drug scaffold target identification and validation in Plasmodium. We expect our findings to act as a tool for future investigations on PMIX/PMX inhibition in antimalarial drug discovery.
Collapse
Affiliation(s)
| | - Gemma L Nixon
- Department of Chemistry, University of Liverpool Liverpool L69 7ZD UK
| | | | - Neil G Berry
- Department of Chemistry, University of Liverpool Liverpool L69 7ZD UK
| | - Andy Coninckx
- Department of Chemistry, University of Liverpool Liverpool L69 7ZD UK
| | - L Charlie Qie
- Department of Chemistry, University of Liverpool Liverpool L69 7ZD UK
| | - Suet C Leung
- Department of Chemistry, University of Liverpool Liverpool L69 7ZD UK
| | - Donatella Taramelli
- Dipartimento di Scienze Farmacologiche e Biomolecolari (DISFEB), Università degli Studi di Milano 20133 Milano Italy
- Affiliated to Centro Interuniversitario di Ricerche sulla Malaria/Italian Malaria Network (CIRM-IMN), Università degli Studi di Camerino Italy
| | - Nicoletta Basilico
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano 20133 Milano Italy
- Affiliated to Centro Interuniversitario di Ricerche sulla Malaria/Italian Malaria Network (CIRM-IMN), Università degli Studi di Camerino Italy
| | - Silvia Parapini
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano 20133 Milano Italy
- Affiliated to Centro Interuniversitario di Ricerche sulla Malaria/Italian Malaria Network (CIRM-IMN), Università degli Studi di Camerino Italy
| | - Stephen A Ward
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine Liverpool L3 5QA UK
| | - Oscar Vadas
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, CMU, 1 rue Michel-Servet CH-1211 Genève 4 Switzerland
| | - Dominique Soldati-Favre
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, CMU, 1 rue Michel-Servet CH-1211 Genève 4 Switzerland
| | - W David Hong
- Department of Chemistry, University of Liverpool Liverpool L69 7ZD UK
| | - Paul M O'Neill
- Department of Chemistry, University of Liverpool Liverpool L69 7ZD UK
| |
Collapse
|
2
|
Jeffreys LN, Ardrey A, Hafiz TA, Dyer LA, Warman AJ, Mosallam N, Nixon GL, Fisher NE, Hong WD, Leung SC, Aljayyoussi G, Bibby J, Almeida DV, Converse PJ, Fotouhi N, Berry NG, Nuermberger EL, Upton AM, O'Neill PM, Ward SA, Biagini GA. Identification of 2-Aryl-Quinolone Inhibitors of Cytochrome bd and Chemical Validation of Combination Strategies for Respiratory Inhibitors against Mycobacterium tuberculosis. ACS Infect Dis 2023; 9:221-238. [PMID: 36606559 PMCID: PMC9926492 DOI: 10.1021/acsinfecdis.2c00283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 01/07/2023]
Abstract
Mycobacterium tuberculosis cytochrome bd quinol oxidase (cyt bd), the alternative terminal oxidase of the respiratory chain, has been identified as playing a key role during chronic infection and presents a putative target for the development of novel antitubercular agents. Here, we report confirmation of successful heterologous expression of M. tuberculosis cytochrome bd. The heterologous M. tuberculosis cytochrome bd expression system was used to identify a chemical series of inhibitors based on the 2-aryl-quinolone pharmacophore. Cytochrome bd inhibitors displayed modest efficacy in M. tuberculosis growth suppression assays together with a bacteriostatic phenotype in time-kill curve assays. Significantly, however, inhibitor combinations containing our front-runner cyt bd inhibitor CK-2-63 with either cyt bcc-aa3 inhibitors (e.g., Q203) and/or adenosine triphosphate (ATP) synthase inhibitors (e.g., bedaquiline) displayed enhanced efficacy with respect to the reduction of mycobacterium oxygen consumption, growth suppression, and in vitro sterilization kinetics. In vivo combinations of Q203 and CK-2-63 resulted in a modest lowering of lung burden compared to treatment with Q203 alone. The reduced efficacy in the in vivo experiments compared to in vitro experiments was shown to be a result of high plasma protein binding and a low unbound drug exposure at the target site. While further development is required to improve the tractability of cyt bd inhibitors for clinical evaluation, these data support the approach of using small-molecule inhibitors to target multiple components of the branched respiratory chain of M. tuberculosis as a combination strategy to improve therapeutic and pharmacokinetic/pharmacodynamic (PK/PD) indices related to efficacy.
Collapse
Affiliation(s)
- Laura N Jeffreys
- Centre for Drugs and Diagnostics, Department of Tropical Infectious Diseases, Liverpool School of Tropical Medicine, Pembroke Place, LiverpoolL3 5QA, U.K
| | - Alison Ardrey
- Centre for Drugs and Diagnostics, Department of Tropical Infectious Diseases, Liverpool School of Tropical Medicine, Pembroke Place, LiverpoolL3 5QA, U.K
| | - Taghreed A Hafiz
- Centre for Drugs and Diagnostics, Department of Tropical Infectious Diseases, Liverpool School of Tropical Medicine, Pembroke Place, LiverpoolL3 5QA, U.K
| | - Lauri-Anne Dyer
- Centre for Drugs and Diagnostics, Department of Tropical Infectious Diseases, Liverpool School of Tropical Medicine, Pembroke Place, LiverpoolL3 5QA, U.K
| | - Ashley J Warman
- Centre for Drugs and Diagnostics, Department of Tropical Infectious Diseases, Liverpool School of Tropical Medicine, Pembroke Place, LiverpoolL3 5QA, U.K
| | - Nada Mosallam
- Department of Chemistry, University of Liverpool, LiverpoolL69 7ZD, U.K
| | - Gemma L Nixon
- Department of Chemistry, University of Liverpool, LiverpoolL69 7ZD, U.K
| | - Nicholas E Fisher
- Centre for Drugs and Diagnostics, Department of Tropical Infectious Diseases, Liverpool School of Tropical Medicine, Pembroke Place, LiverpoolL3 5QA, U.K
| | - W David Hong
- Department of Chemistry, University of Liverpool, LiverpoolL69 7ZD, U.K
| | - Suet C Leung
- Department of Chemistry, University of Liverpool, LiverpoolL69 7ZD, U.K
| | - Ghaith Aljayyoussi
- Centre for Drugs and Diagnostics, Department of Tropical Infectious Diseases, Liverpool School of Tropical Medicine, Pembroke Place, LiverpoolL3 5QA, U.K
| | - Jaclyn Bibby
- Department of Chemistry, University of Liverpool, LiverpoolL69 7ZD, U.K
| | - Deepak V Almeida
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland21205, United States
| | - Paul J Converse
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland21205, United States
| | - Nader Fotouhi
- Global Alliance for TB Drug Development, New York, New York10005, United States
| | - Neil G Berry
- Department of Chemistry, University of Liverpool, LiverpoolL69 7ZD, U.K
| | - Eric L Nuermberger
- Center for Tuberculosis Research, Johns Hopkins University School of Medicine, Baltimore, Maryland21205, United States
| | - Anna M Upton
- Global Alliance for TB Drug Development, New York, New York10005, United States.,Evotec (US) Inc., 303B College Road East, Princeton, New Jersey08540, United States
| | - Paul M O'Neill
- Department of Chemistry, University of Liverpool, LiverpoolL69 7ZD, U.K
| | - Stephen A Ward
- Centre for Drugs and Diagnostics, Department of Tropical Infectious Diseases, Liverpool School of Tropical Medicine, Pembroke Place, LiverpoolL3 5QA, U.K
| | - Giancarlo A Biagini
- Centre for Drugs and Diagnostics, Department of Tropical Infectious Diseases, Liverpool School of Tropical Medicine, Pembroke Place, LiverpoolL3 5QA, U.K
| |
Collapse
|
3
|
Hong WD, O’Neill PM, Taylor MJ, Turner JD, Ward SA, Gusovsky F, Benayoud F, Shibuguchi N, Girish D, Fang FG, Talabhakthla RK, Vaddi A, Challa C, Reddy KSA, Kalla V, Srinivasa Rao S, Nagireddi DMK, Patel J, Khile AS. Transformation of the Manufacturing Process from Discovery to Kilogram Scale for AWZ1066S: A Highly Specific Anti- Wolbachia Drug Candidate for a Short-Course Treatment of Filariasis. Org Process Res Dev 2023. [DOI: 10.1021/acs.oprd.2c00167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- W. David Hong
- Department of Chemistry, University of Liverpool, L69 7ZD Liverpool, United Kingdom
| | - Paul M. O’Neill
- Department of Chemistry, University of Liverpool, L69 7ZD Liverpool, United Kingdom
| | - Mark J. Taylor
- Research Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Joseph D. Turner
- Research Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Stephen A. Ward
- Research Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Fabian Gusovsky
- G2D2 Eisai Inc., 35 Cambridgepark Drive, Cambridge, Massachusetts 02140, United States
| | - Farid Benayoud
- Eisai AiM Institute, Eisai, Inc., Andover, Massachusetts 01810, United States
| | - Nao Shibuguchi
- Analytical Research, Pharmaceutical Science & Technology, CFU, Medicine Development Center, Eisai Co. Ltd., 5-1-3-Tokodai, Tsukuba-shi, Ibaraki 300-2635, Japan
| | - Dixit Girish
- Eisai Pharmaceuticals India Pvt. Ltd., Ramky Pharma City, (SEZ), Plot Nos.96, 97, 98,124 &126, Parawada, Visakhapatnam, Andhra Pradesh 531019, India
| | - Francis Gerard Fang
- Eisai AiM Institute, Eisai, Inc., Andover, Massachusetts 01810, United States
| | - Ravi Kumar Talabhakthla
- Eisai Pharmaceuticals India Pvt. Ltd., Ramky Pharma City, (SEZ), Plot Nos.96, 97, 98,124 &126, Parawada, Visakhapatnam, Andhra Pradesh 531019, India
| | - Anand Vaddi
- Eisai Pharmaceuticals India Pvt. Ltd., Ramky Pharma City, (SEZ), Plot Nos.96, 97, 98,124 &126, Parawada, Visakhapatnam, Andhra Pradesh 531019, India
| | - Chiranjeevi Challa
- Eisai Pharmaceuticals India Pvt. Ltd., Ramky Pharma City, (SEZ), Plot Nos.96, 97, 98,124 &126, Parawada, Visakhapatnam, Andhra Pradesh 531019, India
| | - Karri Satya Ammi Reddy
- Eisai Pharmaceuticals India Pvt. Ltd., Ramky Pharma City, (SEZ), Plot Nos.96, 97, 98,124 &126, Parawada, Visakhapatnam, Andhra Pradesh 531019, India
| | - Vijay Kalla
- Eisai Pharmaceuticals India Pvt. Ltd., Ramky Pharma City, (SEZ), Plot Nos.96, 97, 98,124 &126, Parawada, Visakhapatnam, Andhra Pradesh 531019, India
| | - Sugandham Srinivasa Rao
- Eisai Pharmaceuticals India Pvt. Ltd., Ramky Pharma City, (SEZ), Plot Nos.96, 97, 98,124 &126, Parawada, Visakhapatnam, Andhra Pradesh 531019, India
| | - Durga Mahesh Kumar Nagireddi
- Eisai Pharmaceuticals India Pvt. Ltd., Ramky Pharma City, (SEZ), Plot Nos.96, 97, 98,124 &126, Parawada, Visakhapatnam, Andhra Pradesh 531019, India
| | - Jayesh Patel
- Eisai Pharmaceuticals India Pvt. Ltd., Ramky Pharma City, (SEZ), Plot Nos.96, 97, 98,124 &126, Parawada, Visakhapatnam, Andhra Pradesh 531019, India
| | - Anil Shahaji Khile
- Eisai Pharmaceuticals India Pvt. Ltd., Ramky Pharma City, (SEZ), Plot Nos.96, 97, 98,124 &126, Parawada, Visakhapatnam, Andhra Pradesh 531019, India
| |
Collapse
|
4
|
Saifuddin Ekram ARM, Espinoza SE, Ernst ME, Ryan J, Beilin L, Stocks NP, Ward SA, McNeil JJ, Shah RC, Woods RL. The Association between Metabolic Syndrome, Frailty and Disability-Free Survival in Healthy Community-dwelling Older Adults. J Nutr Health Aging 2023; 27:1-9. [PMID: 36651481 PMCID: PMC10061371 DOI: 10.1007/s12603-022-1860-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To examine the association between metabolic syndrome (MetS) and frailty, and determine whether co-existent MetS and frailty affect disability-free survival (DFS), assessed through a composite of death, dementia or physical disability. DESIGN Longitudinal study. SETTING AND PARTICIPANTS Community-dwelling older adults from Australia and the United States (n=18,264) from "ASPirin in Reducing Events in the Elderly" (ASPREE) study. MEASUREMENTS MetS was defined according to American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines (2018). A modified Fried phenotype and a deficit accumulation Frailty Index (FI) were used to assess frailty. Association between MetS and frailty was examined using multinomial logistic regression. Cox regression was used to analyze the association between MetS, frailty and DFS over a median follow-up of 4.7 years. RESULTS Among 18,264 participants, 49.9% met the criteria for MetS at baseline. Participants with Mets were more likely to be pre-frail [Relative Risk Ratio (RRR): 1.22; 95%Confidence Interval (CI): 1.14, 1.30)] or frail (RRR: 1.66; 95%CI: 1.32, 2.08) than those without MetS. MetS alone did not shorten DFS while pre-frailty or frailty alone did [Hazard Ratio (HR): 1.68; 95%CI: 1.45, 1.94; HR: 2.65; 95%CI:1.92, 3.66, respectively]. Co-existent MetS with pre-frailty/frailty did not change the risk of shortened DFS. CONCLUSIONS MetS was associated with pre-frailty or frailty in community-dwelling older individuals. Pre-frailty or frailty increased the risk of reduced DFS but presence of MetS did not change this risk. Assessment of frailty may be more important than MetS in predicting survival free of dementia or physical disability.
Collapse
Affiliation(s)
- A R M Saifuddin Ekram
- Dr. A R M Saifuddin Ekram, Senior Clinical Research Consultant (ASPREE), SPHPM, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia. Mobile phone: +61449031659, E-mail:
| | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Amporndanai K, Pinthong N, O’Neill PM, Hong WD, Amewu RK, Pidathala C, Berry NG, Leung SC, Ward SA, Biagini GA, Hasnain SS, Antonyuk SV. Targeting the Ubiquinol-Reduction (Q i) Site of the Mitochondrial Cytochrome bc1 Complex for the Development of Next Generation Quinolone Antimalarials. Biology (Basel) 2022; 11:biology11081109. [PMID: 35892964 PMCID: PMC9330653 DOI: 10.3390/biology11081109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022]
Abstract
Antimalarials targeting the ubiquinol-oxidation (Qo) site of the Plasmodium falciparum bc1 complex, such as atovaquone, have become less effective due to the rapid emergence of resistance linked to point mutations in the Qo site. Recent findings showed a series of 2-aryl quinolones mediate inhibitions of this complex by binding to the ubiquinone-reduction (Qi) site, which offers a potential advantage in circumventing drug resistance. Since it is essential to understand how 2-aryl quinolone lead compounds bind within the Qi site, here we describe the co-crystallization and structure elucidation of the bovine cytochrome bc1 complex with three different antimalarial 4(1H)-quinolone sub-types, including two 2-aryl quinolone derivatives and a 3-aryl quinolone analogue for comparison. Currently, no structural information is available for Plasmodial cytochrome bc1. Our crystallographic studies have enabled comparison of an in-silico homology docking model of P. falciparum with the mammalian's equivalent, enabling an examination of how binding compares for the 2- versus 3-aryl analogues. Based on crystallographic and computational modeling, key differences in human and P. falciparum Qi sites have been mapped that provide new insights that can be exploited for the development of next-generation antimalarials with greater selective inhibitory activity against the parasite bc1 with improved antimalarial properties.
Collapse
Affiliation(s)
- Kangsa Amporndanai
- Molecular Biophysics Group, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 7ZB, UK; (K.A.); (N.P.); (S.S.H.)
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, TN 37232-0146, USA
| | - Nattapon Pinthong
- Molecular Biophysics Group, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 7ZB, UK; (K.A.); (N.P.); (S.S.H.)
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Paul M. O’Neill
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, UK; (W.D.H.); (R.K.A.); (C.P.); (N.G.B.); (S.C.L.)
- Correspondence: (P.M.O.); (S.V.A.); Tel.: +44-(0)-1517955145 (S.V.A.); +44-(0)-1517943552 (P.M.O.)
| | - W. David Hong
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, UK; (W.D.H.); (R.K.A.); (C.P.); (N.G.B.); (S.C.L.)
| | - Richard K. Amewu
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, UK; (W.D.H.); (R.K.A.); (C.P.); (N.G.B.); (S.C.L.)
- Department of Chemistry, School of Physical and Mathematical Sciences, University of Ghana, Accra P.O. Box LG 586, Ghana
| | - Chandrakala Pidathala
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, UK; (W.D.H.); (R.K.A.); (C.P.); (N.G.B.); (S.C.L.)
- Composite Interceptive Med-Science Laboratories Pvt. Ltd., Bengaluru 60099, Karnataka, India
| | - Neil G. Berry
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, UK; (W.D.H.); (R.K.A.); (C.P.); (N.G.B.); (S.C.L.)
| | - Suet C. Leung
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, UK; (W.D.H.); (R.K.A.); (C.P.); (N.G.B.); (S.C.L.)
| | - Stephen A. Ward
- Centre for Drugs and Diagnostics, Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK; (S.A.W.); (G.A.B.)
| | - Giancarlo A. Biagini
- Centre for Drugs and Diagnostics, Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK; (S.A.W.); (G.A.B.)
| | - S. Samar Hasnain
- Molecular Biophysics Group, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 7ZB, UK; (K.A.); (N.P.); (S.S.H.)
| | - Svetlana V. Antonyuk
- Molecular Biophysics Group, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 7ZB, UK; (K.A.); (N.P.); (S.S.H.)
- Correspondence: (P.M.O.); (S.V.A.); Tel.: +44-(0)-1517955145 (S.V.A.); +44-(0)-1517943552 (P.M.O.)
| |
Collapse
|
6
|
Mansoor R, Commons RJ, Douglas NM, Abuaku B, Achan J, Adam I, Adjei GO, Adjuik M, Alemayehu BH, Allan R, Allen EN, Anvikar AR, Arinaitwe E, Ashley EA, Ashurst H, Asih PBS, Bakyaita N, Barennes H, Barnes KI, Basco L, Bassat Q, Baudin E, Bell DJ, Bethell D, Bjorkman A, Boulton C, Bousema T, Brasseur P, Bukirwa H, Burrow R, Carrara VI, Cot M, D’Alessandro U, Das D, Das S, Davis TME, Desai M, Djimde AA, Dondorp AM, Dorsey G, Drakeley CJ, Duparc S, Espié E, Etard JF, Falade C, Faucher JF, Filler S, Fogg C, Fukuda M, Gaye O, Genton B, Ghulam Rahim A, Gilayeneh J, Gonzalez R, Grais RF, Grandesso F, Greenwood B, Grivoyannis A, Hatz C, Hodel EM, Humphreys GS, Hwang J, Ishengoma D, Juma E, Kachur SP, Kager PA, Kamugisha E, Kamya MR, Karema C, Kayentao K, Kazienga A, Kiechel JR, Kofoed PE, Koram K, Kremsner PG, Lalloo DG, Laman M, Lee SJ, Lell B, Maiga AW, Mårtensson A, Mayxay M, Mbacham W, McGready R, Menan H, Ménard D, Mockenhaupt F, Moore BR, Müller O, Nahum A, Ndiaye JL, Newton PN, Ngasala BE, Nikiema F, Nji AM, Noedl H, Nosten F, Ogutu BR, Ojurongbe O, Osorio L, Ouédraogo JB, Owusu-Agyei S, Pareek A, Penali LK, Piola P, Plucinski M, Premji Z, Ramharter M, Richmond CL, Rombo L, Roper C, Rosenthal PJ, Salman S, Same-Ekobo A, Sibley C, Sirima SB, Smithuis FM, Somé FA, Staedke SG, Starzengruber P, Strub-Wourgaft N, Sutanto I, Swarthout TD, Syafruddin D, Talisuna AO, Taylor WR, Temu EA, Thwing JI, Tinto H, Tjitra E, Touré OA, Tran TH, Ursing J, Valea I, Valentini G, van Vugt M, von Seidlein L, Ward SA, Were V, White NJ, Woodrow CJ, Yavo W, Yeka A, Zongo I, Simpson JA, Guerin PJ, Stepniewska K, Price RN. Haematological consequences of acute uncomplicated falciparum malaria: a WorldWide Antimalarial Resistance Network pooled analysis of individual patient data. BMC Med 2022; 20:85. [PMID: 35249546 PMCID: PMC8900374 DOI: 10.1186/s12916-022-02265-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/18/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Plasmodium falciparum malaria is associated with anaemia-related morbidity, attributable to host, parasite and drug factors. We quantified the haematological response following treatment of uncomplicated P. falciparum malaria to identify the factors associated with malarial anaemia. METHODS Individual patient data from eligible antimalarial efficacy studies of uncomplicated P. falciparum malaria, available through the WorldWide Antimalarial Resistance Network data repository prior to August 2015, were pooled using standardised methodology. The haematological response over time was quantified using a multivariable linear mixed effects model with nonlinear terms for time, and the model was then used to estimate the mean haemoglobin at day of nadir and day 7. Multivariable logistic regression quantified risk factors for moderately severe anaemia (haemoglobin < 7 g/dL) at day 0, day 3 and day 7 as well as a fractional fall ≥ 25% at day 3 and day 7. RESULTS A total of 70,226 patients, recruited into 200 studies between 1991 and 2013, were included in the analysis: 50,859 (72.4%) enrolled in Africa, 18,451 (26.3%) in Asia and 916 (1.3%) in South America. The median haemoglobin concentration at presentation was 9.9 g/dL (range 5.0-19.7 g/dL) in Africa, 11.6 g/dL (range 5.0-20.0 g/dL) in Asia and 12.3 g/dL (range 6.9-17.9 g/dL) in South America. Moderately severe anaemia (Hb < 7g/dl) was present in 8.4% (4284/50,859) of patients from Africa, 3.3% (606/18,451) from Asia and 0.1% (1/916) from South America. The nadir haemoglobin occurred on day 2 post treatment with a mean fall from baseline of 0.57 g/dL in Africa and 1.13 g/dL in Asia. Independent risk factors for moderately severe anaemia on day 7, in both Africa and Asia, included moderately severe anaemia at baseline (adjusted odds ratio (AOR) = 16.10 and AOR = 23.00, respectively), young age (age < 1 compared to ≥ 12 years AOR = 12.81 and AOR = 6.79, respectively), high parasitaemia (AOR = 1.78 and AOR = 1.58, respectively) and delayed parasite clearance (AOR = 2.44 and AOR = 2.59, respectively). In Asia, patients treated with an artemisinin-based regimen were at significantly greater risk of moderately severe anaemia on day 7 compared to those treated with a non-artemisinin-based regimen (AOR = 2.06 [95%CI 1.39-3.05], p < 0.001). CONCLUSIONS In patients with uncomplicated P. falciparum malaria, the nadir haemoglobin occurs 2 days after starting treatment. Although artemisinin-based treatments increase the rate of parasite clearance, in Asia they are associated with a greater risk of anaemia during recovery.
Collapse
|
7
|
Jeffreys LN, Pennington SH, Duggan J, Caygill CH, Lopeman RC, Breen AF, Jinks JB, Ardrey A, Donnellan S, Patterson EI, Hughes GL, Hong DW, O'Neill PM, Aljayyoussi G, Owen A, Ward SA, Biagini GA. Remdesivir-ivermectin combination displays synergistic interaction with improved in vitro activity against SARS-CoV-2. Int J Antimicrob Agents 2022; 59:106542. [PMID: 35093538 PMCID: PMC8801767 DOI: 10.1016/j.ijantimicag.2022.106542] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/20/2022] [Accepted: 01/20/2022] [Indexed: 11/05/2022]
Abstract
A key element for the prevention and management of coronavirus disease 2019 is the development of effective therapeutics. Drug combination strategies offer several advantages over monotherapies. They have the potential to achieve greater efficacy, to increase the therapeutic index of drugs and to reduce the emergence of drug resistance. We assessed the in vitro synergistic interaction between remdesivir and ivermectin, both approved by the US Food and Drug Administration, and demonstrated enhanced antiviral activity against severe acute respiratory syndrome coronavirus-2. Whilst the in vitro synergistic activity reported here does not support the clinical application of this combination treatment strategy due to insufficient exposure of ivermectin in vivo, the data do warrant further investigation. Efforts to define the mechanisms underpinning the observed synergistic action could lead to the development of novel treatment strategies.
Collapse
|
8
|
Johnston KL, Hong WD, Turner JD, O'Neill PM, Ward SA, Taylor MJ. Anti-Wolbachia drugs for filariasis. Trends Parasitol 2021; 37:1068-1081. [PMID: 34229954 DOI: 10.1016/j.pt.2021.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/21/2021] [Accepted: 06/07/2021] [Indexed: 10/20/2022]
Abstract
The mutualistic association between Wolbachia endosymbionts and their filarial nematode hosts has been exploited as a validated drug target delivering macrofilaricidal outcomes. Limitations of existing antibiotics to scale-up have driven the search for new drugs, which are effective in shorter regimens of 7 days or less. Here, we review the last 14 years of anti-Wolbachia drug discovery by the anti-Wolbachia (A·WOL) consortium, which has screened more than two million compounds, delivering thousands of hit compounds. Refined screening models integrated with robust pharmacokinetic/pharmacodynamic (PK/PD) driven optimisation and selection strategies have delivered the first two drug candidates specifically designed to target Wolbachia. AWZ1066S and ABBV-4083 are currently progressing through clinical trials with the aim of delivering safe and effective macrofilaricides to support the elimination of onchocerciasis and lymphatic filariasis.
Collapse
Affiliation(s)
- Kelly L Johnston
- Centre for Neglected Tropical Diseases and Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK; School of Life Sciences, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - W David Hong
- Department of Chemistry, University of Liverpool, Liverpool, UK
| | - Joseph D Turner
- Centre for Neglected Tropical Diseases and Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Paul M O'Neill
- Department of Chemistry, University of Liverpool, Liverpool, UK
| | - Stephen A Ward
- Centre for Neglected Tropical Diseases and Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Mark J Taylor
- Centre for Neglected Tropical Diseases and Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK.
| |
Collapse
|
9
|
McGillan P, Berry NG, Nixon GL, Leung SC, Webborn PJH, Wenlock MC, Kavanagh S, Cassidy A, Clare RH, Cook DA, Johnston KL, Ford L, Ward SA, Taylor MJ, Hong WD, O’Neill PM. Development of Pyrazolopyrimidine Anti- Wolbachia Agents for the Treatment of Filariasis. ACS Med Chem Lett 2021; 12:1421-1426. [PMID: 34527179 PMCID: PMC8436242 DOI: 10.1021/acsmedchemlett.1c00216] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/16/2021] [Indexed: 11/30/2022] Open
Abstract
![]()
Anti-Wolbachia therapy has been identified as
a viable treatment for combating filarial diseases. Phenotypic screening
revealed a series of pyrazolopyrimidine hits with potent anti-Wolbachia activity. This paper focuses on the exploration
of the SAR for this chemotype, with improvement of metabolic stability
and solubility profiles using medicinal chemistry approaches. Organic
synthesis has enabled functionalization of the pyrazolopyrimidine
core at multiple positions, generating a library of compounds of which
many analogues possess nanomolar activity against Wolbachia
in vitro with improved DMPK parameters. A lead compound, 15f, was selected for in vivo pharmacokinetics
(PK) profiling in mice. The combination of potent anti-Wolbachia activity in two in vitro assessments plus the exceptional
oral PK profiles in mice puts this lead compound in a strong position
for in vivo proof-of-concept pharmacodynamics studies
and demonstrates the strong potential for further optimization and
development of this series for treatment of filariasis in the future.
Collapse
Affiliation(s)
- Paul McGillan
- Department of Chemistry, University of Liverpool, Crown Street, Liverpool L69 7ZD, United Kingdom
| | - Neil G. Berry
- Department of Chemistry, University of Liverpool, Crown Street, Liverpool L69 7ZD, United Kingdom
| | - Gemma L. Nixon
- Department of Chemistry, University of Liverpool, Crown Street, Liverpool L69 7ZD, United Kingdom
| | - Suet C. Leung
- Department of Chemistry, University of Liverpool, Crown Street, Liverpool L69 7ZD, United Kingdom
| | - Peter J. H. Webborn
- Drug Safety & Metabolism, IMED Biotech Unit, AstraZeneca U.K., Cambridge CB2 0AA, United Kingdom
| | - Mark C. Wenlock
- Drug Safety & Metabolism, IMED Biotech Unit, AstraZeneca U.K., Cambridge CB2 0AA, United Kingdom
| | - Stefan Kavanagh
- Oncology Safety Sciences, Clinical Pharmacology & Safety Sciences, R&D, AstraZeneca, Cambridge CB2 0AA, United Kingdom
| | - Andrew Cassidy
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom
| | - Rachel H. Clare
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom
| | - Darren A. Cook
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom
| | - Kelly L. Johnston
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom
- Institute of Systems, Molecular & Integrative Biology, School of Life Sciences, University of Liverpool, Crown Street, Liverpool L69 7ZB, United Kingdom
| | - Louise Ford
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom
| | - Stephen A. Ward
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom
| | - Mark J. Taylor
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom
| | - W. David Hong
- Department of Chemistry, University of Liverpool, Crown Street, Liverpool L69 7ZD, United Kingdom
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, United Kingdom
| | - Paul M. O’Neill
- Department of Chemistry, University of Liverpool, Crown Street, Liverpool L69 7ZD, United Kingdom
| |
Collapse
|
10
|
Woodley CM, Nixon GL, Basilico N, Parapini S, Hong WD, Ward SA, Biagini GA, Leung SC, Taramelli D, Onuma K, Hasebe T, O'Neill PM. Enantioselective Synthesis and Profiling of Potent, Nonlinear Analogues of Antimalarial Tetraoxanes E209 and N205. ACS Med Chem Lett 2021; 12:1077-1085. [PMID: 34267877 PMCID: PMC8274084 DOI: 10.1021/acsmedchemlett.1c00031] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/17/2021] [Indexed: 01/09/2023] Open
Abstract
Synthetic endoperoxide antimalarials, such as 1,2,4-trioxolanes and 1,2,4,5-tetraoxanes, are promising successors for current front-line antimalarials, semisynthetic artemisinin derivatives. However, limited solubility of second-generation analogues in biological-relevant media represents a barrier in clinical development. We present methodology for the synthesis of nonlinear analogues of second-generation tetraoxane antimalarials E209 and N205 to investigate reduced molecular symmetry on in vitro antimalarial activity and physicochemical properties. While maintaining good antimalarial activity and metabolic stability, head-to-head comparison of linear and nonlinear counterparts showed up to 10-fold improvement in FaSSIF solubility for three of the four analogues studied. Pharmacokinetic studies in rats comparing a selected nonlinear analogue 14a and its parent N205 showed improvement on oral absorption and exposure in vivo with more than double the AUC and a significant increase in oral bioavailability (76% versus 41%). These findings provide support for further in vivo efficacy studies in preclinical animal species.
Collapse
Affiliation(s)
| | - Gemma L Nixon
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, United Kingdom
| | - Nicoletta Basilico
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy.,Affiliated to Centro Interuniversitario di Ricerche sulla Malaria/Italian Malaria Network (CIRM-IMN), Università degli Studi di Milano, 20133 Milano, Italy
| | - Silvia Parapini
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy.,Affiliated to Centro Interuniversitario di Ricerche sulla Malaria/Italian Malaria Network (CIRM-IMN), Università degli Studi di Milano, 20133 Milano, Italy
| | - Weiqian David Hong
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, United Kingdom
| | - Stephen A Ward
- Centre for Drugs and Diagnostics. Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Giancarlo A Biagini
- Centre for Drugs and Diagnostics. Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Suet C Leung
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, United Kingdom
| | - Donatella Taramelli
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy.,Affiliated to Centro Interuniversitario di Ricerche sulla Malaria/Italian Malaria Network (CIRM-IMN), Università degli Studi di Milano, 20133 Milano, Italy
| | - Keiko Onuma
- Eisai Co.,Ltd. Tsukuba Research Laboratories, 5-1-3 Tokodai, Tsukubashi, Ibaraki 300-2635, Japan
| | - Takashi Hasebe
- Eisai Co.,Ltd. Tsukuba Research Laboratories, 5-1-3 Tokodai, Tsukubashi, Ibaraki 300-2635, Japan
| | - Paul M O'Neill
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, United Kingdom
| |
Collapse
|
11
|
Stachulski AV, Taujanskas J, Pate SL, Rajoli RKR, Aljayyoussi G, Pennington SH, Ward SA, Hong WD, Biagini GA, Owen A, Nixon GL, Leung SC, O’Neill PM. Therapeutic Potential of Nitazoxanide: An Appropriate Choice for Repurposing versus SARS-CoV-2? ACS Infect Dis 2021; 7:1317-1331. [PMID: 33352056 PMCID: PMC7771247 DOI: 10.1021/acsinfecdis.0c00478] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Indexed: 12/16/2022]
Abstract
The rapidly growing COVID-19 pandemic is the most serious global health crisis since the "Spanish flu" of 1918. There is currently no proven effective drug treatment or prophylaxis for this coronavirus infection. While developing safe and effective vaccines is one of the key focuses, a number of existing antiviral drugs are being evaluated for their potency and efficiency against SARS-CoV-2 in vitro and in the clinic. Here, we review the significant potential of nitazoxanide (NTZ) as an antiviral agent that can be repurposed as a treatment for COVID-19. Originally, NTZ was developed as an antiparasitic agent especially against Cryptosporidium spp.; it was later shown to possess potent activity against a broad range of both RNA and DNA viruses, including influenza A, hepatitis B and C, and coronaviruses. Recent in vitro assessment of NTZ has confirmed its promising activity against SARS-CoV-2 with an EC50 of 2.12 μM. Here we examine its drug properties, antiviral activity against different viruses, clinical trials outcomes, and mechanisms of antiviral action from the literature in order to highlight the therapeutic potential for the treatment of COVID-19. Furthermore, in preliminary PK/PD analyses using clinical data reported in the literature, comparison of simulated TIZ (active metabolite of NTZ) exposures at two doses with the in vitro potency of NTZ against SARS-CoV-2 gives further support for drug repurposing with potential in combination chemotherapy approaches. The review concludes with details of second generation thiazolides under development that could lead to improved antiviral therapies for future indications.
Collapse
Affiliation(s)
| | - Joshua Taujanskas
- Department of Chemistry, University of
Liverpool, Liverpool L69 7ZD, U.K.
| | - Sophie L. Pate
- Department of Chemistry, University of
Liverpool, Liverpool L69 7ZD, U.K.
| | - Rajith K. R. Rajoli
- Department of Molecular and Clinical Pharmacology,
Materials Innovation Factory, University of Liverpool,
Liverpool L7 3NY, U.K.
| | - Ghaith Aljayyoussi
- Centre for Drugs and Diagnostics, Department of Tropical
Disease Biology, Liverpool School of Tropical Medicine,
Liverpool L3 5QA, U.K.
| | - Shaun H. Pennington
- Centre for Drugs and Diagnostics, Department of Tropical
Disease Biology, Liverpool School of Tropical Medicine,
Liverpool L3 5QA, U.K.
| | - Stephen A. Ward
- Centre for Drugs and Diagnostics, Department of Tropical
Disease Biology, Liverpool School of Tropical Medicine,
Liverpool L3 5QA, U.K.
| | - Weiqian David Hong
- Department of Chemistry, University of
Liverpool, Liverpool L69 7ZD, U.K.
| | - Giancarlo A. Biagini
- Centre for Drugs and Diagnostics, Department of Tropical
Disease Biology, Liverpool School of Tropical Medicine,
Liverpool L3 5QA, U.K.
| | - Andrew Owen
- Department of Molecular and Clinical Pharmacology,
Materials Innovation Factory, University of Liverpool,
Liverpool L7 3NY, U.K.
| | - Gemma L. Nixon
- Department of Chemistry, University of
Liverpool, Liverpool L69 7ZD, U.K.
| | - Suet C. Leung
- Department of Chemistry, University of
Liverpool, Liverpool L69 7ZD, U.K.
| | - Paul M. O’Neill
- Department of Chemistry, University of
Liverpool, Liverpool L69 7ZD, U.K.
| |
Collapse
|
12
|
Arshad U, Pertinez H, Box H, Tatham L, Rajoli RKR, Curley P, Neary M, Sharp J, Liptrott NJ, Valentijn A, David C, Rannard SP, O’Neill PM, Aljayyoussi G, Pennington SH, Ward SA, Hill A, Back DJ, Khoo SH, Bray PG, Biagini GA, Owen A. Prioritization of Anti-SARS-Cov-2 Drug Repurposing Opportunities Based on Plasma and Target Site Concentrations Derived from their Established Human Pharmacokinetics. Clin Pharmacol Ther 2020; 108:775-790. [PMID: 32438446 PMCID: PMC7280633 DOI: 10.1002/cpt.1909] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [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: 04/24/2020] [Accepted: 05/18/2020] [Indexed: 12/13/2022]
Abstract
There is a rapidly expanding literature on the in vitro antiviral activity of drugs that may be repurposed for therapy or chemoprophylaxis against severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). However, this has not been accompanied by a comprehensive evaluation of the target plasma and lung concentrations of these drugs following approved dosing in humans. Accordingly, concentration 90% (EC90 ) values recalculated from in vitro anti-SARS-CoV-2 activity data was expressed as a ratio to the achievable maximum plasma concentration (Cmax ) at an approved dose in humans (Cmax /EC90 ratio). Only 14 of the 56 analyzed drugs achieved a Cmax /EC90 ratio above 1. A more in-depth assessment demonstrated that only nitazoxanide, nelfinavir, tipranavir (ritonavir-boosted), and sulfadoxine achieved plasma concentrations above their reported anti-SARS-CoV-2 activity across their entire approved dosing interval. An unbound lung to plasma tissue partition coefficient (Kp Ulung ) was also simulated to derive a lung Cmax /half-maximal effective concentration (EC50 ) as a better indicator of potential human efficacy. Hydroxychloroquine, chloroquine, mefloquine, atazanavir (ritonavir-boosted), tipranavir (ritonavir-boosted), ivermectin, azithromycin, and lopinavir (ritonavir-boosted) were all predicted to achieve lung concentrations over 10-fold higher than their reported EC50 . Nitazoxanide and sulfadoxine also exceeded their reported EC50 by 7.8-fold and 1.5-fold in lung, respectively. This analysis may be used to select potential candidates for further clinical testing, while deprioritizing compounds unlikely to attain target concentrations for antiviral activity. Future studies should focus on EC90 values and discuss findings in the context of achievable exposures in humans, especially within target compartments, such as the lungs, in order to maximize the potential for success of proposed human clinical trials.
Collapse
Affiliation(s)
- Usman Arshad
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | - Henry Pertinez
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | - Helen Box
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | - Lee Tatham
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | - Rajith K. R. Rajoli
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | - Paul Curley
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | - Megan Neary
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | - Joanne Sharp
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | - Neill J. Liptrott
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | - Anthony Valentijn
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | - Christopher David
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | | | | | - Ghaith Aljayyoussi
- Department of Tropical Disease BiologyLiverpool School of Tropical MedicineCentre for Drugs and DiagnosticsLiverpoolUK
| | - Shaun H. Pennington
- Department of Tropical Disease BiologyLiverpool School of Tropical MedicineCentre for Drugs and DiagnosticsLiverpoolUK
| | - Stephen A. Ward
- Department of Tropical Disease BiologyLiverpool School of Tropical MedicineCentre for Drugs and DiagnosticsLiverpoolUK
| | - Andrew Hill
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | - David J. Back
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | - Saye H. Khoo
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| | | | - Giancarlo A. Biagini
- Department of Tropical Disease BiologyLiverpool School of Tropical MedicineCentre for Drugs and DiagnosticsLiverpoolUK
| | - Andrew Owen
- Department of Molecular and Clinical PharmacologyMaterials Innovation FactoryUniversity of LiverpoolLiverpoolUK
| |
Collapse
|
13
|
Smit MR, Ochomo EO, Aljayyoussi G, Kwambai TK, Abong'o BO, Bousema T, Waterhouse D, Bayoh NM, Gimnig JE, Samuels AM, Desai MR, Phillips-Howard PA, Kariuki SK, Wang D, Ward SA, Ter Kuile FO. Human Direct Skin Feeding Versus Membrane Feeding to Assess the Mosquitocidal Efficacy of High-Dose Ivermectin (IVERMAL Trial). Clin Infect Dis 2020; 69:1112-1119. [PMID: 30590537 PMCID: PMC6743833 DOI: 10.1093/cid/ciy1063] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 09/03/2018] [Accepted: 12/20/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Ivermectin is being considered for mass drug administration for malaria, due to its ability to kill mosquitoes feeding on recently treated individuals. In a recent trial, 3-day courses of 300 and 600 mcg/kg/day were shown to kill Anopheles mosquitoes for at least 28 days post-treatment when fed patients' venous blood using membrane feeding assays. Direct skin feeding on humans may lead to higher mosquito mortality, as ivermectin capillary concentrations are higher. We compared mosquito mortality following direct skin and membrane feeding. METHODS We conducted a mosquito feeding study, nested within a randomized, double-blind, placebo-controlled trial of 141 adults with uncomplicated malaria in Kenya, comparing 3 days of ivermectin 300 mcg/kg/day, ivermectin 600 mcg/kg/day, or placebo, all co-administered with 3 days of dihydroartemisinin-piperaquine. On post-treatment day 7, direct skin and membrane feeding assays were conducted using laboratory-reared Anopheles gambiae sensu stricto. Mosquito survival was assessed daily for 28 days post-feeding. RESULTS Between July 20, 2015, and May 7, 2016, 69 of 141 patients participated in both direct skin and membrane feeding (placebo, n = 23; 300 mcg/kg/day, n = 24; 600 mcg/kg/day, n = 22). The 14-day post-feeding mortality for mosquitoes fed 7 days post-treatment on blood from pooled patients in both ivermectin arms was similar with direct skin feeding (mosquitoes observed, n = 2941) versus membrane feeding (mosquitoes observed, n = 7380): cumulative mortality (risk ratio 0.99, 95% confidence interval [CI] 0.95-1.03, P = .69) and survival time (hazard ratio 0.96, 95% CI 0.91-1.02, P = .19). Results were consistent by sex, by body mass index, and across the range of ivermectin capillary concentrations studied (0.72-73.9 ng/mL). CONCLUSIONS Direct skin feeding and membrane feeding on day 7 resulted in similar mosquitocidal effects of ivermectin across a wide range of drug concentrations, suggesting that the mosquitocidal effects seen with membrane feeding accurately reflect those of natural biting. Membrane feeding, which is more patient friendly and ethically acceptable, can likely reliably be used to assess ivermectin's mosquitocidal efficacy. CLINICAL TRIALS REGISTRATION NCT02511353.
Collapse
Affiliation(s)
- Menno R Smit
- Liverpool School of Tropical Medicine, United Kingdom
| | - Eric O Ochomo
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu
| | | | - Titus K Kwambai
- Liverpool School of Tropical Medicine, United Kingdom.,Kenya Medical Research Institute, Centre for Global Health Research, Kisumu.,Kenya Ministry of Health, Kisumu County, Kisumu
| | - Bernard O Abong'o
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu
| | - Teun Bousema
- Radboud University Medical Center, Nijmegen, The Netherlands.,London School of Hygiene and Tropical Medicine, United Kingdom
| | | | - Nabie M Bayoh
- US Centers for Disease Control and Prevention, Center for Global Health, Division of Parasitic Diseases and Malaria, Atlanta, Georgia
| | - John E Gimnig
- US Centers for Disease Control and Prevention, Center for Global Health, Division of Parasitic Diseases and Malaria, Atlanta, Georgia
| | - Aaron M Samuels
- US Centers for Disease Control and Prevention, Center for Global Health, Division of Parasitic Diseases and Malaria, Atlanta, Georgia
| | - Meghna R Desai
- US Centers for Disease Control and Prevention, Center for Global Health, Division of Parasitic Diseases and Malaria, Atlanta, Georgia
| | | | - Simon K Kariuki
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu
| | - Duolao Wang
- Liverpool School of Tropical Medicine, United Kingdom
| | | | | |
Collapse
|
14
|
Yu P, Yang JN, Yan JW, Meng ZZ, Hong WD, Roberts AP, Ward SA, Zhang L, Li S. A novel fluorescent probe for the detection of AmpC beta-lactamase and the application in screening beta-lactamase inhibitors. Spectrochim Acta A Mol Biomol Spectrosc 2020; 234:118257. [PMID: 32208355 DOI: 10.1016/j.saa.2020.118257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/01/2020] [Accepted: 03/13/2020] [Indexed: 06/10/2023]
Abstract
The rapid detection of β-lactamases (Blas) and effective screening of Bla inhibitors are critically important and urgent for solving antibiotic resistance and improving precision medicine. Here a novel fluorescent probe CDC-559 was designed and synthesized, which can be used for the selective and direct detection of AmpC Blas. More importantly, it can realize screening the Bla inhibitors with sulbactam sodium and tazobactam as model compounds, and the half-maximal inhibitory concentration are 0.279 μM and 0.053 μM, respectively. CDC-559 can be applied not only to examine the resistance of bacterial strains, but also to categorize its mode of action specifically, which is consistent with the essential result of the Blas. The research suggests that CDC-559 probe has tremendous potential in the rapid detection of AmpC Blas as well as the strains with AmpC-encoded gene, which is instructive in promoting better antibiotic stewardship practices and developments.
Collapse
Affiliation(s)
- Pan Yu
- MOE Joint International Research Laboratory of Synthesis Biology and Medicine, School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, PR China
| | - Jia-Ning Yang
- MOE Joint International Research Laboratory of Synthesis Biology and Medicine, School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, PR China
| | - Jin-Wu Yan
- MOE Joint International Research Laboratory of Synthesis Biology and Medicine, School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, PR China
| | - Zhi-Zhong Meng
- MOE Joint International Research Laboratory of Synthesis Biology and Medicine, School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, PR China
| | - W David Hong
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, United Kingdom
| | - Adam P Roberts
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Stephen A Ward
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom
| | - Lei Zhang
- MOE Joint International Research Laboratory of Synthesis Biology and Medicine, School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, PR China; Guangdong Provincial Engineering and Technological Centre for Biopharmaceuticals, South China University of Technology, Guangzhou 510006, PR China.
| | - Shan Li
- MOE Joint International Research Laboratory of Synthesis Biology and Medicine, School of Biology and Biological Engineering, South China University of Technology, Guangzhou 510006, PR China.
| |
Collapse
|
15
|
Klinkhamhom A, Glaharn S, Srisook C, Ampawong S, Krudsood S, Ward SA, Viriyavejakul P. M1 macrophage features in severe Plasmodium falciparum malaria patients with pulmonary oedema. Malar J 2020; 19:182. [PMID: 32414377 PMCID: PMC7226720 DOI: 10.1186/s12936-020-03254-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 12/18/2019] [Accepted: 05/08/2020] [Indexed: 11/25/2022] Open
Abstract
Background Pulmonary oedema (PE) is a serious complication of Plasmodium falciparum malaria which can lead to acute lung injury in severe cases. Lung macrophages are activated during malaria infection due to a complex host-immune response. The molecular basis for macrophage polarization is still unclear but understanding the predominant subtypes could lead to new therapeutic strategies where the diseases present with lung involvement. The present study was designed to study the polarization of lung macrophages, as M1 or M2 macrophages, in the lungs of severe P. falciparum malaria patients, with and without evidence of PE. Methods Lung tissue samples, taken from patients who died from severe P. falciparum malaria, were categorized into severe malaria with PE and without PE (non-PE). Expression of surface markers (CD68+, all macrophages; CD40+, M1 macrophage; and CD163+, M2 macrophage) on activated lung macrophages was used to quantify M1/M2 macrophage subtypes. Results Lung injury was demonstrated in malaria patients with PE. The expression of CD40 (M1 macrophage) was prominent in the group of severe P. falciparum malaria patients with PE (63.44 ± 1.98%), compared to non-PE group (53.22 ± 3.85%, p < 0.05), whereas there was no difference observed for CD163 (M2 macrophage) between PE and non-PE groups. Conclusions The study demonstrates M1 polarization in lung tissues from severe P. falciparum malaria infections with PE. Understanding the nature of macrophage characterization in malaria infection may provide new insights into therapeutic approaches that could be deployed to reduce lung damage in severe P. falciparum malaria.
Collapse
Affiliation(s)
- Aekkarin Klinkhamhom
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
| | - Supattra Glaharn
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
| | - Charit Srisook
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
| | - Sumate Ampawong
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
| | - Srivicha Krudsood
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
| | - Stephen A Ward
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Parnpen Viriyavejakul
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand.
| |
Collapse
|
16
|
Requena-Méndez A, Davies G, Waterhouse D, Ardrey A, Jave O, López-Romero SL, Ward SA, Moore DAJ. Intra-individual effects of food upon the pharmacokinetics of rifampicin and isoniazid. J Antimicrob Chemother 2020; 74:416-424. [PMID: 30412245 DOI: 10.1093/jac/dky444] [Citation(s) in RCA: 2] [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] [Received: 07/29/2018] [Accepted: 10/01/2018] [Indexed: 01/21/2023] Open
Abstract
Background Poor response to TB therapy might be attributable to subtherapeutic levels in drug-compliant patients. Pharmacokinetic parameters can be affected by comorbidities or the interaction of drugs with food. Objectives This study aimed to determine the effect of food intake upon pharmacokinetics of rifampicin and isoniazid in a Peruvian population with TB. Methods Rifampicin and isoniazid levels were analysed at 2, 4 and 6 h after drug intake in both fasting and non-fasting states using LC-MS methods. Results Sixty patients participated in the study. The median rifampicin Cmax and AUC0-6 were higher during fasting than non-fasting: 7.02 versus 6.59 mg/L (P = 0.054) and 28.64 versus 24.31 mg·h/L (P = 0.002). There was a statistically significant delay overall of non-fasting Tmax compared with the fasting state Tmax (P = 0.005). In the multivariate analysis, besides the effect of fasting, Cmax for females was 20% higher than for males (P = 0.03). Concerning isoniazid, there were significant differences in the Cmax during non-fasting (median = 3.51 mg/L) compared with fasting (4.54 mg/L). The isoniazid dose received had an effect upon the isoniazid levels (1.26, P = 0.038). In the multivariate analysis, isoniazid exposure during fasting was found to be 14% higher than during non-fasting (CI = 1.02-1.28, P < 0.001). Neither radiological extent of the disease nor consumption of food with drug intake nor pharmacokinetics of rifampicin or isoniazid was associated with a poorer treatment outcome. Conclusions Rifampicin in particular and isoniazid pharmacokinetics were significantly affected by the intake of the drug with food between and within individuals.
Collapse
Affiliation(s)
- Ana Requena-Méndez
- Barcelona Institute for Global Health (ISGlobal-CRESIB), Hospital Clinic-Universitat de Barcelona, Barcelona, Spain
| | - Geraint Davies
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - David Waterhouse
- Department of Molecular Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Alison Ardrey
- Department of Molecular Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Oswaldo Jave
- Servicio de Pneumología, Hospital Dos de Mayo, Lima, Peru
| | - Sonia Llanet López-Romero
- Laboratorio de Investigación de Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Stephen A Ward
- Department of Molecular Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - David A J Moore
- TB Centre and Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
17
|
Rajoli RK, Pertinez H, Arshad U, Box H, Tatham L, Curley P, Neary M, Sharp J, Liptrott NJ, Valentijn A, David C, Rannard SP, Aljayyoussi G, Pennington SH, Hill A, Boffito M, Ward SA, Khoo SH, Bray PG, O'Neill PM, Hong WD, Biagini G, Owen A. Dose prediction for repurposing nitazoxanide in SARS-CoV-2 treatment or chemoprophylaxis. medRxiv 2020:2020.05.01.20087130. [PMID: 32511548 PMCID: PMC7274229 DOI: 10.1101/2020.05.01.20087130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been declared a global pandemic by the World Health Organisation and urgent treatment and prevention strategies are needed. Many clinical trials have been initiated with existing medications, but assessments of the expected plasma and lung exposures at the selected doses have not featured in the prioritisation process. Although no antiviral data is currently available for the major phenolic circulating metabolite of nitazoxanide (known as tizoxanide), the parent ester drug has been shown to exhibit in vitro activity against SARS-CoV-2. Nitazoxanide is an anthelmintic drug and its metabolite tizoxanide has been described to have broad antiviral activity against influenza and other coronaviruses. The present study used physiologically-based pharmacokinetic (PBPK) modelling to inform optimal doses of nitazoxanide capable of maintaining plasma and lung tizoxanide exposures above the reported nitazoxanide 90% effective concentration (EC 90 ) against SARS-CoV-2. METHODS A whole-body PBPK model was constructed for oral administration of nitazoxanide and validated against available tizoxanide pharmacokinetic data for healthy individuals receiving single doses between 500 mg SARS-CoV-2 4000 mg with and without food. Additional validation against multiple-dose pharmacokinetic data when given with food was conducted. The validated model was then used to predict alternative doses expected to maintain tizoxanide plasma and lung concentrations over the reported nitazoxanide EC 90 in >90% of the simulated population. Optimal design software PopDes was used to estimate an optimal sparse sampling strategy for future clinical trials. RESULTS The PBPK model was validated with AAFE values between 1.01 SARS-CoV-2 1.58 and a difference less than 2-fold between observed and simulated values for all the reported clinical doses. The model predicted optimal doses of 1200 mg QID, 1600 mg TID, 2900 mg BID in the fasted state and 700 mg QID, 900 mg TID and 1400 mg BID when given with food, to provide tizoxanide plasma and lung concentrations over the reported in vitro EC 90 of nitazoxanide against SARS-CoV-2. For BID regimens an optimal sparse sampling strategy of 0.25, 1, 3 and 12h post dose was estimated. CONCLUSION The PBPK model predicted that it was possible to achieve plasma and lung tizoxanide concentrations, using proven safe doses of nitazoxanide, that exceed the EC 90 for SARS-CoV-2. The PBPK model describing tizoxanide plasma pharmacokinetics after oral administration of nitazoxanide was successfully validated against clinical data. This dose prediction assumes that the tizoxanide metabolite has activity against SARS-CoV-2 similar to that reported for nitazoxanide, as has been reported for other viruses. The model and the reported dosing strategies provide a rational basis for the design (optimising plasma and lung exposures) of future clinical trials of nitazoxanide in the treatment or prevention of SARS-CoV-2 infection.
Collapse
|
18
|
Taylor MJ, von Geldern TW, Ford L, Hübner MP, Marsh K, Johnston KL, Sjoberg HT, Specht S, Pionnier N, Tyrer HE, Clare RH, Cook DAN, Murphy E, Steven A, Archer J, Bloemker D, Lenz F, Koschel M, Ehrens A, Metuge HM, Chunda VC, Ndongmo Chounna PW, Njouendou AJ, Fombad FF, Carr R, Morton HE, Aljayyoussi G, Hoerauf A, Wanji S, Kempf DJ, Turner JD, Ward SA. Preclinical development of an oral anti- Wolbachia macrolide drug for the treatment of lymphatic filariasis and onchocerciasis. Sci Transl Med 2020; 11:11/483/eaau2086. [PMID: 30867321 DOI: 10.1126/scitranslmed.aau2086] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/19/2018] [Indexed: 01/04/2023]
Abstract
There is an urgent global need for a safe macrofilaricide drug to accelerate elimination of the neglected tropical diseases onchocerciasis and lymphatic filariasis. From an anti-infective compound library, the macrolide veterinary antibiotic, tylosin A, was identified as a hit against Wolbachia This bacterial endosymbiont is required for filarial worm viability and fertility and is a validated target for macrofilaricidal drugs. Medicinal chemistry was undertaken to develop tylosin A analogs with improved oral bioavailability. Two analogs, A-1535469 and A-1574083, were selected. Their efficacy was tested against the gold-standard second-generation tetracycline antibiotics, doxycycline and minocycline, in mouse and gerbil infection models of lymphatic filariasis (Brugia malayi and Litomosoides sigmodontis) and onchocerciasis (Onchocerca ochengi). A 1- or 2-week course of oral A-1535469 or A-1574083 provided >90% Wolbachia depletion from nematodes in infected animals, resulting in a block in embryogenesis and depletion of microfilarial worm loads. The two analogs delivered comparative or superior efficacy compared to a 3- to 4-week course of doxycycline or minocycline. A-1574083 (now called ABBV-4083) was selected for further preclinical testing. Cardiovascular studies in dogs and toxicology studies in rats and dogs revealed no adverse effects at doses (50 mg/kg) that achieved plasma concentrations >10-fold above the efficacious concentration. A-1574083 (ABBV-4083) shows potential as an anti-Wolbachia macrolide with an efficacy, pharmacology, and safety profile that is compatible with a short-term oral drug course for treating lymphatic filariasis and onchocerciasis.
Collapse
Affiliation(s)
- Mark J Taylor
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Thomas W von Geldern
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, IL, USA.,Franciscan Institute for World Health, Franciscan University, Steubenville, OH, USA
| | - Louise Ford
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Marc P Hübner
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Kennan Marsh
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, IL, USA
| | - Kelly L Johnston
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Hanna T Sjoberg
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Sabine Specht
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Nicolas Pionnier
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Hayley E Tyrer
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Rachel H Clare
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Darren A N Cook
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Emma Murphy
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Andrew Steven
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - John Archer
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Dominique Bloemker
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Franziska Lenz
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Marianne Koschel
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Alexandra Ehrens
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Haelly M Metuge
- Research Foundation for Tropical Diseases and the Environment, Buea, Cameroon.,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Valerinne C Chunda
- Research Foundation for Tropical Diseases and the Environment, Buea, Cameroon.,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Patrick W Ndongmo Chounna
- Research Foundation for Tropical Diseases and the Environment, Buea, Cameroon.,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Abdel J Njouendou
- Research Foundation for Tropical Diseases and the Environment, Buea, Cameroon.,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Fanny F Fombad
- Research Foundation for Tropical Diseases and the Environment, Buea, Cameroon.,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Robert Carr
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, IL, USA
| | - Howard E Morton
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, IL, USA
| | - Ghaith Aljayyoussi
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Samuel Wanji
- Research Foundation for Tropical Diseases and the Environment, Buea, Cameroon.,Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Dale J Kempf
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, IL, USA
| | - Joseph D Turner
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Stephen A Ward
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK.
| |
Collapse
|
19
|
Nkhoma SC, Trevino SG, Gorena KM, Nair S, Khoswe S, Jett C, Garcia R, Daniel B, Dia A, Terlouw DJ, Ward SA, Anderson TJC, Cheeseman IH. Co-transmission of Related Malaria Parasite Lineages Shapes Within-Host Parasite Diversity. Cell Host Microbe 2020; 27:93-103.e4. [PMID: 31901523 PMCID: PMC7159252 DOI: 10.1016/j.chom.2019.12.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 10/17/2019] [Accepted: 12/05/2019] [Indexed: 12/30/2022]
Abstract
In high-transmission regions, we expect parasite lineages within complex malaria infections to be unrelated due to parasite inoculations from different mosquitoes. This project was designed to test this prediction. We generated 485 single-cell genome sequences from fifteen P. falciparum malaria patients from Chikhwawa, Malawi-an area of intense transmission. Patients harbored up to seventeen unique parasite lineages. Surprisingly, parasite lineages within infections tend to be closely related, suggesting that superinfection by repeated mosquito bites is rarer than co-transmission of parasites from a single mosquito. Both closely and distantly related parasites comprise an infection, suggesting sequential transmission of complex infections between multiple hosts. We identified tetrads and reconstructed parental haplotypes, which revealed the inbred ancestry of infections and non-Mendelian inheritance. Our analysis suggests strong barriers to secondary infection and outbreeding amongst malaria parasites from a high transmission setting, providing unexpected insights into the biology and transmission of malaria.
Collapse
Affiliation(s)
- Standwell C Nkhoma
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi; Liverpool School of Tropical Medicine, Liverpool, UK; Wellcome Trust Liverpool Glasgow Centre for Global Health Research, Liverpool, UK; Texas Biomedical Research Institute, San Antonio, TX, USA.
| | | | - Karla M Gorena
- University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Shalini Nair
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Stanley Khoswe
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Catherine Jett
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Roy Garcia
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Benjamin Daniel
- University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Aliou Dia
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Dianne J Terlouw
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi; Liverpool School of Tropical Medicine, Liverpool, UK
| | | | | | | |
Collapse
|
20
|
Ehrens A, Lunde CS, Jacobs RT, Struever D, Koschel M, Frohberger SJ, Lenz F, Fendler M, Turner JD, Ward SA, Taylor MJ, Freund YR, Stefanakis R, Easom E, Li X, Plattner JJ, Hoerauf A, Hübner MP. In vivo efficacy of the boron-pleuromutilin AN11251 against Wolbachia of the rodent filarial nematode Litomosoides sigmodontis. PLoS Negl Trop Dis 2020; 14:e0007957. [PMID: 31986143 PMCID: PMC7004383 DOI: 10.1371/journal.pntd.0007957] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/15/2019] [Revised: 02/06/2020] [Accepted: 11/27/2019] [Indexed: 11/19/2022] Open
Abstract
The elimination of filarial diseases such as onchocerciasis and lymphatic filariasis is hampered by the lack of a macrofilaricidal-adult worm killing-drug. In the present study, we tested the in vivo efficacy of AN11251, a boron-pleuromutilin that targets endosymbiotic Wolbachia bacteria from filarial nematodes and compared its efficacy to doxycycline and rifampicin. Doxycycline and rifampicin were previously shown to deplete Wolbachia endosymbionts leading to a permanent sterilization of the female adult filariae and adult worm death in human clinical studies. Twice-daily oral treatment of Litomosoides sigmodontis-infected mice with 200 mg/kg AN11251 for 10 days achieved a Wolbachia depletion > 99.9% in the adult worms, exceeding the Wolbachia reduction by 10-day treatments with bioequivalent human doses of doxycycline and a similar reduction as high-dose rifampicin (35 mg/kg). Wolbachia reductions of > 99% were also accomplished by 14 days of oral AN11251 at a lower twice-daily dose (50 mg/kg) or once-per-day 200 mg/kg AN11251 treatments. The combinations tested of AN11251 with doxycycline had no clear beneficial impact on Wolbachia depletion, achieving a > 97% Wolbachia reduction with 7 days of treatment. These results indicate that AN11251 is superior to doxycycline and comparable to high-dose rifampicin in the L. sigmodontis mouse model, allowing treatment regimens as short as 10-14 days. Therefore, AN11251 represents a promising pre-clinical candidate that was identified in the L. sigmodontis model, and could be further evaluated and developed as potential clinical candidate for human lymphatic filariasis and onchocerciasis.
Collapse
Affiliation(s)
- Alexandra Ehrens
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | | | - Robert T. Jacobs
- Anacor Pharmaceuticals, Palo Alto, California, United States of America
| | - Dominique Struever
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Marianne Koschel
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Stefan J. Frohberger
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Franziska Lenz
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Martina Fendler
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | - Joseph D. Turner
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Stephen A. Ward
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Mark J. Taylor
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Yvonne R. Freund
- Anacor Pharmaceuticals, Palo Alto, California, United States of America
| | - Rianna Stefanakis
- Anacor Pharmaceuticals, Palo Alto, California, United States of America
| | - Eric Easom
- Anacor Pharmaceuticals, Palo Alto, California, United States of America
| | - Xianfeng Li
- Anacor Pharmaceuticals, Palo Alto, California, United States of America
| | - Jacob J. Plattner
- Anacor Pharmaceuticals, Palo Alto, California, United States of America
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
| | - Marc P. Hübner
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| |
Collapse
|
21
|
Hübner MP, Koschel M, Struever D, Nikolov V, Frohberger SJ, Ehrens A, Fendler M, Johannes I, von Geldern TW, Marsh K, Turner JD, Taylor MJ, Ward SA, Pfarr K, Kempf DJ, Hoerauf A. In vivo kinetics of Wolbachia depletion by ABBV-4083 in L. sigmodontis adult worms and microfilariae. PLoS Negl Trop Dis 2019; 13:e0007636. [PMID: 31381563 PMCID: PMC6695197 DOI: 10.1371/journal.pntd.0007636] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 04/23/2019] [Revised: 08/15/2019] [Accepted: 07/17/2019] [Indexed: 11/18/2022] Open
Abstract
Depletion of Wolbachia endosymbionts of human pathogenic filariae using 4–6 weeks of doxycycline treatment can lead to permanent sterilization and adult filarial death. We investigated the anti-Wolbachia drug candidate ABBV-4083 in the Litomosoides sigmodontis rodent model to determine Wolbachia depletion kinetics with different regimens. Wolbachia reduction occurred in mice as early as 3 days after the initiation of ABBV-4083 treatment and continued throughout a 10-day treatment period. Importantly, Wolbachia levels continued to decline after a 5-day-treatment from 91.5% to 99.9% during a 3-week washout period. In jirds, two weeks of ABBV-4083 treatment (100mg/kg once-per-day) caused a >99.9% Wolbachia depletion in female adult worms, and the kinetics of Wolbachia depletion were recapitulated in peripheral blood microfilariae. Similar to Wolbachia depletion, inhibition of embryogenesis was time-dependent in ABBV-4083-treated jirds, leading to a complete lack of late embryonic stages (stretched microfilariae) and lack of peripheral microfilariae in 5/6 ABBV-4083-treated jirds by 14 weeks after treatment. Twice daily treatment in comparison to once daily treatment with ABBV-4083 did not significantly improve Wolbachia depletion. Moreover, up to 4 nonconsecutive daily treatments within a 14-dose regimen did not significantly erode Wolbachia depletion. Within the limitations of an animal model that does not fully recapitulate human filarial disease, our studies suggest that Wolbachia depletion should be assessed clinically no earlier than 3–4 weeks after the end of treatment, and that Wolbachia depletion in microfilariae may be a viable surrogate marker for the depletion within adult worms. Furthermore, strict daily adherence to the dosing regimen with anti-Wolbachia candidates may not be required, provided that the full regimen is subsequently completed. Onchocerciasis and lymphatic filariasis represent debilitating neglected tropical diseases that are caused by parasitic filarial nematodes. Current efforts to eliminate onchocerciasis are hampered by the lack of drugs that lead to permanent sterilization of the adult worms or provide a macrofilaricidal effect, i.e. kill the adult worms. In the past, doxycycline has been shown to deplete Wolbachia endosymbionts of filarial nematodes, leading to permanent sterilization and macrofilaricidal efficacy in filariae causing both onchocerciasis and lymphatic filariasis. However, contraindications and a requirement for at least 4 weeks of doxycycline treatment impair its broader use, creating a need for drugs with a shorter treatment regimen and potentially fewer contraindications. ABBV-4083 is such an anti-Wolbachia candidate that was efficacious in several filarial animal models and has recently been tested in a phase 1 clinical trial. The present studies addressed several points that are important for subsequent phase 2 clinical trials, namely the comparison of once vs. twice-per-day treatments, the impact of missed treatments, and a comparison of the kinetics of Wolbachia depletion in adult worms and microfilariae, the latter of which has the potential to be a surrogate indicator to avoid the necessity of surgically removing nodules with adult worms at repeated time points.
Collapse
Affiliation(s)
- Marc P. Hübner
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
- * E-mail:
| | - Marianne Koschel
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Dominique Struever
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Venelin Nikolov
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Stefan J. Frohberger
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Alexandra Ehrens
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Martina Fendler
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Iliana Johannes
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Thomas W. von Geldern
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
- Franciscan Institute for World Health, Franciscan University, Steubenville, Ohio, United States of America
| | - Kennan Marsh
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Joseph D. Turner
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Mark J. Taylor
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Stephen A. Ward
- Centre for Drugs and Diagnostics, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Kenneth Pfarr
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
| | - Dale J. Kempf
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany
| |
Collapse
|
22
|
Camarda G, Jirawatcharadech P, Priestley RS, Saif A, March S, Wong MHL, Leung S, Miller AB, Baker DA, Alano P, Paine MJI, Bhatia SN, O'Neill PM, Ward SA, Biagini GA. Antimalarial activity of primaquine operates via a two-step biochemical relay. Nat Commun 2019; 10:3226. [PMID: 31324806 PMCID: PMC6642103 DOI: 10.1038/s41467-019-11239-0] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 07/02/2019] [Indexed: 12/29/2022] Open
Abstract
Primaquine (PQ) is an essential antimalarial drug but despite being developed over 70 years ago, its mode of action is unclear. Here, we demonstrate that hydroxylated-PQ metabolites (OH-PQm) are responsible for efficacy against liver and sexual transmission stages of Plasmodium falciparum. The antimalarial activity of PQ against liver stages depends on host CYP2D6 status, whilst OH-PQm display direct, CYP2D6-independent, activity. PQ requires hepatic metabolism to exert activity against gametocyte stages. OH-PQm exert modest antimalarial efficacy against parasite gametocytes; however, potency is enhanced ca.1000 fold in the presence of cytochrome P450 NADPH:oxidoreductase (CPR) from the liver and bone marrow. Enhancement of OH-PQm efficacy is due to the direct reduction of quinoneimine metabolites by CPR with the concomitant and excessive generation of H2O2, leading to parasite killing. This detailed understanding of the mechanism paves the way to rationally re-designed 8-aminoquinolines with improved pharmacological profiles. Primaquine (PQ) is a widely used anti-malaria drug, but its mechanism of action is unclear. Here, Camarda et al. show that PQ’s activity against liver and sexual Plasmodium stages depends on generation of hydroxylated-PQ metabolites (OH-PQm), which, undergoing further reactions, results in production of H2O2.
Collapse
Affiliation(s)
- Grazia Camarda
- Centre for Drugs and Diagnostics Research, Tropical Disease Biology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Piyaporn Jirawatcharadech
- Centre for Drugs and Diagnostics Research, Tropical Disease Biology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Richard S Priestley
- Centre for Drugs and Diagnostics Research, Tropical Disease Biology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.,ARUK Oxford Drug Discovery Institute, University of Oxford, Oxford, OX3 7FZ, UK
| | - Ahmed Saif
- Centre for Drugs and Diagnostics Research, Tropical Disease Biology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.,Clinical Laboratory sciences Department, College of Applied Medical Sciences, Najran University, Najran, 61441, Saudi Arabia
| | - Sandra March
- Health Sciences and Technology/Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Michael H L Wong
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Suet Leung
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Alex B Miller
- Health Sciences and Technology/Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - David A Baker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Pietro Alano
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Rome, 00161, Italy
| | - Mark J I Paine
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Sangeeta N Bhatia
- Health Sciences and Technology/Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Paul M O'Neill
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Stephen A Ward
- Centre for Drugs and Diagnostics Research, Tropical Disease Biology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Giancarlo A Biagini
- Centre for Drugs and Diagnostics Research, Tropical Disease Biology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
| |
Collapse
|
23
|
Aljayyoussi G, Donnellan S, Ward SA, Biagini GA. Intracellular PD Modelling ( PDi) for the Prediction of Clinical Activity of Increased Rifampicin Dosing. Pharmaceutics 2019; 11:pharmaceutics11060278. [PMID: 31200534 PMCID: PMC6630509 DOI: 10.3390/pharmaceutics11060278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/31/2019] [Accepted: 06/05/2019] [Indexed: 11/16/2022] Open
Abstract
Increasing rifampicin (RIF) dosages could significantly reduce tuberculosis (TB) treatment durations. Understanding the pharmacokinetic-pharmacodynamics (PK-PD) of increasing RIF dosages could inform clinical regimen selection. We used intracellular PD modelling (PDi) to predict clinical outcomes, primarily time to culture conversion, of increasing RIF dosages. PDi modelling utilizes in vitro-derived measurements of intracellular (macrophage) and extracellular Mycobacterium tuberculosis sterilization rates to predict the clinical outcomes of RIF at increasing doses. We evaluated PDi simulations against recent clinical data from a high dose (35 mg/kg per day) RIF phase II clinical trial. PDi-based simulations closely predicted the observed time-to-patient culture conversion status at eight weeks (hazard ratio: 2.04 (predicted) vs. 2.06 (observed)) for high dose RIF-based treatments. However, PDi modelling was less predictive of culture conversion status at 26 weeks for high-dosage RIF (99% predicted vs. 81% observed). PDi-based simulations indicate that increasing RIF beyond 35 mg/kg/day is unlikely to significantly improve culture conversion rates, however, improvements to other clinical outcomes (e.g., relapse rates) cannot be ruled out. This study supports the value of translational PDi-based modelling in predicting culture conversion rates for antitubercular therapies and highlights the potential value of this platform for the improved design of future clinical trials.
Collapse
Affiliation(s)
- Ghaith Aljayyoussi
- Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
| | - Samantha Donnellan
- Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
| | - Stephen A Ward
- Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
| | - Giancarlo A Biagini
- Centre for Drugs & Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
| |
Collapse
|
24
|
Clare RH, Clark R, Bardelle C, Harper P, Collier M, Johnston KL, Plant H, Plant D, McCall E, Slatko BE, Cantin L, Wu B, Ford L, Murray D, Rich K, Wigglesworth M, Taylor MJ, Ward SA. Development of a High-Throughput Cytometric Screen to Identify Anti- Wolbachia Compounds: The Power of Public-Private Partnership. SLAS Discov 2019; 24:537-547. [PMID: 30958712 PMCID: PMC6537165 DOI: 10.1177/2472555219838341] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The Anti-Wolbachia (A·WOL) consortium at the Liverpool School of
Tropical Medicine (LSTM) has partnered with the Global High-Throughput Screening
(HTS) Centre at AstraZeneca to create the first anthelmintic HTS for neglected
tropical diseases (NTDs). The A·WOL consortium aims to identify novel
macrofilaricidal drugs targeting the essential bacterial symbiont
(Wolbachia) of the filarial nematodes causing
onchocerciasis and lymphatic filariasis. Working in collaboration, we have
validated a robust high-throughput assay capable of identifying compounds that
selectively kill Wolbachia over the host insect cell. We
describe the development and validation process of this complex, phenotypic
high-throughput assay and provide an overview of the primary outputs from
screening the AstraZeneca library of 1.3 million compounds.
Collapse
Affiliation(s)
- Rachel H Clare
- 1 Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Roger Clark
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Catherine Bardelle
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Paul Harper
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Matthew Collier
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Kelly L Johnston
- 1 Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Helen Plant
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Darren Plant
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Eileen McCall
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Barton E Slatko
- 3 Genome Biology Division, New England Biolabs, Inc., Ipswich, MA, USA
| | - Lindsey Cantin
- 3 Genome Biology Division, New England Biolabs, Inc., Ipswich, MA, USA
| | - Bo Wu
- 3 Genome Biology Division, New England Biolabs, Inc., Ipswich, MA, USA
| | - Louise Ford
- 1 Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - David Murray
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Kirsty Rich
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Mark Wigglesworth
- 2 Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, UK
| | - Mark J Taylor
- 1 Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Stephen A Ward
- 1 Centre for Drugs and Diagnostics Research, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| |
Collapse
|
25
|
Jacobs RT, Lunde CS, Freund YR, Hernandez V, Li X, Xia Y, Carter DS, Berry PW, Halladay J, Rock F, Stefanakis R, Easom E, Plattner JJ, Ford L, Johnston KL, Cook DAN, Clare R, Cassidy A, Myhill L, Tyrer H, Gamble J, Guimaraes AF, Steven A, Lenz F, Ehrens A, Frohberger SJ, Koschel M, Hoerauf A, Hübner MP, McNamara CW, Bakowski MA, Turner JD, Taylor MJ, Ward SA. Boron-Pleuromutilins as Anti- Wolbachia Agents with Potential for Treatment of Onchocerciasis and Lymphatic Filariasis. J Med Chem 2019; 62:2521-2540. [PMID: 30730745 PMCID: PMC6421521 DOI: 10.1021/acs.jmedchem.8b01854] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Indexed: 01/07/2023]
Abstract
A series of pleuromutilins modified by introduction of a boron-containing heterocycle on C(14) of the polycyclic core are described. These analogs were found to be potent anti- Wolbachia antibiotics and, as such, may be useful in the treatment of filarial infections caused by Onchocerca volvulus, resulting in Onchocerciasis or river blindness, or Wuchereria bancrofti and Brugia malayi and related parasitic nematodes resulting in lymphatic filariasis. These two important neglected tropical diseases disproportionately impact patients in the developing world. The lead preclinical candidate compound containing 7-fluoro-6-oxybenzoxaborole (15, AN11251) was shown to have good in vitro anti- Wolbachia activity and physicochemical and pharmacokinetic properties providing high exposure in plasma. The lead was effective in reducing the Wolbachia load in filarial worms following oral administration to mice.
Collapse
Affiliation(s)
- Robert T. Jacobs
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Christopher S. Lunde
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Yvonne R. Freund
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Vincent Hernandez
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Xianfeng Li
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Yi Xia
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - David S. Carter
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Pamela W. Berry
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Jason Halladay
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Fernando Rock
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Rianna Stefanakis
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Eric Easom
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Jacob J. Plattner
- Anacor
Pharmaceuticals, 1020
East Meadow Circle, Palo Alto, California 94303, United States
| | - Louise Ford
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Kelly L. Johnston
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Darren A. N. Cook
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Rachel Clare
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Andrew Cassidy
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Laura Myhill
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Hayley Tyrer
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Joanne Gamble
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Ana F. Guimaraes
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Andrew Steven
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Franziska Lenz
- Institute
for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Alexandra Ehrens
- Institute
for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Stefan J. Frohberger
- Institute
for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Marianne Koschel
- Institute
for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Achim Hoerauf
- Institute
for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Marc P. Hübner
- Institute
for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Case W. McNamara
- Calibr, 11119 North
Torrey Pines Road, Suite 100, La Jolla, California 92037, United States
| | - Malina A. Bakowski
- Calibr, 11119 North
Torrey Pines Road, Suite 100, La Jolla, California 92037, United States
| | - Joseph D. Turner
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Mark J. Taylor
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| | - Stephen A. Ward
- Centre
for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K.
| |
Collapse
|
26
|
Birgersson S, Valea I, Tinto H, Traore-Coulibaly M, Toe LC, Hoglund RM, Van Geertruyden JP, Ward SA, D’Alessandro U, Abelö A, Tarning J. Population pharmacokinetics of artesunate and dihydroartemisinin in pregnant and non-pregnant women with uncomplicated Plasmodium falciparum malaria in Burkina Faso: an open label trial. Wellcome Open Res 2019; 4:45. [PMID: 32025570 PMCID: PMC6974929 DOI: 10.12688/wellcomeopenres.14849.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2019] [Indexed: 01/03/2023] Open
Abstract
Background: Malaria during pregnancy is a major health risk for both the mother and the foetus. Pregnancy has been shown to influence the pharmacokinetics of a number of different antimalarial drugs. This might lead to an under-exposure in these patients which could increase the risk of treatment failure and the development of drug resistance. The study aim was to evaluate the pharmacokinetics of artesunate and dihydroartemisinin in pregnant and non-pregnant patients using a population modelling approach. Methods: Twenty-four women in their second and third trimester of pregnancy and twenty-four paired non-pregnant women, all with uncomplicated P. falciparum malaria, were enrolled in this study. Treatment was a fixed-dose combination of oral artesunate and mefloquine once daily for three days. Frequent blood samples were collected and concentration-time data for artesunate and dihydroartemisinin were analysed simultaneously using nonlinear mixed-effects modelling. Results: Artesunate pharmacokinetics was best described by a transit-compartment absorption model followed by a one-compartment disposition model under the assumption of complete in vivo conversion of artesunate into dihydroartemisinin. Dihydroartemisinin pharmacokinetics was best described by a one-compartment disposition model with first-order elimination. Pregnant women had a 21% higher elimination clearance of dihydroartemisinin, compared to non-pregnant women, resulting in proportionally lower drug exposure. In addition, initial parasitaemia and liver status (alanine aminotransferase) were found to affect the relative bioavailability of artesunate. Conclusions: Results presented here show a substantially lower drug exposure to the antimalarial drug dihydroartemisinin during pregnancy after standard oral treatment of artesunate and mefloquine. This might result in an increased risk of treatment failure and drug resistance development, especially in low transmission settings where relative immunity is lower. Trial registration: ClinicalTrials.gov NCT00701961 (19/06/2008).
Collapse
Affiliation(s)
- Sofia Birgersson
- Department of Pharmacology, University of Gothenburg, Gothenburg, 405 30, Sweden
| | - Innocent Valea
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l’Ouest Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
- Institut de Recherche en Sciences de la Sante´, Unite´ de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l’Ouest Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
- Institut de Recherche en Sciences de la Sante´, Unite´ de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
| | - Maminata Traore-Coulibaly
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l’Ouest Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
- Institut de Recherche en Sciences de la Sante´, Unite´ de Recherche Clinique de Nanoro, Nanoro, Burkina Faso
| | - Laeticia C. Toe
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l’Ouest Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
- Department of Food Safety, Quality and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, B-9000, Belgium
| | - Richard M. Hoglund
- Mahidol-Oxford Tropical Medicine Resarch Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | | | - Stephen A. Ward
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | | | - Angela Abelö
- Department of Pharmacology, University of Gothenburg, Gothenburg, 405 30, Sweden
| | - Joel Tarning
- Mahidol-Oxford Tropical Medicine Resarch Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| |
Collapse
|
27
|
Birgersson S, Valea I, Tinto H, Traore-Coulibaly M, Toe LC, Hoglund RM, Van Geertruyden JP, Ward SA, D’Alessandro U, Abelö A, Tarning J. Population pharmacokinetics of artesunate and dihydroartemisinin in pregnant and non-pregnant women with uncomplicated Plasmodium falciparum malaria in Burkina Faso: an open label trial. Wellcome Open Res 2019. [DOI: 10.12688/wellcomeopenres.14849.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Malaria during pregnancy is a major health risk for both the mother and the foetus. Pregnancy has been shown to influence the pharmacokinetics of a number of different antimalarial drugs. This might lead to an under-exposure in these patients which could increase the risk of treatment failure and the development of drug resistance. The study aim was to evaluate the pharmacokinetics of artesunate and dihydroartemisinin in pregnant and non-pregnant patients using a population modelling approach. Methods: Twenty-four women in their second and third trimester of pregnancy and twenty-four paired non-pregnant women, all with uncomplicated P. falciparum malaria, were enrolled in this study. Treatment was a fixed-dose combination of oral artesunate and mefloquine once daily for three days. Frequent blood samples were collected and concentration-time data for artesunate and dihydroartemisinin were analysed simultaneously using nonlinear mixed-effects modelling. Results: Artesunate pharmacokinetics was best described by a transit-compartment absorption model followed by a one-compartment disposition model under the assumption of complete in vivo conversion of artesunate into dihydroartemisinin. Dihydroartemisinin pharmacokinetics was best described by a one-compartment disposition model with first-order elimination. Pregnant women had a 21% higher elimination clearance of dihydroartemisinin, compared to non-pregnant women, resulting in proportionally lower drug exposure. In addition, initial parasitaemia and liver status (alanine aminotransferase) were found to affect the relative bioavailability of artesunate. Conclusions: Results presented here show a substantially lower drug exposure to the antimalarial drug dihydroartemisinin during pregnancy after standard oral treatment of artesunate and mefloquine. This might result in an increased risk of treatment failure and drug resistance development, especially in low transmission settings where relative immunity is lower. Trial registration: ClinicalTrials.gov NCT00701961 (19/06/2008)
Collapse
|
28
|
von Geldern TW, Morton HE, Clark RF, Brown BS, Johnston KL, Ford L, Specht S, Carr RA, Stolarik DF, Ma J, Rieser MJ, Struever D, Frohberger SJ, Koschel M, Ehrens A, Turner JD, Hübner MP, Hoerauf A, Taylor MJ, Ward SA, Marsh K, Kempf DJ. Discovery of ABBV-4083, a novel analog of Tylosin A that has potent anti-Wolbachia and anti-filarial activity. PLoS Negl Trop Dis 2019; 13:e0007159. [PMID: 30818326 PMCID: PMC6413952 DOI: 10.1371/journal.pntd.0007159] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 11/30/2018] [Revised: 03/12/2019] [Accepted: 01/15/2019] [Indexed: 12/02/2022] Open
Abstract
There is a significant need for improved treatments for onchocerciasis and lymphatic filariasis, diseases caused by filarial worm infection. In particular, an agent able to selectively kill adult worms (macrofilaricide) would be expected to substantially augment the benefits of mass drug administration (MDA) with current microfilaricides, and to provide a solution to treatment of onchocerciasis / loiasis co-infection, where MDA is restricted. We have identified a novel macrofilaricidal agent, Tylosin A (TylA), which acts by targeting the worm-symbiont Wolbachia bacterium. Chemical modification of TylA leads to improvements in anti-Wolbachia activity and oral pharmacokinetic properties; an optimized analog (ABBV-4083) has been selected for clinical evaluation.
Collapse
Affiliation(s)
- Thomas W. von Geldern
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
- Franciscan Institute for World Health, Franciscan University, Steubenville, Ohio, United States of America
| | - Howard E. Morton
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Rick F. Clark
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Brian S. Brown
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Kelly L. Johnston
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Louise Ford
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Sabine Specht
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Robert A. Carr
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Deanne F. Stolarik
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Junli Ma
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Matthew J. Rieser
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Dominique Struever
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Stefan J. Frohberger
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Marianne Koschel
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Alexandra Ehrens
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Joseph D. Turner
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Marc P. Hübner
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology, University Hospital, Bonn, Germany
| | - Mark J. Taylor
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Stephen A. Ward
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Kennan Marsh
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| | - Dale J. Kempf
- Global Pharmaceutical Research and Development, AbbVie, North Chicago, Illinois, United States of America
| |
Collapse
|
29
|
Clare RH, Bardelle C, Harper P, Hong WD, Börjesson U, Johnston KL, Collier M, Myhill L, Cassidy A, Plant D, Plant H, Clark R, Cook DAN, Steven A, Archer J, McGillan P, Charoensutthivarakul S, Bibby J, Sharma R, Nixon GL, Slatko BE, Cantin L, Wu B, Turner J, Ford L, Rich K, Wigglesworth M, Berry NG, O'Neill PM, Taylor MJ, Ward SA. Industrial scale high-throughput screening delivers multiple fast acting macrofilaricides. Nat Commun 2019; 10:11. [PMID: 30602718 PMCID: PMC6315057 DOI: 10.1038/s41467-018-07826-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [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: 07/26/2018] [Accepted: 11/29/2018] [Indexed: 01/22/2023] Open
Abstract
Nematodes causing lymphatic filariasis and onchocerciasis rely on their bacterial endosymbiont, Wolbachia, for survival and fecundity, making Wolbachia a promising therapeutic target. Here we perform a high-throughput screen of AstraZeneca’s 1.3 million in-house compound library and identify 5 novel chemotypes with faster in vitro kill rates (<2 days) than existing anti-Wolbachia drugs that cure onchocerciasis and lymphatic filariasis. This industrial scale anthelmintic neglected tropical disease (NTD) screening campaign is the result of a partnership between the Anti-Wolbachia consortium (A∙WOL) and AstraZeneca. The campaign was informed throughout by rational prioritisation and triage of compounds using cheminformatics to balance chemical diversity and drug like properties reducing the chance of attrition from the outset. Ongoing development of these multiple chemotypes, all with superior time-kill kinetics than registered antibiotics with anti-Wolbachia activity, has the potential to improve upon the current therapeutic options and deliver improved, safer and more selective macrofilaricidal drugs. Parasitic nematodes causing onchocerciasis and lymphatic filariasis rely on a bacterial endosymbiont, Wolbachia, which is a validated therapeutic target. Here, Clare et al. perform a high-throughput screen of 1.3 million compounds and identify 5 chemotypes with faster kill rates than existing anti-Wolbachia drugs.
Collapse
Affiliation(s)
- Rachel H Clare
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Catherine Bardelle
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Paul Harper
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - W David Hong
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Ulf Börjesson
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Gothenburg, SE-431 83, Sweden
| | - Kelly L Johnston
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Matthew Collier
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Laura Myhill
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Andrew Cassidy
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Darren Plant
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Helen Plant
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Roger Clark
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Darren A N Cook
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Andrew Steven
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - John Archer
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Paul McGillan
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Sitthivut Charoensutthivarakul
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Jaclyn Bibby
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Raman Sharma
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Gemma L Nixon
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Barton E Slatko
- Genome Biology Division, New England Biolabs, Inc, Ipswich, 01938, MA, USA
| | - Lindsey Cantin
- Genome Biology Division, New England Biolabs, Inc, Ipswich, 01938, MA, USA
| | - Bo Wu
- Genome Biology Division, New England Biolabs, Inc, Ipswich, 01938, MA, USA
| | - Joseph Turner
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Louise Ford
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Kirsty Rich
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Mark Wigglesworth
- Hit Discovery, Discovery Sciences, IMED Biotech Unit, AstraZeneca, Macclesfield, SK10 4TG, UK
| | - Neil G Berry
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Paul M O'Neill
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK.
| | - Mark J Taylor
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Stephen A Ward
- Centre for Drugs and Diagnostics, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| |
Collapse
|
30
|
David Hong W, Leung SC, Amporndanai K, Davies J, Priestley RS, Nixon GL, Berry NG, Samar Hasnain S, Antonyuk S, Ward SA, Biagini GA, O’Neill PM. Potent Antimalarial 2-Pyrazolyl Quinolone bc 1 (Q i) Inhibitors with Improved Drug-like Properties. ACS Med Chem Lett 2018; 9:1205-1210. [PMID: 30613327 DOI: 10.1021/acsmedchemlett.8b00371] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/19/2018] [Indexed: 01/29/2023] Open
Abstract
A series of 2-pyrazolyl quinolones has been designed and synthesized in 5-7 steps to optimize for both in vitro antimalarial potency and various in vitro drug metabolism and pharmacokinetics (DMPK) features. The most potent compounds display no cross-resistance with multidrug resistant parasite strains (W2) compared to drug sensitive strains (3D7), with IC50 (concentration of drug required to achieve half maximal growth suppression) values in the range of 15-33 nM. Furthermore, members of the series retain moderate activity against the atovaquone-resistant parasite isolate (TM90C2B). The described 2-pyrazoyl series displays improved DMPK properties, including improved aqueous solubility compared to previously reported quinolone series and acceptable safety margin through in vitro cytotoxicity assessment. The 2-pyrazolyl quinolones are believed to bind to the ubiquinone-reducing Qi site of the parasite bc 1 complex, which is supported by crystallographic studies of bovine cytochrome bc 1 complex.
Collapse
Affiliation(s)
- W. David Hong
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, U.K
| | - Suet C. Leung
- Research Centre for Drugs & Diagnostics, Parasitology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, U.K
| | - Kangsa Amporndanai
- Molecular Biophysics Group, Institute of Integrative Biology, University of Liverpool, Liverpool, L69 7ZB, U.K
| | - Jill Davies
- Research Centre for Drugs & Diagnostics, Parasitology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, U.K
| | - Richard S. Priestley
- Research Centre for Drugs & Diagnostics, Parasitology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, U.K
| | - Gemma L. Nixon
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, U.K
| | - Neil G. Berry
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, U.K
| | - S. Samar Hasnain
- Molecular Biophysics Group, Institute of Integrative Biology, University of Liverpool, Liverpool, L69 7ZB, U.K
| | - Svetlana Antonyuk
- Molecular Biophysics Group, Institute of Integrative Biology, University of Liverpool, Liverpool, L69 7ZB, U.K
| | - Stephen A. Ward
- Research Centre for Drugs & Diagnostics, Parasitology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, U.K
| | - Giancarlo A. Biagini
- Research Centre for Drugs & Diagnostics, Parasitology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, U.K
| | - Paul M. O’Neill
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, U.K
| |
Collapse
|
31
|
Nkhoma SC, Banda RL, Khoswe S, Dzoole-Mwale TJ, Ward SA. Intra-host dynamics of co-infecting parasite genotypes in asymptomatic malaria patients. Infect Genet Evol 2018; 65:414-424. [PMID: 30145390 PMCID: PMC6219893 DOI: 10.1016/j.meegid.2018.08.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 08/13/2018] [Accepted: 08/20/2018] [Indexed: 11/22/2022]
Abstract
Malaria-infected individuals often harbor mixtures of genetically distinct parasite genotypes. We studied intra-host dynamics of parasite genotypes co-infecting asymptomatic adults in an area of intense malaria transmission in Chikhwawa, Malawi. Serial blood samples (5 ml) were collected over seven consecutive days from 25 adults with asymptomatic Plasmodium falciparum malaria and analyzed to determine whether a single peripheral blood sample accurately captures within-host parasite diversity. Blood samples from three of the participants were also analyzed by limiting dilution cloning and SNP genotyping of the parasite clones isolated to examine both the number and relatedness of co-infecting parasite haplotypes. We observed rapid turnover of co-infecting parasite genotypes in 88% of the individuals sampled (n = 22) such that the genetic composition of parasites infecting these individuals changed dramatically over the course of seven days of follow up. Nineteen of the 25 individuals sampled (76%) carried multiple parasite genotypes at baseline. Analysis of serial blood samples from three of the individuals revealed that they harbored 6, 12 and 17 distinct parasite haplotypes respectively. Approximately 70% of parasite haplotypes recovered from the three extensively sampled individuals were unrelated (proportion of shared alleles <83.3%) and were deemed to have primarily arisen from superinfection (inoculation of unrelated parasite haplotypes through multiple mosquito bites). The rest were related at the half-sib level or greater and were deemed to have been inoculated into individual human hosts via parasite co-transmission from single mosquito bites. These findings add further to the growing weight of evidence indicating that a single blood sample poorly captures within-host parasite diversity and underscore the importance of repeated blood sampling to accurately capture within-host parasite ecology. Our data also demonstrate a more pronounced role for parasite co-transmission in generating within-host parasite diversity in high transmission settings than previously assumed. Taken together, these findings have important implications for understanding the evolution of drug resistance, malaria transmission, parasite virulence, allocation of gametocyte sex ratios and acquisition of malaria immunity.
Collapse
Affiliation(s)
- Standwell C Nkhoma
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi; Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; Wellcome Trust-Liverpool-Glasgow Centre for Global Health Research, 70 Pembroke Place, Liverpool L69 3GF, UK.
| | - Rachel L Banda
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Stanley Khoswe
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Tamika J Dzoole-Mwale
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Stephen A Ward
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| |
Collapse
|
32
|
Wu PP, He H, Hong WD, Wu TR, Huang GY, Zhong YY, Tu BR, Gao M, Zhou J, Zhao SQ, Li DL, Xu XT, Sheng ZJ, Ward SA, O'Neill PM, Zhang K. The biological evaluation of fusidic acid and its hydrogenation derivative as antimicrobial and anti-inflammatory agents. Infect Drug Resist 2018; 11:1945-1957. [PMID: 30498366 PMCID: PMC6207271 DOI: 10.2147/idr.s176390] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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] [Indexed: 01/15/2023] Open
Abstract
Background Fusidic acid (FA) (WU-FA-00) is the only commercially available antimicrobial from the fusidane family that has a narrow spectrum of activity against Gram-positive bacteria. Methods Herein, the hydrogenation derivative (WU-FA-01) of FA was prepared and both compounds were examined against a panel of six bacterial strains. In addition, their anti-inflammatory properties were evaluated using a 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced mouse ear edema model. Results The results of the antimicrobial assay revealed that both WU-FA-00 and WU-FA-01 displayed a high level of antimicrobial activity against Gram-positive strains. Moreover, killing kinetic studies were performed and the results were in accordance with the minimum inhibitory concentration and minimum bactericidal concentration results. We also demonstrated that the topical application of WU-FA-00 and WU-FA-01 effectively decreased TPA-induced ear edema in a dose-dependent manner. This inhibitory effect was associated with the inhibition of TPA-induced upregulation of proinflammatory cytokines IL-1β, TNF-α, and COX-2. WU-FA-01 significantly suppressed the expression levels of p65, IκB-α, and p-IκB-α in the TPA-induced mouse ear model. Conclusion Overall, our results showed that WU-FA-00 and WU-FA-01 not only had effective antimicrobial activities in vitro, especially to the Gram-positive bacteria, but also possessed strong anti-inflammatory effects in vivo. These results provide a scientific basis for developing FA derivatives as antimicrobial and anti-inflammatory agents.
Collapse
Affiliation(s)
- Pan-Pan Wu
- Faculty of Chemical and Environmental Engineering, Wuyi University, Jiangmen, China, ; .,Department of Pharmaceutical Engineering, Faculty of Chemical Engineering and Light Industry, Guangdong University of Technology, Guangzhou, China, ; .,International Healthcare Innovation Institute (Jiangmen), Jiangmen, China, ;
| | - Hao He
- Faculty of Chemical and Environmental Engineering, Wuyi University, Jiangmen, China, ; .,International Healthcare Innovation Institute (Jiangmen), Jiangmen, China, ;
| | - W David Hong
- Faculty of Chemical and Environmental Engineering, Wuyi University, Jiangmen, China, ; .,International Healthcare Innovation Institute (Jiangmen), Jiangmen, China, ; .,Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, UK.,Department of Chemistry, University of Liverpool, UK
| | - Tong-Rong Wu
- Faculty of Chemical and Environmental Engineering, Wuyi University, Jiangmen, China, ; .,International Healthcare Innovation Institute (Jiangmen), Jiangmen, China, ;
| | - Gui-Ying Huang
- Department of Pharmaceutical Engineering, Faculty of Chemical Engineering and Light Industry, Guangdong University of Technology, Guangzhou, China, ;
| | - Ying-Ying Zhong
- Department of Pharmaceutical Engineering, Faculty of Chemical Engineering and Light Industry, Guangdong University of Technology, Guangzhou, China, ;
| | - Bo-Rong Tu
- Faculty of Chemical and Environmental Engineering, Wuyi University, Jiangmen, China, ; .,International Healthcare Innovation Institute (Jiangmen), Jiangmen, China, ;
| | - Min Gao
- Faculty of Chemical and Environmental Engineering, Wuyi University, Jiangmen, China, ; .,International Healthcare Innovation Institute (Jiangmen), Jiangmen, China, ;
| | - Jun Zhou
- Faculty of Chemical and Environmental Engineering, Wuyi University, Jiangmen, China, ; .,International Healthcare Innovation Institute (Jiangmen), Jiangmen, China, ;
| | - Su-Qing Zhao
- Faculty of Chemical and Environmental Engineering, Wuyi University, Jiangmen, China, ; .,Department of Pharmaceutical Engineering, Faculty of Chemical Engineering and Light Industry, Guangdong University of Technology, Guangzhou, China, ; .,International Healthcare Innovation Institute (Jiangmen), Jiangmen, China, ;
| | - Dong-Li Li
- Faculty of Chemical and Environmental Engineering, Wuyi University, Jiangmen, China, ; .,International Healthcare Innovation Institute (Jiangmen), Jiangmen, China, ;
| | - Xue-Tao Xu
- Faculty of Chemical and Environmental Engineering, Wuyi University, Jiangmen, China, ; .,International Healthcare Innovation Institute (Jiangmen), Jiangmen, China, ;
| | - Zhao-Jun Sheng
- Faculty of Chemical and Environmental Engineering, Wuyi University, Jiangmen, China, ; .,International Healthcare Innovation Institute (Jiangmen), Jiangmen, China, ;
| | - Stephen A Ward
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Kun Zhang
- Faculty of Chemical and Environmental Engineering, Wuyi University, Jiangmen, China, ; .,Department of Pharmaceutical Engineering, Faculty of Chemical Engineering and Light Industry, Guangdong University of Technology, Guangzhou, China, ; .,International Healthcare Innovation Institute (Jiangmen), Jiangmen, China, ;
| |
Collapse
|
33
|
Smit MR, Ochomo EO, Waterhouse D, Kwambai TK, Abong'o BO, Bousema T, Bayoh NM, Gimnig JE, Samuels AM, Desai MR, Phillips-Howard PA, Kariuki SK, Wang D, Ter Kuile FO, Ward SA, Aljayyoussi G. Pharmacokinetics-Pharmacodynamics of High-Dose Ivermectin with Dihydroartemisinin-Piperaquine on Mosquitocidal Activity and QT-Prolongation (IVERMAL). Clin Pharmacol Ther 2018; 105:388-401. [PMID: 30125353 PMCID: PMC6585895 DOI: 10.1002/cpt.1219] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 03/21/2018] [Accepted: 08/05/2018] [Indexed: 12/26/2022]
Abstract
High‐dose ivermectin, co‐administered for 3 days with dihydroartemisinin‐piperaquine (DP), killed mosquitoes feeding on individuals for at least 28 days posttreatment in a recent trial (IVERMAL), whereas 7 days was predicted pretrial. The current study assessed the relationship between ivermectin blood concentrations and the observed mosquitocidal effects against Anopheles gambiae s.s. Three days of ivermectin 0, 300, or 600 mcg/kg/day plus DP was randomly assigned to 141 adults with uncomplicated malaria in Kenya. During 28 days of follow‐up, 1,393 venous and 335 paired capillary plasma samples, 850 mosquito‐cluster mortality rates, and 524 QTcF‐intervals were collected. Using pharmacokinetic/pharmacodynamic (PK/PD) modeling, we show a consistent correlation between predicted ivermectin concentrations and observed mosquitocidal‐effects throughout the 28‐day study duration, without invoking an unidentified mosquitocidal metabolite or drug‐drug interaction. Ivermectin had no effect on piperaquine's PKs or QTcF‐prolongation. The PK/PD model can be used to design new treatment regimens with predicted mosquitocidal effect. This methodology could be used to evaluate effectiveness of other endectocides.
Collapse
Affiliation(s)
- Menno R Smit
- Liverpool School of Tropical Medicine (LSTM), Liverpool, UK
| | - Eric O Ochomo
- Kenya Medical Research Institute (KEMRI), Centre for Global Health Research, Kisumu, Kenya
| | | | - Titus K Kwambai
- Liverpool School of Tropical Medicine (LSTM), Liverpool, UK.,Kenya Medical Research Institute (KEMRI), Centre for Global Health Research, Kisumu, Kenya.,Kenya Ministry of Health (MoH), Kisumu County, Kisumu, Kenya
| | - Bernard O Abong'o
- Kenya Medical Research Institute (KEMRI), Centre for Global Health Research, Kisumu, Kenya
| | - Teun Bousema
- Radboud University Nijmegen Medical Center (Radboud), Nijmegen, The Netherlands.,London School of Hygiene and Tropical Medicine (LSHTM), London, UK
| | - Nabie M Bayoh
- US Centers for Disease Control and Prevention (CDC), Center for Global Health, Division of Parasitic Diseases and Malaria, Atlanta, Georgia, USA
| | - John E Gimnig
- US Centers for Disease Control and Prevention (CDC), Center for Global Health, Division of Parasitic Diseases and Malaria, Atlanta, Georgia, USA
| | - Aaron M Samuels
- US Centers for Disease Control and Prevention (CDC), Center for Global Health, Division of Parasitic Diseases and Malaria, Atlanta, Georgia, USA
| | - Meghna R Desai
- US Centers for Disease Control and Prevention (CDC), Center for Global Health, Division of Parasitic Diseases and Malaria, Atlanta, Georgia, USA
| | | | - Simon K Kariuki
- Kenya Medical Research Institute (KEMRI), Centre for Global Health Research, Kisumu, Kenya
| | - Duolao Wang
- Liverpool School of Tropical Medicine (LSTM), Liverpool, UK
| | | | - Stephen A Ward
- Liverpool School of Tropical Medicine (LSTM), Liverpool, UK
| | | |
Collapse
|
34
|
O' Neill PM, Stocks PA, Sabbani S, Roberts NL, Amewu RK, Shore ER, Aljayyoussi G, Angulo-Barturén I, Belén M, Jiménez-Díaz, Bazaga SF, Martínez MS, Campo B, Sharma R, Charman SA, Ryan E, Chen G, Shackleford DM, Davies J, Nixon GL, Biagini GA, Ward SA. Synthesis and profiling of benzylmorpholine 1,2,4,5-tetraoxane analogue N205: Towards tetraoxane scaffolds with potential for single dose cure of malaria. Bioorg Med Chem 2018; 26:2996-3005. [DOI: 10.1016/j.bmc.2018.05.006] [Citation(s) in RCA: 9] [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] [Received: 01/30/2018] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 01/08/2023]
|
35
|
Aljayyoussi G, Tyrer HE, Ford L, Sjoberg H, Pionnier N, Waterhouse D, Davies J, Gamble J, Metuge H, Cook DAN, Steven A, Sharma R, Guimaraes AF, Clare RH, Cassidy A, Johnston KL, Myhill L, Hayward L, Wanji S, Turner JD, Taylor MJ, Ward SA. Author Correction: Short-Course, High-Dose Rifampicin Achieves Wolbachia Depletion Predictive of Curative Outcomes in Preclinical Models of Lymphatic Filariasis and Onchocerciasis. Sci Rep 2018; 8:1384. [PMID: 29348597 PMCID: PMC5773522 DOI: 10.1038/s41598-018-19723-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A correction to this article has been published and is linked from the HTML version of this paper. The error has been fixed in the paper.
Collapse
Affiliation(s)
- Ghaith Aljayyoussi
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Hayley E Tyrer
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Louise Ford
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Hanna Sjoberg
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Nicolas Pionnier
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - David Waterhouse
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Jill Davies
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Joanne Gamble
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Haelly Metuge
- Research Foundation in Tropical Medicine and the Environment, Buea, Cameroon
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Darren A N Cook
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Andrew Steven
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Raman Sharma
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Ana F Guimaraes
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Rachel H Clare
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Andrew Cassidy
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Kelly L Johnston
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Laura Myhill
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Laura Hayward
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Samuel Wanji
- Research Foundation in Tropical Medicine and the Environment, Buea, Cameroon
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Joseph D Turner
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Mark J Taylor
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Stephen A Ward
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| |
Collapse
|
36
|
Sharma R, Aljayyoussi G, Tyrer HE, Gamble J, Hayward L, Guimaraes AF, Davies J, Waterhouse D, Cook DAN, Myhill LJ, Clare RH, Cassidy A, Steven A, Johnston KL, Ford L, Turner JD, Ward SA, Taylor MJ. Corrigendum: Minocycline as a re-purposed anti-Wolbachia macrofilaricide: superiority compared with doxycycline regimens in a murine infection model of human lymphatic filariasis. Sci Rep 2018; 8:46934. [PMID: 29308790 PMCID: PMC5757190 DOI: 10.1038/srep46934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This corrects the article DOI: 10.1038/srep23458.
Collapse
|
37
|
Török ME, Aljayyoussi G, Waterhouse D, Chau T, Mai N, Phu NH, Hien TT, Hope W, Farrar JJ, Ward SA. Suboptimal Exposure to Anti-TB Drugs in a TBM/HIV+ Population Is Not Related to Antiretroviral Therapy. Clin Pharmacol Ther 2017; 103:449-457. [PMID: 28160272 DOI: 10.1002/cpt.646] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/24/2017] [Accepted: 01/29/2017] [Indexed: 11/08/2022]
Abstract
A placebo-controlled trial that compares the outcomes of immediate vs. deferred initiation of antiretroviral therapy in HIV +ve tuberculous meningitis (TBM) patients was conducted in Vietnam in 2011. Here, the pharmacokinetics of rifampicin, isoniazid, pyrazinamide, and ethambutol were investigated in the presence and absence of anti-HIV treatment in 85 patients. Pharmacokinetic analyses show that HIV therapy has no significant impact on the pharmacokinetics of TB drugs in this cohort. The same population, however, displayed generally low cerebrospinal fluid (CSF) and systemic exposures to rifampicin compared to previously reported HIV -ve cohorts. Elevated CSF concentrations of pyrazinamide, on the other hand, were strongly and independently correlated with increased mortality and neurological toxicity. The findings suggest that the current standard dosing regimens may put the patient at risk of treatment failure from suboptimal rifampicin exposure, and potentially increasing the risk of adverse central nervous system events that are independently correlated with pyrazinamide CSF exposure.
Collapse
Affiliation(s)
- M E Török
- University of Cambridge, Department of Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - G Aljayyoussi
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - D Waterhouse
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Tth Chau
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Hi Chi Minh City, Vietnam
| | - Nth Mai
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Hi Chi Minh City, Vietnam
| | - N H Phu
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Hi Chi Minh City, Vietnam
| | - T T Hien
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Hi Chi Minh City, Vietnam
| | - W Hope
- University of Liverpool, Liverpool, UK
| | - J J Farrar
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Hi Chi Minh City, Vietnam
| | - S A Ward
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| |
Collapse
|
38
|
Johnston KL, Cook DAN, Berry NG, David Hong W, Clare RH, Goddard M, Ford L, Nixon GL, O’Neill PM, Ward SA, Taylor MJ. Identification and prioritization of novel anti- Wolbachia chemotypes from screening a 10,000-compound diversity library. Sci Adv 2017; 3:eaao1551. [PMID: 28959730 PMCID: PMC5617373 DOI: 10.1126/sciadv.aao1551] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/01/2017] [Indexed: 06/07/2023]
Abstract
Lymphatic filariasis and onchocerciasis are two important neglected tropical diseases (NTDs) that cause severe disability. Control efforts are hindered by the lack of a safe macrofilaricidal drug. Targeting the Wolbachia bacterial endosymbionts in these parasites with doxycycline leads to a macrofilaricidal outcome, but protracted treatment regimens and contraindications restrict its widespread implementation. The Anti-Wolbachia consortium aims to develop improved anti-Wolbachia drugs to overcome these barriers. We describe the first screening of a large, diverse compound library against Wolbachia. This whole-organism screen, streamlined to reduce bottlenecks, produced a hit rate of 0.5%. Chemoinformatic analysis of the top 50 hits led to the identification of six structurally diverse chemotypes, the disclosure of which could offer interesting avenues of investigation to other researchers active in this field. An example of hit-to-lead optimization is described to further demonstrate the potential of developing these high-quality hit series as safe, efficacious, and selective anti-Wolbachia macrofilaricides.
Collapse
Affiliation(s)
- Kelly L. Johnston
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Darren A. N. Cook
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Neil G. Berry
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, UK
| | - W. David Hong
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, UK
| | - Rachel H. Clare
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Megan Goddard
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Louise Ford
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Gemma L. Nixon
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, UK
| | - Paul M. O’Neill
- Department of Chemistry, University of Liverpool, Liverpool L69 7ZD, UK
| | - Stephen A. Ward
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Mark J. Taylor
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| |
Collapse
|
39
|
Hong WD, Gibbons PD, Leung SC, Amewu R, Stocks PA, Stachulski A, Horta P, Cristiano MLS, Shone AE, Moss D, Ardrey A, Sharma R, Warman AJ, Bedingfield PTP, Fisher NE, Aljayyoussi G, Mead S, Caws M, Berry NG, Ward SA, Biagini GA, O'Neill PM, Nixon GL. Rational Design, Synthesis, and Biological Evaluation of Heterocyclic Quinolones Targeting the Respiratory Chain of Mycobacterium tuberculosis. J Med Chem 2017; 60:3703-3726. [PMID: 28304162 DOI: 10.1021/acs.jmedchem.6b01718] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A high-throughput screen (HTS) was undertaken against the respiratory chain dehydrogenase component, NADH:menaquinone oxidoreductase (Ndh) of Mycobacterium tuberculosis (Mtb). The 11000 compounds were selected for the HTS based on the known phenothiazine Ndh inhibitors, trifluoperazine and thioridazine. Combined HTS (11000 compounds) and in-house screening of a limited number of quinolones (50 compounds) identified ∼100 hits and four distinct chemotypes, the most promising of which contained the quinolone core. Subsequent Mtb screening of the complete in-house quinolone library (350 compounds) identified a further ∼90 hits across three quinolone subtemplates. Quinolones containing the amine-based side chain were selected as the pharmacophore for further modification, resulting in metabolically stable quinolones effective against multi drug resistant (MDR) Mtb. The lead compound, 42a (MTC420), displays acceptable antituberculosis activity (Mtb IC50 = 525 nM, Mtb Wayne IC50 = 76 nM, and MDR Mtb patient isolates IC50 = 140 nM) and favorable pharmacokinetic and toxicological profiles.
Collapse
Affiliation(s)
- W David Hong
- Department of Chemistry, University of Liverpool , Liverpool L69 7ZD, U.K
| | - Peter D Gibbons
- Department of Chemistry, University of Liverpool , Liverpool L69 7ZD, U.K
| | - Suet C Leung
- Department of Chemistry, University of Liverpool , Liverpool L69 7ZD, U.K
| | - Richard Amewu
- Department of Chemistry, University of Ghana , P.O. Box LG56, Legon-Accra, Ghana
| | - Paul A Stocks
- Department of Chemistry, University of Liverpool , Liverpool L69 7ZD, U.K
| | - Andrew Stachulski
- Department of Chemistry, University of Liverpool , Liverpool L69 7ZD, U.K
| | - Pedro Horta
- CCMAR and Department of Chemistry and Pharmacy, University of Algarve , 8005-139 Faro, Portugal
| | - Maria L S Cristiano
- CCMAR and Department of Chemistry and Pharmacy, University of Algarve , 8005-139 Faro, Portugal
| | - Alison E Shone
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool L3 5QA, U.K
| | - Darren Moss
- School of Pharmacy, Keele University , Keele ST5 5BG, U.K
| | - Alison Ardrey
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool L3 5QA, U.K
| | - Raman Sharma
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool L3 5QA, U.K
| | - Ashley J Warman
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool L3 5QA, U.K
| | - Paul T P Bedingfield
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool L3 5QA, U.K
| | - Nicholas E Fisher
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool L3 5QA, U.K
| | - Ghaith Aljayyoussi
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool L3 5QA, U.K
| | - Sally Mead
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool L3 5QA, U.K
| | - Maxine Caws
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool L3 5QA, U.K
| | - Neil G Berry
- Department of Chemistry, University of Liverpool , Liverpool L69 7ZD, U.K
| | - Stephen A Ward
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool L3 5QA, U.K
| | - Giancarlo A Biagini
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine , Pembroke Place, Liverpool L3 5QA, U.K
| | - Paul M O'Neill
- Department of Chemistry, University of Liverpool , Liverpool L69 7ZD, U.K
| | - Gemma L Nixon
- Department of Chemistry, University of Liverpool , Liverpool L69 7ZD, U.K
| |
Collapse
|
40
|
Mungthin M, Watanatanasup E, Sitthichot N, Suwandittakul N, Khositnithikul R, Ward SA. Influence of the pfmdr1 Gene on In Vitro Sensitivities of Piperaquine in Thai Isolates of Plasmodium falciparum. Am J Trop Med Hyg 2017; 96:624-629. [PMID: 28044042 DOI: 10.4269/ajtmh.16-0668] [Citation(s) in RCA: 4] [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] [Indexed: 12/27/2022] Open
Abstract
Piperaquine combined with dihydroartemisinin is one of the artemisinin derivative combination therapies, which can replace artesunate-mefloquine in treating uncomplicated falciparum malaria in Thailand. The aim of this study was to determine the in vitro sensitivity of Thai Plasmodium falciparum isolates against piperaquine and the influence of the pfmdr1 gene on in vitro response. One hundred and thirty-seven standard laboratory and adapted Thai isolates of P. falciparum were assessed for in vitro piperaquine sensitivity. Polymorphisms of the pfmdr1 gene were determined by polymerase chain reaction methods. The mean and standard deviation of the piperaquine IC50 in Thai isolates of P. falciparum were 16.7 ± 6.3 nM. The parasites exhibiting chloroquine IC50 of ≥ 100 nM were significantly less sensitive to piperaquine compared with the parasite with chloroquine IC50 of < 100 nM. No significant association between the pfmdr1 copy number and piperaquine IC50 values was found. In contrast, the parasites containing the pfmdr1 86Y allele exhibited significantly reduced piperaquine sensitivity. Before nationwide implementation of dihydroartemisinin-piperaquine as the first-line treatment in Thailand, in vitro and in vivo evaluations of this combination should be performed especially in areas where parasites containing the pfmdr1 86Y allele are predominant such as the Thai-Malaysian border.
Collapse
Affiliation(s)
- Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | | | - Naruemon Sitthichot
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | | | | | - Stephen A Ward
- Division of Molecular and Biochemical Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| |
Collapse
|
41
|
Aljayyoussi G, Tyrer HE, Ford L, Sjoberg H, Pionnier N, Waterhouse D, Davies J, Gamble J, Metuge H, Cook DAN, Steven A, Sharma R, Guimaraes AF, Clare RH, Cassidy A, Johnston KL, Myhill L, Hayward L, Wanji S, Turner JD, Taylor MJ, Ward SA. Short-Course, High-Dose Rifampicin Achieves Wolbachia Depletion Predictive of Curative Outcomes in Preclinical Models of Lymphatic Filariasis and Onchocerciasis. Sci Rep 2017; 7:210. [PMID: 28303006 PMCID: PMC5428297 DOI: 10.1038/s41598-017-00322-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [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: 10/04/2016] [Accepted: 02/21/2017] [Indexed: 12/29/2022] Open
Abstract
Lymphatic filariasis (LF) and onchocerciasis are priority neglected tropical diseases targeted for elimination. The only safe drug treatment with substantial curative activity against the filarial nematodes responsible for LF (Brugia malayi, Wuchereria bancrofti) or onchocerciasis (Onchocerca volvulus) is doxycycline. The target of doxycycline is the essential endosymbiont, Wolbachia. Four to six weeks doxycycline therapy achieves >90% depletion of Wolbachia in worm tissues leading to blockade of embryogenesis, adult sterility and premature death 18-24 months post-treatment. Long treatment length and contraindications in children and pregnancy are obstacles to implementing doxycycline as a public health strategy. Here we determine, via preclinical infection models of Brugia malayi or Onchocerca ochengi that elevated exposures of orally-administered rifampicin can lead to Wolbachia depletions from filariae more rapidly than those achieved by doxycycline. Dose escalation of rifampicin achieves >90% Wolbachia depletion in time periods of 7 days in B. malayi and 14 days in O. ochengi. Using pharmacokinetic-pharmacodynamic modelling and mouse-human bridging analysis, we conclude that clinically relevant dose elevations of rifampicin, which have recently been determined as safe in humans, could be administered as short courses to filariasis target populations with potential to reduce anti-Wolbachia curative therapy times to between one and two weeks.
Collapse
Affiliation(s)
- Ghaith Aljayyoussi
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Hayley E Tyrer
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Louise Ford
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Hanna Sjoberg
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Nicolas Pionnier
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - David Waterhouse
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Jill Davies
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Joanne Gamble
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Haelly Metuge
- Research Foundation in Tropical Medicine and the Environment, Buea, Cameroon
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Darren A N Cook
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Andrew Steven
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Raman Sharma
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Ana F Guimaraes
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Rachel H Clare
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Andrew Cassidy
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Kelly L Johnston
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Laura Myhill
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Laura Hayward
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Samuel Wanji
- Research Foundation in Tropical Medicine and the Environment, Buea, Cameroon
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Joseph D Turner
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Mark J Taylor
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Stephen A Ward
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| |
Collapse
|
42
|
Jiang Z, Hong WD, Cui X, Gao H, Wu P, Chen Y, Shen D, Yang Y, Zhang B, Taylor MJ, Ward SA, O'Neill PM, Zhao S, Zhang K. Synthesis and structure–activity relationship of N4-benzylamine-N2-isopropyl-quinazoline-2,4-diamines derivatives as potential antibacterial agents. RSC Adv 2017. [DOI: 10.1039/c7ra10352b] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This paper investigated the SAR of the N4-benzylamine-N2-isopropyl-quinazoline-2,4-diamines derivatives with heterocyclic scaffold which showed good activities against S. aureus, E. coli, MRSA, S. epidermidis and S. typhimurium.
Collapse
|
43
|
O' Neill PM, Sabbani S, Nixon GL, Schnaderbeck M, Roberts NL, Shore ER, Riley C, Murphy B, McGillan P, Ward SA, Davies J, Amewu RK. Optimisation of the synthesis of second generation 1,2,4,5 tetraoxane antimalarials. Tetrahedron 2016. [DOI: 10.1016/j.tet.2016.08.043] [Citation(s) in RCA: 12] [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: 01/08/2023]
|
44
|
Ismail HM, Barton VE, Panchana M, Charoensutthivarakul S, Biagini GA, Ward SA, O'Neill PM. Berichtigung: A Click Chemistry-Based Proteomic Approach Reveals that 1,2,4-Trioxolane and Artemisinin Antimalarials Share a Common Protein Alkylation Profile. Angew Chem Int Ed Engl 2016. [DOI: 10.1002/ange.201607032] [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: 11/07/2022]
|
45
|
Ismail HM, Barton VE, Panchana M, Charoensutthivarakul S, Biagini GA, Ward SA, O'Neill PM. Corrigendum: A Click Chemistry-Based Proteomic Approach Reveals that 1,2,4-Trioxolane and Artemisinin Antimalarials Share a Common Protein Alkylation Profile. Angew Chem Int Ed Engl 2016; 55:10548. [PMID: 27552550 DOI: 10.1002/anie.201607032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
46
|
Aljayyoussi G, Kay K, Ward SA, Biagini GA. OptiMal-PK: an internet-based, user-friendly interface for the mathematical-based design of optimized anti-malarial treatment regimens. Malar J 2016; 15:344. [PMID: 27388207 PMCID: PMC4936002 DOI: 10.1186/s12936-016-1401-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/07/2016] [Accepted: 06/17/2016] [Indexed: 01/26/2023] Open
Abstract
Background The search for highly effective anti-malarial therapies has gathered pace and recent years have seen a number of promising single and combined therapies reach the late stages of development. A key drug development challenge is the need for early assessment of the clinical utility of new drug leads as it is often unclear for developers whether efforts should be focused on efficacy or metabolic stability/exposure or indeed whether the continuation of iterative QSAR (quantitative structure–activity and relationships) cycles of medicinal chemistry and biological testing will translate to improved clinical efficacy. Pharmacokinetic and pharmacodynamic (PK/PD)-based measurements available from in vitro studies can be used for such clinical predictions. However, these predictions often require bespoke mathematical PK/PD modelling expertise and are normally performed after candidate development and, therefore, not during the pre-clinical development phase when such decisions need to be made. Methods An internet-based tool has been developed using STELLA® software. The tool simulates multiple differential equations that describe anti-malarial PK/PD relationships where the user can easily input PK/PD parameters. The tool utilizes a simple stop-light system to indicate the efficacy of each combination of parameters. This tool, called OptiMal-PK, additionally allows for the investigation of the effect of drug combinations with known or custom compounds. Results The results of simulations obtained from OptiMal-PK were compared to a previously published and validated mathematical model on which this tool is based. The tool has also been used to simulate the PK/PD relationship for a number of existing anti-malarial drugs in single or combined treatment. Simulations were predictive of the published clinical parasitological clearance activities for these existing therapies. Conclusions OptiMal-PK is designed to be implemented by medicinal chemists and pharmacologists during the pre-clinical anti-malarial drug development phase to explore the impact of different PK/PD parameters upon the predicted clinical activity of any new compound. It can help investigators to identify which pharmacological features of a compound are most important to the clinical performance of a new chemical entity and how partner drugs could potentially improve the activity of existing therapies.
Collapse
Affiliation(s)
- Ghaith Aljayyoussi
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Katherine Kay
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.,State University of New York at Buffalo, Buffalo, NY, 14214, USA
| | - Stephen A Ward
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Giancarlo A Biagini
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
| |
Collapse
|
47
|
Sahota AS, Gowda R, Arasaradnam RP, Daulton E, Savage RS, Skinner JR, Adams E, Ward SA, Covington JA. A simple breath test for tuberculosis using ion mobility: A pilot study. Tuberculosis (Edinb) 2016; 99:143-146. [PMID: 27450016 DOI: 10.1016/j.tube.2016.05.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/18/2016] [Accepted: 05/22/2016] [Indexed: 11/26/2022]
Abstract
Tuberculosis (TB) remains one of the world's major health burdens with 9.6 million new infections globally. Though considerable progress has been made in reduction of TB incidence and mortality, there is a continuous need for lower cost, simpler and more robust means of diagnosis. One method that may fulfil these requirements is in the area of breath analysis. In this study we analysed the breath of 21 patients with pulmonary or extra-pulmonary TB, recruited from a UK teaching hospital (University Hospital Coventry and Warwickshire) before or within 1 week of commencing treatment for TB. TB diagnosis was confirmed by reference tests (mycobacterial culture), histology or radiology. 19 controls were recruited to calculate specificity; these patients were all interferon-gamma release assay negative (T.SPOT(®).TB, Oxford Immunotec Ltd.). Whole breath samples were collected with subsequent chemical analysis undertaken by Ion Mobility Spectrometry. Our results produced a sensitivity of 81% and a specificity of 79% for all cases of TB (pulmonary and extra-pulmonary). Though lower than other studies analysing pulmonary TB alone, we believe that this technique shows promise, and a higher sensitivity could be achieved by further improving our sample capture methodology.
Collapse
Affiliation(s)
- Amandip S Sahota
- Dept. of Infection and Tropical Medicine, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester, LE1 5WW, UK.
| | - Ravi Gowda
- Department of Infectious Diseases, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK.
| | - Ramesh P Arasaradnam
- Dept. of Gastroenterology, University Hospital Coventry and Warwickshire, and Clinical Sciences Research Institute, University of Warwick, Coventry, CV2 2DX, UK.
| | - Emma Daulton
- School of Engineering, University of Warwick, Coventry, UK.
| | - Richard S Savage
- Systems Biology Centre/Medical School, University of Warwick, CV4 7AL, UK.
| | - Jim R Skinner
- Centre for Complexity Science, University of Warwick, CV4 7AL, UK.
| | - Emily Adams
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Stephen A Ward
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | | |
Collapse
|
48
|
Ismail HM, Barton VE, Panchana M, Charoensutthivarakul S, Biagini GA, Ward SA, O'Neill PM. A Click Chemistry-Based Proteomic Approach Reveals that 1,2,4-Trioxolane and Artemisinin Antimalarials Share a Common Protein Alkylation Profile. Angew Chem Weinheim Bergstr Ger 2016; 128:6511-6515. [PMID: 27397940 PMCID: PMC4934454 DOI: 10.1002/ange.201512062] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 02/19/2016] [Indexed: 12/12/2022]
Abstract
In spite of the recent increase in endoperoxide antimalarials under development, it remains unclear if all these chemotypes share a common mechanism of action. This is important since it will influence cross-resistance risks between the different classes. Here we investigate this proposition using novel clickable 1,2,4-trioxolane activity based protein-profiling probes (ABPPs). ABPPs with potent antimalarial activity were able to alkylate protein target(s) within the asexual erythrocytic stage of Plasmodium falciparum (3D7). Importantly, comparison of the alkylation fingerprint with that generated from an artemisinin ABPP equivalent confirms a highly conserved alkylation profile, with both endoperoxide classes targeting proteins in the glycolytic, hemoglobin degradation, antioxidant defence, protein synthesis and protein stress pathways, essential biological processes for plasmodial survival. The alkylation signatures of the two chemotypes show significant overlap (ca. 90 %) both qualitatively and semi-quantitatively, suggesting a common mechanism of action that raises concerns about potential cross-resistance liabilities.
Collapse
Affiliation(s)
- Hanafy M. Ismail
- Research Centre for Drugs and DiagnosticsLiverpool School of Tropical MedicinePembroke PlaceLiverpoolL3 5QAUK
| | | | - Matthew Panchana
- Research Centre for Drugs and DiagnosticsLiverpool School of Tropical MedicinePembroke PlaceLiverpoolL3 5QAUK
| | | | - Giancarlo A. Biagini
- Research Centre for Drugs and DiagnosticsLiverpool School of Tropical MedicinePembroke PlaceLiverpoolL3 5QAUK
| | - Stephen A. Ward
- Research Centre for Drugs and DiagnosticsLiverpool School of Tropical MedicinePembroke PlaceLiverpoolL3 5QAUK
| | - Paul M. O'Neill
- Department of ChemistryUniversity of LiverpoolLiverpoolL69 7ZDUK
| |
Collapse
|
49
|
Ismail HM, Barton VE, Panchana M, Charoensutthivarakul S, Biagini GA, Ward SA, O'Neill PM. A Click Chemistry-Based Proteomic Approach Reveals that 1,2,4-Trioxolane and Artemisinin Antimalarials Share a Common Protein Alkylation Profile. Angew Chem Int Ed Engl 2016; 55:6401-5. [PMID: 27089538 PMCID: PMC4934138 DOI: 10.1002/anie.201512062] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 02/19/2016] [Indexed: 12/11/2022]
Abstract
In spite of the recent increase in endoperoxide antimalarials under development, it remains unclear if all these chemotypes share a common mechanism of action. This is important since it will influence cross-resistance risks between the different classes. Here we investigate this proposition using novel clickable 1,2,4-trioxolane activity based protein-profiling probes (ABPPs). ABPPs with potent antimalarial activity were able to alkylate protein target(s) within the asexual erythrocytic stage of Plasmodium falciparum (3D7). Importantly, comparison of the alkylation fingerprint with that generated from an artemisinin ABPP equivalent confirms a highly conserved alkylation profile, with both endoperoxide classes targeting proteins in the glycolytic, hemoglobin degradation, antioxidant defence, protein synthesis and protein stress pathways, essential biological processes for plasmodial survival. The alkylation signatures of the two chemotypes show significant overlap (ca. 90 %) both qualitatively and semi-quantitatively, suggesting a common mechanism of action that raises concerns about potential cross-resistance liabilities.
Collapse
Affiliation(s)
- Hanafy M Ismail
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Victoria E Barton
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK
| | - Matthew Panchana
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | | | - Giancarlo A Biagini
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Stephen A Ward
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Paul M O'Neill
- Department of Chemistry, University of Liverpool, Liverpool, L69 7ZD, UK.
| |
Collapse
|
50
|
Kaewpruk N, Tan-ariya P, Ward SA, Sitthichot N, Suwandittakul N, Mungthin M. PFMDR1 POLYMORPHISMS INFLUENCE ON IN VITRO SENSITIVITY OF THAI PLASMODIUM FALCIPARUM ISOLATES TO PRIMAQUINE, SITAMAQUINE AND TAFENOQUINE. Southeast Asian J Trop Med Public Health 2016; 47:366-376. [PMID: 27405118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Primaquine (PQ), an 8-aminoquinoline, is considered a tissue schizonticide drug for radical cure in vivax and ovale malaria, with minimal impact on asexual erythrocytic stages at therapeutic concentrations. Tafenoquine (TQ), a new 8-aminoquinoline analog of PQ, is active against both malaria parasite tissue and blood stages and is being promoted as a drug candidate for antimalarial chemotherapy and chemoprophylaxis and potential transmission blocking against Plasmodium vivax and P. falciparum. This study compared in vitro sensitivity of Thai P. falciparum isolates against three 8-aminoquinolines, PQ, TQ and sitamaquine (SQ), a related 8-aminoquinoline and assessed the importance of pfmdr1 polymorphism on the in vitro response. Seventy-eight laboratory adapted Thai P. falciparum isolates were evaluated for in vitro sensitivity to the three 8-aminoquinolines using a radioisotopic assay, and pfmdr1 polymorphisms were determined using PCR-based methods. All three drugs have weak antiplasmodial activity against asexual erythrocytic stage with SQ being the most potent by almost 10 folds. Cross susceptibility was observed in all three 8-aminoquinolines. Parasites containing pfmdr1 86Y, 184Y or 1034S allele exhibit significantly higher PQ IC₅₀. TQ sensitivity was reduced in those parasites containing pfmdr1 86Y, 1034S or 1042N allele. However, there was no significant influence of pfmdr1 alleles on SQ sensitivity. The data highlight unique differences among three representative 8-aminoquinoline drugs that may be useful in understanding their potential utility in antimalarial development.
Collapse
|