Folic acid, synthesis

The first L-folic acid synthesis was based on the concept of a thiee-component, one-pot reaction (7,22). Ttiainino-4(3JT)-pyrirnidinone [1004-45-7] (10) was reacted simultaneously with C -dibromo aldehyde [5221-17-0] (11) and j )-aminoben2oyl-L-glutamic acid [4271-30-1] (12) to yield fohc acid (1). 

Sulfa drugs Sulfonamides Inhibit folic acid synthesis by Gram-positive and -negative... 

Trimethoprim Trimethoprim Inhibits folic acid synthesis by Used in combination with... 

Folic acid synthesis inhibitors Sulfonamides Trimethoprim... 

Sulfa drugs inhibit bacterial folic acid synthesis... 

Sulfa drugs were the first important antibacterials. Sulfa drugs act by inhibiting bacterial folic acid synthesis. 

Thus sulfonamides are bacteriostatic drugs that inhibit bacterial growth by interfering with the microbial synthesis of folic acid. More specifically, sulfonamides block the biosynthetic pathway of folic acid synthesis, thus competitively inhibiting the transformation of p-aminobenzoic acid to folic acid (mediated by the enzyme dihydropteroate synthetase), which allows them to be considered as antimetabolites. 

Pharmacology Sulfonamides exert their bacteriostatic action by competitive antagonism of para-aminobenzoic acid (PABA), an essential component in folic acid synthesis. 

Pharmacology Aminosalicylic acid is bacteriostatic against Mycobacterium tuberculosis. It inhibits the onset of bacterial resistance to streptomycin and isoniazid. The mechanism of action has been postulated to be inhibition of folic acid synthesis (but without potentiation with antifolic compounds) or inhibition of synthesis of the cell wall component, mycobactin, thus reducing iron uptake by M. tuberculosis. 

Both sulfonamides and trimethoprim (not a sulfonamide) sequentially interfere with folic acid synthesis by bacteria. Folic acid functions as a coenzyme in the transfer of one-carbon units required for the synthesis of thymidine, purines, and some amino acids and consists of three components a pteridine moiety, PABA, and glutamate (Fig. 44.1). The sulfonamides, as structural analogues, competitively block PABA incorporation sulfonamides inhibit the enzyme dihydropteroate synthase, which is necessary for PABA to be incorporated into dihydropteroic acid, an intermediate compound in the formation of folinic acid. Since the sulfonamides reversibly block the synthesis of folic acid, they are bacteriostatic drugs. Humans cannot synthesize folic acid and must acquire it in the diet thus, the sulfonamides selectively inhibit microbial growth. 

A) Selective inhibition of incorporation of PABA into human cell folic acid synthesis. 

E) Inhibition of folic acid synthesis by blocking different steps... 

B. Humans cannot synthesize folic acid (A) diet is their main source. Sulfonamides selectively inhibit microbially synthesized folic acid. Incorporation (B) of PABA into microbial folic acid is competitively inhibited by sulfonamides. The TMP-SMX combination is synergistic because it acts at different steps in microbial folic acid synthesis. All sulfonamides are bacteriostatic. Inhibition of the transpeptidation reaction (C) involved in the synthesis of the bacterial cell wall is the basic mechanism of action of (3-lac-tam antibiotics Changes in DNA gyrases (D) and active efflux transport system are mechanisms for resistance to quinolones. Structural changes (E) in dihydropteroate synthetase and overproduction of PABA are mechanisms of resistance to the sulfonamides. 

B. Overproduction (A) of PABA is one of the resistance mechanisms of sulfonamides. Changes in the synthesis of DNA gyrases (B) is a well-described mechanism for quinolone resistance. Plasmid-mediated resistance (C) does not occur with quinolones. An active efflux system for transport of drug out of the cell has been described for quinolone resistance, but it is not plasmid mediated. Inhibition of structural blocks (D) in bacterial cell wall synthesis is a basic mechanism of action of p-lactam antibiotics. Inhibition of folic acid synthesis (E) by blocking different steps is the basic mechanism of action of sulfonamides. 

The suifones are structural analogues of PABA and are competitive inhibitors of folic acid synthesis. Suifones are bacteriostatic and are used only in the treatment of... 

Chloroguanide hydrochloride (Paludrine) is activated to a triazine metabolite, cycloguanil, which also interferes with parasite folic acid synthesis. It is a dihydrofolate reductase inhibitor that is used for the prophylaxis of malaria caused by all susceptible strains of plasmodia. Chloroguanide is rapidly absorbed from the gas-... 

Aminosalicylic acid (Paser, PAS) exerts its effects in a manner similar to the sulfonamide drugs that is, aminosalicylic acid is structurally similar to para-aminobenzoic acid (PABA) and inhibits folic acid synthesis by competing with PABA in tuberculosis... 

Dapsone (Avlosulfon) is a member of a class of chemical agents known as the sulfones. Dapsone is especially effective against M. leprae and is used with rifampin as the primary method of treating leprosy. Dapsone appears to exert its antibacterial effects in a manner similar to that of the sulfonamide drugs that is, dapsone impairs folic acid synthesis by competing with PABA in bacterial cells. Primary adverse effects associated with dapsone include peripheral motor weakness, hypersensitivity reactions (skin rashes, itching), fever, and blood dyscrasias, such as hemolytic anemia. 

The sulfonamides include sulfadiazine, sulfamethizole, and similar agents (see Table 33-4). Sulfonamides interfere with bacterial nucleic acid production by disrupting folic acid synthesis in susceptible bacteria. Sulfonamide drugs are structurally similar to PABA, which is the substance used in the first step of folic acid synthesis in certain types of bacteria (see Fig. 33-2). Sulfonamides either directly inhibit the enzyme responsible for PABA utilization or become a substitute for PABA, which results in the abnormal synthesis of folic acid. In either case, folic acid synthesis is reduced, and bacterial nucleic acid synthesis is impaired. 

Mechanism of Action. Pyrimethamine blocks the production of folic acid in susceptible protozoa by inhibiting the function of the dihydrofolate reductase enzyme. Folic acid helps catalyze the production of nucleic and amino acids in these parasites. Therefore, this drug ultimately impairs nucleic acid and protein synthesis by interfering with folic acid production. The action of sulfadoxine and other sulfonamide antibacterial agents was discussed in Chapter 33. These agents also inhibit folic acid synthesis in certain bacterial and protozoal cells. 

Although folic acid is vital for human health, we don t have the enzymes to make it it s a vitamin, which means we must take it in our diet or we die. Bacteria, on the other hand, do make folic acid. This is very useful, because it means that if we inhibit the enzymes of folic acid synthesis we can kill bacteria but we cannot possibly harm ourselves as we don t have those enzymes. The sulfa drugs, such as sul-famethoxypyridazine or sulfamethoxazole, imitate p-aminobenzoic acid and inhibit the enzyme dihy-dropteroate synthase. Each has a new heterocyclic system added to the sulfonamide part of the drug. 

The next step in folic acid synthesis is the reduction of dihydrofolate to tetrahydrofolate. This can be done by both humans and bacteria and, although it looks like a rather trivial reaction (see black portion of molecules), it can only be done by the very important enzyme dihydrofolate reductase. 

When assessing manifestations of toxicity, evaluators might base their conclusions about relevance on the mechanism that produces a toxicological effect however, a basic default assumption is that any manifestation of reproductive or developmental toxicity is relevant to humans unless the mechanism by which it occurs is impossible in humans. For example, if a toxic effect occurs in animals through an inhibition of folic acid synthesis, that effect would not be considered relevant for humans because humans do not synthesize folic acid. It is unusual, however, to have such detailed knowledge about mechanisms of toxicity from experimental animal studies. 

A fourth difference between bacterial and human cells involves specific biosynthetic pathways. Bacterial cells usually synthesize their own folic acid, whereas humans receive folic acid preformed in their food. Thus drugs that can inhibit folic acid synthesis are selectively toxic for bacteria. 

Sulfanilamide and p-aminobenzoic acid are similar in size and shape and have related functional groups. Thus, when sulfanilamide is administered, bacteria attempt to use it in place of p-aminobenzoic acid to synthesize folic acid. Derailing folic acid synthesis means that the bacteria cannot grow and reproduce. Sulfanilamide only affects bacterial cells, though, because humans do not synthesize folic acid, and must obtain it from their diets. 

A closer look at these events reveals that bacteria synthesize folic acid using several enzymes, including one called dihydropteroate synthetase, which catalyzes the attachment of p-aminobenzoic acid to a pteridine ring system. When sulfanilamide is present it competes with the p-amino-benzoic acid (note the structural similarity) for the active site on the enzyme. This activity makes it a competitive inhibitor. Once this site is occupied on the enzyme, folic acid synthesis stops and bacterial growth stops. Folic acid can also be synthesized in the laboratory. ... 

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