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Antimicrobial Agents and Chemotherapy, February 2007, p. 755-758, Vol. 51, No. 2
0066-4804/07/$08.00+0 doi:10.1128/AAC.01360-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
Deletion of the Trypanosoma brucei Superoxide Dismutase Gene sodb1 Increases Sensitivity to Nifurtimox and Benznidazole
S. Radhika Prathalingham,
Shane R. Wilkinson,
David Horn, and
John M. Kelly*
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
Received 31 October 2006/
Returned for modification 10 November 2006/
Accepted 21 November 2006

ABSTRACT
It has been more than 25 years since it was first reported that
nifurtimox and benznidazole promote superoxide production in
trypanosomes. However, there has been no direct evidence of
an association between the drug-induced free radicals and trypanocidal
activity. Here, we identify a superoxide dismutase required
to protect
Trypanosoma brucei from drug-generated superoxide.

TEXT
Parasites of the
Trypanosoma brucei complex are the causative
agents of African trypanosomiasis. Vaccine development against
this disease is unlikely, and chemotherapy is unsatisfactory
(
1,
4): drugs require administration under medical supervision,
can fail to eradicate parasitemia, and are often toxic. Melarsoprol,
which is used against late-stage disease, kills 5 to 10% of
patients (
12). Without treatment, trypanosomiasis is fatal.
A new approach, currently under trial, is the use of nifurtimox
in combination with eflornithine (
18,
21). The nitroheterocyclic
drugs nifurtimox and benznidazole are normally used to treat
Trypanosoma cruzi infections. Although effective against acute-stage
Chagas' disease, they are of limited use against the chronic
stage, which occurs in

30% of patients, often many years after
the initial infection (
2,
9). Nifurtimox can be orally administered,
is readily absorbed, and crosses the blood-brain barrier. However,
side effects include nausea/vomiting and central nervous system
toxicity, and use has been associated with genotoxic and carcinogenic
effects (
10,
19). In addition, some
T. cruzi strains are refractory
to treatment (
16). If nifurtimox is to be used against African
trypanosomiasis, it is important that both the mechanism(s)
of action and the potential for resistance are more fully explored.
One hypothesis for the trypanocidal effects of nifurtimox proposes similarities to the antibacterial activity of other nitrofurans, with drug activation by type I nitroreductases leading to the generation of reactive moieties that promote DNA damage (14, 20). The only trypanosome enzyme reported to mediate this type of two-electron reduction is prostaglandin F2
synthase (13) and then only under anaerobic conditions. A second hypothesis invokes the generation of oxidative stress, following one-electron reduction of the drug by type II nitroreductases. Under aerobic conditions, this promotes redox cycling, with the formation of superoxide anions and drug regeneration (6, 7, 15, 23). However, there is no evidence that these free radicals contribute to trypanocidal activity. Normally, superoxide anions are detoxified by superoxide dismutases (SODs), a family of antioxidant metalloenzymes. Trypanosome SODs belong to the Fe class, a group restricted to protozoans, prokaryotes, and chloroplasts. T. brucei contains four isoforms (8, 11, 25): TbSODA and TbSODC, which are mitochondrial, and TbSODB1 and TbSODB2, which are localized predominantly in the glycosome, a kinetoplastid-specific organelle (3, 17, 24). TbSODB1 and TbSODB2 also display some cytosolic localization, particularly the former (8, 25). Neither TbSODA nor TbSODC is essential for parasite viability, although when TbSODA was down-regulated using RNA interference (RNAi), the bloodstream form of T. brucei became sensitive to the superoxide generator paraquat but not to nifurtimox or benznidazole (25). When RNAi was targeted at Tbsodb1 or Tbsodb2, both transcripts were down-regulated, due to their high levels of sequence identity. The effect was lethal, with growth cessation occurring within 24 h.
To assess the contributions of Tbsodb1 and Tbsodb2 to oxidative defense and to determine whether they protect against drug-induced free radicals, we investigated the possibility of generating null mutant cell lines. The flanking regions of Tbsodb1 and Tbsodb2 are not highly conserved and are sufficiently divergent to facilitate targeted gene knockout. Vectors for this purpose were constructed (Fig. 1) and used to transfect T. brucei bloodstream forms, using electroporation (25). Tbsodb1 was replaced by the genes for puromycin acetyltransferase (pac) and blasticidin deaminase (bla). Similarly, Tbsodb2 was replaced by bla and the gene that confers phleomycin resistance (ble). Targeted deletion was confirmed by Southern analysis (Fig. 1). The Tbsodb1- and Tbsodb2-null mutants were both viable in culture and did not exhibit significantly altered phenotypes in terms of growth rate or infectivity in BALB/c mice (data not shown).
We further examined the null mutants to determine if they displayed
increased sensitivity to nifurtimox, benznidazole, and paraquat.
Parasites were seeded at 1
x 10
4 cells per ml in microtiter
plates with 200 µl of growth media containing different
drug concentrations and were incubated at 37°C for 48 h
(
25). Twenty microliters of Alamar Blue was then added to each
well, and the plates were analyzed by a fluorescent plate reader
(Fig.
2). There were no significant differences between the
drug concentrations required to inhibit growth of the Tb
sodb2-null
mutant and the parental cell line by 50% (IC
50). However, the
Tb
sodb1 mutant displayed twofold-, threefold-, and fourfold-increased
susceptibility to benznidazole, nifurtimox, and paraquat, respectively
(Fig.
2). To confirm that loss of Tb
sodb1 was responsible for
the increased drug sensitivity, we reintroduced a copy of the
0.6-kb Tb
sodb1 gene into the null mutants, using pTubEx (
5).
This vector facilitates integration into the tubulin gene array
and contains the neomycin phosphotransferase gene (
neo) as a
selectable marker. Transformants were verified by Southern hybridization,
and expression of Tb
sodb1 was confirmed by Northern blotting
(Fig.
3). In the complemented cell line, processing of the Tb
sodb1 RNA is mediated by tubulin gene-flanking sequences and produces
a 0.9-kb transcript. When these cells were reexamined, we found
that expression of TbSODB1 from this locus completely reversed
the drug sensitivity phenotype in the cases of benznidazole
and nifurtimox and partially so in the case of paraquat.
Previously, the limitations of RNAi meant we could not distinguish
between TbSODB1 and TbSODB2 in terms of functional significance
(
25). Furthermore, drug sensitivity studies were restricted
by rapid-growth inhibition and cell death. By independently
deleting Tb
sodb1 and Tb
sodb2, we have now demonstrated that,
under normal growth conditions, there is functional redundancy
in this arm of the
T. brucei oxidative defense. However, TbSODB1,
but not TbSODB2, is required to protect the parasite from superoxide
radicals generated by the redox cycling of nitroheterocyclic
drugs. As in most organisms, trypanosome SODs are highly compartmentalized
(
8,
25). This reflects the restricted ability of superoxide
anions to cross biological membranes and the requirement for
detoxification to occur at the site of free radical formation.
By implication, the subcellular location of an enzyme(s) that
mediates the one-electron reduction of nifurtimox and benznidazole,
leading to the generation of superoxide radicals, must overlap
with TbSODB1. In this context, the observation that TbSODB1
is more abundant in the cytosol than TbSODB2 (
8) may be significant.
Fe-SODs have been highlighted as potential chemotherapeutic
targets because of their parasite specificity (
22). The crucial
role of TbSODB1 in preventing drug-induced, superoxide-mediated
killing suggests that inhibitors targeted at Fe-SODs could act
synergistically with nifurtimox.

ACKNOWLEDGMENTS
This work was funded by the Wellcome Trust.

FOOTNOTES
* Corresponding author. Mailing address: Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom. Phone: 44 207 927 2330. Fax: 44 207 636 8739. E-mail:
john.kelly{at}lshtm.ac.uk.

Published ahead of print on 4 December 2006. 

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Antimicrobial Agents and Chemotherapy, February 2007, p. 755-758, Vol. 51, No. 2
0066-4804/07/$08.00+0 doi:10.1128/AAC.01360-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
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