The antimalarial MMV688533 provides potential for single-dose cures with a high barrier to Plasmodium falciparum parasite resistance

Science Translational Medicine
21 July 2021 Vol 13, Issue 603


Research Articles
The antimalarial MMV688533 provides potential for single-dose cures with a high barrier to Plasmodium falciparum parasite resistance
By James M. Murithi, Cécile Pascal, Jade Bath, Xavier Boulenc, Nina F. Gnädig, Charisse Flerida A. Pasaje, Kelly Rubiano, Tomas Yeo, Sachel Mok, Sylvie Klieber, Paul Desert, María Belén Jiménez-Díaz, Jutta Marfurt, Mélanie Rouillier, Mohammed H. Cherkaoui-Rbati, Nathalie Gobeau, Sergio Wittlin, Anne-Catrin Uhlemann, Ric N. Price, Grennady Wirjanata, Rintis Noviyanti, Patrick Tumwebaze, Roland A. Cooper, Philip J. Rosenthal, Laura M. Sanz, Francisco Javier Gamo, Jayan Joseph, Shivendra Singh, Sridevi Bashyam, Jean Michel Augereau, Elie Giraud, Tanguy Bozec, Thierry Vermat, Gilles Tuffal, Jean-Michel Guillon, Jérôme Menegotto, Laurent Sallé, Guillaume Louit, Marie-José Cabanis, Marie Françoise Nicolas, Michel Doubovetzky, Rita Merino, Nadir Bessila, Iñigo Angulo-Barturen, Delphine Baud, Lidiya Bebrevska, Fanny Escudié, Jacquin C. Niles, Benjamin Blasco, Simon Campbell, Gilles Courtemanche, Laurent Fraisse, Alain Pellet, David A. Fidock, Didier Leroy
Science Translational Medicine21 Jul 2021 Full Access
We report an acylguanidine preclinical candidate with pharmacological features compatible with single low-dose malaria cure.
Antimalarial advance
The need for antimalarial drugs is urgent in the face of growing resistance to existing therapies. Murithi et al. characterized MMV688533, an acylguanidine identified from compounds inhibiting known human drug targets that were screened for activity against Plasmodium falciparum. MMV688533 showed rapid in vitro killing of multiple P. falciparum strains as well as P. vivax. A single dose of MMV688533 rapidly reduced parasitemia in a P. falciparum NSG mouse model of infection, and this agent displayed favorable pharmacokinetic and toxicity profiles. MMV688533 selected for only low-grade resistance, with resistant parasites remaining sensitive to existing antimalarials. These findings suggest that MMV688533 is a promising antimalarial candidate with a low resistance risk and the promise of a single-dose cure, which merits further study.