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Nifurtimox activation by trypanosomal type I nitroreductases generates cytotoxic nitrile metabolites.

Abstract
The prodrug nifurtimox has been used for more than 40 years to treat Chagas disease and forms part of a recently approved combinational therapy that targets West African trypanosomiasis. Despite this, its mode of action is poorly understood. Detection of reactive oxygen and nitrogen intermediates in nifurtimox-treated extracts led to the proposal that this drug induces oxidative stress in the target cell. Here, we outline an alternative mechanism involving reductive activation by a eukaryotic type I nitroreductase. Several enzymes proposed to metabolize nifurtimox, including prostaglandin F2α synthase and cytochrome P450 reductase, were overexpressed in bloodstream-form Trypanosoma brucei. Only cells with elevated levels of the nitroreductase displayed altered susceptibility to this nitrofuran, implying a key role in drug action. Reduction of nifurtimox by this enzyme was shown to be insensitive to oxygen and yields a product characterized by LC/MS as an unsaturated open-chain nitrile. This metabolite was shown to inhibit both parasite and mammalian cell growth at equivalent concentrations, in marked contrast to the parental prodrug. These experiments indicate that the basis for the selectivity of nifurtimox against T. brucei lies in the expression of a parasite-encoded type I nitroreductase.
AuthorsBelinda S Hall, Christopher Bot, Shane R Wilkinson
JournalThe Journal of biological chemistry (J Biol Chem) Vol. 286 Issue 15 Pg. 13088-95 (Apr 15 2011) ISSN: 1083-351X [Electronic] United States
PMID21345801 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Nitriles
  • Protozoan Proteins
  • Trypanocidal Agents
  • Nitroreductases
  • Nifurtimox
Topics
  • Animals
  • Cell Line
  • Enzyme Activation (drug effects)
  • Humans
  • Nifurtimox (pharmacology)
  • Nitriles (metabolism)
  • Nitroreductases (metabolism)
  • Oxidation-Reduction (drug effects)
  • Protozoan Proteins (metabolism)
  • Trypanocidal Agents (pharmacology)
  • Trypanosoma brucei brucei (enzymology)
  • Trypanosomiasis, African (drug therapy, enzymology)

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