4.8 Article

Triaminopyrimidine is a fast-killing and long-acting antimalarial clinical candidate

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NATURE COMMUNICATIONS
卷 6, 期 -, 页码 -

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NATURE PORTFOLIO
DOI: 10.1038/ncomms7715

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  1. Medicines for Malaria Venture (MMV) [MMV 09/5400]
  2. National Institutes of Health [R01 AI50234, AI109023]

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The widespread emergence of Plasmodium falciparum (Pf) strains resistant to frontline agents has fuelled the search for fast-acting agents with novel mechanism of action. Here, we report the discovery and optimization of novel antimalarial compounds, the triaminopyrimidines (TAPs), which emerged from a phenotypic screen against the blood stages of Pf. The clinical candidate (compound 12) is efficacious in a mouse model of Pf malaria with an ED99 <30 mg kg(-1) and displays good in vivo safety margins in guinea pigs and rats. With a predicted half-life of 36 h in humans, a single dose of 260 mg might be sufficient to maintain therapeutic blood concentration for 4-5 days. Whole-genome sequencing of resistant mutants implicates the vacuolar ATP synthase as a genetic determinant of resistance to TAPs. Our studies highlight the potential of TAPs for single-dose treatment of Pf malaria in combination with other agents in clinical development.

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