Phenotypic screening reveals a highly selective phthalimide-based compound with antileishmanial activity

Pharmacophores such as hydroxyethylamine (HEA) and phthalimide (PHT) have been identified as potential synthons for the development of compounds against various parasitic infections. In order to further advance our progress, we conducted an experiment utilising a collection of PHT and HEA derivatives through phenotypic screening against a diverse set of protist parasites. This approach led to the identification of a number of compounds that exhibited significant effects on the survival of Entamoeba histolytica, Trypanosoma brucei, and multiple life-cycle stages of Leishmania spp. The Leishmania hits were pursued due to the pressing necessity to expand our repertoire of reliable, cost-effective, and efficient medications for the treatment of leishmaniases. Antileishmanials must possess the essential capability to efficiently penetrate the host cells and their compartments in the disease context, to effectively eliminate the intracellular parasite. Hence, we performed a study to assess the effectiveness of eradicating L. infantum intracellular amastigotes in a model of macrophage infection. Among eleven L. infantum growth inhibitors with low-micromolar potency, PHT-39, which carries a trifluoromethyl substitution, demonstrated the highest efficacy in the intramacrophage assay, with an EC50 of 1.2 +/- 3.2 mu M. Cytotoxicity testing of PHT-39 in HepG2 cells indicated a promising selectivity of over 90-fold. A chemogenomic profiling approach was conducted using an orthology-based method to elucidate the mode of action of PHT-39. This genome-wide RNA interference library of T. brucei identified sensitivity determinants for PHT-39, which included a P-type ATPase that is crucial for the uptake of miltefosine and amphotericin, strongly indicating a shared route for cellular entry. Notwithstanding the favourable properties and demonstrated efficacy in the Plasmodium berghei infection model, PHT-39 was unable to eradicate L. major infection in a murine infection model of cutaneous leishmaniasis. Currently, PHT-39 is undergoing derivatization to optimize its pharmacological characteristics. Two novel compound series, based on hydroxyethylamine (HEA) and phthalimide (PHT) pharmacophores, previously led to the discovery of antiplasmodial lead compounds, both with therapeutic efficacy in a murine Plasmodium infection model. Here we employed these compound libraries, supplemented with newly designed HEA derivatives, for phenotypic screening against a wide range of protist parasites associated with unmet medical needs. We report potent hit compounds for Entamoeba histolytica, Trypanosoma brucei and Leishmania spp., with limited overlap in their structure-activity relation. PHT-39 efficiently penetrated host macrophages to effectively eliminate Leishmania intracellular amastigotes, while displaying high selectivity. Leveraging an orthology-based genome-wide RNAi library screen, we propose an uptake route for the PHT-39 that relies on a transmembrane flippase, known as crucial uptake transporter for the two frontline antileishmanials miltefosine and amphotericin. Despite favourable drug properties of PHT-39, experimental PHT-39 treatment failed to eliminate the Leishmania infection in a cutaneous leishmaniasis animal model. Considering PHT-39 high selectivity and the ability of the drug to effectively reach the intracellular stage of the parasite, we suggest PHT-39 for further optimization.