title: Protein binding and alpha : beta anomer ratio of dihydroartemisinin in vivo.
abstract: OBJECTIVE
  To determine the ratio of alpha : beta anomers and the protein binding of dihydroartemisinin (DHA) in vivo.
  
  
  METHODS
  10-[(3)H]-DHA was synthesized by reduction of artemisinin with sodium boro-[(3)H]-hydride and purified with preparative thin layer chromatography. A solution of (3)H-DHA (2000 ng in 20 micro l) was added to 2 ml whole blood from 15 healthy volunteers and 22 Vietnamese patients with falciparum or vivax malaria. The blood was centrifuged and the plasma stored at -25 degrees C until analysed by HPLC with radiochromatographic detection. Protein-free ultrafiltrate of the plasma was assayed to determine the free fraction of DHA and the in vivo ratio of alpha-DHA : beta-DHA.
  
  
  RESULTS
  The DHA fraction unbound (mean +/- SD) was 0.068 +/- 0.032 in Vietnamese patients with falciparum malaria (n = 17), 0.065 +/- 0.009 in Vietnamese patients with vivax malaria (n = 5), 0.117 +/- 0.015 in Vietnamese volunteers (n = 7) and 0.092 +/- 0.020 in Caucasian volunteers (n = 8). The ratios of alpha-DHA : beta-DHA for the four groups were 6.3 +/- 0.9, 6.9 +/- 0.8, 6.9 +/- 0.6 and 5.4 +/- 0.8, respectively.
  
  
  CONCLUSIONS
  DHA is approximately 93% protein-bound in patients with malaria infection and there is a preferential existence in vivo of the alpha-DHA anomer. Knowledge of this stereochemistry may be valuable in elucidation of the mechanisms of DHA action and/or toxicity, and in the synthesis of new trioxane antimalarials.
authors.affiliation: Pharmacology Unit, School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia. Kevin.Batty@curtin.edu.au
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Batty
authors.forename: Kenneth F
authors.initials: KF
authors.lastname: Ilett
authors.forename: Timothy M E
authors.initials: TM
authors.lastname: Davis
mesh_terms: D000328:Adult; D000418:Albumins / Q000378:metabolism; D000962:Antimalarials / Q000378:metabolism*; D037621:Artemisinins / Q000378:metabolism*; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy; D008297:Male; D011485:Protein Binding; D012717:Sesquiterpenes / Q000378:metabolism*
chemical_list: D000418:Albumins; D000962:Antimalarials; D037621:Artemisinins; D012717:Sesquiterpenes; C039060:artenimol