Drugs to treat Malaria
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Transcript of Drugs to treat Malaria
![Page 1: Drugs to treat Malaria](https://reader033.fdocuments.in/reader033/viewer/2022051522/5896f95d1a28ab995c8bd00e/html5/thumbnails/1.jpg)
Anti-malarial Drug DiscoveryJeffrey Baldwin, PhD
UT Southwestern Medical CenterDepartment of Pharmacology
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Malaria Burden
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Life Cycle
Jones & Good, Nature Medicine (Feb. 2006)
Complex life cycleIntracellular parasite
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Pathogenesis
4 Plasmodium species are human pathogens:
FalciparumVivaxOvaleMalariae
Miller et al, Nature (7 Feb, 2002)
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Clinical Outcomes
Miller et al, Nature (7 Feb, 2002)
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Immune Evasion
PfEMP1 is key to lethality of P. falciparum
Sticky molecules evade immune response and clog capillaries
Miller et al, Nature (7 Feb, 2002)
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Discovery Process
I. Rational Drug Designrequires detailed structural information
II. Combinatorial Chemistrycompound diversity is based on a core structural template
III. Compound Librariesscreen compounds with diverse chemical properties
identification of novel “scaffolds”
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Why more anti-malarials?
Quinoline and related antimalarials Antifolates
OtherQuinine
Chloroquine
Lumefantrine
Pyrimethamine Proguanil
Artemisinin AtovaquoneMefloquine
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Pyrimidine Biosynthesis inPlasmodium falciparum
L-Gln
HCO3-
ATP
CPSICP
Asp
ATCCA
DHOL-DHO OA
DHODH OPRTOMP
PRPP
OMPDCUMP
Malaria parasites rely exclusively on de novo pathway whereas the human host is also capable of salvage
Inhibitors of pyrimidine biosynthesis are proven drugs, eg. TS and DHFR
These data suggest other enzymes in the pathway are also essential and therefore represent potential drug targets
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DHODH as a drug target against Malaria
CoQH2 CoQ
L-DHO Orotate
FMNFMNH2
DHODH catalyzes the FMN-dependent oxidation of L-dihydroorotic acid
Malarial DHODH is mitochondrial and is rate limiting in the synthesis of UMP
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Human DHODH is a validated target
Leflunomide (Arava) A77-1726
DMARD approved for treatment of rheumatoid arthritis
Mode of Action: Inhibition of DHODH
-DHODH is major binding protein of A77-1726
-uridine reverses growth toxicity effects
Selectivity based on differential pyrimidine requirements in resting versus activated T/B cells
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X-ray structure of human DHODH
Truncated human DHODH (Δ30)
Two domains:
1. TIM barrel
-orotate and FMN binding sites
2. α-helical domain forms tunnel opening leading to the active site
The A77-1726 and brequinar binding site is in a channel formed by the helix region and is the site of binding for the CoQ substrate
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Active site of DHODH is variable
Inhibitor binding site is not conserved in malarial enzyme—selective inhibition is feasible
Grey residues are conserved between human and malarial enzymes
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Validation of active site selectivity
Confirm species selective inhibition between human and malarial enzymesTest derivatives of existing scaffolds that inhibit DHODH from other species,
–A77-1726 analogs–Redoxal, DCL
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Strategies to identify malaria DHODH specific inhibitors
Strong species selectivity as predicted from structure and sequence alignments
Existing inhibitor scaffolds will require a significant chemistry effort to improve activity on the malarial enzyme
Search for novel scaffolds
High-throughput screening of a small molecule library
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High-throughput Screening (HTS)•Small molecule library consisting drug-like compounds
•Automated screening of molecules for inhibition of enzyme activity
•Assay Requirements
•Simple, robust, and reproducible
•End-point
•Reliable method of detection
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DHODH HTS Assay
DCIP DCIPH2 (colorless)λmax=600nm
Endpoint colorimetric assay
Initial HTS of malaria DHODH at 3 μM for compound collection > 200,000 small molecules
Hit was defined at > 4 SD from the mean
Screen 12,800 per day
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DHODH HTS Results
Representative 384-well plate from HTS
Abs
(600
nm
)
Initial Abs
1.14 ± 0.02
60% Inhibition
1350 compounds were identified as ‘hits’ from the primary HTS
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DHODH HTS Strategy
End-point calorimetric assay
DCIPλmax=600nm
DCIPH2 (colorless)
1350 hits from initial screen were tested at 0.12, 0.6, and 3 μM for both malaria and human DHODH enzymes
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DHODH HTS Results
63 compounds were identified with IC50 values less than 600 nM for pfDHODH
-all but one displayed selective binding to the malarial enzyme
~30 compounds fall into related structural classes
1. Halogenated phenyl benzamide/naphthamides
2. Urea-based naphthyl or quinolinyl compounds
-remaining compounds identified with novel scaffolds
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General classes of HTS hits
R1 R2 IC50 μM fold#
4 Br H .06 18005 Cl F .10 12006 Cl Cl .016 12500 7 F F .26 7709 Cl Cl .08 90010 CF3 H .08 1900
Biphenyl amides:
-Reversible enzyme inhibitors
-IC50 = 20 – 300 nM pfDHODH
-900 - 20,000 fold selective
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General classes of HTS hitsNaphthyl phenyl amides:
-IC50 = 50 – 500 nM pfDHODH
-70 – 4,000 fold selective
R1, R2 = halogen, H, or CH3
Napthyl phenyl ureas:
-IC50 = 200 – 800 nM pfDHODH
-150 – 2,000 fold selective
R = halogen, CF3, OCH3
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SAR analysis of pfDHODH Inhibitors
-aromatic rings
-prefers amide bonds
-tolerates variable size and substituents on one ring
-has a strong preference for 2,3-methyl-nitro substituents
-selectivity increases with potency
Reconfirm and validate hits
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HPLC purification and MS analysis
0 25 50 75Minutes
0.20
0.18
0.16
0.14
0.02
0.04
0.06
0.08
0.10
0.12
0.22
0.00
A U
320 325 330
(M-H)-
(M+H)+
m/z
1
2
3
4
Expected mass = 324
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Selective inhibition of pfDHODH
12,500 fold selective
0
0.2
0.4
0.6
0.8
1
1.2
0.001 0.01 0.1 1 10 100 1000
hDHODH = 200 μM
pfDHODH = 16 nM
[Compound 6], μM
vi/v
o
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Analysis of inhibitor binding site
Grey = conserved between human and malaria enzymes
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Analysis of inhibitor binding site
Mutation of conserved residues in the CoQ site reduces inhibitor potency
The effect is larger for H185 (20 vs. 6300 fold)
vi/v
o
[Compound 6], μM
H185A
R265A
pfDHODH
0
0.2
0.4
0.6
0.8
1
1.2
0.001 0.01 0.1 1 10 100
IC50 = 0.02 μM
IC50 = 0.4 μM20-fold
IC50 = 130 μM6300-fold
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Analysis of inhibitor binding site
Compound 6 is a competitive inhibitor of CoQ
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Analysis of inhibitor binding site
Mutagenesis data strongly suggests that these newly identified pfDHODH inhibitors bind the same site as the established inhibitors of hDHODH (e.g. A77-1726 and brequinar)
Kinetic analysis suggests this is also the CoQ site
Species differences in the amino acid composition of this site explain the structural basis for selective binding
The more conserved orotate site does not appear to be targeted in screen
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Activity of biphenyl amides and ureas on P. falciparum cultures
Compound 1; 20% at 10 μM
No growth inhibition observed for others up to 10 - 100 μM
Selective and potent inhibitors of the malarial enzyme
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DHODH HTS Results—Selective inhibition by GR-34
pfDHODH IC50 = 38 nM
Human DHODH IC50 = 640 μM
> 17,000 fold selectivity
0
0.2
0.4
0.6
0.8
1
1.2
0.001 0.01 0.1 1 10 100 1000 104[GR-34], μM
vi/v
o
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DHODH HTS Results—Activity of GR-34 on P. falciparum cultures
0
20
40
60
80
100
120
0.1 1 10 100 1000 104
% C
ell G
rowt
h
[GR-34], nM
Measured by 3H-hypoxanthine incorporation
Human L1210
P. falciparum 3D7
EC50 = 60 nM
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In vivo Screening
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Conclusions
Identified potent and selective inhibitors of malarial DHODH
–Inhibitors likely bind the CoQ binding site
–Structural basis for selectivity is large sequence variations in this site between species
Identified a pfDHODH inhibitor that kills malarial parasites with specificity
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Acknowledgments
Phillips Lab-Meg Phillips–Nick Malmquist–Jeongmi Lee-Farah El Mazouni
HTS Core (Biochemistry)–Carolyn Michnoff–Mike Roth
University of Washington
-Pradip Rathod
-Azizeh Farajallah
-Ramesh Gujjar
–John White
Funding
NIH, The Welch Foundation