Antimalarial endoperoxides mechanisms

As described in this chapter, significant progress has been made in the elucidation of the chemical mechanisms of bioactivation and identification of potential biological targets of the antimalarial endoperoxide class of drug. Equally, medicinal chemists have had success in the preparation of both semi-synthetic artemisinin analogues and simplified... 

Artemisinin ( qinghaosu ) (18), a sesquiterpene lactone antimalarial compound with an endoperoxide group, discovered in the Peoples Republic of China as a constituent of Artemisia annua L., has created great interest in the biomedical community, owing to its unique mechanism of action on the heme complex. Artemisinin serves as an option for the treatment of chloroquine (4l)-resistant malaria and is used in some Asian countries as an antimalarial. However, the use of artemisinin as a single agent anti-malarial is a potential risk since the malaria parasite may become resistant to this compound class. 

It should be emphasized that virmaUy all of the above discussion is based on biomimetic chemistry, where the Fe(II) source varies from salts such FeS04 to the more reactive FeCla-THaO as well as heme mimetics (TPP) and ester hematin variants. When heme models are used, since porphyrin alkylation is a favoured process, end-product distributions of products can be very different from when a free ferrous ion source is employed. Furthermore, solvent has been shown to have a profound effect on the rate of reaction and product distributions obtained in iron-mediated endoperoxide degradation. Thus all of these studies are truly only approximate models of the actual events within the malaria parasites. Future work is needed to correlate the results of biomimetic chemistry with the actual situation within the parasite. In general, most workers do accept the role of carbon-centred radicals in mediating the antimalarial activity of the endoperoxides, but the key information defining (a) the chemical mechanism by which these species alkylate proteins and (b) the basis for the high parasite selectivity remains to be unequivocally established. 

This pro-drug approach provides a paradigm for future antimalarial drug discovery efforts in the sense that this approach can be extended to any protease inhibitor that contains a carbonyl group as the reactive protease inhibitor warhead . Simply masking the carbonyl group within a trioxane or endoperoxide provides a unique and selective mechanism for targeting the malaria parasite by two different mechanisms . ... 

In addition to the CIEEL mechanism, peroxides and endoperoxides are key intermediates in a number of chemical and biological processes. There are a growing number of examples where ET to the 0-0 bond in these systems is accepted as an important step in their activity. For example, it is now generally agreed that the first step in the bioactivity of the recently discovered potent antimalarial, artemisinin, involves an ET from Fe-heme to the 0-0 bond, leading to fragmentation and a number of psytotoxic radical intermediates. " In contrast to the enormous amount of literature on the thermal and photochemical reactivity of peroxides, there is relatively little known about their ET chemistry. It is this lack of kinetic data on ET to peroxides and endoperoxides and the possible relationship of this data to Saveant s model for dissociative ET that initiated our own interest in this chemistry.22 23 2 - - - ... 

Artemisinin compounds clear parasites from the blood more rapidly than any other antimalarial agent, by a unique pharmacodynamic action. They are concentrated in parasitized erythrocytes, and structure-activity relations (see Chapter 2) suggest that their endoperoxide bridge is essential for the antimalarial effect. A critical step in the mechanism of action seems to be a hemin-catalyzed reduction of the peroxide moiety, which results in free radicals and reactive aldehydes that subsequently kill the malaria parasites. The hemin-rich internal environment of the parasites is assumed to be responsible for the selective toxicity of artemisinin toward these organisms. 

As endoperoxides are investigated as antimalarial compounds, more selective methods have been developed for their preparation (for example the Griesbaum Coozonolysis). The Criegee mechanism is valid for reactions in hydrocarbons, CH2C12, or other non-interactive solvents. Alcohols react with the carbonyl oxide to give hydroperoxy hemiacetals ... 

Stocks, P.A. et al. (2007) Evidence for a common non-heme chelatable-iron-dependent activation mechanism for semisymthetic and synthetic endoperoxide antimalarial drugs. Angew. Chem. 46, 6278-6283... 

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