In vitro evaluations of antimalarial drugs and their relevance to clinical outcomes

Plasmodium falciparum resistance to the former first-line antimalarials chloroquine and sulfadoxine/pyrimethamine has reached critically high levels in many malaria-endemic regions. This has spurred the introduction of several new artemisinin-based combination therapies (ACTs) that display excellent potency in treating drug-resistant malaria. Monitoring for the emergence of drug resistant P. falciparum is important for maximising the clinically effective lifespan of ACTs. Here, we provide a commentary on the article by Kaddouri et al., published in this issue of the International Journal of Parasitology, which documents the levels of susceptibility to ACT drugs and chloroquine in P. falciparum isolates from Mali. These authors report that some isolates approached a proposed in vitro threshold of resistance to monodesethyl-amodiaquine (the principal effective metabolite of amodiaquine, an important ACT partner drug), and establish baseline levels of susceptibility to the ACT drugs dihydroartemisinin and lumefantrine. The majority of clinical isolates manifested in vitro resistance to chloroquine. The authors also show good concordance between field-based assays employing a non-radioactive lactate dehydrogenase-based method of determining in vitro drug IC₅₀ values and the well-established [³H]hypoxanthine-based radioactive method. This work illustrates a good example of drug resistance surveillance, whose global coordination is being championed by the World Antimalarial Resistance Network. Our current opinion also more generally discusses the complexities inherent to conducting in vitro investigations with P. falciparum patient isolates and correlating these findings with treatment outcome data.     

Antimalarial properties of soy-bean fat emulsions

Intralipid^® and Ivelip^® are commercial preparations of soy-bean lipid extracts used for intravenous supplementation of lipids in various clinical conditions. They were found to inhibit the growth of Plasmodium falciparum in culture with an IC₅₀ of 8.07 ± 2.13 and 13.32 ± 2.05 mg.ml⁻¹, respectively. Intralipid^® rapidly and efficiently inhibited nucleic acid synthesis in cultured P. falciparum, exhibiting full inhibitory activity in less than 2 h. Ivelip^® injected intraperitoneally, was found by the 4-day suppressive test to be active in vivo against P. vinckei petteri within the normal recommended regimen for dietary lipid supply (0.5–4 g.kg⁻¹), but it was impossible to obtain a radical cure even with very high doses (6.4 g.kg⁻¹). Ivelip^® was less effective against P. berghei and P. yoelii nigeriensis. As Ivelip^® showed no interference with the antimalarial activity of chloroquine, it could be considered for use in the treatment of severe human malaria in association with 4-aminoquinolines to expedite the clearance of parasites.     

In vitro antiplasmodial activity of extract and constituents from Esenbeckia febrifuga, a plant traditionally used to treat malaria in the Brazilian Amazon

Esenbeckia febrifuga (Rutaceae) is a plant traditionally used to treat malaria in the Brazilian Amazon region. Ethanol extract of stems displayed a good antiplasmodial activity against Plasmodium falciparum strains W-2 (IC₅₀ 15.5±0.71 μg/ml) and 3 D7 (IC₅₀ 21.0±1.4 μg/ml). Two coumarins (bergaptene 1 and isopimpinellin 2), five alkaloids (flindersiamine 3, kokusaginine 4, skimmiamine 5, γ-fagarine 6 and 1-hydroxy-3-methoxy-N-methylacridone, 7), besides a limonoid (rutaevine 8), have been isolated for the first time from this species. Antiplasmodial activity of compounds 3, 5–8 has been evaluated in vitro against P. falciparum strains (W-2 and 3D7) and the furoquinolines 5 and 6 were the most potent displaying IC₅₀ values <50 μg/ml; flindersiamine (3) showed a weak activity while alkaloid 7 and rutaevine (8) were inactive (IC₅₀>100 μg/ml).     

In vitro antiprotozoal activity of the lipophilic extracts of different parts of Turkish Pistacia vera L.

Thirteen lipophilic extracts prepared with n-hexane from various parts of Pistacia vera L. tree (Anacardiaceae) growing in Turkey were screened for their in vitro activity against four parasitic protozoa, Trypanosoma brucei rhodesiense, Trypanosoma cruzi, Leishmania donovani and Plasmodium falciparum. Melarsoprol, benznidazole, miltefosine, artemisinin and chloroquine were used as reference drugs. The cytotoxic potentials of the extracts on rat skeletal myoblast (L6) cells were also assessed and compared to that of podophyllotoxin. The screening method employed was medium-throughput, where the extracts were tested at two concentrations, at 0.8 and 4.8 μg/ml (T. brucei rhodesiense, L. donovani and Plasmodium falciparum), or at 1.6 and 9.7 μg/ml (T. cruzi and L6 cells). At 4.8 μg/ml concentration, the branch extract of Pistacia vera (PV-BR) significantly inhibited (77.3%) the growth of L. donovani, whereas the dry leaf extract (PV-DL) was active against Plasmodium falciparum (60.6% inhibition). The IC₅₀ values of these extracts were determined as 2.3 μg/ml (PV-BR, L. donovani) and 3.65 μg/ml (PV-DL, Plasmodium falciparum). None of the extracts possessed cytotoxicity on mammalian cells.     

Gametocytocidal activity of pyronaridine and DNA topoisomerase II inhibitors against multidrug-resistant Plasmodium falciparum in vitro

Gametocytocidal activities of pyronaridine and DNA topoisomerase II inhibitors against two isolates of multidrug-resistant Plasmodium falciparum, KT1 and KT3 were determined. After sorbitol treatment, pure gametocyte cultures of Plasmodium falciparum containing mostly young gametocytes (stage II and III) obtained on day 11 were exposed to the drugs for 48 h. The effect of the drugs on gametocyte development was assessed by counting gametocytes on day 15 of culture. Pyronaridine was the most effective gametocytocidal drug against P. falciparum isolates KT1 and KT3 with 50% inhibitory concentration of 6 and 20 nM, respectively. Moreover, the 50% inhibitory concentration of pyronaridine was lower than that of primaquine which is the only drug used to treat malaria patients harboring gametocytes. Prokaryotic (norfloxacin) and eukaryotic (amsacrine and etoposide) DNA topoisomerase II inhibitors were only effective against asexual but not sexual stages of the malaria parasites. Pyronaridine has both schizontocidal and gametocytocidal activities against the human malaria parasite, P. falciparum.     

Mutation underlying resistance of Plasmodium berghei to atovaquone in the quinone binding domain 2 (Qo(2)) of the cytochrome b gene

The anti-malarial agent atovaquone specifically targets the cytochrome bc₁ complex and inhibits the parasite respiration. Resistance to this drug, a coenzyme Q analogue, is associated with mutations in the mitochondrial cytochrome b gene. We previously reported atovaquone resistant mutations in Plasmodium berghei, in the first quinone binding domain (Qo₁) of the cytochrome b gene (M133I and L144S) with V284F in the sixth transmembrane domain. However, in P. falciparum the most common mutations are found in the Qo₂ region. To obtain a better model for biochemical and genetic studies, we have now extended our study to isolate a wider range of P. berghei resistant strains, in particular those in the Qo₂. Here we report four new mutations (Y268N, Y268C, L271V and K272R), all in the Qo₂ domain. Two of these mutations are convergent to codon 268 (nt802–804) drug-induced mutation in P. falciparum.     

Crystallographic and NMR studies of antiinfective tricyclic guanidine alkaloids from the sponge Monanchora unguifera

Three tricyclic guanidine alkaloids, including 1,8a;8b,3a-didehydro-8β-hydroxyptilocaulin (1), 1,8a;8b,3a-didehydro-8-hydroxyptilocaulin (2) and mirabilin B (3), were identified from the marine sponge Monanchora unguifera. 1,8a;8b,3a-Didehydro-8-hydroxyptilocaulin (2) is a new stereoisomer of 1, the structure of which was elucidated by spectroscopic analysis, comparison of its spectral data with those of 1, and confirmed by X-ray analysis. Compounds 1 and 2 co-crystallized in an unusual perfect order and packed around an approximate inversion center. A mixture of 1 and 2 is active against the malaria parasite Plasmodium falciparum with an IC₅₀ value of 3.8 μg/mL while mirabilin B (3) exhibited antifungal activity against Cryptococcus neoformans with an IC₅₀ value of 7.0 μg/mL and antiprotozoal activity against Leishmania donovani with an IC₅₀ value of 17 μg/mL.     

Monoquaternary ammonium derivatives inhibit growth of protozoan parasites

The phospholipid metabolism of Plasmodium falciparum-infected erythrocytes has been shown to be an effective pharmacological target for novel chemotherapy. Thirty-seven monoquaternary ammonium derivatives analogous to choline were screened for their potential antiprotozoal activity against P. falciparum and Leishmania braziliensis. Twenty-three compounds inhibited chloroquine resistant and sensitive P. falciparum strains with inhibitory concentrations ranging from 0.001 μM to 47 μM. Among the inhibitors were six compounds with nanomolar activity containing at least one ethyl group in the polar head and a hydrophobic alkyl chain with 10 to 14 methylene groups. Four compounds also exhibited in vitro antileishmanial properties in the micromolar range.     

Isolation of mitochondria from Plasmodium falciparum showing dihydroorotate dependent respiration.

Using N₂ cavitation, we established a protocol to prepare the active mitochondria from Plasmodium falciparum showing a higher succinate dehydrogenase activity than previously reported and a dihydroorotate-dependent respiration. The fact that fumarate partially inhibited the dihydroorotate dependent respiration suggests that complex II (succinate–ubiquinone reductase/quinol–fumarate reductase) in the erythrocytic stage cells of P. falciparum functions as a quinol–fumarate reductase.     

Allelic variation in the cg2 gene does not correlate with chloroquine resistance among Indian Plasmodium falciparum isolates.

The cg2 gene of Plasmodium falciparum has been proposed to be associated with chloroquine resistance. Here we describe PCR amplification and sequencing of all the four repeat regions (kappa (κ), gamma (γ), psi (φ) and omega (ω)) of this gene, from Indian isolates. There were variant forms for each of these repeat regions (two for κ and γ, and three for φ and ω) among the 123 Indian isolates of P. falciparum. Among these isolates certain forms of φ and ω repeats were uniquely present while some of the reported forms of the κ and ω repeats were absent. The pattern of combination of all four repeat regions of cg2 gene (genotype) was analysed from 52 isolates. A total of 11 different genotypes were observed among these cases, of which 10 were unique to Indian isolates. Certain genotypes were more common than others. The nucleotide sequencing of all the four repeat regions revealed that Indian isolates have some unique repeating units within the γ and ω domains. Altogether, the PCR and sequencing results showed that there was an unrelatedness between cg2 repeats and chloroquine resistance.     

Dicationic near-linear biphenyl benzimidazole derivatives as DNA-targeted antiprotozoal agents

A series of near-linear biphenyl benzimidazole diamidines 5a–h were synthesized from their respective diamidoximes (4a–h), through the bis-O-acetoxyamidoxime, followed by hydrogenation in glacial acetic acid/ethanol in the presence of Pd–C. Compounds 4a–h were obtained in three steps, starting with the Suzuki coupling reaction of the appropriate haloarylcarbonitriles 1a–g or 4-bromo-2-fluorobenzaldehyde with 4-formylphenylboronic acid or 4-cyanophenylboronic acid to form the anticipated 4-formylbiphenyl carbonitrile analogues 2a–h. Subsequent condensation of the formyl derivatives 2a–h with 3,4-diaminobenzonitrile in the presence of sodium bisulfite or 1,4-benzoquinone gave the desired dinitriles 3a–h, the precursors for 4a–h. All the diamidines showed strong DNA affinities, as judged by high ΔT_m values with poly(dA.dT)_2. The compounds were quite active in vitro versus Trypanosoma brucei rhodesiense, giving IC₅₀ values ranging from 3 to 37 nM. These compounds were even more active versus Plasmodium falciparum, exhibiting IC₅₀ values ranging from 0.5 to 23 nM. The compounds showed moderate to good activity in vivo in the STIB900 model for acute African trypanosomiasis. The most active compounds 5b and e gave 3/4 cures on an IP dosage of 20 mg/kg.     

289株VVC致病菌的菌种分布和对9种抗真菌药物敏感性

外阴阴道念珠菌病（vulvovaginal candidiasis,VVC）是女性的常见病。本研究收集了2018年1月-12月苏州地区VVC患者分离的289株念珠菌进行了病原学鉴定和包括棘白菌素类、新三唑类药物在内的9种抗真菌药物体外敏感性分析。本文采用核糖体RNA的D1/D2基因进行念珠菌菌种鉴定。参照M27-A3方法检测其对9种抗真菌药物（包括棘白菌素类及新三唑类药物）的体外敏感性。结果表明,289株VVC念珠菌菌株中,白念珠菌259株、光滑念珠菌14株、克柔念珠菌10株、热带念珠菌4株、近平滑念珠菌2株。259株VVC白念珠菌对棘白菌素类体外敏感性好,对米卡芬净敏感性高于另外两种棘白菌素类;对两性霉素B、5-氟胞嘧啶、氟康唑敏感性好;但对伊曲康唑、伏立康唑敏感性差;对泊沙康唑敏感性好。光滑念珠菌株和克柔念珠菌分离株对卡泊芬净敏感性差,但对米卡芬净、阿尼芬净敏感性好;光滑念珠菌株对两性霉素B、5-氟胞嘧啶体外敏感性好,对伊曲康唑敏感性差,对泊沙康唑敏感性好;伏立康唑对光滑念珠菌分离株MIC₅₀/₉₀为0.5/1μg/mL;克柔念珠菌对伊曲康唑、伏立康唑50%耐药;4株热带念珠菌对伊曲康唑50%耐药,对卡泊芬净、氟康唑、伏立康唑100%耐药,对其余5种抗真菌药物敏感。近平滑念珠菌对9种抗真菌药物均敏感。白念珠菌仍为苏州地区VVC的主要病原菌,其次是光滑念珠菌和克柔念珠菌,它们对临床常用药物伊曲康唑、伏立康唑、卡泊芬净敏感性差。研究结果提示对VVC病人常规进行分泌物培养、菌种鉴定,对苏州地区临床医生制定VVC治疗方案具有重要参考价值。尽管棘白菌素类、两性霉素B、5-氟胞嘧啶、新三唑类药物尚未应用到VVC的临床治疗中,但是这些药物对VVC病原体总体敏感性较好,未来有望成为氟康唑、咪唑类药物治疗失败患者的新选择。     

The potent and selective inhibition of estrogen production by non-steroidal aromatase inhibitor, YM511

YM511 inhibited aromatase activities in microsomes from rat ovary and human placenta competitively (IC₅₀s: 0.4 and 0.12 nM, respectively). YM511 was about 3 times more potent than other aromatase inhibitors, such as CGS 16949A, CGS 20267 and R 76713. YM511 decreased the contents of estradiol stimulated by pregnant mare's serum gonadotropin in rat ovary with an ED₅₀ of 0.002 mg/kg, indicating that YM511 was equipotent to CGS 20267 and 3 times more potent than the other two inhibitors. Serum estradiol levels in female rats were reduced by YM511 at 0.01 mg/kg into the ovariectomized range. YM511 at 1 mg/kg for 2 weeks decreased rat uterine weight to levels comparable to ovariectomy, showing it was 10 times more potent than other inhibitors. But the maximal inhibitory effect of tamoxifen failed to reach ovariectomized level. YM511 slightly inhibited production of other steroid hormones in vitro and in vivo. The IC₅₀s of YM511 for aldosterone and cortisol production from adrenal cells were from 5500 to 9800 times higher than that for rat ovarian aromatase and 130,000 times higher for testosterone production, indicating that YM511 is a highly specific aromatase inhibitor. The data suggest that YM511 may be a potent and selective agent for suppressing estrogen-dependent action without affecting serum levels of other steroid hormones.     

Synthesis, spectral studies and in vitro assessment for antiamoebic activity of new cyclooctadiene ruthenium(II) complexes with 5-nitrothiophene-2-carboxaldehyde thiosemicarbazones

We report here the synthesis, characterization and in vitro antiamoebic activity of 5-nitrothiophene-2-carboxaldehyde thiosemicarbazones (TSC), 1–5, and their bidentate complexes [Ru(η⁴-C₈H₁₂)(TSC)Cl₂] 1a–5a. The biological studies of these compounds were investigated against HK-9 strain of Entamoeba histolytica and the concentration causing 50% cell growth inhibition (IC₅₀) was calculated in the micromolar range. The ligands exhibited antiamoebic activity in the range (2.05–5.29 μM). Screening results indicated that the potencies of the compounds increased by the incorporation of ruthenium(II) in the thiosemicarbazones. The complexes 1a–5a showed antiamoebic activity with an IC₅₀ of 0.61–1.43 μM and were better inhibitors of growth of E. histolytica, based on IC₅₀ values. The most promising among them is Ru(II) complex 2a having 1,2,3,4-tetrahydroquinoline as N⁴ substitution.     

Substance P and neurokinin A metabolism by cultured human skeletal muscle myocytes and fibroblasts

A recent study determined that cultured human skeletal muscle adult myoblasts, myotubes, and fibroblasts degraded angiotensins and kinins via neutral endopeptidase-24.11 (NEP-24.11; EC 3.4.24.11) and aminopeptidase N (APN; EC 3.4.11.2). Due to the possible importance of other peptides to skeletal muscle blood flow and function, the present study looked specifically at the metabolism of the neurokinins substance P (SP) and neurokinin A (NKA) by skeletal muscle peptidases. The results show that SP is degraded not only by NEP-24.11, but also sequentially by dipeptidyl(amino)peptidase IV (DAP IV; EC 3.4.14.5)/APN. NKA is unaffected by DAP IV but is metabolized by NEP-24.11 and APN. NEP-24.11 was inhibited by phosphoramidon (IC₅₀ = 80 nM), thiorphan and ZINCOV, DAP IV by diprotin A (IC₅₀ = 8 μM), and APN by amastatin (IC₅₀ = 50 nM) and bestatin (IC₅₀ = 100 μM). Skeletal muscle myocyte and fibroblast metabolism of SP and NKA may regulate local skeletal muscle vascular and extravascular functions including SP- and NKA-mediated nerve-induced vasodilation. Inhibition of both NEP-24.11 and DAP IV/APN may increase skeletal muscle blood flow and decrease peripheral vascular resistance via potentiation of local neurokinin levels.     

Inhibitors of Plasmepsin II-potential antimalarial agents

In order to overcome the problem of drug resistance in malaria, it appears wise to concentrate drug discovery efforts toward new structural classes and new mechanisms of action. We report our results, targeting Plasmepsin II, a Plasmodium falciparum aspartic protease active in hemoglobin degradation, a parasite specific catabolic pathway. The results show that the new structural class is not only inhibiting PMII in vitro but is also active in a P. falciparum infected human red blood cell assay.     

7株野生虫草菌的鉴定及其菌丝体醇提取物对HepG2细胞的抑制活性

结合形态学与ITS序列分析对7株野生虫草真菌进行分类鉴定。MTT法分析它们的菌丝体醇提取物对肝癌HepG2细胞增殖的抑制活性。鉴定结果表明菌株MF7、MF9、MF14为细脚棒束孢Isaria tenuipes,菌株MF11、MF12、MF13为蝉棒束孢Isaria cicadae,菌株MF10为球孢白僵菌Beauveria bassiana;MTT结果显示分离到的3株细脚棒束孢和3株蝉棒束孢的菌丝体醇提取物对HepG2的抑制活性较差,IC₅₀均大于500μg/mL;球孢白僵菌MF10对HepG2细胞有一定抑制作用,IC₅₀值为221.6μg/mL,略强于蝙蝠蛾拟青霉发酵菌丝粉产品金水宝胶囊（IC₅₀=364μg/mL）和中华被毛孢发酵菌丝粉产品百令胶囊（IC₅₀=268.7μg/mL）。另外,发现供对比试验的3株蛹虫草菌株（MF1、MF5、MF15）对HepG2细胞均有较好的抑制作用,其中MF15的发酵菌丝体醇提取物活性最强,IC₅₀为55.56μg/mL,暗示蛹虫草发酵菌丝体具有重要的研究价值。     

Structural insights into the Plasmodium falciparum histone deacetylase 1 (PfHDAC-1): A novel target for the development of antimalarial therapy

The histone deacetylase (HDAC) enzyme from Plasmodium falciparum has been identified as a novel target for the development of antimalarial therapy. A ligand-refined homology model of PfHDAC-1 was generated from the crystal structures of human HDAC8 and HDLP using a restraint guided optimization procedure involving the OPLS/GBSA potential setup. The model was extensively validated using protein structure checking tools. A predictive docking study was carried out using a set of known human HDAC inhibitors, which were shown to have in vitro antimalarial activity against the chloroquine sensitive D6 and resistant W2 strains of P. falciparum. Pose validation and score-based active/inactive separation studies provided independent validation of the geometric accuracy and the predictive ability of the generated model. Comparative analysis was carried out with the human HDACs to identify differences in the binding site topology and interacting residues, which might be utilized to develop selective PfHDAC-1 inhibitors.     

Infectivity and ecology of Pseudomonas spp. from natural epizootics in the rice leaf folder, Cnaphalocrocis medinalis (Lepidoptera: Pyralidae) in India

In 2001, populations of the leaf folder (LF) (Cnaphalocrocis medinalis Guenee) reached 19-30 larvae/hill in Rabi rice (variety Lalat) fields at Choudwar, Baranga, Alani and Tangi, Orissa, India infesting 61-98% of the plants. Three bacteria viz. Pseudomonas aeruginosa (Pa1 and Pa2) and P. fluorescens (Pf) infected 62-98% of the larvae in different fields. No correlation was found among populations of the Pseudomonas spp. on the rice phyllosphere and larvae harboring the bacteria at different fields. The median lethal concentrations (LC₅₀s; ×10³ bacteria/mL) of Pa1, Pa2 and Pf were 4-4.2, 4.8-4.9 and 5.7-5.9, respectively, for the leaf piece assay and 4.8-4.9, 5-5.1 and 6.3-6.7, respectively, for the potted plant assay against second to fifth instar larvae. The median lethal times (LT₅₀s) were 2.1-2.4, 3.2-3.5 and 5.3-6 days for the leaf piece assay, and 4-4.7, 4.7-4.9 and 6.1-6.8 days for the potted plant assay with Pa1, Pa2 and Pf, respectively. The Pa1 and Pa2 were compatible, exhibited synergistic effect and co-inoculation reduced the LC₅₀ and LT₅₀ as compared to inoculation with individual organisms. The Pf had no synergism with Pa1 or Pa2, and therefore, the lethal values for Pf alone or with the other bacteria were similar. Fulfillment of Koch's postulates confirmed that Pa1, Pa2 and Pf were pathogens of C. medinalis.     

供磷水平对梨砧木生长和15N-尿素吸收利用特性的影响

以一年生盆栽豆梨、川梨、木梨实生苗为试材,采用¹⁵N同位素示踪技术,研究了不同供磷水平(P₂O₅分别为0、50、100、150、200 kg·hm^-2,分别用P₀、P₁、P₂、P₃、P₄表示)对3种梨砧木生长和¹⁵N-尿素吸收、利用特性的影响.结果表明: 随着供磷水平的提高,砧木的株高、地径、干质量、根系总表面积、总根长、根尖数、根系活力、根系呼吸速率、Ndff值和氮素利用率均先升高后降低,但不同砧木升降幅度不同,且各指标出现峰值的磷水平不同.在同一磷素水平下,木梨的株高、地径、干质量均最高,川梨次之,豆梨最低,根系形态指标和根系呼吸速率呈相同规律,而Ndff值和氮素利用率表现不同.在不同磷素水平下,木梨在P₃处理各指标均达到最高水平,而川梨和豆梨分别在P₂和P₁处理各指标均达到最高水平;砧木各器官的Ndff值在不同磷水平下均以茎最高;木梨的最高氮素利用率(种植季的肥料N回收率)为9.6%、川梨为8.9%、豆梨为8.3%.以上结果表明,不同梨砧木生长和氮素吸收利用特性在不同磷水平下响应不同,生产中应根据砧木需磷特性合理施磷.