title: Desferrithiocin analogue iron chelators: iron clearing efficiency, tissue distribution, and renal toxicity.
abstract: The current solution to iron-mediated damage in transfusional iron overload disorders is decorporation of excess unmanaged metal, chelation therapy. The clinical development of the tridentate chelator deferitrin (1, Table 1) was halted due to nephrotoxicity. It was then shown by replacing the 4'-(HO) of 1 with a 3,6,9-trioxadecyloxy group, the nephrotoxicity could be ameliorated. Further structure-activity relationship studies have established that the length and the position of the polyether backbone controlled: (1) the ligand's iron clearing efficiency (ICE), (2) chelator tissue distribution, (3) biliary ferrokinetics, and (4) tissue iron reduction. The current investigation compares the ICE and tissue distribution of a series of (S)-4,5-dihydro-2-[2-hydroxy-4-(polyether)phenyl]-4-methyl-4-thiazolecarboxylic acids (Table 1, 3-5) and the (S)-4,5-dihydro-2-[2-hydroxy-3-(polyether)phenyl]-4-methyl-4-thiazolecarboxylic acids (Table 1, 8-10). The three most effective polyether analogues, in terms of performance ratio (PR), defined as mean ICE(primate)/ICE(rodent), are 3 (PR 1.1), 8, (PR 1.5), and 9, now in human trials, (PR 2.2). At the onset of the clinical trial on 9, no data were available for ligand 3 or 8. This is unfortunate, as 3 has many advantages over 9, e.g., the ICE of 3 in rats is 2.5-fold greater than that of 9 and analogue 3 achieves very high levels in the liver, pancreas, and heart, the organs most affected by iron overload. Finally, the impact of 3 on the urinary excretion of kidney injury molecule-1 (Kim-1), an early diagnostic biomarker for monitoring acute kidney toxicity, has been carried out in rats; no evidence of nephrotoxicity was found. Overall, the results suggest that 3 would be a far superior clinical candidate to 9.
authors.affiliation: Department of Medicinal Chemistry, University of Florida, JHMHC, Box 100485, Gainesville, FL 32610-0485, USA. rayb@ufl.edu
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Bergeron
authors.forename: Jan
authors.initials: J
authors.lastname: Wiegand
authors.forename: Neelam
authors.initials: N
authors.lastname: Bharti
authors.forename: James S
authors.initials: JS
authors.lastname: McManis
authors.forename: Shailendra
authors.initials: S
authors.lastname: Singh
mesh_terms: D000818:Animals; D002428:Cebus; D015815:Cell Adhesion Molecules / Q000652:urine; D004095:Dihydropyridines / Q000009:adverse effects* / Q000737:chemistry / Q000493:pharmacokinetics*; D005243:Feces / Q000737:chemistry; D007501:Iron / Q000378:metabolism* / Q000652:urine; D007502:Iron Chelating Agents / Q000009:adverse effects* / Q000737:chemistry / Q000493:pharmacokinetics*; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism; D008297:Male; D015394:Molecular Structure; D051381:Rats; D017207:Rats, Sprague-Dawley; D013844:Thiazoles / Q000009:adverse effects* / Q000737:chemistry / Q000493:pharmacokinetics*
chemical_list: D015815:Cell Adhesion Molecules; D004095:Dihydropyridines; D007501:Iron; D007502:Iron Chelating Agents; D013844:Thiazoles; C110936:Havcr1 protein, rat; C050223:desferrithiocin