Recently, the World Health Organization approved the
nifurtimox–eflornithine
combination therapy for the treatment of human African trypanosomiasis,
renewing interest in nitroheterocycle therapies for this and associated
diseases. In this study, we have synthesized a series of novel 5-nitro-2-furancarboxylamides
that show potent trypanocidal activity, ∼1000-fold more potent
than nifurtimox against in vitro Trypanosoma brucei with very low cytotoxicity against human HeLa cells. More importantly,
the most potent analogue showed very limited cross-resistance to nifurtimox-resistant
cells and vice versa. This implies that our novel, relatively easy
to synthesize and therefore cheap, 5-nitro-2-furancarboxylamides are
targeting a different, but still essential, biochemical process to
those targeted by nifurtimox or its metabolites in the parasites.
The significant increase in potency (smaller dose probably required)
has the potential for greatly reducing unwanted side effects and also
reducing the likelihood of drug resistance. Collectively, these findings
have important implications for the future therapeutic treatment of
African sleeping sickness.