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Antimicrobial Agents and Chemotherapy, January 2001, p. 187-195, Vol. 45, No. 1
0066-4804/01/$04.00+0 DOI: 10.1128/AAC.45.1.187-195.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Efficacies of Lipophilic Inhibitors of
Dihydrofolate Reductase against Parasitic Protozoa
Hollis
Lau,1
Jill
T.
Ferlan,1
Victoria Hertle
Brophy,2
Andre
Rosowsky,3 and
Carol
Hopkins
Sibley1,*
Department of Genetics, University of
Washington, Seattle, Washington 98195-73601;
Division of Medical Genetics, Department of Medicine,
University of Washington, Seattle, Washington
98195-73502; and Dana-Farber Cancer
Institute and Department of Biological Chemistry and Molecular
Pharmacology, Harvard Medical School, Boston, Massachusetts
021153
Received 3 July 2000/Returned for modification 11 September
2000/Accepted 5 October 2000
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ABSTRACT |
Competitive inhibitors of dihydrofolate reductase (DHFR) are used
in chemotherapy or prophylaxis of many microbial pathogens, including
the eukaryotic parasites Plasmodium falciparum and
Toxoplasma gondii. Unfortunately, point mutations in
the DHFR gene can confer resistance to inhibitors specific to these
pathogens. We have developed a rapid system for testing
inhibitors of DHFRs from a variety of parasites. We replaced the DHFR
gene from the budding yeast Saccharomyces cerevisiae
with the DHFR-coding region from humans, P. falciparum,
T. gondii, Pneumocystis carinii, and bovine or
human-derived Cryptosporidium parvum. We studied 84 dicyclic and tricyclic 2,4-diaminopyrimidine derivatives in this
heterologous system and identified those most effective against the
DHFR enzymes from each of the pathogens. Among these compounds, six
tetrahydroquinazolines were effective inhibitors of every strain
tested, but they also inhibited the human DHFR and were not
selective for the parasites. However, two quinazolines and four
tetrahydroquinazolines were both potent and selective inhibitors
of the P. falciparum DHFR. These compounds show promise for
development as antimalarial drugs.
 |
INTRODUCTION |
The treatment of diseases caused by
eukaryotic pathogens is particularly difficult because of the
similarity between their cell biology and that of their human host. The
selection for pathogens resistant to currently effective drugs and the
increase in immunocompromised individuals have added urgency to the
search for new therapies directed specifically against these pathogens.
One fruitful avenue for identification of chemotherapeutic drugs is to
screen compounds that have already been synthesized in order to
identify those that might be active against these increasingly
important pathogens. We have adopted this strategy and screened a
large library of compounds that are directed against the enzyme
dihydrofolate reductase (DHFR) (EC 1.5.1.3). DHFR is a central
enzyme in nucleic acid and amino acid synthesis in all cells, but the
active sites of enzymes from different organisms show subtle
differences that allow the identification of inhibitors specific for a
particular species (3, 16-18, 24). For example,
pyrimethamine is a selective inhibitor that is effective in the
nanomolar range against the DHFRs from Plasmodium falciparum
and Toxoplasma gondii, but the human enzyme is relatively
insensitive to the drug (8, 14, 24). Thus, pyrimethamine
has been used in malaria and toxoplasmosis therapy for many years
(9, 49).
We have designed an easy and inexpensive system to test in budding
yeast (Saccharomyces cerevisiae) potential DHFR inhibitors against the enzymes from a variety of parasites. Function of the endogenous dfr1 gene was eliminated from the yeast
(15), and the defect was complemented by expression of a
heterologous DHFR gene from P. falciparum, T. gondii, Pneumocystis carinii,
Cryptosporidium parvum, or humans (4).
DHFR inhibitors function principally as competitive inhibitors of the
enzyme. We have shown that the sensitivity of our engineered yeast
strains to DHFR inhibitors depends on the interaction of the drug and
the heterologous DHFR enzyme (4, 44, 48). For example,
point mutations within the coding region of the P. falciparum DHFR gene can render the enzyme resistant to
pyrimethamine. As one would expect, yeast that depends on a
pyrimethamine-sensitive (Pyrs) allele of the P. falciparum DHFR gene are killed by treatment with nanomolar
concentrations of pyrimethamine, but the same yeast strain dependent
upon a mutant pyrimethamine-resistant (Pyrr) allele of DHFR
is resistant to the drug. We have expanded this approach to design a
rapid screen to identify DHFR inhibitors that are effective against
yeast strains that depend upon a series of Pyrr alleles of
P. falciparum and against DHFR enzymes from other parasites.
In this paper, we report the analysis of 84 compounds to determine
their efficacy against the P. falciparum, T. gondii, C. parvum, P. carinii, and
human DHFR enzymes. We have identified six compounds that are potent
inhibitors of all of the enzymes. Several of the compounds show
selective inhibition of one or several of the parasite enzymes compared
with the human DHFR. Among these selective inhibitors, a large number
were effective against pyrimethamine-resistant alleles of P. falciparum. These data will allow further refinement of the
structure-resistance profiles of these parasite enzymes and the design
of more effective, selective inhibitors.
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MATERIALS AND METHODS |
Yeast strains.
The S. cerevisiae strain used as a
recipient of all of the plasmids was the dfr1 mutant TH5
(MATa leu2-3,112 trp1 ura3-52 dfr1::URA3
tup1), generously provided by Tun Huang (15). Yeast was cultured for all experiments at 30°C on minimal, dropout, or rich
(yeast extract-peptone-dextrose medium, using standard yeast genetics
techniques (1, 13). Growth of the dfr1 mutant was supported by supplementation of the medium with 100 µg of dTMP
(Sigma, St. Louis, Mo.) per ml.
The TH5 yeast strain was transfected with a set of vectors that each
expressed a heterologous DHFR enzyme. The parent expression vector,
pEH2, is derived from pRS314 (45, 48). The DHFR-coding region from P. carinii (Pc-yeast) (11),
S. cerevisiae (Sc-yeast) (12), or humans
(Hu-yeast) (26) was cloned into the vector flanked at its
5' end by a portion of the yeast DHFR promoter region and at its 3' end
by a portion of the yeast DHFR terminator, as described in detail by
Brophy et al. (4). In Apicomplexan parasites, the DHFR
enzyme is one domain of a bifunctional protein that also contains the
thymidylate synthase (TS) activity (5, 18, 46). The same
plasmid that contains the DHFR and TS domains from T. gondii
was a gift from David Roos and Mary Reynolds (27). The
DHFR domains from two strains of C. parvum were used, one derived from an infected human (hCp-yeast) and the other from a bovine
infection (bCp-yeast) (46). Although the two differ at
nine positions, none of these differences occur in amino acids that
would be expected to cause changes in drug sensitivity; we have
detected no differences in this study or in a previous one (4,
46). A set of yeast strains that expressed the DHFR domain from
P. falciparum was also constructed (48). Each
strain expressed an allele of P. falciparum DHFR whose
sensitivity to the DHFR inhibitor pyrimethamine was known
(18). The P. falciparum-derived strains are
designated by their amino acid differences compared with the
pyrimethamine-sensitive allele (S108). The S108N, N51I + S108N,
C59R + S108N, N51I + C59R + S108N, and N51I + C59R + S108N + I164L alleles exhibit progressively higher
levels of resistance to pyrimethamine (18). Two novel DHFR
alleles (Y57H and I164M) were also tested; both show somewhat higher
pyrimethamine resistance than the wild type (22). All of
these heterologous DHFR enzymes complemented the dfr1
mutation in the TH5 yeast strain.
Synthesis of the test
compounds.
The 84 compounds tested in this work are listed by
structure in Fig. 1 and 2. These were
archival samples with a purity of
90% as determined by thin-layer
chromatography. The compounds in entries 1 to 6 were made from
4-[N-(2,4-diaminopteridin-6-yl)methyl-N-methyl]aminobenzoic acid and amines by the mixed anhydride method using isobutyl
chloroformate and triethylamine (6, 7), whereas those in
entries 7 to 15 were made by reaction of amines with diethyl
N-[4-(2,4-diaminopteridin-6-yl)methyl-N-methyl]aminobenzoyl-L-glutamate (methotrexate diethyl ester) (30).
2,4-Diamino-6-methylpteridine (entry 16) and its 7-isomer (entry 17)
were synthesized from 2,4,5,6-tetraaminopyrimidine and
1,3-dihydroxyacetone as described previously (43). The
6,7-disubstituted pteridines (entries 18 to 24) were made from
2,4,5,6-tetraaminopyrimidine and 1,2-diketones (28). The
pteridines with a diarylamine side chain (entries 25 to 30) were
obtained from 2,4-diamino-6-bromomethylpteridine and the appropriate
diarylamine (29). The guanidinoquinazolines (entries 31 to
35) were prepared from arylamines, cyanoguanidine, and acetone
(32, 38). The 2,4-diamino-5-chloroquinazolines were
obtained by reductive coupling of
2,4-diamino-5-chloroquinazoline-6-carbonitrile with an arylamine
(entries 36 and 37), by reductive coupling of 2,4,6-triamino-5-chloroquinazoline with an aromatic aldehyde (entries 38, 41, and 42), or by N methylation of a preformed
6-arylmethylaminoquinazoline with formaldehyde and sodium
cyanoborohydride (entry 40) (37). The
2,4-diaminoquinazolines with an aromatic substituent at the position 5 were obtained from 2,4-diamino-5-iodoquinazoline and an arylalkene or
arylalkyne via a palladium-catalyzed coupling reaction followed by
catalytic hydrogenation (entries 43 to 45), by reductive coupling of
2,4-diaminoquinazoline-5-carbonitrile with an arylamine (entries 46 and
47), or by N methylation of a preformed 5-anilinomethylquinazoline
(entries 48 and 49) (35). The 5- and 6-substituted
2,4-diaminothieno[2,3-d]pyrimidines (entries 50 to 54)
were made from the corresponding 2-aminothiophene-3-carbonitriles and
chloroformamidine hydrochoride (33, 36), whereas the
2,4-diamino-6-anilinomethylthieno[2,3-d]pyrimidines (entries 55 to 58) were made via a four-step sequence from
2,4-diamino-5-methylthieno[2,3-d]pyrimidine (41). One member of the latter group (entry 58) was
obtained by reductive dehalogenation of the corresponding 6-bromo
compound (41). The pyrido[4,3-d]pyrimidines
(entries 59 to 61) were made by alkylation of the unsubstituted amine
(33, 41), whereas the compounds in entries 62 to 65 were made from
2,4-diamino-6-bromomethylpyrido[3,2-d]pyrimidine and
anilines or N-methylanilines (31). The
tetrahydroquinazolines (entries 66 to 79) and other several other di-
and tricyclic pyrimidines (entries 80 to 84) were made from cyclic
ketones and cyanoguanidine (39, 40, 42).
Drug sensitivity assays.
The radial assay used here has been
described in detail by Sibley et al. (44) and Brophy et
al. (4). Briefly, drugs were dissolved in dimethyl
sulfoxide (DMSO) at 10
2 M and stored at
70°C until
use. Drug dilutions in DMSO were made just before use and added to the
growth medium or plate at a maximum final concentration of 1% DMSO in
any solution. Addition of sulfanilamide increased the sensitivity of
the yeast strains to the test drugs on plates. Therefore, for drug
sensitivity experiments on solid medium, sulfanilamide was spread on
the surface of the plate at a final concentration of 1 mM for tests of
the complete set of heterologous strains. For some experiments testing
only the P. falciparum set, 0.4 mM sulfanilamide was used on
the plates. Drug sensitivity tests were made using a double replica
plating procedure because this improved the discrimination of growth. A
10-µl volume of the test drug was added directly to the center of the
plate. After 3 days of growth, each strain was scored for sensitivity
by comparison with growth on the control plate without drug. Each drug
was tested in triplicate.
The quantitative drug sensitivity assays were also conducted as
previously described (44). Log-phase yeast cells were
diluted uniformly into wells of a 96-well plate to generate the final concentrations required. Control wells lacked drug but contained a
concentration of DMSO equal to that used in drug treatment; these were
scored as 100% growth. The DMSO concentration was always <1%. The
optical densities at 650 nm of the various drug dilutions were divided
by this control value to determine percentage growth at each drug
concentration. The 50% inhibitory concentration (IC50) was
calculated using the two values that flanked the 50% mark and the
formula y = mx + b, where m and
b were the slope and y intercept, respectively,
calculated using the two flanking drug concentrations. The solution for
x at y = 50% yielded the IC50.
 |
RESULTS AND DISCUSSION |
The overall goal of this study was to rapidly screen a set of
lipophilic compounds that were designed as inhibitors of DHFR in order
to identify those effective against several human pathogens. We were
especially interested in identifying inhibitors that are effective
against the alleles of DHFR from Pyrr P. falciparum, but the DHFR enzymes from C. parvum,
P. carinii, and T. gondii were included as well.
The gene that encoded the enzyme from each pathogen was expressed in
the same strain of DHFR-deficient S. cerevisiae; the growth
of each yeast strain was dependent upon the activity of the
heterologous enzyme (4). Two additional specificity
controls were included: the same yeast strain dependent on the human
DHFR or the S. cerevisiae enzyme expressed from the same
single-copy plasmid as the heterologous DHFR genes.
The compounds are listed in Fig. 1 and 2. Each compound was tested in a
simple radial assay; the results from a typical experiment are shown in
Fig. 3 to illustrate the strategy for
screening. The yeast strains were streaked on master plates in a radial
pattern as depicted at the bottom of Fig. 3. Eight compounds were
tested in a set with two kinds of controls. Trimetrexate is a potent inhibitor of all DHFR enzymes (20) and was included in
each series as a positive control. In order to increase sensitivity to
the DHFR inhibitor, all plates contained 1 mM sulfanilamide. As a
result, the yeasts were also replica plated from a master plate to a
plate with sulfanilamide alone to ensure that growth was not inhibited
by that addition. Each plate was then made from the master plate and
spotted with 10 µl of a 10 mM solution of a test drug dissolved in
DMSO. To ensure that the transfer was complete, a final plate with no
drug was also included, as shown at the bottom of Fig. 3. In each case,
the relative growth of the yeast strain reflected the relative
inhibition of the DHFR enzyme expressed by the test strain.

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FIG. 3.
Outline of basic screening protocol. Plates shown at the
top are those normally included in each set. All plates except the
no-drug control contain 1 mM sulfanilamide. The sulfa control shows
growth of each yeast strain with no additional drug, and each plate
with a designated compound was spotted with 10 µl of a 10-mg/ml
solution of the compound dissolved in DMSO as described in Materials
and Methods. Each set also contained a test plate with trimetrexate, a
drug known to efficiently inhibit all test strains. At the bottom, a
map of the location of each strain on the plates is shown. Pc-yeast,
dfr1 yeast dependent upon the DHFR enzyme from P. carinii; Tg-yeast, DHFR-TS from T. gondii; hCp-yeast,
DHFR-TS from human-derived C. parvum; bCp-yeast, DHFR-TS
from bovine-derived C. parvum; Hu-yeast, DHFR from human; Pf
PyrR-yeast, DHFR domain from the pyrimethamine-resistant
(N51I + S108N) allele of P. falciparum; Pf
PyrS-yeast, DHFR domain from the pyrimethamine-sensitive
(S108) allele of P. falciparum; yeast control, DHFR gene
from S. cerevisiae.
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Figure 3 also illustrates that different drugs showed different
patterns of inhibition against the set of yeast strains. For example,
the two pyrido[3,2-d]pyrimidines, compounds 64 and 65, were potent inhibitors of all of the strains, similar to the pattern displayed by trimetrexate. In contrast, the quinazoline, compound 37, and the thieno[2,3-d]pyrimidines, compounds 55 and 56, inhibited only the pyrimethamine-sensitive enzyme from P. falciparum, while 2,4-diamino-5-[3-(3,4,5-trimethoxyphenyl)ethyl]-6,7-dihydro-5H-cyclopenta[d]pyrimidine, compound 80, was effective against both the Pyrs and
Pyrr alleles of the P. falciparum enzyme.
Differences of this sort in the patterns of inhibition reflect
variations in drug potency (4) and were the basis for our
classification of the 84 compounds into five categories. These are
summarized in Fig. 4. A table with data
for all of the compounds is located on our website
(http://depts.washington.edu/genetics/spokeassay.htm).

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FIG. 4.
Summary of patterns of drug activity observed on radial
assay. The diagram at the bottom shows a typical pattern used to define
each category. All drugs were tested three times, and if minor
differences were observed, the category was determined by two of three
patterns. The protocol was as described in Fig. 3 and in Materials and
Methods. *, the Hu-yeast was more sensitive to compound 63 than the
two Cp-yeast strains but was more resistant than the Pf- or Tg-yeasts,
and thus the drug appears in categories panels B, C, and E. A complete
table of the data for all of the compounds is available on our website
(http://depts.washington.edu/genetics/spokeassay.htm).
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There are presently no effective drugs for treatment of C. parvum infections, so we specifically searched for compounds that would inhibit yeast expressing the C. parvum DHFR. Figure 4A
shows the typical pattern for the six tetrahydroquinazolines that were extremely potent inhibitors of all of the yeast strains, including those dependent upon C. parvum. The nine compounds shown in
Fig. 4B were effective against the human enzyme and at least some
others but showed no inhibition of the C. parvum-dependent
strains. This group contained three quinazolines, two
tetrahydroquinazolines, and four pyrimidine derivatives. The nine
compounds listed in Fig. 4C, comprised of pyrimidine derivatives and
quinazolines, inhibited P. falciparum and the related
pathogen T. gondii. Figure 4D lists a large number of
compounds that were specific inhibitors of the P. falciparum
enzyme alone. Most of the pteridines tested fell into this category,
and a large number of the quinazolines did so as well.
It was of particular interest that a number of compounds were effective
inhibitors of the yeast strain that expressed a pyrimethamine-resistant enzyme from P. falciparum; these are displayed in Fig. 4E.
Some compounds in this category are also listed in Fig. 4B because they
were ineffective against the C. parvum-dependent
strains, but these represent an important subset of lead compounds to
be studied as potential antimalarial drugs. Some of the
pyrido[3,2-d]pyrimidines and most of the
tetrahydroquinazolines fell into this category. Some of these compounds
had been tested in vitro against the purified DHFR enzymes of P. carinii, T. gondii, or rat liver (39). We assumed that the inhibition of the rat and human enzymes would be
similar, and this allowed us to compare the radial assay with the in
vitro assay. The correspondence was excellent. For example, the
tetrahydroquinazolines were generally potent inhibitors of all of the
yeast strains tested and were scored as positive in the radial assay.
We noted that neither compound 69 [(6R,
6S)-2,4-diamino-6-phenyl-5,6,7,8-tetrahydroquinazoline] nor
compound 74 [(6R,
6S)-2,4-diamino-6-(3,4-dichlorobenzyl)-5,6,7,8-tetrahydroquinazoline] fell into this group. Both of these compounds had shown little or no
inhibition in vitro of the purified DHFR enzymes of P. carinii, T. gondii, or rat liver (39),
demonstrating the congruence of this yeast-based screening system with
the results observed from direct assay of the purified enzyme.
Due to their highly lipophilic nature, some of the compounds were only
sparingly soluble in the aqueous agar and precipitated as they were
spotted on the plate. For this reason, six compounds (compounds 20, 47, 49, 53, and 55) were not amenable to testing by this assay method,
which requires a very high initial concentration of the drug to be
spotted in the center of the plate. However, any of these drugs might
be effective if tested in vitro, where a lower initial concentration
could be used.
These experiments also illustrate an interesting advantage of testing
the compounds against living cells. Each assay included the same yeast
strain dependent upon expression of the S. cerevisiae DHFR from the same plasmid used to express the heterologous enzymes. Even trimetrexate showed an extremely modest inhibition of this strain
(Fig. 3B). If no inhibition of the yeast control was observed, this
demonstrated that nonspecific toxicity of that compound was not a
problem, at least for yeast cells. Compounds 36, 63 to 68, 70 to 76, 77, and 79 showed this kind of pattern (see Fig. 4B and D for
examples). Whenever a compound did inhibit the yeast control, that
compound was retested to determine whether addition of dTMP and the
drug would restore the yeast growth. This reversal of inhibition was
the case for these compounds, and we concluded that the growth deficit
resulted from specific inhibition of the folate pathway by the drug.
Most of the drugs in this category were in the tetrahydroquinazoline
group. The tetrahydroquinazoline compound 78 showed incomplete reversal
of growth inhibition in the presence of dTMP; this likely reflects at
least some nonspecific inhibition of the yeast growth. Although the
inhibition of the yeast enzyme was generally modest, compounds in this
group may show promise as leads for development of antifungal agents.
The radial assay is only semiquantitative; to more precisely test the
potency and specificity of promising compounds, we grew the yeast
strains in a range of drug concentrations in liquid and measured their
growth relative to that of the same strain without drug. We first
tested the relative effectiveness of the compounds against C. parvum and human DHFR. An example of these data is shown in Fig.
5. Compound 36 (Fig. 5A) had been shown to be a reasonable inhibitor of the P. carinii, T. gondii, and rat liver enzymes in vitro (39), and it
was a potent inhibitor of all three strains tested in this assay,
showing IC50s in the 10
7 M range. Both
compounds 63 and 69 were in the category shown in Fig. 4B and more
effectively inhibited the Hu-yeast than the two C. parvum
strains. In this liquid growth assay, compound 69 inhibited the
Hu-yeast in the micromolar range but was ineffective against the two
Cp-yeasts (Fig. 5B). Compound 63 inhibited all three strains, but the
IC50 was about 10-fold lower against the Hu-yeast (Fig.
5C). We next focused on correlating the qualitative categories defined
by the radial assay with the IC50s for the same
compounds. We concentrated on comparing the human- and
C. parvum-dependent yeast strains, and the data for 14 compounds are summarized in Table 1. The
three compounds (compounds 36, 63, and 69) displayed in Fig. 5
are in boldface in Table 1. In addition, Table 1 lists the published
IC50s for the same compounds tested in vitro against the
purified enzyme from rat liver. Several conclusions can be drawn.
First, compounds that were ineffective in vitro were equally
ineffective in the yeast assay (compounds 43, 50, 52, 54, 69, and 81).
However, there was one compound, compound 28, that apparently did not
penetrate the yeast, since it was without activity against any of the
yeast strains, but showed good potency in vitro. Second, the relative
effectiveness of the compounds against the rat liver enzyme and the
Hu-yeast was similar, as one would expect for two mammalian enzymes.
The most effective against rat liver were compounds 36 and 39, and these were also the most potent against the Hu-yeast. This direct comparison allows assessment of the relative sensitivity of the human
enzyme and the DHFR from bovine-derived and human-derived C. parvum. Compounds 36 and 39 were also the most effective in this
group against the two Cp-yeast strains, but the efficiency against the
parasite DHFR was three- to fourfold lower than that against the
Hu-yeast. No differences in sensitivity of the two forms of the
C. parvum enzyme were observed. The correlation between the
qualitative radial assay and the IC50 determinations, along with their correspondence with earlier assays against the purified enzyme, support the utility of the rapid screen as a first step in
identification of drugs that are effective against these pathogens.

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FIG. 5.
Quantitative determination of efficacy of drugs against
Hu-yeast, hCp-yeast, and bCp-yeast. Each strain was grown to log phase
and then resuspended in growth medium containing 1 mM sulfanilamide and
one of the indicated drugs at a concentration range of 0 to
10 5 M. The growth at each concentration relative to that
of the no-drug control was calculated and graphed. Each determination
was done in triplicate, and the mean value was used to calculate the
growth. The IC50 was calculated as described in Materials
and Methods.
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The most promising lead that emerged from the qualitative screen was
the effectiveness of several categories of compounds against the
Pyrr allele of P. falciparum. To examine this
lead in more detail, we tested the compounds that were effective
against the Pyrr allele further against a set of yeast
strains that carry eight different alleles of P. falciparum
DHFR with known sensitivity to pyrimethamine. These were arrayed in a
radial pattern with the pyrimethamine-sensitive allele (S108) at the
upper right and five progressively more pyrimethamine-resistant forms
in a clockwise pattern, as shown in Fig.
6D. In addition, two novel alleles with a
fivefold elevation in pyrimethamine resistance were included (Met164
and His57) (22). This set of P. falciparum-dependent strains was classified in comparison to their
sensitivity to pyrimethamine and to the potent experimental DHFR
inhibitor
4,6-diamino-1,2-dihydro-2,2-dimethyl-1-[3'-(2,4,5-trichlorophenoxy)-propyloxy]-1,3,5- triazine
hydrochloride (WR99210) (21), as shown in Fig. 6B and C. The yeast that carried the human DHFR allele was not included in this
part of the screen because the human enzyme is much more resistant to
the test compounds, and we could not have assayed all of the P. falciparum alleles on the same plate had it been included. For
these experiments, a lower level of sulfanilamide, 0.4 mM, was present
in the plates for the first 20 of these compounds, and no sulfanilamide
was used for the remaining 13 compounds. When sulfanilamide was added,
a sulfa-only control was always included, and this is depicted in Fig.
6A. In each case, the effectiveness of the test compound was measured
against WR99210 or pyrimethamine under the same conditions.

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FIG. 6.
Protocol for testing DHFR alleles from P. falciparum. Yeast strains dependent upon the DHFRs from eight
different P. falciparum alleles were radially arrayed as
shown in panel D. The master plates were grown for 2 to 3 days at
30°C and replica plated to plates that contained 0.4 mM
sulfanilamide. Each test plate was spotted with 10 µl of the drug to
be tested, and the results were tabulated after an additional 3 days of
growth. The control plate with sulfanilamide alone is shown for each
set of test plates, since growth of two of the strains was slowed
somewhat by the sulfanilamide. Each strain is designated by the
genotype of the allele, with the amino acid change from the wild type
indicated. The DHFR domains from the first six strains are derived from
standard reference strains of P. falciparum whose
sensitivity to pyrimethamine has been established. The Met 164 and His
57 alleles are novel mutations that confer a low level of pyrimethamine
resistance (21).
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Figure 7A summarizes these data for the
33 compounds that showed activity against the Pyrr P. falciparum. We were interested both in the potency of the compounds and in whether the strains with more mutations showed higher
levels of resistance to these drugs, as they do against pyrimethamine
(18). Because of the chemical similarity of the compounds,
we assumed that diffusion would be similar enough for all compounds to
allow us to categorize the drugs qualitatively. Strains were placed in
two categories: less or more potent than pyrimethamine (Fig. 7A and B),
but with a pattern of resistance similar to that observed for
pyrimethamine. The third group (Fig. 7C) included compounds that had a
novel pattern of resistance. For example, on the plate shown, the most
resistant strain carries the N51I + S108N allele, whereas for most
compounds tested, the resistance was highest in strains that carried
three or four mutations. Compounds 43, 72, and 80 were then tested in
liquid culture to determine the IC50s against four of these
DHFR alleles: the most pyrimethamine-sensitive (S108), two double
mutant alleles that confer intermediate pyrimethamine resistance
(N51I + S108N and C59R + S108N) and the highly resistant
allele (N51I + C59R + S108N + I164L). Compounds 26, 70, and 77 were tested against only the highly resistant allele. Table
2 summarizes these data in comparison with both pyrimethamine and WR99210. As expected, pyrimethamine is
extremely effective against the S108 allele but shows about a 10-fold
higher IC50 against both double mutants and no effect on
the quadruple mutant. In contrast, WR99210 was effective against all of
the alleles tested, even the highly pyrimethamine-resistant mutant form
(21). Among the test compounds, compound 72 showed excellent potency, in the same range as pyrimethamine and WR99210, against all of the alleles except the quadruple mutant. This compound, (6R,
6S)-2,4-diamino-6-(3-methylbenzyl)-5,6,7,8-tetrahydroquinazoline, showed about
fourfold selectivity when the purified DHFR of T. gondii was
compared in vitro with the human DHFR as well (39). The quinazolines, compounds 38 and 39, and the related
tetrahydroquinazolines, compounds 67, 70, 71, and 75, all showed a
similar excellent potency and reasonable selectivity, even
against the triple (N51I + C59R + S108N) mutant P. falciparum DHFR allele.

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|
FIG. 7.
Summary of efficacy of drugs tested against eight
different P. falciparum alleles of DHFR. The drugs tested
were categorized in comparison to the potency of pyrimethamine and the
experimental DHFR inhibitor WR99210. (A and B) Compounds in which the
effectiveness of the drug against the set of reference alleles was
similar to the pattern for pyrimethamine. (C) Compounds in which the
relative effectiveness of the drug against the reference alleles was
different from the pattern for pyrimethamine.
|
|
The pattern of resistance of P. falciparum DHFR to
pyrimethamine is well studied. In that case, the loss of potency is
gradual as one examines DHFR alleles with increasing numbers of
mutations. The pattern for the tetrahydroquinazolines is different; the
drugs efficiently inhibit all of the alleles with one to three
mutations. The change from isoleucine to leucine at amino acid 164 has
a profound effect, abrogating the effectiveness of all drugs in this
class. Only WR99210 was effective against the quadruple mutant allele
(N51I + C59R + S108N + I164L). This mutant has not yet been observed in African populations of P. falciparum
(2, 19, 23, 25, 47), and thus a compound effective against
the common double and triple mutant alleles is an extremely interesting
lead for further development.
While DHFR inhibitors are extremely effective drugs, point mutations
have been rapidly selected in P. falciparum populations whenever they have been used. The mutations selected by pyrimethamine have been clearly identified, and their pattern of sensitivity seems to
be similar in the set of compounds studied here (10, 18).
However, identification of inhibitors still effective against the most
pyrimethamine-resistant alleles holds the potential for reversing this
pattern. WR99210 is one example of such a situation; some mutations
that confer resistance to WR99210 increase the sensitivity to
pyrimethamine (48). If other compounds also show this
"opposing selection," it may be possible to slow the selection of
parasites resistant to these newer DHFR inhibitors.
The large libraries of already-synthesized inhibitors of DHFR are a
potentially fruitful source of lead compounds. Several of the
tetrahydroquinazolines surveyed here show real promise both for more
detailed analysis of the active site of P. falciparum and
for further development as antimalarials or drugs effective against
T. gondii. The ease with which this yeast-based assay is
performed and the opportunity to screen compounds against DHFR enzymes
from a variety of pathogens make it a reasonable first step in
narrowing the search for drugs that are effective against these
infectious diseases of humans or domestic animals.
 |
ACKNOWLEDGMENTS |
We thank Khang Le for his assistance with this study and the
Sibley lab for their support.
This work received financial support from National Institutes of Health
grants AI 42321 (to C.H.S.) and AI 29904 (to A.R.).
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Department of
Genetics, Box 357360, University of Washington, Seattle, WA
98195-7360. Phone: (206) 685-9378. Fax: (206) 543-0754. E-mail:
sibley{at}genetics.washington.edu.
 |
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Antimicrobial Agents and Chemotherapy, January 2001, p. 187-195, Vol. 45, No. 1
0066-4804/01/$04.00+0 DOI: 10.1128/AAC.45.1.187-195.2001
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