Expedient on-resin synthesis of peptidic benzimidazoles

The benzimidazole moiety is a ubiquitous pharmacophore present in numerous anthelmintic, antibacterial, antiviral, antineoplastic, and antifungal drugs. While the polypharmacology of this heterocycle has spurred the development of numerous solution-phase syntheses, only a handful of disparate and inefficient methods detailing its synthesis on-resin have been reported. Here we report the concise and expedient syntheses of internal and C-terminal peptidic benzimidazoles – an emerging class of peptide deformylase (PDF)-inhibiting antimicrobials. This method benefits from being performed wholly on solid-phase at room temperature resulting in minimal purification and tolerance of temperature-sensitive functionality.     

New technologies for the control of human hookworm infection

Since the 1990s, the major approach to hookworm control has been morbidity reduction in school-aged children by periodic deworming with benzimidazoles. Now, efforts are underway to determine the feasibility of integrating deworming with control programs that target other neglected tropical diseases. However, the sustainability of benzimidazole deworming for hookworm is of concern because of the variable efficacy of mebendazole, high rates of post-treatment reinfection and possible development of drug resistance. This requires parallel efforts to develop new and complementary hookworm control tools, such as new anthelmintic drugs (e.g. tribendimidine) and a recombinant hookworm vaccine. It is hoped that, ultimately, anthelmintic vaccination will be linked to deworming as part of an expanded control package.     

Review of methodology for the determination of benzimidazole residues in biological matrices

Benzimidazoles are anthelmintic agents widely used in the treatment of parasitic infections in a range of species and as fungicidal agents in the control of spoilage of crops during storage and transport. In this paper, the more important benzimidazoles are introduced and their pharmacological effects and physiochemical properties discussed. The metabolism of these drugs is described relating to the occurrence and persistence of residues in biological matrices, providing information for selection of suitable matrices and target residues for testing. Methods for determination of benzimidazoles are reviewed for a range of biological matrices. The importance of selecting suitable extraction and clean-up procedures is discussed, along with the difficulties encountered in adapting single residue methods to multi-residue methods. The importance of suitable detection systems for determination of benzimidazoles, namely, screening, HPLC, GC and confirmatory methods is described in detail. The future for benzimidazole residue analysis is discussed, focusing on selection of appropriate residues for screening methods and protocols for confirmation of benzimidazole residues.     

Antifungal and anthelmintic activity of novel benzofuran derivatives containing thiazolo benzimidazole nucleus: an in vitro evaluation

A novel series of thiazolo[3,2-a]benzimidazole derivatives containing benzofuran nucleus (5a–l) have been synthesized. The key intermediate, substituted benzimidazol-sulfanyl benzofuran ethanone (3a–d) was prepared by refluxing the mixture of substituted 2-acetyl benzofuran and substituted 2-mercaptobenzimidazole in acetic acid. The cyclisation of compounds (3a–d) using polyphosphoric acid furnished the corresponding 6-substituted benzofuran thiazolo[3,2-a]benzimidazoles (4a–d). Further, the cyclized compounds (4a–d) were subjected for Mannich reaction to give corresponding Mannich bases (5a–l). All newly synthesized compounds were screened for antifungal and anthelmintic activity. Amongst the tested compounds, 4b and 4d exhibited potential antifungal activity. From the anthelmintic activity data, it was found that the compounds 3a, 3b and 5i were found to be more effective against the tested earthworm Pheretima posthuma. In correlation to anthelmintic activity, the selected compounds were subjected for molecular docking studies and the compounds 3a and 5i have emerged as active anthelmintic agents with maximum binding affinity (?3.7 and ?5.4 kcal/mol).     

Penta-substituted benzimidazoles as potent antagonists of the calcium-sensing receptor (CaSR-antagonists)

A series of novel benzimidazole derivatives has been designed via a scaffold morphing approach based on known calcilytics chemotypes. Subsequent lead optimisation led to the discovery of penta-substituted benzimidazoles that exhibit attractive in vitro and in vivo calcium-sensing receptor (CaSR) inhibitory profiles. In addition, synthesis and structure–activity relationship data are provided.     

Aryl-substituted aminobenzimidazoles targeting the hepatitis C virus internal ribosome entry site

We describe the exploration of N1-aryl-substituted benzimidazoles as ligands for the hepatitis C virus (HCV) internal ribosome entry site (IRES) RNA. The design of the compounds was guided by the co-crystal structure of a benzimidazole viral translation inhibitor in complex with the RNA target. Structure-binding activity relationships of aryl-substituted benzimidazole ligands were established that were consistent with the crystal structure of the translation inhibitor complex.     

Anthelmintic resistance in nematodes: extent, recent understanding and future directions for control and research

Resistance has now been reported to all of the broad spectrum anthelmintic types currently available, namely to the benzimidazoles, levamisole/morantel and to ivermectin. The problem causes most concern for parasite control in sheep, but anthelmintic resistance has also been reported in nematodes of horses, goats, pigs and more recently cattle. Our understanding of the factors which select rapidly for resistance has increased and programmes of worm control which minimize selection for anthelmintic resistance are being developed and tested. One of the greatest problems encountered in attempting to reduce the selection for overt drug resistance is the need for more sensitive tests for developing resistance. In the long term, new approaches to chemotherapy and to overcoming anthelmintic resistance problems will arise from improving our understanding of the modes of action of, and mechanisms of resistance to, anthelmintics at the level of the receptor proteins and their genes.     

Amidino benzimidazole inhibitors of bacterial two-component systems.

Amidino benzimidazoles have been identified as inhibitors of the bacterial KinA/Spo0F two-component system (TCS). Many of these inhibitors exhibit good in vitro antibacterial activity against a variety of susceptible and resistant Gram-positive organisms. The moiety at the 2-position of the benzimidazole was extensively modified. In addition, the regioisomeric benzoxazoles, heterocyclic replacements for the benzimidazole, have been synthesized and their activity against the TCS evaluated.     

The expulsion of Aspiculuris tetraptera and syphacia spp. from mice after anthelmintic treatment

The expulsion of Aspiculuris tetraptera and Syphacia spp. from mice after anthelmintic treatment. International Journal for Parasitology10: 205–211. The effect of four benzimidazoles, piperazine and levamisole on the expulsion of adult Aspiculuris tetraptera and Syphacia spp. from mice is described on a quantitative basis. Levamisole and piperazine were found to initiate expulsion within a few hours, but this ceased by 24 h. Following benzimidazole treatment most pinworms were expelled between 24 and 48 h. Syphacia spp. responded earlier to the benzimidazoles than did A. tetraptera, but later to levamisole; both species responded similarly to piperazine. Only levamisole and mebendazole were completely effective against both species within 24 h, piperazine being the least effective. The in vitro effects of levamisole on the motility and the recovery from drug-induced paralysis of the same nematode species are also reported.     

Anthelmintics for ruminants

There is now a wide range of potent broad-spectrum anthelmintics for cattle and small ruminants, including the benzimidazoles, the avermectins, tetrahydropyrimidines and imidothiazoles which are highly efficacious against parasite gastroenteritis and bronchitis. Fascioliasis can be controlled with the salicy-lanilide and related phenolic compounds, the benzimidazoles, albendazole and triclabendazole the latter being the first flukicide with excellent activity against all stages of liver fluke infestation.The major developments for anthelmintic therapy have been and will be in the use of intraruminal boluses with either sustained release or pulse release of anthelmintic and other methods for group medication. The implications of such strategies for helminth resistance and individual immunity require further evaluation.     

Benzimidazoles as new potent and selective DP antagonists for the treatment of allergic rhinitis

A series of 2-substituted N-benzyl benzimidazole containing molecules has been synthesized and its structure-activity relationship for the human DP receptor has been evaluated. Selective DP antagonists with nanomolar potency for the DP receptor were identified in this novel series of benzimidazoles.     

Survey of parasite control programs used in captive wild ruminants

The purpose of this study was to document, through a mailed questionnaire survey, the methods of parasite control currently used in captive wild ruminants. There was a 69% overall response to the survey. The majority of respondents indicated that they used parasite surveillance and identification techniques similar to those used for domestic ruminants. Of the four major anthelmintic drug classes, the benzimidazoles and ivermectin were used most commonly. Many of the parasite control programs had high treatment frequencies which were similar to dosing frequencies reported to result in anthelmintic resistance in domestic animals. Lack of effectiveness by benzimidazoles was perceived to be a problem by many respondents.     

Analysis of β-tubulin Gene Fragments from Benzimidazole-sensitive and -tolerant Cercospora beticola

Cercospora leaf spot of sugar beet, caused by the fungus Cercospora beticola, is a major foliar pathogen on sugar beet. Fungicide sprays have been used extensively to manage Cercospora leaf spot, including the benzimidazole fungicides. Resistance to benzimidazoles has been observed in isolates of C. beticola. The precise genetics of this resistance is not known in this fungus. We tested benzimidazole‐tolerant and ‐sensitive isolates and found a single mutation in the β‐tubulin gene of benzimidazole‐tolerant isolates that corresponds to a mutation known to confer benzimidazole tolerance in other ascomycetes. This mutation is predicted to cause a change from glutamic acid to alanine in the protein product. Isolates containing this mutation further show an increased sensitivity to an N‐phenylcarbamate, as would be predicted based on the mutant phenotype found in other filamentous fungi. Only a single mutation was found in isolates from different regions of the United States, isolated in different growing seasons.     

Treatment Response of Cystic Echinococcosis to Benzimidazoles: A Systematic Review

Over the past 30 years, benzimidazoles have increasingly been used to treat cystic echinococcosis (CE). The efficacy of benzimidazoles, however, remains unclear. We systematically searched MEDLINE, EMBASE, SIGLE, and CCTR to identify studies on benzimidazole treatment outcome. A large heterogeneity of methods in 23 reports precluded a meta-analysis of published results. Specialist centres were contacted to provide individual patient data. We conducted survival analyses for cyst response defined as inactive (CE4 or CE5 by the ultrasound-based World Health Organisation [WHO] classification scheme) or as disappeared. We collected data from 711 treated patients with 1,308 cysts from six centres (five countries). Analysis was restricted to 1,159 liver and peritoneal cysts. Overall, 1–2 y after initiation of benzimidazole treatment 50%–75% of active C1 cysts were classified as inactive/disappeared compared to 30%–55% of CE2 and CE3 cysts. Further in analyzing the rate of inactivation/disappearance with regard to cyst size, 50%–60% of cysts <6 cm responded to treatment after 1–2 y compared to 25%–50% of cysts >6 cm. However, 25% of cysts reverted to active status within 1.5 to 2 y after having initially responded and multiple relapses were observed; after the second and third treatment 60% of cysts relapsed within 2 y. We estimated that 2 y after treatment initiation 40% of cysts are still active or become active again. The overall efficacy of benzimidazoles has been overstated in the past. There is an urgent need for a pragmatic randomised controlled trial that compares standardized benzimidazole therapy on responsive cyst stages with the other treatment modalities.     

Deep amplicon sequencing as a powerful new tool to screen for sequence polymorphisms associated with anthelmintic resistance in parasitic nematode populations

Parasitic gastrointestinal nematodes contribute to significant human morbidity and cause billions of dollars per year in lost agricultural production. Control is dependent on the use of anthelmintic drugs which, in the case of livestock parasites, is severely compromised by the widespread development of drug resistance. There are now concerns regarding the emergence of anthelmintic resistance in parasitic nematodes of humans in response to the selection pressure resulting from mass drug administration programs. Consequently, there is an urgent need for sensitive, scalable and accurate diagnostic tools to detect the emergence of anthelmintic resistance. Detecting and measuring the frequency of resistance-associated mutations in parasite populations has the potential to provide sensitive and quantitative assessment of resistance emergence from an early stage. Here, we describe the development and validation of deep amplicon sequencing as a powerful new approach to detect and quantify the frequency of single nucleotide polymorphisms associated with benzimidazole resistance. We have used parasite communities in sheep to undertake a proof-of-concept study of this approach. Sheep provide an excellent host system, as there are multiple co-infecting trichostrongylid nematode species, each likely with a varying prevalence of benzimidazole resistance. We demonstrate that the approach provides an accurate measure of resistance allele frequencies, and can reliably detect resistance alleles down to a frequency of 0.1%, making it particularly valuable for screening mutations in the early stages of resistance. We illustrate the power of the technique by screening UK sheep flocks for benzimidazole resistance-associated single nucleotide polymorphisms at three different codons of the β-tubulin gene in seven different parasite species from 164 populations (95 from ewes and 69 from lambs) in a single MiSeq sequencing run. This approach provides a powerful new tool to screen for the emergence of anthelmintic resistance mutations in parasitic nematode populations of both animals and humans.     

Levamisole resistance in Trichostrongylus colubriformis: a sex-linked recessive character

Reciprocal crosses between susceptible and levamisole resistant strains of Trichostrongylus colubriformis produced F1 offspring consistent with resistance being inherited as a sex-linked recessive character. The resistance status of the offspring of the backcrosses of the F1 to both parental strains supported this hypothesis. The results are consistent with resistance being controlled by a single gene, or a tightly linked group of genes, but indicate that other autosomal loci have minor effects. The results contrast with the reported observations that resistance to the benzimidazole anthelmintics is polygenic and autosomal. The results are discussed relative to a general evolutionary model for anthelmintic resistance which predicts that selection from the upper extreme of an anthelmintic tolerance distribution results in polygenicity.     

A molecular diagnostic tool to replace larval culture in conventional faecal egg count reduction testing in sheep

The accurate diagnosis of parasitic nematode infections in livestock (including sheep and goats) is central to their effective control and the detection of the anthelmintic resistance. Traditionally, the faecal egg count reduction test (FECRT), combined with the technique of larval culture (LC), has been used widely to assess drug-susceptibility/resistance in strongylid nematodes. However, this approach suffers from a lack of specificity, sensitivity and reliability, and is time-consuming and costly to conduct. Here, we critically assessed a specific PCR assay to support FECRT, in a well-controlled experiment on sheep with naturally acquired strongylid infections known to be resistant to benzimidazoles. We showed that the PCR results were in close agreement with those of total worm count (TWC), but not of LC. Importantly, albendazole resistance detected by PCR-coupled FECRT was unequivocally linked to Teladorsagia circumcincta and, to lesser extent, Trichostrongylus colubriformis, a result that was not achievable by LC. The key findings from this study demonstrate that our PCR-coupled FECRT approach has major merit for supporting anthelmintic resistance in nematode populations. The findings also show clearly that our PCR assay can be used as an alternative to LC, and is more time-efficient and less laborious, which has important practical implications for the effective management and control strongylid nematodes of sheep.     

Use of benzimidazole chemotherapy in human helminthiases: indications and efficacy

The past two decades have seen some remarkable developments in anthelmintic chemotherapy in clinical medicine. Whereas praziquantel has revolutionized the management of many cestode and trematode infections, Gordon Cook explains how the introduction of the benzimidazoles - most importantly thiabendazole, mebendazole and recently albendazole (flubendazole, cambendazole, ciclobendazole, and triclabendazole have also been used on a very limited scale) - has had a major impact upon the safe and effective management of several important intestinal and systemic nematode and, to a leser extent, cestode infections.     

The fumarate reductase system as a site of anthelmintic attack inAscaris suum

Various benzimidazole compounds have been shown to be highly eIIective as inhibitors (up to 50% reduction of activity) in vitro of the helminth-specilic enzyme, fumarate reductase, ofAscaris suum. Anthelmintically active and inactive benzimidazoles were similarly effective as inhibitors of enzyme activity. Albendazole-induced inhibition of Iumarate reductase was not observed when the enzyme was preincubated with NADH.     

Prevalence of anthelmintic resistance in gastrointestinal nematodes of dairy goats under extensive management conditions in southwestern France

The occurrence of benzimidazole (BZ) and levamisole resistance was investigated in 18 randomly selected dairy goat herds located in southwestern France and characterized by extensive management. On each of the 18 farms, 45 adult goats were randomly allocated into three groups of 15 animals each: an untreated control group, a group that was orally administered fenbendazole (10 mg kg(-1) body weight) and a group that received orally a levamisole drench (12 mg kg(-1) body weight). Individual faecal egg counts and pooled larval cultures were done 10 days after anthelmintic treatment. Naive lambs were infected with larvae obtained from control and fenbendazole treated groups and were necropsied 35 days after infection for worm recovery. Faecal egg count reductions (FERC) were calculated for fenbendazole and levamisole and, when less than 95 per 100, were considered as indicative of anthelmintic resistance. An in vitro egg hatch test (EHT) was conducted with thiabendazole on eggs isolated from pooled faeces of fenbendazole treated goats in nine farms. Faecal egg count reductions indicated the occurrence of benzimidazole resistance in 15 out of 18 farms. Among these farms, nine had EHT values above 0.1 microg thiabendazole ml(-1) confirming the benzimidazole resistance status. Levamisole resistance was detected in two farms through FECR. Based on necropsy results, the prevalence of benzimidazole resistance was higher in Trichostrongylus colubriformis, medium in Haemonchus contortus and lower in Teladorsagia circumcincta. In nine farms the benzimidazole resistance was monospecific whereas multispecific resistance was found in the six remaining farms. A negative relationship was found between FECR for fenbendazole and the average number of anthelmintic treatments given per year on the farm. Despite extensive management including a low number of treatments, the prevalence of benzimidazole resistance was very high suggesting that the repeated and sometimes exclusive use of benzimidazole drugs, even at low frequency, is probably the main cause in developing nematode resistance in dairy goat herds. The importance of other factors such as under-dosing or buying animals already carrying resistant nematodes are discussed.