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PubMed1990

Stereoselective interaction of an azole antifungal agent with its target, lanosterol 14 alpha-demethylase (cytochrome P-45014DM): a model study with stereoisomers of triadimenol and purified cytochrome P-45014DM from yeast.

The effect of the four triadimenol stereoisomers on the purified yeast lanosterol 14 alpha-demethylase (cytochrome P-45014DM), the primary target of azole antifungal agents, was studied. (1S,2R)-Triadimenol was the most potent demethylase inhibitor and bound quantitatively to the enzyme below 0.05 microM. This isomer also interfered with the chemical reduction of cytochrome P-45014DM and the binding of CO to the cytochrome. The other isomers showed a lower inhibitory effect on the enzyme, and the order of activity was (1R,2R) greater than (1R,2S) greater than or equal to (1S,2S). Based on these findings and the reported preferred conformations for the triadimenol stereoisomers (Anderson, N.H. et al., Pestic. Sci. 15:310-316, 1984), it is predicted that orientation of the hydrophobic tert-butyl and p-chlorophenyl groups relative to the azole nitrogen is important to fit the antifungal agent in the active site of the demethylase.

Azoles↗
PubMed2003

Effects of anti-ecdysteroid quaternary derivatives of azole analogues of metyrapone on the post-embryonic development of the red cotton bug (Dysdercus cingulatus F).

In order to improve the larvicidal activity of the azole analogues of metyrapone, previously found to have a strong inhibitory activity on ecdysone 20-monooxygenase (E-20-M) from the fleshfly Neobellieria bullata Parker, soft-alkylated compounds (3-(1,1-dimethyl-2-oxo-2-phenylethyl)-1-dodecanoyloxymethyl-1H-imidazolium chloride, sPIM) and (1-(1,1-dimethyl-2-oxo-2-phenylethyl)-4-dodecanoyloxymethyl-1H-1,2,4-triazolium chloride, sPTM), derivatives of phenyl-imidazolyl-metyrapone (PIM) and phenyl-1,2,4-triazolyl-metyrapone (PTM), respectively, were synthesized. Both sPIM and sPTM, designed as propesticides, inhibited E-20-M in vitro at 10(-4) M concentration, which was unexpected since they had been expected to be inactive in vitro and to gain activity only within the organism. sPTM significantly delayed the pupariation of N. bullata larvae and this effect could be reversed by the simultaneous application of 20-hydroxyecdysone (20E), supporting the hypothesis that sPTM can act by interfering with the moulting hormone system. Due to this in vitro activity, sPTM and sPIM cannot be considered to be simple drug precursors, and their structure should contain structural elements (pharmacophores) responsible for the observed biological effects. In order to examine this hypothesis, derivatives of sPTM and sPIM were synthesised in which the hydrolytically labile N(+)-CH2O(CO)- moiety was changed to the more stable N(+)-CH2CH2(CO)-group. In three new stable derivatives, a dodecylamino or a phenyl group, respectively, is attached to the carbonyl group to obtain PTM and PIM derivatives quaternised with a 2-dodecylcarbamoylethyl or a 3-oxo-3-phenylpropyl group. In one derivative, the 2-oxo-2-phenylethyl quaternising group has one fewer carbon atom. In addition to their moderate activity (LC50 = 10(-6)-10(-5) M) against the red cotton bug Dysdercus cingulatus F, they delayed development and caused developmental abnormalities, including mortality in the pharate phase, mortality during moulting and wing deformations. These symptoms and the delay in development are characteristic of known compounds inhibiting the synthesis of 20E or interfering in the moulting processes. The facts that the frequent appearance of insects with developmental abnormalities and the delay in development could be reversed by co-application of 20E indicate that the moulting system might be the site of action. We presume that the quaternary azole derivatives of PIM and PTM can themselves also interact with the moulting system.

Animals↗
PubMed1985

Biochemical targets for antifungal azole derivatives: hypothesis on the mode of action.

The selective interaction of low concentrations of azole derivatives and other nitrogen heterocycles with cytochrome P-450 may be at the origin of the inhibition of ergosterol biosynthesis. From the depletion of ergosterol and the concomitant accumulation of 14 alpha-methylsterols, alterations in membrane functions, the synthesis and activity of membrane-bound enzymes, mitochondrial activities, and an uncoordinated activation of chitin synthase may result. Since chitin synthesis is more important in the hyphal form than in the budding form of C. albicans, the uncoordinated activation of chitin synthesis may be more trouble for the hyphal growth than for yeast budding. The assumption is made that from this difference the greater sensitivity of hyphal growth to azole antifungal agents may originate. It is also assumed that the higher degree of lipid unsaturation may be related to an inhibition of ergosterol biosynthesis. The inhibition of fatty acid desaturation and elongation induced by higher doses of miconazole and ketoconazole and the longer contact times might be related to interference with membrane fluidity, or it might due to chelation of the iron used in the oxidation reduction sequence during desaturation. The decreased availability of ergosterol and the accumulation of 14 alpha-methylsterols also may provide the environment needed to inactivate membrane-bound enzymes; e.g., cytochrome c peroxidase. However, it is still too speculative to correlate effects on membrane components with miconazole-induced changes in properties of all oxidases; e.g., the NADH-dependent, cyanide-insensitive oxidase. The accumulation of toxic concentrations of hydrogen peroxide, resulting from an increased NADH-oxidase activity and disappearance of the peroxidase and catalase activity, may contribute to the degeneration of subcellular structures. The complete disappearance of catalase observed at concentrations of miconazole greater than or equal to 10(-5) M may originate from direct effects on the cell. At these high concentrations reached only by topical application, direct membrane damage resulting from interaction of miconazole with lipids was observed. These direct interactions result in an inhibition of membrane-bound enzyme and mitochondrial activities and in leakage of intracellular components. The direct interactions were much less pronounced in cells treated with ketoconazole. This correlates with the smaller area occupied in the membrane per ketoconazole molecule (30 A2), compared with that occupied in the membrane per miconazole molecule (90 A2).(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed2006

Effect of azoles on the secretion of a Candida albicans metallopeptidase.

Azole antifungals act by inhibiting the activity of a lanosterol demethylase involved in the generation of the ergosterol of the cellular membrane of fungi. These drugs could also have action on other yeast components, like secreted aspartyl proteases. We demonstrate in this study that the in vitro secretion of a metallopeptidase could be modified during the growth of Candida albicans with subinhibitory concentrations of some azoles. Eight isolates of this yeast have been cultivated in presence of MIC, MIC/2 and MIC/4 of voriconazole, fluconazole and itraconazole. The presence of voriconazole and fluconazole decreased the secretion of the metallopeptidase in the culture medium, whereas itraconazole increased this secretion for three isolates. This study points to the fact that some antifungals, given in prophylaxis, could act in an unfavourable way on some potential factors of pathogenicity.

Antifungal Agents↗
PubMed1990

A novel lanosterol isomer produced in response to azole antifungals.

Gas chromatography-mass spectrometry has revealed the existence of a novel lanosterol-like sterol which is produced by fungi in response to treatment with azole drugs. The significance of this finding may be related to the changes in fungal sterol synthesis as a consequence to prolonged exposure to azoles and consequent development of resistance to these agents.

Antifungal Agents↗
PubMed2004

Modeling and interactions of Aspergillus fumigatus lanosterol 14-alpha demethylase 'A' with azole antifungals.

Recent identification of the sterol 14-alpha demethylase genes (CYP51 A and B) from Aspergillus fumigatus and other species by Mellado et al. (J. Clin. Microbiol. 2001, 39(7), 2431-2438), has opened up possibilities of investigating the interactions of azole antifungals with the enzyme(s) from fungi. This study describes for the first time, a model of the three-dimensional structure of A. fumigatus 14-alpha demethylase (AF-CYP51A), using the crystal structure of Mycobacterium tuberculosis 14-alpha demethylase (PDB code:1EA1) as a template. The paper also describes the various interactions between azole antifungals and the target from A. fumigatus (AF-CYP51A). Quantitative evaluation of these interactions is done using COMBINE analysis to understand contributions of active site residues to ligand activity. It also provides explanation for the activity/inactivity of different ligands for AF-CYP51A.

Amino Acid Motifs↗
PubMed2006

A new non-azole inhibitor of ABA 8'-hydroxylase: effect of the hydroxyl group substituted for geminal methyl groups in the six-membered ring.

We designed and synthesized AHI4 that has an axial hydroxyl group instead of geminal methyl groups at C-6' of AHI1, previously reported as a lead compound for the development of non-azole inhibitors of ABA 8'-hydroxylase. (+)-AHI4 competitively inhibited 8'-hydroxylation of ABA by recombinant CYP707A3. The K(I) value was found to be 0.14 microM, 10-fold less than that of (+)-AHI1, suggesting that enzyme affinity increased by a factor of 10 due to substitution of the hydroxyl group by the geminal methyls at C-6'. This finding should assist in the design of more effective, non-azole ABA 8'-hydroxylase inhibitors.

Azoles↗
PubMed2006

ortho-Substituted azoles as selective and dual inhibitors of VEGF receptors 1 and 2.

We have developed a series of novel potent ortho-substituted azole derivatives active against kinases VEGFR-1 and VEGFR-2. Both specific and dual ATP-competitive inhibitors of VEGFR-2 were identified. Kinase activity and selectivity could be controlled by varying the arylamido substituents at the azole ring. The most specific molecule (17) displayed > 10-fold selectivity for VEGFR-2 over VEGFR-1. Compound activities in enzymatic and cell-based assays were in the range of activities for reported clinical and development candidates (IC50 < 100 nM), including Novartis' PTK787 (Vatalanib). High permeability of active compounds across the Caco-2 cell monolayer (> 30x10(-5) cm/min) is indicative of their potential for intestinal absorption upon oral administration.

Adenosine Triphosphate↗
PubMed2000

Differential inhibition of human CYP3A4 and Candida albicans CYP51 with azole antifungal agents.

The inhibition by azole antifungals of human cytochrome CYP3A4, the major form of drug metabolising enzyme within the liver, was compared with their inhibitory activity against their target enzyme, Candida albicans sterol 14alpha-demethylase (CYP51), following heterologous expression in Saccharomyces cerevisiae. IC(50) values for ketoconazole and itraconazole CYP3A4 inhibition were 0.25 and 0. 2 microM. These values compared with much lower doses required for the complete inhibition of C. albicans CYP51, where IC(50) values of 0.008 and 0.0076 microM were observed for ketoconazole and itraconazole, respectively. Additionally, stereoselective inhibition of CYP3A4 and CYP51 was observed with enantiomers of the azole antifungal compounds diclobutrazol and SCH39304. In both instances, the RR(+) configuration at their asymmetric carbon centres was most active. Interestingly, the SS(-) enantiomeric form of SCH39304 was inactive and failed to bind CYP3A4, as demonstrable by Type II binding spectra.

Antifungal Agents↗
PubMed1998

Azole resistance among oral Candida species isolates from AIDS patients under ketoconazole exposure.

This is a prospective study designed to investigate species distribution and azole susceptibility profile among Candida spp. isolated from the oral cavities of AIDS patients. One hundred thirty-two AIDS patients sequentially admitted at a teaching tertiary care hospital were enrolled in this study. Samples were obtained by swabbing the oral cavities of the patients. Yeast isolates were identified by classical methods and the antifungal susceptibility profile was further determined according to the NCCLS microbroth assay. Among all patients with prescriptions of systemic antifungal drugs, ketoconazole had been elected to treat 56% of patients. We found 82% of oral yeast carriage, 22% of them harboring non-albicans species. Overall rates of susceptibility dose dependent/resistance to azoles was 16% for itraconazole, 13% for ketoconazole, and 10% for fluconazole with a high agreement rate among the susceptibility profiles of all isolates tested against the triazoles.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Antifungal drug resistance to azoles and polyenes.

There is an increased awareness of the morbidity and mortality associated with fungal infections caused by resistant fungi in various groups of patients. Epidemiological studies have identified risk factors associated with antifungal drug resistance. Selection pressure due to the continuous exposure to azoles seems to have an essential role in developing resistance to fluconazole in Candida species. Haematological malignancies, especially acute leukaemia with severe and prolonged neutropenia, seem to be the main risk factors for acquiring deep-seated mycosis caused by resistant filamentous fungi, such us Fusarium species, Scedosporium prolificans, and Aspergillus terreus. The still unacceptably high mortality rate associated with some resistant mycosis indicates that alternatives to existing therapeutic options are needed. Potential measures to overcome antifungal resistance ranges from the development of new drugs with better antifungal activity to improving current therapeutic strategies with the present antifungal agents. Among the new antifungal drugs, inhibitors of beta glucan synthesis and second-generation azole and triazole derivatives have characteristics that render them potentially suitable agents against some resistant fungi. Other strategies including the use of high doses of lipid formulations of amphotericin B, combination therapy, and adjunctive immune therapy with cytokines are under investigation. In addition, antifungal control programmes to prevent extensive and inappropriate use of antifungals may be needed.

Antifungal Agents↗
PubMed1995

Studies on new acidic azoles as glucose-lowering agents in obese, diabetic db/db mice.

Bioisosteric substitution was used as a tool to generate several new structural alternatives to the thiazolidine-2,4-dione and tetrazole heterocycles as potential antidiabetic agents. Among the initial leads that emerged from this strategy, a family of acidic azoles, isoxazol-3- and -5-ones and a pyrazol-3-one, showed significant plasma glucose-lowering activity (17-42% reduction) in genetically obese, diabetic db/db mice at a dose of 100 mg/kg/day x4. Structure-activity relationship studies determined that 5-alkyl-4-(arylmethyl)pyrazol-3-ones, which exist in solution as aromatic enol/iminol tautomers, were the most promising new class of potential antidiabetic agent (32-45% reduction at 20 mg/kg/d x4). Included in this work are convenient syntheses for several types of acidic azoles that may find use as new acidic bioisosteres in medicinal chemistry such as the antidiabetic lead 5-(trifluoromethyl)pyrazol-3-one (hydroxy tautomer) and aza homologs of the pyrazolones, 1,2,3-triazol-5-ones (hydroxy tautomer) and 1,2,3,4-tetrazol-5-one heterocycles. log P and pKa data for 15 potential acidic bioisosteres, all appended to a 2-naphthalenylmethyl residue so as to maintain a similar distance between the acidic hydrogen and arene nucleus, are presented. This new data set allows comparison of a wide variety of potential acid mimetics (pKa 3.78-10.66; log P -0.21 to 2.76) for future drug design.

Animals↗
PubMed1993

Aromatase inhibitors: synthesis, biological activity, and binding mode of azole-type compounds.

The enantiomers of the potent nonsteroidal inhibitor of aromatase fadrozole hydrochloride 3 have been separated and their absolute configuration determined by X-ray crystallography. On the basis of a molecular modeling comparison of the active enantiomer 4 and one of the most potent steroidal inhibitors reported to date, (19R)-10-thiiranylestr-4-ene-3,17-dione, 7, a model describing the relative binding modes of the azole-type and steroidal inhibitors of aromatase at the active site of the enzyme is proposed. It is suggested that the cyanophenyl moiety present in the most active azole inhibitors partially mimics the steroid backbone of the natural substrate for aromatase, androst-4-ene-3,17-dione, 1. The synthesis and biological testing of novel analogues of 3 used to define the accessible and nonaccessible volumes to ligands in the model of the active site of aromatase are reported.

Aromatase Inhibitors↗
PubMed1994

Disposition of azole antifungal agents. II. Hepatic binding and clearance of dichlorophenyl-bis-triazolylpropanol (DTP) in the rat.

DTP (dichlorophenyl-bis-triazolylpropanol) was evaluated as a probe of drug-cytochromes P450 interactions in vitro and in vivo. Studies with rat liver microsomes demonstrate that DTP shows similar P450 binding affinity to its analog, ketoconazole, as determined by P450 difference spectra and inhibition of the metabolism of methoxycoumarin. As a more polar azole, DTP shows less affinity for rat plasma albumin (fraction unbound 0.56) than ketoconazole (fraction unbound 0.037). DTP metabolism is simpler than that of ketoconazole, with only one pathway, N-dealkylation which removes a triazole ring to yield DTP glycol. This primary metabolite is further metabolised to a carboxylic acid, a glycol glucuronide and a third unknown secondary metabolite (probably an acid glucuronide). Over a dose range of 0.1-24mg/kg there is complete mass balance recovery in urine via the five metabolites and unchanged drug. However DTP metabolism is dose dependent and while the affinity of DTP for the cytochromes P450 carrying out the initial dealkylation is high (1.5 microM based on unbound blood concentration), the capacity of the reaction is low (1 nmole/min). Under linear conditions, metabolic clearance is low (19ml/h), but ten-fold higher than renal clearance. The liver is the major distribution site for both DTP and ketoconazole. At low DTP concentrations, a specific high affinity process dominates the hepatic binding of DTP resulting in a liver:blood partition coefficient of approximately 30. Hepatic binding is concentration dependent and the progressive decrease in partition coefficient observed as the dose of DTP is escalated is coincident with a decrease in volume of distribution. The two saturable processes involved in the disposition of DTP result in an unusual concentration dependency in the blood concentration-time profile of this azole. Following administration of a high dose (10mg/kg) of DTP the log concentration-time profile is sigmoidal. At high concentrations (above 1mg/L) both the N-dealkylation and the hepatic binding of DTP are saturated, but as concentrations fall to approximately 0.05mg/L the former process becomes linear and the time profile is convex over this concentration range. At later times as DTP concentrations decline further, the tissue binding also reaches the linear region and the time profile becomes concave. Only at low concentrations (below 0.05mg/L) do both processes become first order and the true half life is evident.

Animals↗
PubMed2005

Azole susceptibility and resistance in Candida dubliniensis.

Candida dubliniensis is a recently described species of pathogenic yeast that shares many phenotypic features with Candida albicans. It is primarily associated with oral colonization and infection in HIV-infected individuals. Isolates of C. dubliniensis are generally susceptible to commonly used azole antifungal agents; however, resistance has been observed in clinical isolates and can be induced by in vitro exposure. Molecular mechanisms of azole resistance in C. dubliniensis include increased drug efflux, modifications of the target enzyme and alterations in the ergosterol biosynthetic pathway.

Antifungal Agents↗
PubMed2001

The combination of oral amphotericin B with azoles prevents the emergence of resistant Candida species in neutropenic patients.

The role of antifungal prophylaxis remains controversial and concerns exist that the use of azoles may potentiate the emergence of resistant Candida species. We used a strategy of combining the latest azole/triazole with oral amphotericin B to reduce this risk. We analysed data on Candida colonization and candidaemia in neutropenic patients from four prophylaxis periods (1985/6: ketoconazole and amphotericin B suspension; 1991/2 & 1997: fluconazole and amphotericin B suspension; 1998/9: itraconazole) to look for evidence of the emergence of potentially resistant species. Overall, the percentage of patients colonized with Candida fell significantly (69.3%, 57.5%, 43.2% and 46%, respectively, P < 0.001) due to a decrease in colonization with C. albicans (49%, 23.1%, 22.2% and 25.2%, respectively, P < 0.001). However, in 1998/9, increased colonization, particularly with C. glabrata in the lower gastrointestinal tract, was noted to coincide with the omission of oral amphotericin B. Despite an increasing population of 'high risk' patients, the incidence of candidaemia has not changed significantly (2%, 1.4%, 1.2% and 2% respectively). However, species causing candidaemia have changed, with resistant organisms now predominating. Our findings support the use of azole prophylaxis although, in view of the trends noted when itraconazole was used alone, we would recommend the additional use of oral amphotericin B.

Amphotericin B↗
PubMed1997

A yeast sterol auxotroph (erg25) is rescued by addition of azole antifungals and reduced levels of heme.

Genetic disruption of the Saccharomyces cerevisiae C-4 sterol methyl oxidase ERG25 gene leads to sterol auxotrophy. We have characterized a suppression system that requires two mutations to restore viability to this disrupted strain. One suppressor mutation is erg11, which is blocked in 14alpha-demethylation of lanosterol and is itself an auxotroph. The second suppressor mutation required is either slu1 or slu2 (suppressor of lanosterol utilization). These mutations are leaky versions of HEM2 and HEM4, respectively; addition of exogenous hemin reverses the suppressing effects of slu1 and slu2. Suppression of erg25 by erg11 slu1 (or erg11 slu2) results in a slow-growing strain in which lanosterol, the first sterol in the pathway, accumulates. This result indicates that endogenously synthesized lanosterol can substitute for ergosterol and support growth. In the triple mutants, all but 1 (ERG6) of the 13 subsequent reactions of the ergosterol pathway are inactive. Azole antibiotics (clotrimazole, ketoconazole, and itraconazole) widely used to combat fungal infections are known to do so by inhibiting the ERG11 gene product, the 14alpha-demethylase. In this investigation, we demonstrate that treatment of the sterol auxotrophs erg25 slu1 or erg25 slu2 with azole antibiotics paradoxically restores viability to these strains in the absence of sterol supplementation via the suppression system we have described.

Antifungal Agents↗
PubMed2004

Identification and activity of a series of azole-based compounds with lactate dehydrogenase-directed anti-malarial activity.

Plasmodium falciparum, the causative agent of malaria, relies extensively on glycolysis coupled with homolactic fermentation during its blood-borne stages for energy production. Selective inhibitors of the parasite lactate dehydrogenase (LDH), central to NAD(+) regeneration, therefore potentially provide a route to new antimalarial drugs directed against a novel molecular target. A series of heterocyclic, azole-based compounds are described that preferentially inhibit P. falciparum LDH at sub-micromolar concentrations, typically at concentrations about 100-fold lower than required for human lactate dehydrogenase inhibition. Crystal structures show these competitive inhibitors form a network of interactions with amino acids within the active site of the enzyme, stacking alongside the nicotinamide ring of the NAD(+) cofactor. These compounds display modest activity against parasitized erythrocytes, including parasite strains with known resistance to existing anti-malarials and against Plasmodium berghei in BALB/c mice. Initial toxicity data suggest the azole derivatives have generally low cytotoxicity, and preliminary pharmoco-kinetic data show favorable bioavailability and circulation times. These encouraging results suggest that further enhancement of these structures may yield candidates suitable for consideration as new therapeutics for the treatment of malaria. In combination these studies also provide strong support for the validity of targeting the Plasmodium glycolytic pathway and, in particular, LDH in the search for novel anti-malarials.

Animals↗