Orientador: Prof. Dr. Fabio Furlan Ferreira / Tese (doutorado) - Universidade Federal do ABC, Programa de Pós-Graduação em Nanociências e Materiais Avançados, 2017. / A malária, apesar de ser uma doença tratável, ainda continua causando um grande número de mortes, principalmente no continente africano, sendo considerada uma das doenças parasitárias mais prevalecentes no mundo. A recomendação da organização mundial da saúde (OMS) para o tratamento da malária consiste na utilização de terapia combinada de artemisinina (artemisinin combined therapy - ACT). A ACT visa combinar a artemisinina ou um derivado com outro fármaco antimalárico que tenha um maior tempo de meia-vida e, assim, tornar o tratamento mais eficaz e evitar o aparecimento de resistência dos parasitas aos antimaláricos. O MEFAS é um novo sal híbrido derivado do artesunato e da mefloquina ¿ dois compostos antimaláricos ¿ que apresenta dois mecanismos de ação diferentes e promissoras características que viabiliza a sua utilização no tratamento da malária. Neste contexto, foi realizado um estudo estrutural do MEFAS em estado sólido e foi proposta uma síntese mecanoquímica para sua obtenção. Com o uso da difração de raios X por policristais (DRXP) foi verificado que uma das amostras de MEFAS estudadas, apresenta uma fase amorfa. A estabilidade química do MEFAS também foi estudada, visto que fases amorfas tendem a ser instáveis; os resultados mostraram que o MEFAS se degradou após dezoito meses de armazenamento, formando a diidroartemisinina (DHA). Isto foi evidenciado com o uso das técnicas de espectroscopia vibracional na região do infravermelho por transformada de Fourier (FTIR), ressonância magnética nuclear de estado sólido (RMN) e também pelos dados de DRXP e método de Rietveld. A estabilidade química do MEFAS em solventes orgânicos também foi estudada. Para os solventes testados, o MEFAS demonstrou ser estável quimicamente apenas em éter etílico. Por fim, uma rota de síntese via mecanoquímica é proposta para a obtenção do MEFAS, com a possibilidade de utilização de pequenas quantidades de solventes. Essa é uma boa estratégia, pois é uma rota de síntese mais rápida, comparada com a obtenção do MEFAS via reação química em solução, e ainda é uma síntese considerada "química verde", ou seja, um método sustentável. Os resultados obtidos pelas técnicas de FTIR e RMN indicaram que a síntese mecanoquímica foi promissora na formação do MEFAS, sendo que após quinze minutos de moagem foi obtido o sal hibrido desejado. / Malaria, despite being a treatable disease, still continues to cause a large number of deaths, especially on the African continent, and is considered one of the most prevalent parasitic diseases in the world. The recommendation of the World Health Organization (WHO) for the treatment of malaria is the use of artemisinin combination therapy ¿ ACT. ACT aims to combine artemisinin or derivative with another antimalarial drug that has a longer half-life and thus make treatment more effective and prevent the emergence of parasite resistance to antimalarials. The MEFAS, a new hybrid salt derived from artesunate and mefloquine ¿ two antimalarials compounds ¿ has two different mechanisms of action and presents promising characteristics that make its use feasible in the treatment of malaria. In this context, a structural study of MEFAS in solid state was performed and a mechanochemical synthesis was proposed to obtain this hybrid salt. With the use of X-ray powder diffraction data (XRPD) it was verified that the MEFAS is in the amorphous form. The chemical stability of MEFAS has also been studied, since that the amorphous phases tend to be unstable; the results showed that MEFAS degraded after eighteen months of storage. When degradation of this hybrid salt occurs, dihydroartemisinin (DHA) is formed. This was evidenced by Fourier transform infrared (FTIR) spectroscopy, nuclear magnetic resonance (NMR) as well as by the Rietveld method with X-ray powder diffraction data. Finally, a route of synthesis via mechanochemistry is proposed to obtain the MEFAS, with the possibility of using catalytic amounts of solvents. This is a good strategy and is still a synthesis considered "green chemistry", that is, a more ecologically correct method. The results obtained by FTIR and NMR techniques indicated that the mechanochemical synthesis was promising in the formation of MEFAS, after fifteen minutes of milling the desired hybrid salt was obtained.

Thesis (M. Tech.) - Central University of Technology, Free State, 2007 / Malaria and the mosquito that induces the disease in humans have hounded the military for decades. Malaria represents one of the most important infectious disease threats to deployed military forces. Malaria in soldiers has a serious economic impact, both in terms of lost productivity and treatment cost for the state. A contingent of South African National Defence Force members has been deployed in Burundi since November 2001, as part of a peacekeeping mission. At the time of the study no information was available regarding the prevalence of malaria among military personnel during deployments in Burundi and East Africa. In Africa, the saying is that malaria is the disease of poverty and a cause of poverty. To combat malaria, it is of vital importance that the recommended medication be taken exactly as prescribed and that the course is completed. However, one of the greatest challenges facing the African continent in the present fight against malaria is drug resistance. The discovery of Mefloquine and the subsequent development of suitable drugs, have been intimately associated with military imperatives, contingencies and requirements. Since World War II, the development of Chloroquine-resistant falciparum malaria has driven the search for new drugs. Mefloquine, developed by the Walter Reed Army Institute of Research in the United States, was first shown effective as a prophylaxis and treatment of resistant falciparum malaria in the 1970’s. To obtain data, questionnaires were administered to SANDF soldiers deployed in Burundi, East Africa. The total size of the population under investigation was 336 with a final sample size of 111 respondents. The sample was selected by using simple random sampling. The questionnaire aimed to determine the perception of respondents regarding the malaria threat, their compliance with taking the medication, and their experiencing of possible side-effects which might occur due to the chemoprophylaxis and the prophylactic efficacy of Mefliam®. The fact that, of the 111 people who used Mefliam®, only four presented with any malaria symptoms, is an indicator that Mefliam® is an effective option as an antimalarial drug to be used in East Africa and Burundi. The results of this study will be used by the personnel of the South African National Defence Force (SANDF) and other military forces deployed in East Africa. It is envisaged that the results will be used by military policy- and decision-makers as a control programme and by others involved in the control of malaria. The findings and recommendations should also be of interest to anyone visiting the area.

Malaria affects millions of people annually especially in third world countries. Increase in resistance and limited research being conducted adds to the global burden of malaria. Mefloquine, known for unwanted adverse reactions and neurotoxicity, is highly lipophilic and is still used as treatment and prophylaxis. Lipid drug delivery systems are commonly used to increase solubility and efficacy and decrease toxicity. The most generally used lipid drug delivery system is liposomes. The lipid bilayer structure varying in size from 25 nm to 100 μm can entrap both hydrophilic and lipophilic compounds. Similar in structure and size to liposomes, Pheroid™ technology consist of natural fatty acids and is also able to entrap lipophilic and hydrophilic compounds. The aim of this study was to formulate liposomes and Pheroid™ vesicles loaded with mefloquine and evaluate the physiochemical characteristic of the formulations followed by efficacy and toxicity studies. Pheroid™ vesicles and liposomes with and without mefloquine were evaluated in size, morphology, pH and entrapment efficacy during three month accelerated stability testing. Optimization of size determination by flow cytometry lead to accurate determination of size for both Pheroid™ vesicles and liposomes. During the three months stability testing, Pheroid™ vesicles showed a small change in size from 3.07 ± 0.01 μm to approximately 3 μm for all three temperatures. Confocal laser scanning microscopic evaluation of the liposomes showed structures uniform in spherical shape and size. No difference in size or structure between the Pheroid™ vesicles with and without mefloquine were obtained. Significant increase (p=0.027) in size from 6.46 ± 0.01 μm to above 10 μm was observed for liposomes at all the temperatures. Clearly formed lipid bilayer structures were observed on micrographs. With the addition of mefloquine to the liposome formulation, a decrease in the amount of bilayer structures and an increase in oil droplets were found. Entrapment efficacy was determined by firstly separating the entrapped drug from the unentrapped drug utilizing a Sephadex®G50 mini column. This was followed by spectrophotometric evaluation by UV-spectrophotometry at 283 nm. Initial entrapment efficacy of both Pheroid™ vesicles and liposomes was above 60%. An increase in entrapment efficacy was observed for Pheroid™ vesicles. The addition of mefloquine to already formulated Pheroid™ vesicles illustrated entrapment efficacy of 60.14 ± 5.59% after 14 days. Formulations loaded with mefloquine resulted in lower pH values as well as a decrease in pH over time. Optimization of efficacy studies utilizing propidium iodide was necessary due to the similarity in size and shape of the drug delivery systems to erythrocytes. A gating strategy was successfully implemented for the determination of the percentage parasitemia. Efficacy testing of mefloquine loaded in Pheroid™ vesicles and liposomes showed a 186% and 207% decrease in parasitemia levels compared to the control of mefloquine. Toxicity studies conducted include haemolysis and ROS (reactive oxygen species) analysis on erythrocytes as well as cell viability on mouse neuroblastoma cells. Pheroid™ vesicles with and without mefloquine resulted in a dose dependent increase in ROS and haemolysis over time. A dose dependent increase in ROS and haemolysis in both liposome formulations were observed, but to a lesser extent. Mefloquine proved to be neurotoxic with similar results obtained when mefloquine was entrapped in liposomes. Pheroid™ vesicles seem to have neuroprotective properties resulting in higher cell viability. Mefloquine could be entrapped successfully in Pheroid™ vesicles and less in liposomes. Pheroid™ vesicles was more stable over a three months accelerated stability testing with more favourable characteristics. The increase in ROS levels of Pheroid™ vesicles could be responsible for the higher efficacy and haemolytic activity. DL-α-Tocopherol in Pheroid™ vesicles possibly acted as a pro-oxidant due to the presence of iron in the erythrocytes. DL-α-Tocopherol showed possible antioxidant properties in the neurotoxicity evaluation resulting in higher cell viability. Even though liposomes illustrated higher efficacy and little haemolysis and ROS production, no difference in neurotoxicity was observed together with unfavourable properties during stability testing makes this drug delivery system less favourable in comparison to Pheroid™ vesicles. Mefloquine was successfully incorporated into Pheroid™ vesicles resulted in high efficacy and showed possible neuroprotection and therefore makes it an ideal system for treatment of malaria. / Thesis (Ph.D. (Pharmaceutics))--North-West University, Potchefstroom Campus, 2011

Malaria affects millions of people annually especially in third world countries. Increase in resistance and limited research being conducted adds to the global burden of malaria. Mefloquine, known for unwanted adverse reactions and neurotoxicity, is highly lipophilic and is still used as treatment and prophylaxis. Lipid drug delivery systems are commonly used to increase solubility and efficacy and decrease toxicity. The most generally used lipid drug delivery system is liposomes. The lipid bilayer structure varying in size from 25 nm to 100 μm can entrap both hydrophilic and lipophilic compounds. Similar in structure and size to liposomes, Pheroid™ technology consist of natural fatty acids and is also able to entrap lipophilic and hydrophilic compounds. The aim of this study was to formulate liposomes and Pheroid™ vesicles loaded with mefloquine and evaluate the physiochemical characteristic of the formulations followed by efficacy and toxicity studies. Pheroid™ vesicles and liposomes with and without mefloquine were evaluated in size, morphology, pH and entrapment efficacy during three month accelerated stability testing. Optimization of size determination by flow cytometry lead to accurate determination of size for both Pheroid™ vesicles and liposomes. During the three months stability testing, Pheroid™ vesicles showed a small change in size from 3.07 ± 0.01 μm to approximately 3 μm for all three temperatures. Confocal laser scanning microscopic evaluation of the liposomes showed structures uniform in spherical shape and size. No difference in size or structure between the Pheroid™ vesicles with and without mefloquine were obtained. Significant increase (p=0.027) in size from 6.46 ± 0.01 μm to above 10 μm was observed for liposomes at all the temperatures. Clearly formed lipid bilayer structures were observed on micrographs. With the addition of mefloquine to the liposome formulation, a decrease in the amount of bilayer structures and an increase in oil droplets were found. Entrapment efficacy was determined by firstly separating the entrapped drug from the unentrapped drug utilizing a Sephadex®G50 mini column. This was followed by spectrophotometric evaluation by UV-spectrophotometry at 283 nm. Initial entrapment efficacy of both Pheroid™ vesicles and liposomes was above 60%. An increase in entrapment efficacy was observed for Pheroid™ vesicles. The addition of mefloquine to already formulated Pheroid™ vesicles illustrated entrapment efficacy of 60.14 ± 5.59% after 14 days. Formulations loaded with mefloquine resulted in lower pH values as well as a decrease in pH over time. Optimization of efficacy studies utilizing propidium iodide was necessary due to the similarity in size and shape of the drug delivery systems to erythrocytes. A gating strategy was successfully implemented for the determination of the percentage parasitemia. Efficacy testing of mefloquine loaded in Pheroid™ vesicles and liposomes showed a 186% and 207% decrease in parasitemia levels compared to the control of mefloquine. Toxicity studies conducted include haemolysis and ROS (reactive oxygen species) analysis on erythrocytes as well as cell viability on mouse neuroblastoma cells. Pheroid™ vesicles with and without mefloquine resulted in a dose dependent increase in ROS and haemolysis over time. A dose dependent increase in ROS and haemolysis in both liposome formulations were observed, but to a lesser extent. Mefloquine proved to be neurotoxic with similar results obtained when mefloquine was entrapped in liposomes. Pheroid™ vesicles seem to have neuroprotective properties resulting in higher cell viability. Mefloquine could be entrapped successfully in Pheroid™ vesicles and less in liposomes. Pheroid™ vesicles was more stable over a three months accelerated stability testing with more favourable characteristics. The increase in ROS levels of Pheroid™ vesicles could be responsible for the higher efficacy and haemolytic activity. DL-α-Tocopherol in Pheroid™ vesicles possibly acted as a pro-oxidant due to the presence of iron in the erythrocytes. DL-α-Tocopherol showed possible antioxidant properties in the neurotoxicity evaluation resulting in higher cell viability. Even though liposomes illustrated higher efficacy and little haemolysis and ROS production, no difference in neurotoxicity was observed together with unfavourable properties during stability testing makes this drug delivery system less favourable in comparison to Pheroid™ vesicles. Mefloquine was successfully incorporated into Pheroid™ vesicles resulted in high efficacy and showed possible neuroprotection and therefore makes it an ideal system for treatment of malaria. / Thesis (Ph.D. (Pharmaceutics))--North-West University, Potchefstroom Campus, 2011

The aim of the two studies presented here was to evaluate the effects of cocaine and mefloquine (MFQ) on γ-aminobutyric acid (GABA) and dopamine (DA) neurons in the ventral tegmental area (VTA). Cocaine: In vivo, lower doses of intravenous cocaine (0.25-0.5 mg/kg), or methamphetamine (METH), enhanced VTA GABA neuron firing rate via D2/D5 receptor activation. Higher cocaine doses (1.0-2.0 mg/kg) inhibited their firing rate. Cocaine and lidocaine inhibited the firing rate and spike discharges induced by stimulation of the internal capsule (ICPSDs) at dose levels 0.25-2 mg/kg (IC50 1.2 mg/kg), but neither DA nor METH reduced ICPSDs. In VTA GABA neurons in vitro, cocaine reduced (IC50 13 µM) current-evoked spikes and sodium currents in a use-dependent manner. In VTA DA neurons, cocaine reduced IPSCs (IC50 13 µM), increased IPSC paired-pulse facilitation, and decreased sIPSC frequency, without affecting mIPSC frequency or amplitude. These findings suggest cocaine reduces activity-dependent GABA release on DA neurons in the VTA, and that cocaine's use-dependent blockade of VTA GABA neuron voltage-sensitive sodium channels (VSSCs) may synergize with its DAT inhibiting properties to enhance mesolimbic DA transmission implicated in cocaine reinforcement. Mefloquine: Mefloquine (MFQ) is an anti-malarial agent, Connexin-36 (Cx36) gap junction blocker, 5-HT3 antagonist, and calcium ionophore. Mounting evidence of a Cx36-mediated VTA GABA neuron syncytium suggests MFQ-related dysphoria may attribute to its gap junction blocking effects on VTA synaptic homeostasis. We observed that MFQ (25 µM) increased DA neuron spontaneous IPSC frequency 6 fold, and mIPSC 3 fold. Carbenoxolone (CBX, 100 µM) only increased sIPSC frequency 2 fold, and did not affect DA mIPSC frequency. Ondansetron did not mimic MFQ. Additionally, MFQ did not affect VTA DA evoked IPSC paired pulse ratio (PPR). However, Mefloquine did induce a 3.5 fold increase in bath-applied GABA current. Remarkably, MFQ did not affect VTA GABA neuron inhibition. At VTA DA neuron excitatory synapses MFQ increased sEPSC frequency in-part due to an increase in the AMPA/NMDA ratio. These finding suggest MFQ alters VTA synapses differentially depending on neuron and synapse type, and that these alterations appear to involve MFQ's gap junction blocking and calcium ionophore actions.

A mefloquina (MQ), fármaco utilizado na profilaxia e tratamento da malária ocasionada por Plasmodium falciparum resistente à cloroquina, é comercializada na forma racêmica. Apresenta disposição cinética estereosseletiva e ação farmacológica diferencial entre os enantiômeros. A maioria dos métodos analíticos desenvolvidos para análise do fármaco em plasma utiliza como técnicas de preparação das amostras, a extração líquido-líquido ou a extração em fase sólida. Por outro lado, a microextração em fase líquida (LPME), técnica recentemente desenvolvida, pode oferecer resultados bastante satisfatórios para amostras complexas, como fluidos biológicos. Portanto, o presente trabalho teve por finalidade o desenvolvimento e validação de um método analítico empregando a cromatografia líquida de alta eficiência com fases estacionárias quirais juntamente com a LPME para a análise enantiosseletiva da MQ em plasma. Empregando-se a coluna Chiralpak AD com fase móvel constituída por hexano/etanol/DEA (97:3:0,05, v/v/v), obteve-se a separação dos enantiômeros da MQ, com tempos de retenção reduzidos e resolução apropriada. Utilizando-se uma membrana capilar de polipropileno, juntamente com éter diexílico (fase orgânica) e ácido perclórico 10 mmol L-1 (fase aceptora) como componentes do sistema de três fases, obteve-se excelente isolamento dos interferentes endógenos aliado a um enriquecimento satisfatório dos analitos, sendo então possível a validação do método desenvolvido. A metodologia otimizada apresentou linearidade satisfatória no intervalo de 50 ? 1500 ng mL-1 com coeficientes de determinação > 0,998 para ambos enantiômeros. Os valores de recuperação absoluta de (-)-(SR)-MQ e (+)-(RS)-MQ foram 33,2% e 35,0%, respectivamente. Precisão e exatidão, avaliadas por estudos intra-ensaio e interensaio, foram < 15% para ambos enantiômeros. Além disso, não foram observadas racemização ou degradação do fármaco durante a preparação das amostras e análise cromatográfica. Posteriormente, o método desenvolvido e validado foi aplicado em um estudo-piloto de disposição cinética em ratos. Verificou-se que a disposição cinética da MQ em ratos foi estereosseletiva, já que maiores concentrações de (+)-(RS)-MQ foram obtidas em todos os tempos de análise avaliados. / Mefloquine (MQ), a drug used for prophylaxis and treatment of malaria caused by chloroquine-resistant strains of Plasmodium falciparum, is commercialized as a racemic mixture. MQ enantiomers demonstrate differential stereoselective dispositions and pharmacodynamic actions. The majority of methods developed for the determination of mefloquine in plasma includes liquid-liquid or solid-phase extraction as sample preparation. On the other hand, liquid-phase microextraction (LPME), a recently developed technique, may offer satisfactory results for complex matrices, such as biological fluids. Therefore, the aim of this work was to develop and validate an analytical method using chiral high-performance liquid chromatography combined with LPME for the enantioselective analysis of MQ in plasma. Employing a Chiralpak AD column with hexane/ethanol/DEA (97:3:0.05, v/v/v) as mobile phase, separation of MQ enantiomers was achieved with short retention times and appropriate resolution. Using a polypropylene-based capillary membrane together with di-n-hexyl ether (organic phase) and 10 mmol L-1 perchloric acid (acceptor phase) as components of a three-phase system, an excelent clean-up of endogenous interferents, allied with a satisfactory enrichment of analytes, was obtained, which allowed method validation. The optimized methodology exhibited good linearity over a 50 - 1500 ng mL-1 range with correlation coefficients of > 0.998 for both enantiomers. The mean recoveries of (-)-(SR)-MQ and (+)-(RS)-MQ were 33.2 and 35.0%, respectively. Precision and accuracy, demonstrated by within-day and between-day assays, were lower than 15% for both enantiomers. Furthermore, no racemization or degradation were seen during sample preparation and chromatographic analysis. Finally, the developed and validated method was applied to a pilot pharmacokinetic assay in rats. An enantiosselective kinetic disposition of MQ enantiomers was observed in rat plasma, as concentrations of (+)-(RS)-MQ were greater than its antipode at all measured times.

Im Rahmen dieses Promotionsprojektes wurde ein neues, chirales Orientierungsmedium zur Enantiomerenunterscheidung chiraler Amine vorgestellt. Ausgehend von dem enantiomerenreinen (R)- oder (S)-konfigurierten beta-Aminoalkohol, wurde in einer fünfstufigen Synthese (R)- respektive (S)-2-Acrylamido-2-phenylethansulfonsäure ((R)- / (S)-APhES), das zugrundeliegende chirale Monomer dieses neuen Polymergel-basierten Orientierungsmediums, hergestellt. Die daraus resultierenden chiralen Polymergele sind somit in beiden enantiomeren Formen zugänglich. Während die bisher existenten chiralen Orientierungsmedien auf wässrige Lösungen oder apolare organische Lösungsmittel beschränkt waren, zeichnet sich das neue Polymergel durch exzellente Quell- und Orientierungseigenschaften in polaren Lösungsmitteln, wie DMSO, DMF, MeOH und Wasser aus. Im Gegensatz zu den flüssigkristallinen Orientierungsmedien gibt es keine minimale, kritische Konzentration, sodass die Orientierungsstärke, je nach Bedarf, über einen weiten Bereich skaliert werden kann. Neben den exzellenten Orientierungseigenschaften, zeichnet sich dieses neue chirale Polymergel aber hauptsächlich durch seine enantiodiskriminierende Fähigkeit aus. So konnten die beiden Enantiomere des erythro-Mefloquin Hydrochlorids auf Grund unterschiedlicher dipolarer Restkopplungen (RDCs) erfolgreich unterschieden werden. Anhand von Strychnin Hydrochlorid und Menthylamin Hydrochlorid wurde das enantiodiskriminierende Potential der APhES-Gele an zwei weiteren Beispielen erfolgreich demonstriert. In einem unabhängigen Nebenprojekt konnte die absolute Konfiguration von erythro-Mefloquin Hydrochlorid, dem Wirkstoff eines hochrelevanten Anti-Malaria-Medikamentes, erfolgreich bestimmt werden. Bei dem racemisch eingesetzten Wirkstoff wurden seit dessen Entwicklung und besonders im vergangenen Jahrzehnt immer wieder kontroverse Strukturvorschläge bezüglich der absoluten Konfiguration publiziert. Da die beiden etablierten Methoden zur Bestimmung der absoluten Konfiguration, d.h. Totalsynthese oder Kristallstrukturanalyse, zu entgegengesetzten Ergebnissen führten, wurde im Rahmen dieser Promotion eine interdisziplinäre Methode gewählt, bestehend aus den spektroskopischen Verfahren NMR, ORD und ECD in Kombination mit quantenmechanischen DFT-Rechnungen. Basierend auf diesem Ansatz wurde die absolute Konfiguration von (–)-erythro-Mefloquin Hydrochlorid eindeutig als 11R,12S bestimmt. Dieses Ergebnis wurde kurze Zeit später, ebenfalls in dieser Abteilung, durch zwei unabhängige synthetische respektive synthetisch/analytische Methoden bestätigt.

A mefloquina (MQ), fármaco utilizado na profilaxia e tratamento da malária ocasionada por Plasmodium falciparum resistente à cloroquina, é comercializada na forma racêmica. Apresenta disposição cinética estereosseletiva e ação farmacológica diferencial entre os enantiômeros. A maioria dos métodos analíticos desenvolvidos para análise do fármaco em plasma utiliza como técnicas de preparação das amostras, a extração líquido-líquido ou a extração em fase sólida. Por outro lado, a microextração em fase líquida (LPME), técnica recentemente desenvolvida, pode oferecer resultados bastante satisfatórios para amostras complexas, como fluidos biológicos. Portanto, o presente trabalho teve por finalidade o desenvolvimento e validação de um método analítico empregando a cromatografia líquida de alta eficiência com fases estacionárias quirais juntamente com a LPME para a análise enantiosseletiva da MQ em plasma. Empregando-se a coluna Chiralpak AD com fase móvel constituída por hexano/etanol/DEA (97:3:0,05, v/v/v), obteve-se a separação dos enantiômeros da MQ, com tempos de retenção reduzidos e resolução apropriada. Utilizando-se uma membrana capilar de polipropileno, juntamente com éter diexílico (fase orgânica) e ácido perclórico 10 mmol L-1 (fase aceptora) como componentes do sistema de três fases, obteve-se excelente isolamento dos interferentes endógenos aliado a um enriquecimento satisfatório dos analitos, sendo então possível a validação do método desenvolvido. A metodologia otimizada apresentou linearidade satisfatória no intervalo de 50 ? 1500 ng mL-1 com coeficientes de determinação > 0,998 para ambos enantiômeros. Os valores de recuperação absoluta de (-)-(SR)-MQ e (+)-(RS)-MQ foram 33,2% e 35,0%, respectivamente. Precisão e exatidão, avaliadas por estudos intra-ensaio e interensaio, foram < 15% para ambos enantiômeros. Além disso, não foram observadas racemização ou degradação do fármaco durante a preparação das amostras e análise cromatográfica. Posteriormente, o método desenvolvido e validado foi aplicado em um estudo-piloto de disposição cinética em ratos. Verificou-se que a disposição cinética da MQ em ratos foi estereosseletiva, já que maiores concentrações de (+)-(RS)-MQ foram obtidas em todos os tempos de análise avaliados. / Mefloquine (MQ), a drug used for prophylaxis and treatment of malaria caused by chloroquine-resistant strains of Plasmodium falciparum, is commercialized as a racemic mixture. MQ enantiomers demonstrate differential stereoselective dispositions and pharmacodynamic actions. The majority of methods developed for the determination of mefloquine in plasma includes liquid-liquid or solid-phase extraction as sample preparation. On the other hand, liquid-phase microextraction (LPME), a recently developed technique, may offer satisfactory results for complex matrices, such as biological fluids. Therefore, the aim of this work was to develop and validate an analytical method using chiral high-performance liquid chromatography combined with LPME for the enantioselective analysis of MQ in plasma. Employing a Chiralpak AD column with hexane/ethanol/DEA (97:3:0.05, v/v/v) as mobile phase, separation of MQ enantiomers was achieved with short retention times and appropriate resolution. Using a polypropylene-based capillary membrane together with di-n-hexyl ether (organic phase) and 10 mmol L-1 perchloric acid (acceptor phase) as components of a three-phase system, an excelent clean-up of endogenous interferents, allied with a satisfactory enrichment of analytes, was obtained, which allowed method validation. The optimized methodology exhibited good linearity over a 50 - 1500 ng mL-1 range with correlation coefficients of > 0.998 for both enantiomers. The mean recoveries of (-)-(SR)-MQ and (+)-(RS)-MQ were 33.2 and 35.0%, respectively. Precision and accuracy, demonstrated by within-day and between-day assays, were lower than 15% for both enantiomers. Furthermore, no racemization or degradation were seen during sample preparation and chromatographic analysis. Finally, the developed and validated method was applied to a pilot pharmacokinetic assay in rats. An enantiosselective kinetic disposition of MQ enantiomers was observed in rat plasma, as concentrations of (+)-(RS)-MQ were greater than its antipode at all measured times.

Worldwide, malaria is one of the deadliest diseases. In 2016 it sickened 216 million people and caused 445,000 deaths. In order to control the spread of this deadly diseases to human, we can either target the mosquito vector (Anopheles gambiae) or the parasite (Plasmodium falciparum). Due to recent emergence of resistance to current insecticides and antimalarial drugs there is a pressing need to discover and develop new agents that engage new targets in these organisms. To circumvent the effect of resistance to pyrethroid insecticides on the efficacy of insecticide treated nets (ITNs), the use of acetylcholinesterase (AChE) inhibitors on ITNs has drawn attention. In the first project, we explored a small library of γ- substituted oxoisoxazole- 2(3H)-carboxamides and isoxazol-3-yl carbamates, and nitriles as AChE inhibitors targeting wild- type (G3) and resistant (Akron) An. gambiae mosquito. In total 23 compounds were synthesized and evaluated. Both carbamates and carboximides with a 2-cyclopropylethyl side chain (1-87a and 1-88a) were extremely toxic to Akron mosquitos, yet these compounds did not exhibit appreciable selectivity between human and An. gambiae AChE. Unfortunately, none of the nitriles showed appreciable toxicity to G3 strain of the mosquitoes, nor did they inhibit An. gambiae AChE. In the second project, conducted in collaboration with Professor Michael Klemba, we focused on the mode of action of an established antimalarial drug, Mefloquine (MQ). Dr. Klemba's recently developed amino acid efflux assay was used to determine the effect of MQ and its open-ring analogs on hemoglobin endocytosis and catabolism in P. falciparum-infected erythrocytes. In total 26 MQ analogs were synthesized and 18 were studied in depth to determine their potency to inhibit leucine (Leu) efflux and parasite growth (SYBR Green). An excellent correlation (R² = 0.98) over nearly 4 log units was seen for these 18 compounds in the two assays. These data are consistent with the hypothesis that the antimalarial action of these compounds principally derives from inhibition of hemoglobin endocytosis. After this observation, a number of photo-affinity probes were designed and synthesized in hopes of isolating the molecular target of MQ. These analogs are currently being used by Dr. Klemba in pull-down experiments. In the third project, conducted in collaboration with Professor Belen Cassera, we sought to optimize a new antimalarial drug lead that would circumvent current resistance mechanisms. In Plasmodium parasites, the methylerythritol phosphate (MEP) pathway is known to be essential for its growth. This pathway is absent in humans, presenting the opportunity to develop potentially safe and effective therapeutic candidates. Previous work in the Cassera and Carlier lab had established that MMV008138 was the only compound in the Malaria Box that targeted the MEP pathway and that it was (1R,3S)-configured. My research expanded previous efforts in the Carlier group and produced synthesis of 73 analogs of MMV008138 (3-21a'1) that were tested for growth inhibition. These analogs featured variation at the A-, B-, C- and D-ring. In the process, a novel Pictet-Spengler ring expansion reaction of ortho-substituted acetphenones was discovered. The ring-expanded products were identified by means of 1D and 2D NMR experiments, HRMS, and X-ray crystallography. Among the 73 analogs prepared, four compounds showed similar growth inhibition potency to the lead 3-21a'1. In particular, the methoxyamide 3-80a, and the fluorinated A-ring analogs 3-124a, 3-124c and 3-124d all showed excellent (500-700 nM) growth IC₅₀ values against P. falciparum. All four showed full rescue upon co-application of IPP (200 μM), confirming that they target the MEP pathway. ADME-Tox evaluation of these new analogs will soon be underway. / PHD

Malaria affects about forty percent of the world’s population. Annually more than 1.5 million fatalities due to malaria occur and parasite resistance to existing antimalarial drugs such as mefloquine has already reached disturbingly high levels in South-East Asia and on the African continent. Consequently, there is a dire need for new drugs or formulations in the prophylaxis and treatment of malaria. Artesunate, an artemisinin derivative, represents a new category of antimalarials that is effective against drug-resistant Plasmodium falciparum strains and is of significance in the current antimalarial campaign. As formulating an ACT double fixed-dose combination is technically difficult, it is essential that fixed-dose combinations are shown to have satisfactory ingredient compatibility, stability, and dissolution rates similar to the separate oral dosage forms. Since the general deployment of a combination of artesunate and mefloquine in 1994, the cure rate increased again to almost 100% from 1998 onwards, and there has been a sustained decline in the incidence of Plasmodium falciparum malaria in the experimental studies (Nosten et al., 2000:297; WHO, 2010:17). However, the successful formulation of a solid oral dosage form and fixed dosage combination of artesunate and mefloquine remains both a market opportunity and a challenge. Artesunate and mefloquine both exhibited poor flow properties. Furthermore, different elimination half-lives, treatment dosages as well as solubility properties of artesunate and mefloquine required different formulation approaches. To substantiate the FDA’s pharmaceutical quality by design concept, the double fixed-dose combination of artesunate and mefloquine required strict preliminary formulation considerations regarding compatibility between excipients and between the APIs. Materials and process methods were only considered if theoretically and experimentally proved safe. Infrared absorption spectroscopy (IR) and X-ray powder diffraction (XRPD) data proved compatibility between ingredients and stability during the complete manufacturing process by a peak by peak correlation. Scanning Electron Micrographs (SEM) provided explanations for the inferior flow properties exhibited by the investigated APIs. Particle size analysis and SEM micrographs confirmed that the larger, rounder and more consistently sized particles of the granulated APIs contributed to improved flow under the specified testing conditions. A compressible mixture containing 615 mg of the APIs in accordance with the WHO recommendation of 25 mg/kg of mefloquine taken in two or three divided dosages, and 4 mg/kg/day for 3 days of artesunate for uncomplicated falciparum malaria was developed. Mini-tablets of artesunate and mefloquine were compressed separately and successfully with the required therapeutic dosages and complied with pharmacopoeial standards. Preformulation studies eventually led to a formula for a double fixed-dose combination and with the specific aim of delaying the release of artesunate due to its short half-life. A factorial design revealed the predominant factors contributing to the successful wet granulation of artesunate and mefloquine. A fractional factorial design identified the optimum factors and factor levels. The application of the granulation fluid (20% w/w) proved to be sufficient by a spraying method for both artesunate and mefloquine. A compatible acrylic polymer and coating agent for artesunate, Eudragit® L100 was employed to delay the release of approximately half of the artesunate dose from the double fixed-dose combination tablet until a pH of 6.8. A compressible mixture was identified and formulated to contain 200 mg of artesunate and 415 mg of mefloquine per tablet. The physical properties of the tablets complied with BP standards. An HPLC method from available literature was adapted and validated for analytical procedures. Dissolution studies according to a USP method were conducted to verify and quantify the release of the APIs in the double fixed-dose combination. The initial dissolution rate (DRi) of artesunate and mefloquine in the acidic dissolution medium was rapid as required. The enteric coated fraction of the artesunate exhibited no release in an acidic environment after 2 hours, but rapid release in a medium with a pH of 6.8. The structure of the granulated particles of mefloquine may have contributed to its first order release profile in the dissolution mediums. A linear correlation was present between the rate of mefloquine release and the percentage of mefloquine dissolved (R2 = 0.9484). Additionally, a linear relationship was found between the logarithm of the percentage mefloquine remaining against time (R2 = 0.9908). First order drug release is the dominant release profile found in the pharmaceutical industry today and is coherent with the kinetics of release obtained for mefloquine. A concept pre-clinical phase, double fixed-dose combination solid oral dosage form for artesunate and mefloquine was developed. The double fixed-dose combination was designed in accordance with the WHO’s recommendation for an oral dosage regimen of artesunate and mefloquine for the treatment of uncomplicated falciparum malaria. The specifications of the double fixed-dose combination were developed in close accordance with the FDA’s quality by design concept and WHO recommendations. An HPLC analytical procedure was developed to verify the presence of artesunate and mefloquine. The dissolution profiles of artesunate and mefloquine were investigated during the dissolution studies. / PhD (Pharmaceutics), North-West University, Potchefstroom Campus, 2014