Paul Bowyer. (Baker Lab, London School of Hygiene and Tropical Medicine)

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Evaluation of selective inhibitors of the malarial cyclic GMP dependent protein kinase (PKG) Paul Bowyer (Baker Lab, London School of Hygiene and Tropical Medicine)

Talk summary An overview of the P. falciparum cgmp dependent protein kinase (PfPKG) Why we think that PfPKG is a good drug target The strategy we are using to evaluate selective inhibitors of PfPKG

PF14_0346 : cgmp dependent protein kinase Ser / Thr kinase : Transfers phosphate group from ATP to protein target(s) 3 cgmp binding sites (and a fourth pseudo site) Catalytic domain (ATP binding pocket) cgmp cgmp cgmp Catalytic domain ATP binding pocket catalyses transfer of phosphate p to substrate pp peptide /protein O F O O P O O H H O Allosteric activation by cgmp H O PfPKG has a small gatekeeper residue Addition of a large amino acid at the entrance to the ATP binding pocket will confer insensitivty to some inhibitors Threonine 618 replace by glutamine (T618Q) Recombinant enzyme and parasitelines bearing this mutation have been created Recombinant enzyme and parasite lines bearing this mutation have been created within the Baker lab over several years Using these molecular tools we are aiming to develop improved inhibitors that are both selective and specific for the ATP binding pocket of PfPKG

The cgmp dependent protein kinase of P. falciparum performs critical roles throughout the life cycle Blood stage schizonticide In the absence of PKG parasites rupture of do bloodstage not escape schizonts liver merosomes is blocked

In the absence of PKG rupture of bloodstage schizonts is blocked Asexual stage parasites, in the presence of PKG inhibitors, form mature schizonts that are unable to rupture (left). Untreated cultures proceed progress normally (right) PKG inactivated schizont rupture blocked Active PKG Schizont rupture to continue asexual cycle Parasites trapped within the red blood cell PKG inhibition at this stage could provide a blood stage schizonticide This phenotype is not shown in cell lines bearing the T618Q mutant PfPKG

PKG inhibition blocks rupture of late stage schizonts in < 1hr Parasites with PKG inhibited proceed through the bloodstage but do not rupture. This assay measures how quickly invasion of new red blood cells is prevented. ± Inhibitor Invasion assay: Allow varying time for invasion i Count infected rbc s schizont merozoite release red blood cell invasion ring stage parasite Percent cells inv vaded 60.0 50.0 40.0 30.0 20.0 10.0 Compound 2 (1 um) Artemisinin (1 um) one Within 1 hour rupture and reinvasion events are blocked by thepkg inhibitor (compound 2) Even over the course of 3 hours artemisinin treated parasites arerupturing rupturing and re invading 0.0 30 min 1 hr 3 hr 20 hr

The cgmp dependent protein kinase of P. falciparum performs critical roles throughout the life cycle In the absence of PKG rounding up of gametocytes is blocked Transmission blocking potential

Compound 1 inhibits gamete formation at the first step XA activated gametocytes Compound 1-treated gametocytes cannot round up + Compound 1 Untreated 100 100 WT QPKG % rounding up 80 60 % rounding up 40 20 Wild type T618Q mutant 0 XA ZAP XA ZAP Untreated compound 1 (DMSO) (2 µm) Louisa McRobert et al., 2008 PLoS Biology The effects of compound 1 on rounding up are abolished in the T618Q mutant confirming that PKG is the primary target of the inhibitor and that PKG is essential for gametogenesis

Strategy to develop potent and selective inhibitors of PfPKG In all of this work we use the gatekeeper mutation to confirm PKG is the primary target Recombinant proteins: WTPfPKG and T618Q PfPKG gatekeeper mutant both produced in E. coli Parasite lines: P. falciparum line bearing T618Q mutation in PfPKG as well as parent line Drug resistant lines against common anti malarials Screen against recombinant PfPKG produced din E. coli Test against cultured P. falciparum Test against P. berghei mouse model

A fluorescence shift assay for PKG This assay tests activity against purified protein (WT PfPKG and T618Q PfPKG) Runs on EZ Reader platform Use a 6 carboxyfluorescein labelled peptide (FAM) substrate and microfluidic detection system to detect phosphorylation due to PKG. Product will migrate more quickly than substrate in capillary Measure area under curve to determine degree of reaction with different concentrations of inhibitors A single reaction could look like this: Fluorescence intensity Time

PF14_0346 : cgmp dependent protein kinase cgmp cgmp cgmp Catalytic domain ATP binding pocket catalyses transfer of phosphate to substrate peptide /protein O H O H O O P O O H O Allosteric activation by cgmp Addition of a large amino acid at the entrance to the ATP binding pocket will confer insensitivty to some inhibitors Threonine 618 replace by glutamine (T618Q)

Evaluation of WT PfPKG and T618Q PfPKG (gatekeeper mutant)

cgmp analogues can also activate PfPKG PET cgmp has similar effectiveness to cgmp. May present options to control activation of cgmp in parasite culture Analogues with substituents in the 8 position are much less effective analogue (µm) Km cgmp 14 12 10 8 6 4 2 0

Single point discontinuous assay employed for inhibitor screening Discontinuous assay for inhibitors of WT and mutant PfPKG. Use 1.25 nm enzyme, 1.5 µm peptide substrate, 10 µm cgmp, varied inhibitor Pre incubate for 30 min Initiate with ATP (at Km for each enzyme) WT enzyme Gatekeeper mutant

An activator of the T618Q PfPKG mutant In the course of screening compounds that appear to activate the gatekeeper mutant of PfPKG have been identified Kinetic analysis revealed increase Vmax but no change to Km cgmp Percent act tivity remainin ng Rate 0.04 400 0.02 200 o Activator compound 10 Inhibitor um activator 0 0.001 0 2000 0.01 4000 [cgmp] [Inhibitor] 0.1 6000 um 1 8000 10 10000 100

Benefits of the EZ Reader based assay Excellent sensitivity and no radiation Inhibitor testing has identified inhibitors with ca. 200 pm IC 50 values Multiple sampling from single well allows easy simple kinetic analyses Endpoint screening assay suitable for HTS Good agreement with GFC assay

Strategy to develop potent and selective inhibitors of PfPKG Screen against recombinant PfPKG produced in E. coli Test against cultured Test against P. berghei P. falciparum mouse model In all of this work we use the gatekeeper mutation to confirm PKG is the primary target Recombinant proteins: WTPfPKG and T618Q PfPKG gatekeeper mutant both produced in E. coli Parasite lines: P. falciparum line bearing T618Q mutation in PfPKG as well as parent line Drug resistant lines against common anti malarials 3 H hypoxanthine incorporation assay Flow cytometry based assay

P. falciparum replication assay also shows reduced sensitivity in mutant line Culture parasites in the presence of compounds for 48 hours Add 3 H hypoxanthine for a further 24 hours Measure radiation incorporated as a percent of uninfected controls 48hr Absolute IC 50 values are ca. 100 fold greater in parasite assay compared to recombinant protein assay (2 3 nm vs enzyme, 200 300 nm vs parasite) The IC 50 shift observed with mutant is much smaller than in the enzyme assay Ca. 20 fold vs 3000 fold It is likely there are additional targets in the parasite but shift suggests that PKG is the main target.

PfPKG inhibition blocks rupture of schizont: Accumulation of DA rich cells P. falciparum replication can also be assessed by flow cytometry B Using cultures labelled with SYBR green it is possible to visualise the quantify of DA in any given cell 48hr Mean fluorescence intensity shifts as parasite DA replication occurs A tensity Me ean fluorescence in 6000 5000 4000 3000 2000 1000 0 A Start B Finish

Compound 2 50 µm Cell death Compound 2 5 µm Schizont accumulation Compound 2 500 nm Schizont accumulation Compound 2 50 nm o effect, some schizonts but many ring stages Compound 2 50 µm Cell death 160 Compound 2 5 µm Schizont accumulation Compound 2 500 nm Schizont accumulation Plot mean fluorescence of infected cells at each concentration Mean fluorescecne 140 120 100 80 60 40 Fluorescence 20 0 Compound 2 50 nm o effect, some schizonts but many ring stages DA rich population accumulates when PfPKG is inhibited Concentration (nm)

Comparison of mean fluorescence (DA) with infected cells : Artemisinin Infected cells (black bar) can be used to determine IC 50 whilst blue bars represent mean fluorescence of cell o change in mean fluorescence irrespective of replication status

Comparison of mean fluorescence (DA) with infected cells : Compound 2 Infected cells (black bar) can be used to determine IC 50 whilst blue bars represent mean fluorescence of cell Mean fluorescence increase at high dose while number of infected cells does not/ Consistent with continued development within cycle but not rupture and progression to the next

Parasite testing of PfPKG inhibitors Selectivity of PfPKG inhibitors can be measured using the parasite line bearing the T618Q mutant as well as by phenotype analysis using flow cytometry PfPKG inhibitors are generally 100 fold less active against the whole parasite than they are against the wild type enzyme Selectivity of WT PfPKG P. falciparum over the T618Q PfPKG line is greatly reduced compared to the recombinant enzyme. Likely due to non PfPKG targets in the parasite

In vivo testing (mouse model) Compound 2 treatment gives a small reduction in parasitemia in the mouse model Half life is ca. 50 minutes Inhibition of PKG is effective for only a small window during parasite egress It is likely that insufficient compound levels were maintained throughout h the experiment

Conclusions Selective inhibition of PfPKG may have potential to block the parasite lifecycle at multiple stages: Escape from liver cells (in human host) Escape from red blood cells (in human host) Rounding up of gametocytes (in mosquito) Gatekeeper mutants of PfPKGhavebeen used to demonstrate selectivity and confirm parasite phenotypes T618Q gatekeeper provides ca. 2000 fold reduction in sensitivity to compounds T618Q PfPKG provides ca. 20 fold reduction in compound sensitivity iii in culture Primary screen: Enzyme specificity and selectivity using kinase assay on EZ Reader Lower limit of assay sensitivity not yet reached (currently IC50 ~ 200 pm) Secondary screen: Anti parasite activity in cultured P. falciparum using gatekeeper mutants and phenotype analysis Tertiary screen: Plasmodium berghei malaria model

Acknowledgements David Baker Catherine Kettleborough Lindsay Stewart Andrew Merritt Keith Ansell Helen Taylor Simon Osborne Louisa McRobert David Whalley Veronica Fridh Fidh Jon Large Christian Flueck athalie Bouloc Eloise Thompson Ela Smiljanic Hurley Laura Drought Denise Harding Christine Hopp Mary Wheldon Kris Birchall Funding: MRC Developmental Funding Pathway Scheme