Targeting the Trypanosome Alternative Oxidase (TAO) as Promising Chemotherapeutic Approach for African Trypanosomiasis

In Trypanosoma brucei, a parasite that causes African trypanosomiasis in humans (sleeping sickness) and in livestock (nagana) throughout sub-Saharan Africa, the trypanosome alternative oxidase (TAO) is essential for the respiration of bloodstream form parasites (i.e. the human-infective form). Since TAO has no counterpart in mammalian cells and it is conserved among T. brucei subspecies, it has been validated as a promising target for the chemotherapy of African trypanosomiasis. We present here a successful approach to boost the activity of TAO inhibitors based on the conjugation of the inhibitor with lipophilic cations (LC) that can cross lipid bilayers by non-carrier mediated transport, and thus accumulate specifically into mitochondria, driven by the plasma and mitochondrial transmembrane potentials (negative inside). This design afforded several LC–TAO inhibitor conjugates active in the submicromolar to low nanomolar range against wild type and resistant strains of African trypanosomes (T. b. brucei, T. congolense), with selectivity over human cells >500.