Bioorganic & Medicinal Chemistry Letters
The survival times of malaria-infected mice are prolonged more by
several new two-carbon-linked artemisinin-derived dimer
carbamates than by the trioxane antimalarial drug artemether
Ryan C. Conyers a, Jennifer R. Mazzone a, Maxime A. Siegler a, Abhai K. Tripathi b,c, David J. Sullivan b,c
,
Bryan T. Mott a, Gary H. Posner a,c,
⇑
a Department of Chemistry, School of Arts and Sciences, The Johns Hopkins University, 3400 North Charles Street, Baltimore, MD 21218, United States
b W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD 21205, United States
c The Johns Hopkins Malaria Research Institute, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD 21205, United States
a r t i c l e i n f o
a b s t r a c t
Article history:
Sixteen new artemisinin-derived 2-carbon-linked trioxane dimers were prepared to study chemical
structure/antimalarial activity relationships (SAR). Administering a very low single oral dose of only
5 mg/kg of dimer secondary alcohol 6a or 6b plus 15 mg/kg of mefloquine hydrochloride prolonged
the lives of Plasmodium berghei-infected mice to an average of 25 days after infection. This ACT chemo-
therapy result is of high medicinal significance because the antimalarial efficacy of the popular trioxane
drug artemether (2) plus mefloquine under the same conditions was significantly lower (only 20 day
average survival). NH-aryl carbamate derivatives 7e, 7i, and 7j of 2-carbon-linked dimer alcohol 6b also
significantly outperformed artemether (2) in prolonging the survival times (25–27 days) of malaria-
infected mice.
Received 17 December 2013
Revised 13 January 2014
Accepted 21 January 2014
Available online 30 January 2014
Keywords:
Antimalarial chemotherapy
Trioxane dimer carbamates
Single oral dose ACT
Oral bioavailability
Ó 2014 Elsevier Ltd. All rights reserved.
Malaria remains a devastating infectious disease, especially in
tropical and sub-tropical areas of the world. Attempts at develop-
ing vaccines to protect humans from contracting malaria have
been only partially successful.1 Therefore, safe and effective che-
motherapy to cure malaria-infected patients is desperately needed.
With widespread resistance of Plasmodium falciparum malaria par-
asites to such previously reliable antimalarial drugs like chloro-
quine,2–4 antimalarial drugs with new mechanism(s) of action
are valuable for chemotherapy of malaria patients.5,6 In recent
years, a dramatic advance has been made with the use of the triox-
ane artemisinin (1) and its derivatives artemether (2) and sodium
artesunate (3, Fig. 1) as fast-acting and highly efficacious antimal-
arials.7,8 Combining such fast-acting but short lived trioxanes with
known slower-acting but longer-lived nitrogen-containing com-
pounds like mefloquine or lumefantrine is now recommended as
standard operating procedure by the World Health Organization
(WHO).9 Such artemisinin combination therapy (ACT) has led to
several combinations that are now readily available as over-the-
counter drugs. These commercial ACTs, however, typically require
multiple dosing for several days in order to achieve full cures.10–18
Compliance with such a regimen is often problematic. Therefore, a
single dose cure is becoming a major goal in modern antimalarial
chemotherapy.19–24 We have recently designed, synthesized, and
biologically evaluated a series of new C-10 carbon-linked trioxane
dimers some of which completely cure malaria-infected mice using
one single-digit oral dose of trioxane along with a non-trioxane
drug.25–29 Artemisinin-derived C-10 carbon-linked dimers having
linking units of five,26 four,27 and three28,29 carbon atoms as well
as dimers with structurally distinct linking units30–32 having
potent antimalarial activity have been reported. Recently we
described preparation of artemisinin-derived 2-carbon-linked
dimer ketone 4 (36% overall yield from artemisinin) and of its cor-
responding curative oxime derivatives 5.25 We have now discov-
ered that 2-carbon-linked dimer ketone 4 can be reduced with
very high stereocontrol predominantly into secondary alcohol dia-
stereomer 6b. The new chemical entity alcohol 6b was easily trans-
formed in one step into a series of fourteen NH-aryl carbamates 7
some of which are more efficacious than the popular monomeric
trioxane drug artemether (2) in prolonging the survival times of
malaria-infected mice (Scheme 1).
It was important to explore the utility of this new 2-carbon-
linked dimer scaffold by performing a number of functional group
transformations. The dimer ketone 4 was reduced into a pair of
diastereomeric alcohols 6a and 6b that were easily separable on
Abbreviations: SAR, structure–activity relationship; ACT, artemisinin
combination therapy; DIBALH, diisobutylaluminum hydride.
⇑
Corresponding author. Tel.: +1 410 516 4670.
0960-894X/$ - see front matter Ó 2014 Elsevier Ltd. All rights reserved.