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Contrasting Ex Vivo Efficacies of "Reversed Chloroquine" Compounds in Chloroquine-Resistant Plasmodium falciparum and P. vivax Isolates

Wirjanata, Grennady, Sebayang, Boni F., Chalfein, Ferryanto, Prayoga, Pak, Handayuni, Irene, Noviyanti, Rintis, Kenangalem, Enny, Poespoprodjo, Jeanne R., Burgess, Steven J., Peyton, David H., Price, Ric N. and Marfurt, Jutta (2015). Contrasting Ex Vivo Efficacies of "Reversed Chloroquine" Compounds in Chloroquine-Resistant Plasmodium falciparum and P. vivax Isolates. Antimicrobial Agents and Chemotherapy,59(9):5721-5726.

Document type: Journal Article
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IRMA ID 11381xPUB137
NHMRC Grant No. 1023438
Title Contrasting Ex Vivo Efficacies of "Reversed Chloroquine" Compounds in Chloroquine-Resistant Plasmodium falciparum and P. vivax Isolates
Author Wirjanata, Grennady
Sebayang, Boni F.
Chalfein, Ferryanto
Prayoga, Pak
Handayuni, Irene
Noviyanti, Rintis
Kenangalem, Enny
Poespoprodjo, Jeanne R.
Burgess, Steven J.
Peyton, David H.
Price, Ric N.
Marfurt, Jutta
Journal Name Antimicrobial Agents and Chemotherapy
Publication Date 2015
Volume Number 59
Issue Number 9
ISSN 0066-4804   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84940908563
Start Page 5721
End Page 5726
Total Pages 6
Place of Publication United States of America
Publisher American Society for Microbiology
HERDC Category C1 - Journal Article (DIISR)
Abstract Chloroquine (CQ) has been the mainstay of malaria treatment for more than 60 years. However, the emergence and spread of CQ resistance now restrict its use to only a few areas where malaria is endemic. The aim of the present study was to investigate whether a novel combination of a CQ-like moiety and an imipramine-like pharmacophore can reverse CQ resistance ex vivo. Between March to October 2011 and January to September 2013, two “reversed chloroquine” (RCQ) compounds (PL69 and PL106) were tested against multidrug-resistant field isolates of Plasmodium falciparum (n = 41) and Plasmodium vivax (n = 45) in Papua, Indonesia, using a modified ex vivo schizont maturation assay. The RCQ compounds showed high efficacy against both CQ-resistant P. falciparum and P. vivax field isolates. For P. falciparum, the median 50% inhibitory concentrations (IC50s) were 23.2 nM for PL69 and 26.6 nM for PL106, compared to 79.4 nM for unmodified CQ (P < 0.001 and P = 0.036, respectively). The corresponding values for P. vivax were 19.0, 60.0, and 60.9 nM (P < 0.001 and P = 0.018, respectively). There was a significant correlation between IC50s of CQ and PL69 (Spearman's rank correlation coefficient [rs] = 0.727, P < 0.001) and PL106 (rs = 0.830, P < 0.001) in P. vivax but not in P. falciparum. Both RCQs were equally active against the ring and trophozoite stages of P. falciparum, but in P. vivax, PL69 and PL106 showed less potent activity against trophozoite stages (median IC50s, 130.2 and 172.5 nM) compared to ring stages (median IC50s, 17.6 and 91.3 nM). RCQ compounds have enhanced ex vivo activity against CQ-resistant clinical isolates of P. falciparum and P. vivax, suggesting the potential use of reversal agents in antimalarial drug development. Interspecies differences in RCQ compound activity may indicate differences in CQ pharmacokinetics between the two Plasmodium species.
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