Abstract

Histoplasma capsulatum is a dimorphic fungal pathogen endemic to the midwestern and southern United States. It causes mycoses ranging from subclinical respiratory infections to severe systemic disease, and is of particular concern for immunocompromised patients in endemic areas. Clinical management of histoplasmosis relies on protracted regimens of antifungal drugs whose effectiveness can be limited by toxicity. In this study, we hypothesize that conserved biochemical signaling pathways in the eukaryotic domain can be leveraged to repurpose kinase inhibitors as antifungal compounds. We conducted a screen of two kinase inhibitor libraries to identify compounds inhibiting the growth of Histoplasma capsulatum in the pathogenic yeast form. Our approach identified seven compounds with an elongated hydrophobic polyaromatic structure, five of which share a molecular motif including a urea unit linking a halogenated benzene ring and a para-substituted polyaromatic group. The top hits include the cancer therapeutic Sorafenib, which inhibits growth of Histoplasma in vitro and in a macrophage infection model with low host cell cytotoxicity. Our results reveal the possibility of repurposing Sorafenib or derivatives thereof as therapy for histoplasmosis, and suggest that repurposing of libraries developed for human cellular targets may be a fruitful source of antifungal discovery.

Highlights

  • Treatment of systemic fungal infections presents a formidable challenge to the healthcare system

  • Two kinase inhibitor libraries were screened in an effort to identify novel molecules inhibiting Histoplasma growth

  • Published Kinase Inhibitor Set (PKIS)) is a collection of 367 small molecule ATP-competitive kinase inhibitors optimized for drug-like physicochemical properties and developed for diverse kinase targets [34,35]

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Summary

Introduction

Treatment of systemic fungal infections presents a formidable challenge to the healthcare system. Recent advances in medicine have saved the lives of millions with diseases and conditions that were previously untreatable. These advances, including immunomodulatory therapies for cancer treatment, autoimmune disease, and organ transplantation have contributed to the increasing population of individuals with immunocompromised status who have a heightened susceptibility to fungal infection [1]. Invasive and/or systemic fungal infections carry a high cost in human and economic terms; in the United States alone in 2017, 4.5 billion USD was spent on the treatment of fungal infections requiring hospitalization [2]. The dimorphic fungal pathogens—Histoplasma, Blastomyces, Coccidioides and Paracoccidioides—are of particular clinical concern as these organisms infect and cause disease in both immunocompromised and healthy hosts.

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