A new-generation 5-nitroimidazole can induce highly metronidazole-resistant Giardia lamblia in vitro.
The 5-nitroimidazole (NI) compound C17, with a side chain carrying a remote phenyl group in the 2-position of the imidazole ring, is at least 14-fold more active against the gut protozoan parasite Giardialamblia than the 5-NI drug metronidazole (MTR), with a side chain in the 1-position of the imidazole ring, which is the primary drug for the treatment of giardiasis. Over 10 months, lines resistant to C17 were induced in vitro and were at least 12-fold more resistant to C17 than the parent strains. However, these lines had ID(90) values (concentration of drug at which 10% of control parasite ATP levels are detected) for MTR of >200 microM, whilst lines induced to be highly resistant to MTR in vitro have maximum ID(90) values around 100 microM (MTR-susceptible isolates typically have an ID(90) of 5-12.8 microM). The mechanism of MTR activation in Giardia apparently involves reduction to toxic radicals by the activity of pyruvate:ferredoxin oxidoreductase (PFOR) and the electron acceptor ferredoxin. MTR-resistant Giardia have decreased PFOR activity, which is consistent with decreased activation of MTR in these lines, but C17-resistant lines have normal levels of PFOR. Therefore, an alternative mechanism of resistance in Giardia must account for these super-MTR-resistant cells.
Dunn
Linda A
LA
Molecular Genetics Laboratory, Queensland Institute of Medical Research, 300 Herston Road, Brisbane, Qld 4006, Australia.
Burgess
Anita G
AG
Krauer
Kenia G
KG
Eckmann
Lars
L
Vanelle
Patrice
P
Crozet
Maxime D
MD
Gillin
Frances D
FD
Upcroft
Peter
P
Upcroft
Jacqueline A
JA
D000981:Antiprotozoal Agents / Q000494:pharmacology*; D004351:Drug Resistance; D005609:Free Radicals / Q000037:antagonists & inhibitors; D016829:Giardia lamblia / Q000187:drug effects*; D008795:Metronidazole / Q000494:pharmacology*; D009593:Nitroimidazoles / Q000494:pharmacology*; D015800:Protozoan Proteins / Q000378:metabolism; D050743:Pyruvate Synthase / Q000378:metabolism
D000981:Antiprotozoal Agents; D005609:Free Radicals; D009593:Nitroimidazoles; D015800:Protozoan Proteins; D008795:Metronidazole; D050743:Pyruvate Synthase; C052587:4-nitroimidazole
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