Artemisinin Dihydroartemisinin

Artemisinin DihydroartemIsinIn Artemether Arteether Artelinic acid Artesunic acid... 

The followingybwr chemical structures, namely (/) artemisinin (//) dihydroartemisinin (Hi) artemether (oil-soluble) (iv) artemotil (oil soluble) and (v) artesunate (water soluble) are found to be active against the entire Plasmodium genera that cause malaria predominantly across the tropical regions of the globe, such as Africa, Indian sub-continent. South East Asia and the like. 

Figure 6.25 Artemisinin, dihydroartemisinin and some derivatives (full stereochemical structures not shown).

A high level of activity continues in connection with the synthesis of antimalarial artemisinin analogues and congeners, in which the 1,2-dioxepane moiety is embedded. Recent examples include the syntheses of various 10-substituted deoxoartemisinins of type 123 (eg. R1 = Cl COMe) from dihydroartemisinin acetate, and of type 124 (eg. R2 = a-OH, R3 = Me), from Grignard reagent addition to 10-(2-oxoethyl)deoxoartemisinin . 

Woerdenbag and coworkers reported on the cytotoxicity of artemisinin endoperoxides to Ehrlich ascites tumour cells . Artemisinin had an IC50 of 29.8 p.M, whereas arteether, artemether, artelininc acid and sodium artesunate all had more potent activities, ranging from 12.2 to 19.9 p.M. It was found that opening of the lactone ring of artemisinin dramatically reduced the cytotoxicity. An ether dimer of dihydroartemisinin 106, prepared by... 

Artemisinin is very poorly soluble in water or oil and can thus only be administered orally. Active derivatives have been synthesized such as artemether, arteether and beta-arteether (Artemotil), artelinic acid and artesunate, which are used for oral, intramuscular, rectal and intravenous administration. Dihydroartemisinin is the active metabolite of all artemisinin compounds and is also available as a drug in itself (see Fig. 2). 

Oral formulations of artemisinin and its derivatives are absorbed rapidly but incompletely. Peak plasma concentrations are reached in 1-2 h. A relative bioavailability of 43% was found for oral artemether compared to intramuscular administration. The absolute bioavailability of artesunate, the only derivative for which an intravenous formulation exists, was about 15%. Artesunate is extensively hydrolyzed to dihydroartemisinin in the gastro-intestinal lumen before first-pass metabolism in the gut wall and liver takes place. Artesunate acts like a prodrug with fast transformation into... 

Knowledge of local resistance patterns is important to determine the treatment regimen. There is increasing chloroquine and pyrimethamine-sulfado-xine (Fansidar) resistance in Africa and in some areas at the border of Thailand there is resistance for almost all antimalarial drugs including halofantrine, mefloquine and quinine. In these areas only the artemisinin derivatives (artemether, arteether, arte-sunate, dihydroartemisinin) are effective. 

Three currently-used artemisinin based combination therapies (ACT) artesunate-mefloquine, artemether-lumefantrine and dihydroartemisinin-piperaquine, have been proven highly simple, safe and effective in the treatment of multidrug resistant P. falciparum malaria. 

Dihydroartemisinin (DHA) is the active metabolite of acetalic derivatives of artemisinin (artemether, artesunate). Oxidation by cytochrome P450 enzymes or/and hydrolysis provides DHA, which is itself poorly stable in vivo. Indeed, the corresponding oxonium ion, a precursor of inactive metabolites by ring opening or by glucuronidation, can easily be formed (Figure 4.15). 

A new gas chromatography (GC) method was developed to characterize artemether 28a and its metabolites in body fluids. The extracts were derivatized and then separated on an optimized capillary GC system and identified by chemical ionization MS using ammonia as the reagent gas <1998JCH(B)101>. A sensitive, selective, and reproducible GC-MS-SIM method has also been developed for the determination of artemether 28a and dihydroartemisinin 29a in plasma, using artemisinin 9a as an internal standard <1999JCH(B)251>. 

An FIPLC method using electrochemical detection in the reductive mode for the determination of artemether 28a and its metabolite dihydroartemisinin 29a <1997JCFI(B)145> and for the simultaneous quantification of artesunate 31 and dihydroartemisinin 29a in plasma has been developed <1997JCFI(B)259, 1998JCFI(B)201>. An effective reversed-phase FIPLC method using electrochemical and UV detection has been developed for the simultaneous determination in plant extracts of artemisinin and its bioprecursors such as arteannuin B 32a, and artemisitene 27 <1995JNP798, 2001JIC489>. 

With hemin in MeCN-H20 at pH 7.8, artemisinin 9a was converted into acid 72 in 23% yield. Dihydroartemisinin 29a reacted in a different way giving a 1 1 mixture of the 3-deoxo-derivative 71 and the diketoaldehyde 73a < 1996TL253>. 

It is an ethyl ether derivative of dihydroartemisinin in sterile arachis oil. A racemic mixture of a, P-artether (30 70 ratio) has greater solubility and stability than artemisinin and is more cost-effective. 

Artemisia annua L. A. apiacea Hance ex Walpers Qing Guo (Stinking artemisia) (aerial part) Dihydroartemisinin, artesunate, artemisinin, chloroquine, flavonoids, sesquiterpene.33-269-476 This herb is mildly toxic. A schizonticidal agent, antimalarial, treat infections of multidrug-resistant strains of Plasmodium falciparum, the cause of human malignant cerebral malaria. 

Artemisia annua L. China Dihydroartemisinin, artesunate, artemisinin, chloroquine.33 This herb is mildly toxic. A schizonticidal agent, antimalarial. 

The pharmaceutical properties of artemisinin are far from optimal it is insoluble in water and only marginally soluble in oil. It has poor oral bioavailability and has been administered for the treatment of Plasmodium falciparum malaria in humans at total doses of about 1 g (over 3 days). Early studies by Chinese scientists in 1979 led to the discovery of dihydroartemisinin 3, artemether 4 (Artenam), and sodium artesunate 5, oil and water soluble derivatives, respectively (Figure 9.1 ).6-7 These drugs are currently in clinical use in Asia in a number of preparations such as suppositories, i.v. injectables, oil depos, to name only a few.8 Capsules containing 0.5 g of artemisinin for oral administration are available in Vietnam. 

Clearly, extensive whole-animal toxicity studies have not been warranted in the development of structure-toxicity relationships. Accordingly, Wesche et al.11 and Edwards and colleagues12,13 have developed in vitro methods for assessing neurotoxicity in neuronal cells. Based on these studies, dihydroartemisinin has been found to be the most neurotoxic artemisinin analog (Figure 9.2). 

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