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      Diversity-oriented synthesis yields novel multistage antimalarial inhibitors

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      1 , 1 , 2 , 3 , 3 , 1 , 4 , 1 , 2 , 1 , 5 , 2 , 1 , 6 , 7 , 8 , 9 , 10 , 2 , 11 , 1 , 2 , 1 , 2 , 2 , 1 , 12 , 2 , 1 , 4 , 8 , 10 , 1 , 1 , 10 , 1 , 13 , 14 , 9 , 1 , 12 , 8 , 2 , 1 , 6 , 1 , 11 , 1 , 1 , 10 , 14 , 2 , 1 , 1 , 1 , 3 , 5 , 1 , 2 , 1 , 1 , 4
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          Abstract

          Antimalarial drugs have thus far been chiefly derived from two sources—natural products and synthetic drug-like compounds. Here we investigate whether antimalarial agents with novel mechanisms of action could be discovered using a diverse collection of synthetic compounds that have three-dimensional features reminiscent of natural products and are underrepresented in typical screening collections. We report the identification of such compounds with both previously reported and undescribed mechanisms of action, including a series of bicyclic azetidines that inhibit a new antimalarial target, phenylalanyl-tRNA synthetase. These molecules are curative in mice at a single, low dose and show activity against all parasite life stages in multiple in vivo efficacy models. Our findings identify bicyclic azetidines with the potential to both cure and prevent transmission of the disease as well as protect at-risk populations with a single oral dose, highlighting the strength of diversity-oriented synthesis in revealing promising therapeutic targets.

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          Most cited references50

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          Spiroindolones, a potent compound class for the treatment of malaria.

          Recent reports of increased tolerance to artemisinin derivatives--the most recently adopted class of antimalarials--have prompted a need for new treatments. The spirotetrahydro-beta-carbolines, or spiroindolones, are potent drugs that kill the blood stages of Plasmodium falciparum and Plasmodium vivax clinical isolates at low nanomolar concentration. Spiroindolones rapidly inhibit protein synthesis in P. falciparum, an effect that is ablated in parasites bearing nonsynonymous mutations in the gene encoding the P-type cation-transporter ATPase4 (PfATP4). The optimized spiroindolone NITD609 shows pharmacokinetic properties compatible with once-daily oral dosing and has single-dose efficacy in a rodent malaria model.
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            Microscale culture of human liver cells for drug development.

            Tissue function depends on hierarchical structures extending from single cells ( approximately 10 microm) to functional subunits (100 microm-1 mm) that coordinate organ functions. Conventional cell culture disperses tissues into single cells while neglecting higher-order processes. The application of semiconductor-driven microtechnology in the biomedical arena now allows fabrication of microscale tissue subunits that may be functionally improved and have the advantages of miniaturization. Here we present a miniaturized, multiwell culture system for human liver cells with optimized microscale architecture that maintains phenotypic functions for several weeks. The need for such models is underscored by the high rate of pre-launch and post-market attrition of pharmaceuticals due to liver toxicity. We demonstrate utility through assessment of gene expression profiles, phase I/II metabolism, canalicular transport, secretion of liver-specific products and susceptibility to hepatotoxins. The combination of microtechnology and tissue engineering may enable development of integrated tissue models in the so-called 'human on a chip'.
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              Chemical genetics of Plasmodium falciparum

              Malaria caused by Plasmodium falciparum is a catastrophic disease worldwide (880,000 deaths yearly). Vaccine development has proved difficult and resistance has emerged for most antimalarials. In order to discover new antimalarial chemotypes, we have employed a phenotypic forward chemical genetic approach to assay 309,474 chemicals. Here we disclose structures and biological activity of the entire library, many of which exhibited potent in vitro activity against drug resistant strains, and detailed profiling of 172 representative candidates. A reverse chemical genetic study identified 19 new inhibitors of 4 validated drug targets and 15 novel binders among 61 malarial proteins. Phylochemogenetic profiling in multiple organisms revealed similarities between Toxoplasma gondii and mammalian cell lines and dissimilarities between P. falciparum and related protozoans. One exemplar compound displayed efficacy in a murine model. Overall, our findings provide the scientific community with new starting points for malaria drug discovery.
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                Author and article information

                Journal
                0410462
                6011
                Nature
                Nature
                Nature
                0028-0836
                1476-4687
                19 May 2017
                07 September 2016
                20 October 2016
                18 July 2017
                : 538
                : 7625
                : 344-349
                Affiliations
                [1 ]Broad Institute of Harvard and MIT, 415 Main Street, Cambridge, Massachusetts 02142, USA.
                [2 ]Harvard T.H. Chan School of Public Health, 665 Huntington Avenue Boston, Massachusetts 02115, USA.
                [3 ]Molecular Medicine Group, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Road, New Delhi 110067, India.
                [4 ]Department of Chemistry and Chemical Biology, Harvard University, 12 Oxford Street, Cambridge, Massachusetts 02138, USA.
                [5 ]School of Medicine, University of California, San Diego, 9500 Gilman Drive 0760, La Jolla, California 92093, USA.
                [6 ]Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, 240 Longwood Avenue, Boston, Massachusetts 02115, USA.
                [7 ]Department of Chemistry and Department of Molecular Genetics and Microbiology, Duke University, 124 Science Drive, Durham, North Carolina 27708, USA.
                [8 ]Department of Biochemistry and Microbiology, University of Victoria, 270 Petch Hall, Victoria, British Colombia V8P 5C2, Canada.
                [9 ]Eskitis Institute for Drug Discovery, Griffith University, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland 4111, Australia.
                [10 ]Eisai Inc., 4 Corporate Drive, Andover, Massachusetts 01810, USA.
                [11 ]TropIQ Health Sciences, Geert Grooteplein 28, Huispost 268, 6525 GA Nijmegen, The Netherlands.
                [12 ]Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, 500 Main Street, Cambridge, Massachusetts 02142, USA.
                [13 ]Eisai Co. Ltd, 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan.
                [14 ]Department of Parasitology, Biochemical Primate Research Centre, 2280 GH Rijswijk, The Netherlands.
                Author notes
                Correspondence and requests for materials should be addressed to S.L.S. ( stuart_schreiber@ 123456harvard.edu )
                [*]

                These authors contributed equally to this work.

                Article
                PMC5515376 PMC5515376 5515376 nihpa875785
                10.1038/nature19804
                5515376
                27602946
                aa05dda1-5067-4e26-9770-72b58a8a831e

                Reprints and permissions information is available at www.nature.com/reprints.

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