Abstract

BackgroundThe evolution of drug resistance is one of the biggest challenges in leishmaniasis and has prompted the need for new antileishmanial drugs. Repurposing of approved drugs is a faster and very attractive strategy that is gaining supporters worldwide. Different anticancer topoisomerase 1B (TOP1B) inhibitors have shown strong antileishmanial activity and promising selective indices, supporting the potential repurposing of these drugs. However, cancer cells and Leishmania share the ability to become rapidly resistant. The aim of this study was to complete a whole-genome exploration of the effects caused by exposure to topotecan in order to highlight the potential mechanisms deployed by Leishmania to favor its survival in the presence of a TOP1B inhibitor.MethodsWe used a combination of stepwise drug resistance selection, whole-genome sequencing, functional validation, and theoretical approaches to explore the propensity of and potential mechanisms deployed by three independent clones of L. infantum to resist the action of TOP1B inhibitor topotecan.ResultsWe demonstrated that L. infantum is capable of becoming resistant to high concentrations of topotecan without impaired growth ability. No gene deletions or amplifications were identified from the next-generation sequencing data in any of the three resistant lines, ruling out the overexpression of efflux pumps as the preferred mechanism of topotecan resistance. We identified three different mutations in the large subunit of the leishmanial TOP1B (Top1BF187Y, Top1BG191A, and Top1BW232R). Overexpression of these mutated alleles in the wild-type background led to high levels of resistance to topotecan. Computational molecular dynamics simulations, in both covalent and non-covalent complexes, showed that these mutations have an effect on the arrangement of the catalytic pentad and on the interaction of these residues with surrounding amino acids and DNA. This altered architecture of the binding pocket results in decreased persistence of topotecan in the ternary complex.ConclusionsThis work helps elucidate the previously unclear potential mechanisms of topotecan resistance in Leishmania by mutations in the large subunit of TOP1B and provides a valuable clue for the design of improved inhibitors to combat resistance in both leishmaniasis and cancer. Our data highlights the importance of including drug resistance evaluation in drug discovery cascades.Graphical abstract

Highlights

  • The evolution of drug resistance is one of the biggest challenges in leishmaniasis and has prompted the need for new antileishmanial drugs

  • In vitro resistance selection and characterization of the TPT‐resistant mutants Selection for resistance to TPT was performed to evaluate the possible propensity for drug resistance to this anticancer topoisomerase 1B (TOP1B) inhibitor if repurposed against visceral leishmaniasis

  • We used a combination of stepwise drug resistance selection, whole-genome sequencing, and theoretical approaches to explore the propensity of and potential mechanisms deployed by three independent clones of L. infantum to resist the activity of the TOP1B inhibitor TPT

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Summary

Introduction

The evolution of drug resistance is one of the biggest challenges in leishmaniasis and has prompted the need for new antileishmanial drugs. Different anticancer topoisomerase 1B (TOP1B) inhibitors have shown strong antileish‐ manial activity and promising selective indices, supporting the potential repurposing of these drugs. The aim of this study was to complete a wholegenome exploration of the effects caused by exposure to topotecan in order to highlight the potential mechanisms deployed by Leishmania to favor its survival in the presence of a TOP1B inhibitor. Despite 1 million new cases of leishmaniasis being declared every year, there is still no effective vaccine available for humans. Clinical manifestations vary in severity and include cutaneous, mucocutaneous, and visceral leishmaniasis. The latter form, caused by Leishmania infantum, is fatal within 2 years if left untreated [2]. Due to the limited pharmacopeia, most available antileishmanial drugs are used in both humans and dogs. Dogs constitute the main reservoir for the zoonotic life cycle of Leishmania [5, 6]

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