青蒿素类药物的作用机制:一个长久未决的基础研究挑战

青蒿素是中国自主研制的抗疟良药,高效、低毒,许多基于青蒿素研发的衍生物具有良好的抗疟效果,近年来已成为抗疟的一线药物,受到世界医疗卫生界的充分肯定.虽然青蒿素结构奇特,抑疟效果显著,但40年来其生物作用机制之谜一直未被彻底破解.针对青蒿素类药物的作用机制,提出了不同的假说,如血红素参与青蒿素的激活并被烷基化从而起到抑疟作用,线粒体参与青蒿素的激活和作用过程,某些特定的蛋白是青蒿素作用靶点等.除抑疟外,青蒿素类药物在杀灭其他种类寄生虫、抑制某些癌症细胞以及抗病毒、治疗类风湿等方面也有一定作用.本文将对青蒿素类药物作用机制的研究进行综述及展望,包括抗疟疾过程中的药物激活、作用靶点以及简要的青蒿素抑制肿瘤细胞作用机制,以期为今后的研究提供帮助.     

青蒿素生产研究进展

青蒿素是我国利用传统中医自主开发的抗疟特效药.对青蒿人工栽培、离体培养生产青蒿素、青蒿素生物合成与调控等的最新研究进展作了综述,并认为青蒿规模化种植是满足青蒿素现实需求的主要途径,同时应努力运用现代生物技术开启另一条高质高产的青蒿素生产途径.     

青蒿素及其衍生物的抗肿瘤机制

恶性肿瘤是严重威胁人类健康的重大疾病。尽管治疗手段不断发展,但推广度及疗效仍极为有限。新近研究发现,经典抗疟一线药青蒿素及其衍生物具有广泛抗肿瘤活性。大量研究提示,青蒿素及其衍生物通过细胞毒性效应直接杀死肿瘤细胞,也可诱导细胞周期阻滞从而抑制细胞增殖。另一方面,可通过凋亡、自噬、铁死亡途径导致细胞死亡。还可调控肿瘤微环境,从而抑制肿瘤细胞侵袭与转移。然而,尽管青蒿素及其衍生物展现出强大的抗肿瘤潜能,但其作用机制仍十分复杂。本文就青蒿素及其衍生物的抗肿瘤机制及其研究进展作一综述。     

PUMA-BH3结构域短肽的原核表达、纯化及促凋亡活性鉴定

Bcl-2家族蛋白质在线粒体途径凋亡的调控机制中起着重要的作用,p53正向细胞凋亡调控因子（p53 up-regulated modulator of apoptosis protein,PUMA)是该家族的一种只含有BH3同源区域的促凋亡蛋白。为得到PUMA的BH3结构域短肽并检测其生物学活性,将人工合成的编码PUMA-BH3肽的DNA片段克隆到质粒pTYB2上,构建出表达PUMA-BH3-内含肽-几丁质结合域融合蛋白的原核表达载体pTYB2-PUMA-BH3,转化大肠杆菌BL-21(DE3)中IPTG诱导表达。表达的融合蛋白经几丁质亲和层析、二硫苏糖醇（DTT）的柱内还原,直接获得可溶性PUMA-BH3肽。通过研究重组PUMA-BH3肽在体外条件下对线粒体活力、线粒体肿胀度以及细胞色素c释放的影响来鉴定其生物学活性。结果表明,获得的可溶性PUMA-BH3肽能作用于离体线粒体,引起线粒体活力降低,线粒体肿胀并能诱导细胞色素c释放。环孢菌素A对此有一定的抑制作用,提示PUMA-BH3肽对线粒体的上述作用是通过促进通透性转运孔( PTP)开放实现的。经原核表达及纯化,获得了具有促凋亡活性的PUMA-BH3肽,为进一步研制控制凋亡过程的药物奠定了基础。     

丙戊酸钠对抗鱼藤酮诱导的SH-SY5Y细胞损伤的线粒体机制

研究丙戊酸钠（sodiumvalproate,VPA）对抗鱼藤酮（Rotenone）诱导的SH-SY5Y细胞损伤的作用及线粒体机制。以l,10μmol／LVPA预处理SH－SY5Y细胞3h,再加入400nmol／LRotenone作用24h。MTT法检测与相差显微镜观察相结合,分析VPA对抗Rotenone损伤的作用;JC－1染色法与Mito－Tracker染色法分析线粒体膜电位及线粒体数量的变化;Clark氧电极法检测细胞呼吸功能;DCFH-DA探针法检测细胞中Ros的含量;并在离体线粒体上观察VPA对Ca^2＋诱导的线粒体肿胀的影响。结果发现,1,10p．mol／LVPA预处理SH．SY5Y细胞3h可对抗400nmol／LRotenoneI起的细胞损伤,并且可以提高损伤细胞中线粒体的膜电位,增加线粒体的数量,此外,还可以增强损伤细胞的呼吸功能,降低细胞中ROS的含量,但VPA并不能直接作用于离体的线粒体发挥神经保护作用。由此,VPA具有良好的神经保护作用,其机制与增强线粒体功能和数量、从而改善细胞功能有关,这为其应用于帕金森病的预防与治疗提供了实验依据。     

细胞死亡的新理论：溶酶体线粒体轴理论

线粒体在细胞死亡中占有中心地位,但其他细胞器影响线粒体启动细胞死亡的机制仍不十分明确. 近几年来,随着对溶酶体功能的不断了解,Alexei等提出了溶酶体线粒体轴理论.这一理论阐述了溶酶体与线粒体的相互作用,并最终导致细胞死亡的机理. 各种致凋亡因素作用于溶酶体,导致溶酶体膜通透性改变．溶酶体膜通透性改变能通过铁依赖的方式、脂褐素相关的方式、Bcl-2家族依赖的方式和Rho/ROCK途径-JNK信号通路的方式影响线粒体,造成线粒体膜通透性改变,进而启动细胞死亡．而线粒体膜通透性改变能通过ROS依赖的方式和Bcl-2家族依赖的方式引起溶酶体通透性改变,最终导致细胞死亡. 溶酶体线粒体轴理论还能用于解释非酒精性脂肪肝和溶酶体贮积症的发病机制．本文将对溶酶体线粒体轴理论及其与疾病的关系两方面进行阐述．     

线粒体钾通道参与葛根素抗心肌细胞缺氧/复氧损伤的作用

目的:探讨线粒体ATP敏感性钾通道和线粒体钙激活钾通道在葛根素预处理抗心肌细胞缺氧/复氧损伤中的作用。方法:采用酶解分离大鼠心肌细胞复制心肌细胞缺氧/复氧模型,台盼蓝拒染法测定心肌细胞存活率;四甲基罗丹明乙酯(TMRE)孵育测定线粒体膜电位值;分离线粒体测定线粒体渗透性转换孔开放程度。结果:与缺氧/复氧组相比,葛根素(0.24mmol/L)预处理5min可明显增加心肌细胞的存活率,线粒体ATP敏感性钾通道抑制剂5-羟基癸酸(100μmol/L,预处理20min)或线粒体钙激活钾通道阻断剂paxilline(1μmol/L,预处理5min)均可拮抗葛根素的作用。葛根素预处理可明显减弱缺氧引起的线粒体膜电位的耗损,5-羟基癸酸和paxilline都能明显拮抗其作用。在分离心肌线粒体模型上,葛根素显著减弱CaCl2诱导的线粒体在A520处吸光度降低,其作用与单独应用线粒体渗透性转换孔抑制剂环孢菌素A相似;5-羟基癸酸和paxilline可拮抗葛根素的保护作用。结论:在大鼠分离心肌细胞模型或分离线粒体模型上,葛根素预处理具有抗缺氧/复氧损伤的作用,这种保护作用可能与其促进线粒体ATP敏感性钾通道和线粒体钙激活钾通道的开放,进而稳定线粒体膜电位,抑制线粒体渗透性转换孔开放有关。     

线粒体通透性增高过程中新的参与者

 应激时,线粒体通透性增高可导致位于线粒体膜间的致凋亡因子释放入细胞质,胱天蛋白酶 (caspase)激活,以及细胞死亡.但线粒体通透性增高的确切机制尚不清楚.许多研究表明,线粒体通透性增高过程需要Bcl-2家族蛋白中促凋亡Bax亚家族蛋白,主要是Bax和Bak的激活;该家族中其它蛋白可对Bax和Bak进行调节.但最近的研究表明,其它非Bcl-2家庭蛋白的蛋白质包括抑制因子和激活因子,也可对线粒体通透性增高过程进行调节.此外,应激时线粒体脂质重新分布,对于线粒体膜通透性增高过程也起重要作用.     

线粒体自噬在缺氧条件下适应机制的研究进展

由于线粒体能敏感地感受机体内氧浓度的变化,缺氧时会影响线粒体氧化磷酸化过程中电子传递链的正常功能,抑制ATP生成,产生大量活性氧(ROS)。ROS蓄积导致氧化损伤细胞内脂质、DNA和蛋白质等大分子物质,线粒体肿胀,通透性转换孔开放,释放细胞色素C等促凋亡因子,最终严重影响细胞的存活。因此这些功能异常或受损线粒体是缺氧应激状态下细胞是否存活的危险因素,及时清除这些线粒体,对维持线粒体质量、数量及细胞稳态具有重要意义。线粒体自噬是近年来发现的细胞适应缺氧的一种防御性代谢过程,它通过自噬途径选择性清除损伤、衰老和过量产生ROS的线粒体,促进线粒体更新和循环利用,确保细胞内线粒体功能稳定,保护缺氧应激下细胞的正常生长发挥重要的调节作用。本文就线粒体自噬在缺氧条件下发生过程、参与相关蛋白及调节机制等方面研究进行了综述。     

线粒体ATP敏感钾通道与钙激活钾通道激活对正常与缺血脑线粒体通透性转变的影响

目的：明确线粒体ATP敏感钾通道与钙激活钾通道对正常和缺血脑线粒体渗透性转变的作用。方法：实验采用分光光度法,在分离的线粒体上分别观察两种线粒体钾通道激动剂对正常与缺血脑线粒体肿胀的影响。结果：在正常脑线粒体,diazoxide与NSl619能有效抑制由钙诱导的线粒体氏20下降,但其效应可被atractyloside所阻断。与正常相比,缺血损伤后的脑线粒体在钙离子诱导下线粒体A520下降较快,diazoxide与NS1619仍可抑制由钙诱导的线粒体A520下降,其作用同样为atractykxside所阻断。结论：线粒体ATP敏感钾通道与钙激活钾通道激活在离体条件均具有保护脑线粒体的作用,其作用可能是通过影响线粒体通透性转变而实现。     

青蒿素及其类似物抗疟构效关系的DFT研究

为了从原子水平上揭示青蒿素及其类似物的结构与抗疟活性之间的关系,运用密度泛函理论DFT方法,在B3LYP/6-31G*水平上对青蒿素及其类似物二氢青蒿素、蒿甲醚和青蒿琥酯的结构和性质进行了理论计算。从分子的平衡构型、Wiberg键级、溶剂化能、偶极矩和静电势等方面分析了青蒿素及其类似物的抗疟构效关系。结果表明,青蒿素及其类似物结构中七元环上的过氧桥键、醚氧键以及六元环上的内酯结构是其抗疟作用的关键活性位,过氧桥键处负的静电势越多,青蒿素与血红素的相互作用越强,分子的抗疟活性越强。理论预测四个药物分子的抗疟活性顺序为:青蒿素<二氢青蒿素<蒿甲醚<青蒿琥酯,与实验活性结果一致。     

Yeast model uncovers dual roles of mitochondria in action of artemisinin

Artemisinins, derived from the wormwood herb Artemisia annua, are the most potent antimalarial drugs currently available. Despite extensive research, the exact mode of action of artemisinins has not been established. Here we use yeast, Saccharamyces cerevisiae, to probe the core working mechanism of this class of antimalarial agents. We demonstrate that artemisinin's inhibitory effect is mediated by disrupting the normal function of mitochondria through depolarizing their membrane potential. Moreover, in a genetic study, we identify the electron transport chain as an important player in artemisinin's action: Deletion of NDE1 or NDI1, which encode mitochondrial NADH dehydrogenases, confers resistance to artemisinin, whereas overexpression of NDE1 or NDI1 dramatically increases sensitivity to artemisinin. Mutations or environmental conditions that affect electron transport also alter host's sensitivity to artemisinin. Sensitivity is partially restored when the Plasmodium falciparum NDI1 ortholog is expressed in yeast ndi1 strain. Finally, we showed that artemisinin's inhibitory effect is mediated by reactive oxygen species. Our results demonstrate that artemisinin's effect is primarily mediated through disruption of membrane potential by its interaction with the electron transport chain, resulting in dysfunctional mitochondria. We propose a dual role of mitochondria played during the action of artemisinin: the electron transport chain stimulates artemisinin's effect, most likely by activating it, and the mitochondria are subsequently damaged by the locally generated free radicals.     

Artemisinin Directly Targets Malarial Mitochondria through Its Specific Mitochondrial Activation

The biological mode of action of artemisinin, a potent antimalarial, has long been controversial. Previously we established a yeast model addressing its mechanism of action and found mitochondria the key in executing artemisinin''s action. Here we present data showing that artemisinin directly acts on mitochondria and it inhibits malaria in a similar way as yeast. Specifically, artemisinin and its homologues exhibit correlated activities against malaria and yeast, with the peroxide bridge playing a key role for their inhibitory action in both organisms. In addition, we showed that artemisinins are distributed to malarial mitochondria and directly impair their functions when isolated mitochondria were tested. In efforts to explore how the action specificity of artemisinin is achieved, we found strikingly rapid and dramatic reactive oxygen species (ROS) production is induced with artemisinin in isolated yeast and malarial but not mammalian mitochondria, and ROS scavengers can ameliorate the effects of artemisinin. Deoxyartemisinin, which lacks an endoperoxide bridge, has no effect on membrane potential or ROS production in malarial mitochondria. OZ209, a distantly related antimalarial endoperoxide, also causes ROS production and depolarization in isolated malarial mitochondria. Finally, interference of mitochondrial electron transport chain (ETC) can alter the sensitivity of the parasite towards artemisinin. Addition of iron chelator desferrioxamine drastically reduces ETC activity as well as mitigates artemisinin-induced ROS production. Taken together, our results indicate that mitochondrion is an important direct target, if not the sole one, in the antimalarial action of artemisinins. We suggest that fundamental differences among mitochondria from different species delineate the action specificity of this class of drugs, and differing from many other drugs, the action specificity of artemisinins originates from their activation mechanism.     

Plasmodium chabaudi: efficacy of artemisinin + curcumin combination treatment on a clone selected for artemisinin resistance in mice

Recent studies have proposed curcumin as a potential partner for artemisinin in artemisinin combination therapies to treat malaria infections. The efficacy of curcumin alone and in combination with artemisinin was evaluated on a clone of Plasmodium chabaudi selected for artemisinin resistance in vivo. The addition of piperine as an enhancer of curcumin activity was also tested.Results indicated that curcumin, both alone and in combination with piperine had only a modest antimalarial effect and was not able to reverse the artemisinin-resistant phenotype or significantly affect growth of the tested clone when used in combination with artemisinin. This is in contrast with previous in vivo work and calls for further experimental evaluation of the antimalarial potential of curcumin.     

Antimalarial activity of thiophenyl- and benzenesulfonyl-dihydroartemisinin

Each diastereomer of 10-thiophenyl- and 10-benzenesulfonyl-dihydroartemisinin was synthesized from artemisinin in three steps, and screened against chloroquine-resistance and chloroquine-sensitive Plasmodium falciparum. Three of the four tested compounds were found to be effective. Especially, 10 beta-benzenesulfonyl-dihydroartemisinin showed stronger antimalarial activity than artemisinin.     

Distribution of artemisinin and bioactive flavonoids from Artemisia annua L. during plant growth

Artemisia annua L. (Qinghao, Asteraceae) is a promising and potent antimalarial herbal drug. Its activity has been ascribed to the content of artemisinin, a sesquiterpene lactone that is very effective against drug-resistant Plasmodium. Many studies have pointed out that the presence of polymethoxyflavonoids in the phytocomplex can enhance the bioavailability or the activity of artemisinin. In this study the production of both artemisinin and flavonoids by plants of an aromatic ecotype of A. annua L. was characterized in different aerial parts of the plants at different developmental stages. The qualitative profile of the investigated plant parts was similar; in addition to artemisinin, four flavonoids were identified: chrysoplenetin, casticin, eupatin and artemetin. The highest contents of both flavonoids and artemisinin were found at the full blooming stage. At this developmental stage, artemisinin was higher in leaves than in inflorescences, while the total flavonoid levels were similar in both plant organs.     

Novel ferrocenic artemisinin derivatives: synthesis, in vitro antimalarial activity and affinity of binding with ferroprotoporphyrin IX

Following our search for novel compounds with high antimalarial activity, a series of artemisinin (QHS) derivatives containing a ferrocenic nucleus was prepared and tested in vitro against Plasmodium falciparum strains. Two new metallocenic derivatives (1 and 3) were found as potent as QHS. All compounds showed a capacity to bind with ferroprotoporphyrin IX. A decrease in the Soret band absorbance of ferroprotoporphyrin IX, resulting from the addition of different drugs concentrations, was shown. The association stoichiometry of compounds to ferroprotoporphyrin IX appears to be 1:2 at equilibrium, with an intermediate 1:1 complexation. These results appear to strengthen the role of adducts between artemisinin derivatives and heme in generation of artemisinin radicals. Such interaction of artemisinin ferrocenyl derivatives with ferroprotoporphyrin IX and its biological significance could form a basis in future drug development.     

Simultaneous analysis of artemisinin and flavonoids of several extracts of Artemisia annua L. obtained from a commercial sample and a selected cultivar

Artemisia annua L. (Qinghao) is a promising and potent antimalarial herbal drug. This activity has been ascribed to its component artemisinin, a sesquiterpene lactone that is very effective against drug-resistant Plasmodium species with a low toxicity. Our studies indicate that several flavonoids of A. annua can promote and enhance the reaction of artemisinin with hemin. These data are in good agreement with previous investigations on the in vitro potentiation of antimalarial activity of artemisinin by such flavonoids. As a consequence, in view of a possible use of the phytocomplex rather than pure artemisinin, an HPLC/DAD/MS method is proposed for the simultaneous detection and quantification of both flavonoids and artemisinin. Different extracts, obtained from two different herbal drugs, a commercial sample and a selected cultivar, were analyzed in order to determine which solvents provide the best yields of both artemisinin and flavonoids. Qualitative and quantitative results obtained using an HPLC method are described, which will be useful for developing highly effective herbal drug preparations.     

Artemisinin derivatives bearing Mannich base group: synthesis and antimalarial activity

Novel artemisinin derivatives bearing Mannich base group were prepared and tested for their antimalarial activity. These water-soluble artemisinin derivatives were more stable than sodium artesunate and few compounds were found to be more active against Plasmodium berghei in mice than artesunic acid by oral administration. Two most potent derivatives 17b and 17d were examined for their antimalarial activity against Plasmodium knowlesi in rhesus monkeys.     

Molecular docking and 3-D-QSAR studies on the possible antimalarial mechanism of artemisinin analogues

Artemisinin (Qinghaosu) is a natural constituent found in Artemisia annua L, which is an effective drug against chloroquine-resistant Plasmodium falciparum strains and cerebral malaria. The antimalarial activities of artemisinin and its analogues appear to be mediated by the interactions of the drugs with hemin. In order to understand the antimalarial mechanism and the relationship between the physicochemical properties and the antimalarial activities of artemisinin analogues, we performed molecular docking simulations to probe the interactions of these analogues with hemin, and then performed three-dimensional quantitative structure-activity relationship (3-D-QSAR) studies on the basis of the docking models employing comparative molecular force fields analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA). Molecular docking simulations generated probable 'bioactive' conformations of artemisinin analogues and provided a new insight into the antimalarial mechanism. The subsequent partial least squares (PLS) analysis indicates that the calculate binding energies correlate well with the experimental activity values. The CoMFA and CoMSIA models based on the bioactive conformations proved to have good predictive ability and in turn match well with the docking result, which further testified the reliability of the docking model. Combining these results, that is molecular docking and 3-D-QSAR, together, the binding model and activity of new synthesized artemisinin derivatives were well explained.