Transfection technology and the study of drug resistance in the malaria parasite Plasmodium falciparum.

Numerous approaches have been employed to identify the molecules responsible for drug resistance in the human malaria parasite Plasmodium falciparum. However, it was not until the recent development of stable transfection in this parasite that it became possible to prove the role of particular genes in drug resistance and, perhaps more importantly, to characterise the nature of the specific mutations that contribute the resistance phenotype. In this review, the contribution of various molecular genetic approaches to the dissection of drug resistance in P. falciparum is described. Future possibilities in this field are also outlined in the light of recent technological advances.     

Falcipains, Plasmodium falciparum cysteine proteases as key drug targets against malaria

There is a high demand for new drugs against malaria, which takes millions of lives annually. The abuse of classical antimalarials from the late 1940's to the early 1980's has bred resistant parasites, which led to the use of more potent drugs that ended up by refueling the resistance cycle. An example is chloroquine, once highly effective but now virtually useless against malaria. Structure-based rational drug design relies on high-resolution target structures to allow for screening of selective ligands/inhibitors. For the past two decades, and especially after the unveiling of the Plasmodium falciparum genome in 2002, enzymes of this lethal malaria parasite species have been increasingly attracting the attention of Medicinal Chemists worldwide as promising drug targets. There is particular emphasis on proteases having key roles on the degradation of host's hemoglobin within the food vacuole of blood-stage parasites, as these depend on such process for their survival. Among such enzymes, Plasmepsins (aspartic proteases) and, especially, Falcipains (cysteine proteases) are highly promising antimalarial drug targets. The present review will focus on the computational approaches made so far towards the unraveling of the structure, function and inhibition of Falcipains that, by virtue of their quite specific features, are excellent targets for highly selective inhibitors.     

Quinoline-resistance reversing agents for the malaria parasite Plasmodium falciparum.

Resistance to quinoline antimalarials, especially to chloroquine and mefloquine has had a major impact on the treatment of malaria worldwide. In the period since 2000, significant progress has been made in understanding the origins of chloroquine resistance and to a lesser extent mefloquine resistance in Plasmodium falciparum. Chloroquine resistance correlates directly with mutations in the pfcrt gene of the parasite, while changes in another gene, pfmdr1, may also be related to chloroquine resistance in some strains. Mutations in pfcrt do not appear to correlate with mefloquine resistance, but some studies have implicated pfmdr1 in mefloquine resistance. Its involvement however, has not been definitively demonstrated. The protein products of these genes, PfCRT and Pgh-1 are both located in the food vacuole membrane of the parasite. Current evidence suggests that PfCRT is probably a transporter protein. Chloroquine appears to exit the food vacuole via this transporter in resistant PfCRT mutants. Pgh-1 on the other hand, resembles mammalian multi-drug resistance proteins and appears to be involved in expelling hydrophobic drugs from the food vacuole. Resistance reversing agents are believed to act by inhibiting these proteins. The currently known chloroquine- and mefloquine-resistance reversing agents are discussed in this review. This includes a discussion of structure-activity relationships in these compounds and hypotheses on their possible mechanisms of action. The status of current clinical applications is also briefly discussed.     

Toxicity of certain products of lipid peroxidation to the human malaria parasite Plasmodium falciparum

Aldehydes generated during radical-induced lipid peroxidation, in particular 4-hydroxynonenal, are known to inhibit growth of certain cells. To extend our arguments that free radicals might be involved in the host response against malaria parasites we tested 26 carbonyls (n-alkanals, C6-C11; 2-alkenals, C3-C9; 2,4-alkadienals, C7, C9, C10; 4-OH-2-alkenals, C6, C8, C9; 2-alkanones, C3-C9; and malonyldialdehyde) against Plasmodium falciparum in vitro. We had previously detected many of these substances in oxidant-stressed, malaria-infected erythrocytes. Three 2,4-alkadienals (C7, C9 and C10) and three 4-OH-2-alkenals (C6, C8 and C9), at 20-100 microM concentrations, markedly inhibited incorporation of [3H]-hypoxanthine by P. falciparum. Acrolein had low effect, and none of the other compounds (12 aldehydes and 7 ketones) were active at concentrations up to 100 microM. Malonyldialdehyde was without effect at concentrations up to 450 microM. The aldehydes found to be inhibitory against P. falciparum could contribute to both the non-antibody host responses against this parasite and the antimalarial effects of radical-generating compounds such as t-butyl hydroperoxide, hydrogen peroxide, alloxan, isouramil, divicine and primaquine.     

Functional genomic technologies applied to the control of the human malaria parasite, Plasmodium falciparum

Infection with any of the four species of Plasmodium single cell parasites that infects humans causes the clinical disease, malaria. Of these, it is Plasmodium falciparum that is responsible for the majority of the 1.5-2.3 million deaths due to this disease each year. Worldwide there are between 300-500 million cases of malaria annually. To date there is no licensed vaccine and resistance to most of the available drugs used to prevent and/or treat malaria is spreading. There is therefore an urgent need to develop new and effective drugs and vaccines against this devastating parasite. We have outlined a strategy using a combination of DNA-based vaccines and the data derived from the soon-to-be completed P. falciparum genome and the genomes of other species of Plasmodium to develop new vaccines against malaria. Much of the technology that we are developing for vaccine target identification is directly applicable to the identification of potential targets for drug discovery. The publicly available genome sequence data also provides a means for researchers whose focus may not be primarily malaria to leverage their research on cancer, yeast biology and other research areas to the biological problems of malaria.     

Arylpiperazines displaying preferential potency against chloroquine-resistant strains of the malaria parasite Plasmodium falciparum

Arylpiperazines in which the terminal secondary amino group is unsubstituted were found to display a mefloquine-type antimalarial behavior in being significantly more potent against the chloroquine-resistant (W2 and FCR3) strains of Plasmodium falciparum than against the chloroquine-sensitive (D10 and NF54) strains. Substitution of the aforementioned amino group led to a dramatic drop in activity across all strains as well as abolition of the preferential potency against resistant strains that was observed for the unsubstituted counterparts. The data suggest that unsubstituted arylpiperazines are not well-recognized by the chloroquine resistance mechanism and may imply that they act mechanistically differently from chloroquine. On the other hand, 4-aminoquinoline-based heteroarylpiperazines in which the terminal secondary amino group is also unsubstituted, were found to be equally active against the chloroquine-resistant and chloroquine-sensitive strains, suggesting that chloroquine cross-resistance is not observed with these two 4-aminoquinolines. In contrast, two 4-aminoquinoline-based heteroarylpiperazines are positively recognized by the chloroquine resistance mechanism. These studies provide structural features that determine the antimalarial activity of arylpiperazines for further development, particularly against chloroquine-resistant strains.     

Inhibition of protein-protein interactions in Plasmodium falciparum: future drug targets

The rapid development by malaria parasites of resistance to almost all the chemotherapeutic agents so far used for their control means that constant efforts to develop new drugs are necessary. In this review, we propose that the exploration of protein-protein interactions as a new strategy to identify antimalarial drug targets is an attractive and a promising area of research. Nevertheless, one of the most important criteria is that the targeted gene should encode an essential protein within a complex that is able to affect parasite survival. Recently, our research on the biology of Plasmodium falciparum allowed us to identify the interaction of Protein Phosphatase type 1 and actin with two essential partners, PfLRR1 and PfLRR7 respectively, both of which belong to the Leucine Rich Repeat (LRR) protein family. LRR-containing proteins are composed of several consensus LRR motifs LXLXXNXL (where X is any amino acid) that provide sites for the assembly of protein interactions. The LRR combines structural versatility, adaptability and more importantly a high degree of interaction specificity. In addition, it has been shown that a single mutation in a particular LRR motif abolishes the protein-protein interaction and contributes to the expression of severe pathology in humans. This clearly infers that blocking the interaction related to 'hot spots' of LRR motifs can be considered as good targets to block parasite growth and development. Thus, the inhibition of protein-protein interactions by peptides, peptidomimetics or small-molecule inhibitors that interfere with binding domains can contribute to defining new potential drug targets.     

Triazolopyrimidine-based dihydroorotate dehydrogenase inhibitors with potent and selective activity against the malaria parasite Plasmodium falciparum

A Plasmodium falciparum dihydroorotate dehydrogenase ( PfDHODH) inhibitor that is potent ( KI = 15 nM) and species-selective (>5000-fold over the human enzyme) was identified by high-throughput screening. The substituted triazolopyrimidine and its structural analogues were produced by an inexpensive three-step synthesis, and the series showed good association between PfDHODH inhibition and parasite toxicity. This study has identified the first nanomolar PfDHODH inhibitor with potent antimalarial activity in whole cells (EC50 = 79 nM).     

Antimalarial drugs and drug targets specific to fatty acid metabolic pathway of Plasmodium falciparum

Plasmodium falciparum, a causitive agent of malaria, is the third most prevalent factor for mortility in the world. Falciparum malaria is an example of evolutionary and balancing selection. Because of mutation and natural selection, the parasite has developed resistance to most of the existing drugs. Under such circumstances, there is a growing need to develop new molecular targets in P. falciparum. A four membrane bound organelles called apicoplast, very much similar to that of chloroplast of plants, have been found in parasite. Therefore, the proteins involved in metabolic pathways of apicoplasts are important drug targets. Among the pathways in apicoplast, fatty acid biosynthetic pathway is the most important metabolic pathway in P. falciparum. Several studies have explored the role of different proteins involved in this pathway and antimalarial compounds against this target. In this review, we have studied the role of different proteins in fatty acid metabolism and designing, synthesis and evaluation of compounds against the targets identified in fatty acid metabolic pathway.     

Genomics-based drug design targets the AT-rich malaria parasite: implications for antiparasite chemotherapy

Evaluation of: Woynarowski JM, Krugliak M, Ginsburg H: Pharmacogenomic analyses of targeting the AT-rich malaria parasite genome with AT-specific alkylating drugs. Mol. Biochem. Parasitol. 154(1), 70-81 (2007) [1] . The sequencing of the malaria genome sought to expose the parasite's ability to cause disease and identify new targets for antimalarial drugs and vaccines. In this study, the authors discovered how malaria genomic DNA, which is unusually rich in adenine and thymine nucleotides, is intrinsically a target for a selective class of compounds. AT-specific DNA-binding agents have previously been shown to have potent antimalarial activity in vitro. The authors used high-resolution bioinformatic tools to explore the genomic basis for this drug susceptibility, first at the level of individual DNA-binding sites, then expanding to the entire genomic context of each malaria chromosome. Their findings revealed a nonrandom distribution and organization of drug-binding sites that can be further exploited to target these AT sequences. Based on these findings, comparative bioinformatics analyses with other parasite genomes may lead to the identification of new target organisms for these AT-specific drugs and have wide implications for the treatment of human and animal parasitic diseases.     

New targets, new hope: novel drug targets for curbing malaria

Malaria continues to plague the tropical and subtropical regions causing high morbidity and mortality. Every year, millions die due to lack of affordable and effective anti-malarial drugs. Malaria poses significant threat to half of the world's population and our arsenal to combat this disease is nearly empty. Pharmaceutical companies shy away from investing in research and development for anti-malarial drugs and have shunned it as non-profitable venture. In wake of emergence and spread of drug resistant malaria to newer territories, there is imperative need to develop new drugs for curbing malaria. This underscores the need of exploring new drug targets and reevaluation of existing drug targets. Availability of genome sequence of both parasite and human host has greatly facilitated the search for novel drug targets. This endeavor is complemented well by advances in functional genomics, structure - based drug design and high throughput screening methods and raises much optimism about winning this battle against malaria. This review discusses potential drug targets in the malarial parasite for designing intervention strategies and suitable chemotherapeutic agents.     

Purine and pyrimidine pathways as targets in Plasmodium falciparum

Malaria is a leading cause of morbidity and mortality in the tropics. Chemotherapeutic and vector control strategies have been applied for more than a century but have not been efficient in disease eradication. Increased resistance of malaria parasites to drug treatment and of mosquito vectors to insecticides requires the development of novel chemotherapeutic agents. Malaria parasites exhibit rapid nucleic acid synthesis during their intraerythrocytic growth phase. Plasmodium purine and pyrimidine metabolic pathways are distinct from those of their human hosts. Thus, targeting purine and pyrimidine metabolic pathways provides a promising route for novel drug development. Recent developments in enzymatic transition state analysis have provided an improved route to inhibitor design targeted to specific enzymes, including those of purine and pyrimidine metabolism. Modern transition state analogue drug discovery has resulted in transition state analogues capable of binding to target enzymes with unprecedented affinity and specificity. These agents can provide specific blocks in essential pathways. The combination of tight binding with the high specificity of these logically designed inhibitors, results in low toxicity and minor side effects. These features reduce two of the major problems with the current antimalarials. Transition state analogue design is being applied to generate new lead compounds to treat malaria by targeting purine and pyrimidine pathways.     

A prodomain peptide of Plasmodium falciparum cysteine protease (falcipain-2) inhibits malaria parasite development

Falcipain-2 (FP-2), a papain family cysteine protease of Plasmodium falciparum, is a promising target for antimalarial chemotherapy. Designing inhibitors that are highly selective for falcipain-2 has been difficult because of broad specificity of different cysteine proteinases. Because propeptide regions of cysteine proteases have been shown to inhibit their cognate enzymes specifically and selectively, in the present study, we evaluated the inhibitory potential of few falcipain-2 proregion peptides. A 15 residue peptide (PP1) inhibited falcipain-2 enzyme activity in vitro. Studies on the uptake of PP1 into the parasitized erythrocytes showed access of peptide into the infected RBCs. PP1 fused with Antennapedia homeoprotein internalization domain blocked hemoglobin hydrolysis, merozoite release and markedly inhibited Plasmodium falciparum growth and maturation. Together, our results identify a peptide derived from the proregion of falcipain-2 that blocks late-stage malaria parasite development in RBCs, suggesting the development of peptide and peptidometric drugs against the human malaria parasite.     

Novel drug targets in malaria parasite with potential to yield antimalarial drugs with long useful therapeutic lives

The status of chemotherapy as the main strategy in malaria control is rapidly being eroded by development of drug resistant Plasmodia, causing malaria to be dubbed a "re-emerging disease". To counter this misfortune, there is an urgent need to develop novel antimalarial drugs capable of delaying resistance, or circumventing it altogether. Mode of action of antimalarial drugs, inter alia, has a bearing on their useful therapeutic lives (UTLs), with single target drugs having short UTLs compared with drugs which possess pleiotropic action. Quinolines and artemisinins are the two classes of drugs with pleiotropic action and subsequently long UTLs. All other antimalarials are single-target drugs, and have been rendered ineffective within 1 to 5 years of their introduction for clinical use. This strongly underlines the need for development of new antimalarial therapies possessing long UTLs. The present review explores novel drug targets within the malaria parasite that may be exploited in the search for novel drugs that possess long and UTLs.     

Novel therapeutic targets in Plasmodium falciparum: aquaglyceroporins

Background: Malaria is caused by the intracellular parasite Plasmodium falciparum. The constant need for novel malaria therapies is due to the development of resistance against existing drugs. Objective: To summarise attempts to investigate parasitic aquaporins as drug targets in malaria. Methods: Starting with a summary of the history of malaria we present aquaporin structure and function relationships. Potential interactions of inhibitors with plasmodial AQP (PfAQP) are discussed. PfAQP blockage is examined in the light of recent work on knock-out parasites. Since PfAQP is able to transport other small solutes the parasites are sensitive to other compounds which are harmless to the human host. Results/conclusions: Total blockage of PfAQP may not lead to the death of the parasite but application of PfAQP as a vehicle for toxic substances may be a further pathway for research.     

Kinetic and molecular properties of the dihydrofolate reductase from pyrimethamine-sensitive and pyrimethamine-resistant clones of the human malaria parasite Plasmodium falciparum

Dihydrofolate reductase (DHFR) (5,6,7,8-tetrahydrofolate: NADPH+-oxidoreductase; EC 1.5.1.3) was partially purified by affinity chromatography from three clones of the human malaria parasite Plasmodium falciparum. The three clones were representative of pyrimethamine-sensitive (clone 3D7) and pyrimethamine-resistant (clone HB3 and clone 7G8) parasites with ID50 values of 0.53 nM (3D7), 210 nM (HB3), and 540 nM (7G8), when tested in vitro against the drug. The specific activities of the partially purified DHFR differed by less than a factor of 2 between the sensitive clone 3D7 (442 +/- 39 nmol min-1 mg-1 protein) and the resistant clones HB3 (634 +/- 25 nmol min-1 mg-1 protein) and 7G8 (565 +/- 85 nmol min-1 mg-1 protein). The number of catalytic sites in partially purified DHFR from the three clones was similar and ranged from 151 to 194 pmol mg-1 protein. The Km value for NADPH was similar in all three clones (4.5-11.6 microM). The Km value for dihydrofolate was altered 13-fold comparing the sensitive clone 3D7 (3.2 +/- 0.6 microM) with the resistant clone HB3 (42.6 +/- 1.6 microM), with the Km for the resistant clone 7G8 falling in between (11.9 +/- 1.2 microM). The inhibition constants for pyrimethamine increased from 0.19 +/- 0.08 nM (3D7) to 2.0 +/- 0.3 nM (HB3) to 8.9 +/- 0.8 nM (7G8). The inhibition by pyrimethamine of the sensitive clone 3D7 was noncompetitive and competitive for the two other clones. The titration of partially purified DHFR with pyrimethamine revealed a 500-fold increase in the concentration of the drug needed to inhibit the DHFR activity by 50%, when the sensitive clone 3D7 (0.18 +/- 0.02 nM) was compared to the resistant clone 7G8 (95 +/- 16 nM). From the comparison of the specific activities and the catalytic center activities with the Km values for the substrate and the inhibition constants for pyrimethamine, both of which are altered in the resistant clones, we conclude that the molecular mechanism for pyrimethamine resistance in the three clones studied is not based on an overproduction of the DHFR but is due to a decreased affinity to antifolates by a structurally altered enzyme.     

Uptake of [3H]chloroquine by drug-sensitive and -resistant strains of the human malaria parasite Plasmodium falciparum

Chloroquine accumulation by human erythrocytes infected with nine different strains of the malarial parasite Plasmodium falciparum, which varied by ⩾ 20-fold sensitivity to the drug, was measured as a function of time and drug concentration. Although the kinetics of uptake were clearly quite complex in this system, at least two general phases were observed, an extremely rapid short phase (< 30 sec), followed by a slower phase leading to steady state within 60 min. The concentration of chloroquine in the parasite food vacuole quickly exceeded 1 mM at 10⁻⁶ M external drug concentration. Minor alkalinization of this organelle was observed during the first 30 sec; this pH was reduced progressively over time in a concentration-dependent manner. The rate of pH reduction was highest in the drug-sensitive strains. Neither the rate of chloroquine accumulation nor intracellular chloroquine concentrations at steady state could adequately differentiate sensitive from resistant strains. Higher intracellular drug concentrations were required to kill resistant versus sensitive strains, suggesting that a change in sensitivity to chloroquine of an intracellular effector is the mechanism of resistance. The rapid rate and extensive accumulation of chloroquine, and the lack of significant alkalinization, indicate that a new theory of the mechanism of antimalarial action of the drug is required.