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Preclinical development of an oral anti-Wolbachia macrolide drug for the treatment of lymphatic filariasis and onchocerciasis

Abstract:
There is an urgent global need for a safe macrofilaricide drug to accelerate elimination of the neglected tropical diseases onchocerciasis and lymphatic filariasis. From an anti-infective compound library, the macrolide veterinary antibiotic, tylosin A, was identified as a hit against Wolbachia. This bacterial endosymbiont is required for filarial worm viability and fertility and is a validated target for macrofilaricidal drugs. Medicinal chemistry was undertaken to develop tylosin A analogs with improved oral bioavailability. Two analogs, A-1535469 and A-1574083, were selected. Their efficacy was tested against the gold-standard second-generation tetracycline antibiotics, doxycycline and minocycline, in mouse and gerbil infection models of lymphatic filariasis (Brugia malayi and Litomosoides sigmodontis) and onchocerciasis (Onchocerca ochengi). A 1- or 2-week course of oral A-1535469 or A-1574083 provided >90% Wolbachia depletion from nematodes in infected animals, resulting in a block in embryogenesis and depletion of microfilarial worm loads. The two analogs delivered comparative or superior efficacy compared to a 3- to 4-week course of doxycycline or minocycline. A-1574083 (now called ABBV-4083) was selected for further preclinical testing. Cardiovascular studies in dogs and toxicology studies in rats and dogs revealed no adverse effects at doses (50 mg/kg) that achieved plasma concentrations >10-fold above the efficacious concentration. A-1574083 (ABBV-4083) shows potential as an anti-Wolbachia macrolide with an efficacy, pharmacology, and safety profile that is compatible with a short-term oral drug course for treating lymphatic filariasis and onchocerciasis.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1126/scitranslmed.aau2086

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Author
ORCID:
0000-0003-3396-9275
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Author
ORCID:
0000-0002-0649-7885
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ORCID:
0000-0001-7919-2866
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ORCID:
0000-0001-8885-418X
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Author
ORCID:
0000-0001-5076-4234


Publisher:
American Association for the Advancement of Science
Journal:
Science Translational Medicine More from this journal
Volume:
11
Issue:
483
Article number:
eaau2086
Publication date:
2019-03-13
Acceptance date:
2018-10-19
DOI:
EISSN:
1946-6242
ISSN:
1946-6234
Pmid:
30867321


Language:
English
Pubs id:
pubs:983130
UUID:
uuid:7642c81b-d039-49ff-b5ff-b8ec62014b70
Local pid:
pubs:983130
Source identifiers:
983130
Deposit date:
2019-03-18
ARK identifier:

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