Abstract

BackgroundNaphthoquine (NQ) is a suitable partner anti-malarial for the artemisinin-based combination therapy (ACT), which is recommended to be taken orally as a single-dose regimen. The metabolism of NQ was mainly mediated by CYP2D6, which is well-known to show gender-specific differences in its expression. In spite of its clinical use, there is limited information on the pharmacokinetics of NQ, and no data are available for females. In this study, the effect of gender on the pharmacokinetics and antiplasmodial efficacy of NQ in rodents was evaluated. The underlying factors leading to the potential gender difference, i.e., plasma protein binding and metabolic clearance, were also evaluated.MethodsThe pharmacokinetic profiles of NQ were investigated in healthy male or female rats after a single oral administration of NQ. The antiplasmodial efficacy of NQ was studied in male or female mice infected with Plasmodium yoelii. The recrudescence and survival time of infected mice were also recorded after drug treatment. Plasma protein binding of NQ was determined in pooled plasma collected from male or female mice, rat or human. In vitro metabolism experiments were performed in the liver microsomes of male or female mice, rat or human.ResultsThe results showed that the gender of rats did not affect NQ exposure (AUC0–t and Cmax) significantly (P > 0.05). However, a significant (P < 0.05) longer t1/2 was found for NQ in male rats (192.1 ± 47.7), compared with female rats (143.9 ± 27.1). Slightly higher but not significant (P > 0.05) antiplasmodial activity was found for NQ in male mice (ED90, 1.10 mg/kg) infected with P. yoelii, compared with female mice (ED90, 1.67 mg/kg). The binding rates of NQ to plasma protein were similar in males and females. There was no metabolic difference for NQ in male and female mice, rat or human liver microsomes.ConclusionsThese results indicated that the pharmacokinetic profiles of NQ were similar between male and female rats, except for a longer t1/2 in male rats. The difference was not associated with plasma protein binding or hepatic metabolic clearance. Equivalent antiplasmodial activity was found for NQ in male and female mice infected with P. yoelii. This study will be helpful for the rational design of clinical trials for NQ.

Highlights

  • Naphthoquine (NQ) is a suitable partner anti-malarial for the artemisinin-based combination therapy (ACT), which is recommended to be taken orally as a single-dose regimen

  • The plasma matrix was negligible under the current conditions, and the results showed sufficient extraction efficiency (80–95%) for NQ and Internal standard (IS)

  • In infected‐mice The in vivo antiplasmodial activity of NQ was assessed in male or female mice infected with P. yoelii after an oral administration of NQ

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Summary

Introduction

Naphthoquine (NQ) is a suitable partner anti-malarial for the artemisinin-based combination therapy (ACT), which is recommended to be taken orally as a single-dose regimen. To avoid rapid drug resistance, it is recommended to only use artemisinins as part of a combination with other drugs, i.e., the artemisinin drug acts for a rapid clearance of most Plasmodium falciparum and the concomitant partner anti-malarial with a prolonged half-life is responsible for eliminating residual parasites [1, 2]. As a new generation of artemisinin-based combinations, NQ is used in combination with artemisinin (­ARCO®), which is recommended to be taken orally as a single-dose regimen to improve patient compliance and avoid rapid development of parasite resistance [8]. NQ displayed a remarkable antiplasmodial activity against P. falciparum ­(IC50 of 8.0 nM) ex vivo and Plasmodium berghei in mice ­(ED90 of 0.63 mg/kg) [11, 12]

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