Plasmodium falciparum is the leading cause of death from malaria, taking the lives of over a million children and causing clinical illness in 300 to 500 million people each year. The parasite has acquired resistance against most antimalarials and new drugs are required. P. falciparum is a purine auxotroph, requiring purine salvage from human erythrocytes for survival. Using the frontier technology of transition state analysis, the transition state structures of P. falciparum purine nucleoside phosphorylase (PNP) and adenosine deaminase (ADA) have been solved and used to design transition state analogue inhibitors to match a their transition states. These inhibitors block their respective pathways and kill parasites cultured in human erythrocytes, but do not cure infections of Plasmodium yoelii in mice, an animal model of the disease. Metabolite labeling patterns and mouse studies have established that new pathways remain to be discovered and targeted. Inhibitor design against two critical targets will be assisted by solving the transition state structures of P. falciparum hypoxanthine-guanine-xanthine phosphoribosyltransferase (HGXPRT), the most critical step in purine synthesis. In the essential pathway of malarial de novo pyrimidine biosynthesis, orotate phosphoribosyltransferase (OPRT) is the essential first step to form all pyrimidine nucleotides. These transition state structures will be solved by frontier methods coupling kinetic isotope effects and quantum chemistry. A new generation of inhibitors will be patterned on these transition states and tested against parasites cultured in human erythrocytes and in the mouse model of P. yoelii infection. Purine salvage and synthetic pathways in parasites and their interruption with inhibitors will be investigated with purine precursors with specific radioisotope labels. The ultrasensitive method of accelerator mass spectrometry (AMS) will be used to follow normal pathways of purine salvage without perturbing normal pools in cultured cells and in mouse infections. The AMS approach has revealed uncharacterized pathways of purine salvage and these will be defined in metabolic, enzymatic and inhibitor approaches. Antimalarials that block purine salvage or pyrimidine synthesis may be useful therapeutics as single agents or in combination with agents targeted against other pathways. Simultaneous blocking of two targets decreases the ability of mutational escape by the parasite.

Public Health Relevance

Malaria is an infectious disease cause by parasites spread by mosquitoes in tropical regions of the developing world. Approximately one million children die each year from the disease and current drugs are losing their efficiency because of acquired antibiotic resistance by the parasites. This research proposes new ways to treat malaria by discovered new ways to kill the parasites without harming the human host and by exploring new drugs.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
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Drug Discovery and Mechanisms of Antimicrobial Resistance Study Section (DDR)
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Rogers, Martin J
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Albert Einstein College of Medicine
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United States
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