Antileishmanial chemotherapy through clemastine fumarate mediated inhibition of the leishmania inositol phosphorylceramide synthase

John G. M. Mina, Rebecca L. Charlton, Edubiel Alpizar-Sosa, Douglas O. Escrivani, Christopher Brown, Amjed Alqaisi, Maria Paula G. Borsodi, Claudia P. Figueiredo, Emanuelle V. de Lima, Emily A. Dickie, Wenbin Wei, Robson Coutinho-Silva, Andy Merritt, Terry K. Smith, Michael P. Barrett, Bartira Rossi-Bergmann (Lead / Corresponding author), Paul W . Denny (Lead / Corresponding author), Patrick G. Steel (Lead / Corresponding author)

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Current chemotherapeutics for leishmaniasis have multiple deficiencies, and there is a need for new safe, efficacious, and affordable medicines. This study describes a successful drug repurposing approach that identifies the over-the-counter antihistamine, clemastine fumarate, as a potential antileishmanial drug candidate. The screening for inhibitors of the sphingolipid synthase (inositol phosphorylceramide synthase, IPCS) afforded, following secondary screening against Leishmania major (Lmj) promastigotes, 16 active compounds. Further refinement through the dose response against LmjIPCS and intramacrophage L. major amastigotes identified clemastine fumarate with good activity and selectivity with respect to the host macrophage. On target engagement was supported by diminished sensitivity in a sphingolipid-deficient L. major mutant (ΔLmjLCB2) and altered phospholipid and sphingolipid profiles upon treatment with clemastine fumarate. The drug also induced an enhanced host cell response to infection indicative of polypharmacology. The activity was sustained across a panel of Old and New World Leishmania species, displaying an in vivo activity equivalent to the currently used drug, glucantime, in a mouse model of L. amazonensis infection. Overall, these data validate IPCS as an antileishmanial drug target and indicate that clemastine fumarate is a candidate for repurposing for the treatment of leishmaniasis.
Original languageEnglish
Pages (from-to)47-63
Number of pages17
JournalACS Infectious Diseases
Volume7
Issue number1
Early online date8 Dec 2020
DOIs
Publication statusPublished - 8 Jan 2021

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