INTRODUCTION
1.1 Gastric Cancer- Symptoms, Causes and epidemiology
Gastric cancer develops from the lining of the stomach. The stomach wall is made up of three
layers of tissues, namely the mucosal layer (innermost), muscularis (the middle layer), and
the serosal layer (outermost). Gastric cancer begins in the cells lining the mucosal layer and
spreads through the outer layers as it grows
[1]
show symptoms which are not specific to cancer. The symptoms may include upper abdominal
pain, loss of appetite, nausea, heartburn, weight loss, difficulty in swallowing, blood in stool. By
the time symptoms occur, the cancer has often reached an advanced stage and may have also
metastasized, which is one of the main reasons for its relatively poor prognosis
[2]
. Globally
gastric cancer is the fifth leading cause of cancer and third leading cause of cancer death [3] which
renders it as a matter of great concern. The factors that enhance the risk of stomach cancer
include chronic stomach inflammation, environmental factors, smoking
[4]
preservatives and frozen food, obesity, Helicobacter pylori infection. Ethnicity is also proven to
be one of the factors responsible for the risk of gastric cancer. It is less common in the United
States and other Western countries than in countries in Asia and South America. It has a high
prevalence in developing world. Out of all above mentioned factors, H. pylori infection is the
primary cause of stomach cancer [5].
[6]
.This flagella
acts as locomotive tool and assists the rapid movement of the bacterium in mucus layer overlying
gastric epithelial cells [6]. Attributed to the similarity of the DNA base composition, spiral shape
and growth requirements of the bacterium with Campylobacter species, it was initially called as
Campylobacter pyloridis but further studies showed that its ribosomal RNA, fatty acid
1
composition and ultrastructural appearance differs largely from other Campylobacter species, it
was renamed Helicobacter pylori in 1989[7],[8] . It is found only on gastric epithelium where it
clusters around the junction between cells. It is not found in blood, and with rare exceptions, has
not been found in other parts of the body
[9]
mitigates acid exposure as long as urea is available and maintains its cytoplasm at 7.4 [10].It is not
a true microaerophile as shown by a study that under high cell density or under high partial
pressure of CO2 H. pylori can grow in the presence of atmospheric oxygen[11],[12].
1.3 History
The presence of bacteria in human stomach has been known for almost a century. However, the
bacteria present in the stomach were thought to be contaminants from digested food rather than
true colonizers until the discovery of H. pylori and its role in peptic ulcer disease [13] by Barry &
Marshall for which they received Nobel Prize in 2005[14]. It busted the myth that no bacteria can
survive the strong acid environment of the stomach. Self- ingestion experiments by Marshall and
later studies revealed that these bacteria can colonize and induce inflammation of gastric
mucosa[15 ],[16].These initial reports led to further research which showed that gastric colonization
with H. pylori can lead to several upper gastrointestinal disorders such as peptic ulcers, chronic
gastritis, gastric mucosa associated lymphoid tissue (MALT) lymphoma[17].
1.4 Pathogenesis:
Acid Resistance
H. pylori bacteria have a unique way to adapt themselves to survive in the extremely acidic
environment of the human stomach. Upon encountering the gastric mucosa, it drills inside the
gastric mucus propelled by its polar flagella and adheres to the gastric epithelial cells via its
adhesins interacting with host cell receptors. Once H. pylori is safely entrenched in the mucus, it
is able to fight the stomach acid that does reach it with an enzyme it possesses called urease.
Urease converts urea, of which there is an abundant supply in the stomach (from saliva and
gastric juices), into bicarbonate and ammonia, which are strong bases. This creates a cloud of
2
acid neutralizing chemicals around the H. pylori, protecting it from the acid in the stomach as
shown by the following urea hydrolysis reaction:
[18], [19]
immune system responds to H. pylori infection, by sending white blood cells and cytotoxic-T
cells. However, these potential H. pylori eradicators cannot reach the bacteria, because they
cannot easily get through stomach lining. They do not go away either and the immune response
grows and grows. Polymorphs die, and spill their destructive compounds (superoxide radicals)
on stomach lining cells. Extra nutrients are sent to strengthen the white cells, and the H. pylori
can feed on this [20].
CO2, leading to increased concentration of labeled carbon dioxide later measured using
[24]
sometimes gives false results due to infection with coccoid form of H. pylori which does
not produce much urease[25] .
2. Serology test: Serology tests are appropriate where the prevalence of H. pylori infection
is greater than 30%.It is based on the quantization of immunoglobulin G antibodies
H. pylori cannot synthesize purine nucleotides via de novo pathway hence depends only on the
salvage pathway for purine nucleotide biosynthesis[32],[33]
George Weber recognized the association of neoplastic progression with a set of pacemaker
enzymes and postulated that inhibition of these enzymes can be a promising strategy for cancer
chemotherapy[34]. Subsequently, he discovered that Inosine 5-monophosphate dehydrogenase
(IMPDH) is amplified in tumors and rapidly proliferating tissues and hence can be addressed as a
target for drug design[35]. Guanine nucleotide is a precursor for DNA & RNA, therefore it is
essential for the maintenance of cell function and growth. IMPDH catalyses the most significant
step of guanosine-5 monophosphate (GMP) biosynthesis and thus regulates the guanine
nucleotide pool hence, governing cell proliferation [36]. The IMPDH-catalyzed conversion of IMP
to XMP is the first committed and rate-limiting step in guanine nucleotide biosynthesis. XMP is
subsequently converted to GMP by the action of GMP synthase (GMPS).
IMPDH catalyses two very different chemical transformations: i) a dehydrogenase reaction to
form NADH and the covalent intermediate E-XMP* and ii) a hydrolysis reaction which converts
E-XMP* to XMP:
Fig. 1
During the dehydrogenase reaction, the catalytic Cys319 attacks C2 of IMP and hydride is
transferred to NAD+, producing the covalent intermediate E-XMP*. In this step IMPDH exists in
open conformation (that allows NAD to bind). After NADH departs, a mobile flap folds into
NAD site forming a closed conformation bringing the catalytic Arg418 to the active site where
hydrolysis of the covalent intermediate E-XMP* takes place by conserved Arg418 residue
(acting as a general base for the production of XMP). The affinity of NAD+ and the flap are
precisely balanced- if the flap binds too tightly, NAD+ will not be able to compete effectively
and the dehydrogenase reaction cannot occur. If NAD+ binds too tightly, then the flap will not
5
close and EXMP* cannot hydrolyze [36] .Thus, the flap competes with inhibitors that bind in the
NAD site, and this competition is an important determinant of inhibitor potency [37].
The following figure shows the two conformations of IMPDH: an open conformation for redox
reaction and closed conformation for hydrolysis of E-XMP*[38] :
Fig. 2
Hedstrom et al. reported that the presence of potassium ions accelerates the conformational
change in CpIMPDH. This study revealed that in the presence of K+, rate of flap closure
increases by 65 fold [39] as K+ mobilizes residues on the Cys319 loop by providing alternative
interactions for the main chain carbonyl oxygens.
Active Site:
The IMP binding site is conserved in all IMPDHs but NAD binding site and the flap are highly
divergent. Hence, selective inhibitors can be designed that specifically interact with NAD
binding site.
[40]
reported to inhibit C. albicans IMPDH[41]. Micophenolic acid traps E-XMP* by competing with
the flap for NDH site[42] while Mizoribine monophosphate binds to the IMP site and induces the
flap to close[43]. Thus, the equilibrium between open and closed conformations of IMPDH
controls drug sensitivity. Other IMPDH inhibitors such as merimepodib, tiazofurin, and ribavirin
are also used in immunosuppressive, cancer, and antiviral therapy.
Several reports have shown that Cryptosporidium parvum (a protozoa that causes
cryptosporidiosis and several other gastrointestinal disorders) has derived its IMPDH gene from
epsilon-proteobacterium (H. pylori) via lateral transfer and adenosine from host for the purine
synthesis.[44]Also, C. parvum IMPDH has a 60 % similarity with H. pylori IMPDH and
CpIMPDH inhibitors have shown inhibitory activity for H. pylori IMPDH. Based on C. parvum
IMPDH inhibitors, H. pylori inhibitor molecules were designed[45],[46].
Molecule
Docking
Score
NH- 02
-5.5
NH- 01
-5.1
site:
NH- 03
-4.7
NH- 04
-4.6
NH- 05
-4.2
Chapter - 2
EXPERIMENTAL SECTION
8
2.1
Scheme
1:
Synthesis
of
N-(3,4-dimethoxyphenyl)-2-(2-(thiazol-4-yl)-1H-
benzo[d]imidazol-1-yl)acetamide (compound-5)
The mechanism involves nucleophilic addition-elimination reaction between amine 1 and acyl
halide 2 in the first step to yield amide 3. The second step involves nucleophilic substitution of
bromine by tiabendazole 4 aided by K2CO3 to yield acetamide derivative 5.
To a solution of compound 1 (1.62g, 0.01 mol) in DCM (5 mL), bromoacetyl chloride 2 was
added drop wise at 5o C under N2 atmosphere. The reaction mixture was degassed for 5- 10
minutes. After degassing, the reaction mixture was stirred at room temperature for half an hour.
After stirring, DCM was evaporated under reduced pressure from the reaction mixture followed
by dilution with water. Pale grey solid precipitate was filtered, washed with water and dried.
MS (ESI) : Exact mass of C10H12BrNO3 (compound 3) : 273
To a solution of tiabendazole 4 (0.2g, 0.001 mol) in DMF (4 mL) stirred under N 2 atmosphere,
added K2CO3 (0.4 g, 0.003 mol) and allowed to stir at room temperature for five minutes.
Compound 3 (0.27g, 0.001 mol) was added I portions and allowed to stir for 6-7 hours under
inert atmosphere. After the completion of reaction, crushed ice was added to the resulting
mixture and then extracted twice with ethyl acetate. The combined organic layers were washed
with brine followed by drying over anhydrous Na 2SO4. The solvent was evaporated under
reduced pressure. The residue was purified using flash column chromatography (1% MeOH:
DCM) to yield compound 5 as pale brown solid.
MS (ESI): Exact mass of C20H18N4O5S (compound 5) : 394.11
Found (M+1): m/z 395.02
1
H- NMR: 1H NMR (500 MHz, DMSO-d6) 10.32 (d, J = 4.4 Hz, 1H), 9.36 9.27 (m, 1H),
8.56 (dd, J = 4.5, 2.1 Hz, 1H), 7.73 7.60 (m, 2H), 7.29 (tt, J = 7.0, 3.6 Hz, 3H), 7.02 (ddd, J =
9.1, 4.6, 2.3 Hz, 1H), 6.88 (dd, J = 8.8, 4.3 Hz, 1H), 5.68 (d, J = 4.3 Hz, 2H), 3.69 (dd, J = 14.5,
4.3 Hz, 6H).
13
C NMR (126 MHz, DMSO) 165.77, 156.04, 155.73, 149.03, 147.56, 147.51, 147.39, 145.33,
142.77,136.94, 132.91, 123.25, 123.07, 122.79, 122.67, 122.24, 119.87, 119.39, 119.22, 112.59,
112.24, 111.32,111.12, 104.59, 79.62, 56.20, 55.76, 48.28.
10
The mechanism involves nucleophilic addition-elimination reaction between amine 6 and acyl
halide 7 in the first step to yield amide 8. The second step involves nucleophilic substitution of
bromine by tiabendazole 9 aided by K2CO3 to yield acetamide derivative 10.
To a solution of compound 6 (1g, 0.001 mol) in DCM (3 mL), bromoacetyl chloride 7 was added
drop wise at 5o C under N2 atmosphere. The reaction mixture was degassed for 5- 10 minutes.
After degassing, the reaction mixture was stirred at room temperature for half an hour. After
stirring, DCM was evaporated under reduced pressure from the reaction mixture followed by
dilution with water. Extraction was done using ethyl acetate. The combined organic layers were
dried over sodium sulfate and the solvent was evaporated using reduced pressure. The residue
was purified using flash column chromatography and compound 8 was obtained.
11
2.2.2
Synthesis
of
N-(pyridin-3-yl)-2-(2-(thiazol-4-yl)-1H-benzo[d]imidazol-1-
yl)acetamide(compound 10)
To a solution of tiabendazole 9 (0.1g, 0.0005 mol) in DMF (3 mL) stirred under N2 atmosphere,
added K2CO3 (0.4 g, 0.003 mol) and allowed to stir at room temperature for five minutes.
Compound 8 (0.13g, 0.00059 mol) was added in portions and allowed to stir for 6-7 hours under
inert atmosphere. After the completion of reaction, crushed ice was added to the resulting
mixture and then extraction was done twice with ethyl acetate. The combined organic layers
were washed with brine followed by drying over anhydrous Na 2SO4. The solvent was evaporated
under reduced pressure. The residue was purified using flash column chromatography
(4%MeOH: DCM) to yield compound 10.
MS (ESI): Exact Mass of C17H13N5OS (compound 10) = 335.08
Found (M+1) peak: 336.04
1H-NMR: 1H NMR (500 MHz, DMSO-d6) 10.69 (s, 1H), 9.31 (d, J = 2.0 Hz, 1H), 8.73 (d, J =
2.5 Hz, 1H), 8.57 (d, J = 2.1 Hz, 1H), 8.27 (d, J = 4.6 Hz, 1H), 7.99 (d, J = 8.2 Hz, 1H), 7.77
7.63 (m, 2H), 7.32 (dt, J = 23.5, 5.1 Hz, 3H), 5.74 (s, 2H).
13
C NMR (126 MHz, DMSO) 165.61, 146.32, 142.58, 138.35, 134.93, 133.41, 131.06, 129.64,
129.62,129.47, 129.02, 128.34, 128.02, 127.96, 127.65, 127.58, 125.91, 106.91, 76.29, 76.18,
75.36, 73.75, 70.59,70.42, 67.66, 58.23.
12
13
In a sealed round bottomed flask, polyphosphoric acid (5.7 mL, 0.12 mol) was added followed
by aminoalcohol 11 (0.5 g, 0.003 mol) and stirred for 10 minutes and temperature was
maintained 110o C. When the mixture became stirrable (due to high density of PPA), isonicotinic
acid 12 (0.395 g, 0.003 mol) was added to it and the reaction mixture was allowed to stir for 8
hours at 110o C. The reaction mixture was allowed to cool and neutralized with sodium
bicarbonate followed by extraction with ethyl acetate. The combined extracted organic layers
were dried over sodium sulfate. The solvent was evaporated to give the residue, which was
purified by flash column chromatography (90% Ethyl Acetate:
compound 13.
MS(ESI) : Exact mass of C12H7N3O3 (compound 13) :241.05
Found (M+1) peak: 242.01
1
H NMR : (500 MHz, Chloroform-d) 8.89 (s, 2H), 8.74 (d, J = 2.4 Hz, 1H), 8.41 (dd, J = 9.0,
2.4 Hz, 1H), 8.12 (d, J = 4.8 Hz, 2H), 7.76 (d, J = 9.0 Hz, 1H).
In a round bottom flask 5 mL of ethanol was taken, added benzoxazole 13 (0.09 g, 0.0003 mol)
and SnCl2 (0.417g, 0.0018 mol). The reaction mixture was allowed to stir for 1 hour and 30
14
minutes at room temperature under N 2 atmosphere. After the completion of reaction, ethanol was
evaporated and the residue was washed with water to remove tin salts. Purification was done by
column chromatography and the compound 14 was obtained at 3% MeOH: DCM.
MS(ESI) : Exact mass of C12H9N3O (compound 14) : 211.07
Found (M+1) peak: 212.09
1
H-NMR: 1H NMR (500 MHz, Chloroform-d) 8.80 (d, J = 5.1 Hz, 2H), 8.04 (d, J = 5.1 Hz,
2H), 7.40 (d, J = 8.6 Hz, 1H), 7.07 (s, 1H), 6.79 (d, J = 8.6 Hz, 1H), 3.91 3.66 (m, 2H).
To a stirred solution of compound 14 (0.038 g, 0.00018 mol) in DCM (1 mL), added K2CO3
(0.074 g, 0.00054) and stirred for 10 minutes at room temperature under N 2 atmosphere. After
degassing, bromoacetyl chloride 15 (0.0425 g, 0.00027 mol) was added drop wise to the reaction
mixture at 5oC. The reaction mixture was allowed to stir for 30 minutes at room temperature.
After the completion of reaction, DCM was evaporated under reduced pressure from the reaction
mixture followed by dilution with water. The residue was filtered, thoroughly washed with water
and dried to afford compound 16.
MS (ESI): Exact mass of C14H10BrN3O2 compound 16 = 331.0
Found (M+2) peak: 331.9
15
In a round bottom flask, 2 mL DMF, K2CO3 (0.066 g, 0.00048 mol) and 2- naphthol 17 (0.023g,
0.00016 mol) were stirred for 10 minutes under N2 atmosphere at room temperature. Compound
16 (0.053g, 0.00016mol) was then added and the reaction mixture was allowed to stir for 8
hours. Crushed ice was added to reaction mixture followed by extraction in ethyl acetate. The
compound was purified using flash column chromatography to afford compound 18 at 50%
Ethyl acetate: Hexane.
MS (ESI) : Exact mass of the compound 18 : 395.13
Found (M+1) peak: 396.11
16
To a solution of compound 9 (0.050g, 0.00025 mol) in DMF (1 mL) stirred under N 2 atmosphere,
added K2CO3 (0.1 g, 0.00075 mol) and allowed to stir at room temperature for five minutes.
Compound 8 (0.055g, 0.00025 mol) was added in portions and allowed to stir for 6-7 hours
under inert atmosphere. After the completion of reaction, crushed ice was added to the resulting
mixture and then extraction was done twice with ethyl acetate. The combined organic layers
were washed with brine followed by drying over anhydrous Na 2SO4. The solvent was evaporated
under reduced pressure. The residue was purified using flash column chromatography
(4%MeOH: DCM) to yield compound 20.
MS (ESI): Exact mass of C19H15N5O (compound 20) = 329.13
Found (M+1) peak: 330.08
1
H-NMR: 1H NMR (500 MHz, Chloroform-d) 10.68 (s, 1H), 8.71 (d, J = 2.5 Hz, 1H), 8.64
8.59 (m, 1H), 8.43 8.37 (m, 1H), 8.26 (dd, J = 4.7, 1.5 Hz, 1H), 8.04 7.93 (m, 2H), 7.78
7.75 (m, 1H), 7.72 (s, 1H), 7.50 7.45 (m, 1H), 7.37 7.28 (m, 3H).
13
C-NMR (126 MHz, DMSO) : 167.38, 150.28, 149.83, 149.00, 144.78, 142.38, 141.19,
137.96, 137.89, 136.04, 126.57, 124.73, 124.21, 124.19, 123.82, 122.96, 119.95, 111.31, 49.21.
17
18
SUPPORTING INFORMATION:
19
20
21
3.
H- NMR of compound 5
22
23
24
25
6.
H- NMR of compound 10
26
27
28
242.01242.01
8.
H- NMR of compound 13
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
ACKNOWLEDGEMENTS
I would like to express my deep gratitude to my project supervisor Dr. Sivapriya Kirubakaran for
her guidance and motivation throughout the course of training. I would also like to thank Dr.
Kapil Juvale and Mr. Althaf Shaik for helping me learn the synthetic skills and Dr. Vijay Singh
for making me familiar with the basics of molecular modeling and performing docking studies
for the inhibitor molecules. I would like to thank all other members of the research group who
have been of great help in some or the other way.
44
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47. # Unpublished Results
48