Proposal for a New Stereochemically Informative Nonproprietary Drug Naming System.

BACKGROUND: The stereochemical aspects of drugs are generally recognized as fundamentally important influencers of drug action and disposition. Nevertheless, the nonproprietary names of the vast majority of stereochemically relevant therapeutic agents in the USP Dictionary of United States Adopted Names (USAN) and International Drug Names and in the WHO Drug Information listings provide no information on the stereochemical aspects. OBJECTIVE: In view of the importance of stereochemistry in drug action and disposition, it is desirable to have a nonproprietary drug nomenclature system that provides basic information on the stereochemical identity and composition of drugs. METHODS: The USP Dictionary of USAN and International Drug Names, the WHO Drug Information listings, and the chemical literature were examined for stereochemical information on drugs as a basis for proposing a new stereochemically informative nonproprietary drug name system. RESULTS: A new system of stereochemically informative nonproprietary nomenclature system was designed that provides a "flag" alerting to the presence of stereochemical elements in the drug structure and includes basic information on the stereoisomerism of the drug. One of five prefixes would be added to the name: [dex]- (dextrorotatory single chiral stereoisomer); [lev]- (levorotatory single chiral stereoisomer); [rac]- (racemic mixture); [uni]-, (single achiral stereoisomer); and [mix]-, (mixture of stereoisomers other than racemic). CONCLUSIONS: The proposed system would be useful in the various domains of drug information, therapy, and research.

In defense of Louis Pasteur: Critique of Gerald Geison's deconstruction of Pasteur's discovery of molecular chirality.

Louis Pasteur discovered the phenomenon of molecular chirality, based on his studies of tartrate crystals. His finding remains one of the most important discoveries in the history of chemistry and a fundamentally important chemical phenomenon, with essential implications in biology. In his 1995 book The Private Science of Louis Pasteur, the eminent historian of science Gerald L. Geison (1943-2001) was highly critical of much of Pasteur's work including his discovery of molecular chirality. The in-depth analysis provided in this article indicates, however, that the negative assessment of Pasteur's chirality work by Geison is entirely without scientific basis. Criticisms of Pasteur in the book for other "transgressions" in his chirality work, such as supposed influences of his personal biases and stubbornly held a priori notions, misrepresentation of his scientific work in his publications and lectures, and unethical and career-minded conduct, are also not supported by the evidence. Other troubling features of the book include a broad failure to assure accuracy in a variety of fundamental and important information, including errors in names, dates, events, referencing, indexing, and French-language text.

Molecular chirality: language, history, and significance.

In this chapter some background material concerning molecular chirality and enantiomerism is presented. First some basic chemical-molecular aspects of chirality are reviewed, after which certain relevant terminology whose use in the literature has been problematic is discussed. Then an overview is provided of some of the early discoveries that laid the foundations of the science of molecular chirality in chemistry and biology, including the discovery of the phenomenon of molecular chirality by L. Pasteur, the proposals for the asymmetric carbon atom by J.H. van 't Hoff and J.A. Lebel, Pasteur's discovery of biological enantioselectivity, the discovery of enantioselectivity at biological receptors by A. Piutti, the studies of enzymatic stereoselectivity by E. Fischer, and the work on enantioselectivity in pharmacology by A. Cushny. Finally, the role of molecular chirality in pharmacotherapy and new-drug development, arguably one of the main driving forces for the current intense interest in the phenomenon of molecular chirality, is discussed.

Early history of the recognition of molecular biochirality.

This opening chapter recalls the history of the discoveries that led to the appreciation of the nature and importance of molecular chirality in biology, as well as the development of stereochemistry as an interdisciplinary field connecting chemistry and biology. The discoveries described cover roughly the period of ca. 1840-1940, although certain relevant events of earlier or later times are also addressed. A large number of chiral substances occur in nature in unichiral (i.e., single-enantiomer) form, and for centuries many such substances were used in crude extracts for relief from diseases. For the science of biochirality, the first milestone was the discovery of molecular chirality by Louis Pasteur in 1848. Thereafter, fundamental advances were made, beginning in 1857 with Pasteur's discovery of biological enantioselectivity, in the metabolism of (±)-tartaric acid. With the advances in organic chemistry during the second half of the nineteenth century, the structures of many organic molecules were elucidated and new chiral compounds synthesized, and by the turn of the twentieth century studies of stereoselectivity in the biological activity or enzymatic transformations of natural or synthetic substances were proliferating, and chiroselectivity was often found. Among the names associated with important discoveries in biochirality appear Pasteur, Piutti, Fischer, Cushny, Easson and Stedman, and others. The findings soon prompted attempts to explain the phenomenon of enantioselectivity in biological action, beginning with Pasteur's proposal to account for enantioselectivity in the metabolism of tartaric acid. In 1894 Fischer announced his "lock-and-key" metaphor to explain enantioselectivity in enzyme-substrate interactions and in 1933 Easson and Stedman advanced the first chemical-structure-based model, the three-point-attachment paradigm, to rationalize enantioselectivity at adrenergic receptors. This model has been generalized as the simplest basis for enantioselectivity in biological activity. Today molecular chirality is widely recognized as an important modulator of the effects of chiral substances in a variety of branches of biology and medicine.

The discovery of stereoselectivity at biological receptors: Arnaldo Piutti and the taste of the asparagine enantiomers--history and analysis on the 125th anniversary.

In 1886, Italian chemist Arnaldo Piutti isolated, for the first time, d-asparagine, the enantiomer of the known l-asparagine. He obtained 100 g of D-asparagine from 6500 kg of vetches. Using an ingenious synthetic scheme, Piutti established the chemical structure of asparagine and demonstrated that his isolation of D-asparagine from plants was not the result of the racemization of L-asparagine during the extraction procedure. He found a striking difference in the taste of asparagine: L-asparagine was without taste, while D-asparagine was intensely sweet. This was the first example of enantioselectivity in a receptor-mediated biological activity. Receptors constitute one of the most important and most intensively studied phenomena in biology, and enantioselectivity in receptor-mediated activity, including at the sweetness receptor, is today an important and commonly seen aspect of receptor function. Therefore, Piutti's discovery, although made ca. 15 years before the emergence of the receptor concept, was a milestone. The publication of Piutti's asparagine work prompted several eminent scientists, including Louis Pasteur and Arthur Cushny, a leading pharmacologist of the time, to remark on the importance of the discovery. Piutti also carried out investigations in many other fields, e.g., other organic compounds and reactions, pharmaceuticals, alimentary products, radioactivity, noble gases, and spectroscopy. Considerable progress has been made in recent decades concerning the biology and chemistry of sweet taste, but the details of the interactions of chiral molecules with the sweetness receptor remain poorly understood. Piutti and his discovery are largely forgotten today; they deserve the attention of the chirality and receptor "communities."

Stereochemical vocabulary for structures that are chiral but not asymmetric: History, analysis, and proposal for a rational terminology.

Asymmetric objects are necessarily chiral, but a structure may be chiral and not asymmetric if it possesses one or more proper rotation axes. Chiral but not asymmetric molecules are important in chemistry and its applications, but no suitable term exists for the designation of such structures, and their terminology in the literature is confused and chaotic. Dissymmetric has been redefined by some authors as "chiral but not asymmetric," in conflict both with Pasteur's definition of the term as "not superposable on its mirror image" (without other restrictions, i.e., chiral) and the understanding of the term in stereochemistry. Moreover, dissymmetric and asymmetric are frequently confused because of their similar forms. Furthermore, dissymmetric is widely used in many other definitions in chemistry, physics, and other disciplines. Thus, dissymmetric is unsuitable in the new definition of "chiral but not asymmetric," and a new term is needed. The adjective "symmanumorphous" is therefore proposed for "chiral but not asymmetric". "Sym" (from symmetry) indicates the presence of some symmetry in the structure, and "manu" (from "manus," Latin for hand, e.g., manual, manuscript) refers to its handedness. "Morphous," from the Greek "morphe," that is, form, is widely used, for example, anthropomorphous, enantiomorphous, etc. Symmanumorphous is convenient and euphonious and at 15 characters (same as enantiomorphous) is not unduly long. The nouns "a symmanumorph" (a structure that is chiral but not asymmetric) and "symmanumorphism" (the phenomenon of chirality without asymmetry) are also proposed. The new terminology is adaptable in other languages and would contribute to creating order out of linguistic chaos.

Stereoselective determination of the epimer mixtures of itraconazole in human blood plasma using HPLC and fluorescence detection.

Itraconazole is an antifungal drug widely used in a variety of fungal infections, which have become a significant public-health problem in recent decades. Itraconazole is a chiral drug consisting of two diastereoisomeric racemates, i.e., four stereoisomers. Data in the literature suggests that stereochemistry may play a significant role in the action and disposition of the drug and therefore stereoselective analytical methods for the determination of the drug in biological fluids are needed for the elucidation of that role. We report a stereoselective HPLC method that incorporates solvent extraction, the use of an internal standard, two chiral stationary phases in series, and fluorescence detection. The procedure is enantioselective and partially diastereoselective and provides the concentrations in blood plasma of the two epimer mixtures 2R,4S,2'R/2R,4S2'S and 2S,4R,2'R/2S,4R,2'S, respectively, each of which is a combination of the two epimers that differ in the configuration at the sec-butyl group. The analytical method has suitable sensitivity, recovery, precision, and accuracy. Analysis of the plasma of a human subject six hours after the oral administration of a single 200-mg dose of itraconazole showed a 3.4-fold difference between the concentrations of the epimer mixtures. The method has certain advantages over the published alternative procedure that uses LC-MS.

Louis Pasteur, language, and molecular chirality. I. Background and dissymmetry.

Louis Pasteur resolved sodium ammonium (±)-tartrate in 1848, thereby discovering molecular chirality. Although hindered by the primitive state of organic chemistry, he introduced new terminology and nomenclature for his new science of molecular and crystal chirality. He was well prepared for this task by his rigorous education and innate abilities, and his linguistic achievements eventually earned him membership in the supreme institution for the French language, the Académie française. Dissymmetry had been in use in French from the early 1820s for disruption or absence of symmetry or for dissimilarity or difference in appearance between two objects, and Pasteur initially used it in the latter connotation, without any reference to handedness or enantiomorphism. Soon, however, he adopted it in the meaning of chirality. Asymmetry had been in use in French since 1691 but Pasteur ignored it in favor of dissymmetry. The two terms are not synonymous but it is not clear whether Pasteur recognized this difference in choosing the former over the latter. However, much of the literature mistranslates his dissymmetry as asymmetry. Twenty years before Pasteur the British polymath John Herschel proposed that optical rotation in the noncrystalline state is due to the "unsymmetrical" [his term] nature of the molecules and later used dissymmetrical for handed. Chirality, coined by Lord Kelvin in 1894 and introduced into chemistry by Mislow in 1962, has nearly completely replaced dissymmetry in the meaning of handedness, but the use of dissymmetry continues today in other contexts for lack of symmetry, reduction of symmetry, or dissimilarity.

Computational discovery of novel low micromolar human pregnane X receptor antagonists.

Very few antagonists have been identified for the human pregnane X receptor (PXR). These molecules may be of use for modulating the effects of therapeutic drugs, which are potent agonists for this receptor (e.g., some anticancer compounds and macrolide antibiotics), with subsequent effects on transcriptional regulation of xenobiotic metabolism and transporter genes. A recent novel pharmacophore for PXR antagonists was developed using three azoles and consisted of two hydrogen bond acceptor regions and two hydrophobic features. This pharmacophore also suggested an overall small binding site that was identified on the outer surface of the receptor at the AF-2 site and validated by docking studies. Using computational approaches to search libraries of known drugs or commercially available molecules is preferred over random screening. We have now described several new smaller antagonists of PXR discovered with the antagonist pharmacophore with in vitro activity in the low micromolar range [S-p-tolyl 3',5-dimethyl-3,5'-biisoxazole-4'-carbothioate (SPB03255) (IC(50), 6.3 microM) and 4-(3-chlorophenyl)-5-(2,4-dichlorobenzylthio)-4H-1,2,4-triazol-3-ol (SPB00574) (IC(50), 24.8 microM)]. We have also used our computational pharmacophore and docking tools to suggest that most of the known PXR antagonists, such as coumestrol and sulforaphane, could also interact on the outer surface of PXR at the AF-2 domain. The involvement of this domain was also suggested by further site-directed mutagenesis work. We have additionally described an FDA approved prodrug, leflunomide (IC(50), 6.8 microM), that seems to be a PXR antagonist in vitro. These observations are important for predicting whether further molecules may interact with PXR as antagonists in vivo with potential therapeutic applications.

When did Louis Pasteur present his memoir on the discovery of molecular chirality to the Académie des sciences? Analysis of a discrepancy.

Louis Pasteur presented his historic memoir on the discovery of molecular chirality to the Académie des sciences in Paris on May 22nd, 1848. The literature, however, nearly completely ignores this date, widely claiming instead May 15th, 1848, which first surfaced in 1922 in Pasteur's collected works edited by his grandson Louis Pasteur Vallery-Radot. On May 21st, 1848, i.e., one day before Pasteur's presentation in Paris, his mother died in Arbois, eastern France. Informed at an unknown point in time that she was "very ill," Pasteur left for Arbois only after his presentation. Biographies of Pasteur by his son-in-law René Vallery-Radot or the grandson, and Pasteur's collected correspondence edited by the grandson are incomprehensibly laconic or silent about the historic presentation. While no definite conclusions are possible, the evidence strongly suggests a deliberate alteration of the record by the biographer relatives, presumably for fear of adverse public judgment of Pasteur for a real or perceived insensitivity to a grave family medical emergency. Such fear would have been in accord with their hagiographic portrayal of Pasteur, and the findings raise questions concerning the extent of their zeal in protecting his "demigod" image. Universal recognition of the true date of Pasteur's announcement of molecular chirality is long overdue.

The discovery of biological enantioselectivity: Louis Pasteur and the fermentation of tartaric acid, 1857--a review and analysis 150 yr later.

Nearly a decade after discovering molecular chirality in 1848, Louis Pasteur changed research direction and began investigating fermentations. Conflicting explanations have been given for this switch to microbiology, but the evidence strongly suggests that Pasteur's appointment in 1854 to the University of Lille--an agricultural-industrial region where fermentation-based manufacturing was of great importance--and an appeal for help in 1856 by a local manufacturer experiencing problems in his beetroot-fermentation-based alcohol production played a significant role. Thus began, in late 1856, Pasteur's pioneering studies of lactic and alcoholic fermentations. In 1857, reportedly as a result of a laboratory mishap, he found that in incubations of ammonium (+/-)-tartrate with unidentified microorganisms (+)-tartaric acid was consumed with considerable preference over (-)-tartaric acid. In 1860, he demonstrated a similar enantioselectivity in the metabolism of tartaric acid by Penicillium glaucum, a common mold. Chance likely played a significant role both in Pasteur's shift to microbiology and his discovery of enantioselective tartrate fermentations, but he rejected pure serendipity as a significant factor in experimental science and in his own career. Pasteur's milestone discovery of biological enantioselectivity began the process that in the long run established the fundamental importance of molecular chirality in biology.

Carl Friedrich Naumann and the introduction of enantio terminology: a review and analysis on the 150th anniversary.

Enantiomorphism and enantiomorphous were the first enantio-based terms, introduced 150 years ago, by Carl Friedrich Naumann, a German crystallographer, to refer to non-superposable mirror-image crystals. The terminology was not adopted by Pasteur, the discoverer of molecular chirality, and was not embraced at first in the stereochemical context, until it was accepted in 1877 by Van't Hoff in the German edition of his proposal for the tetrahedral asymmetric carbon atom. In the 1890s the use of enantio terms began to spread in the research literature, and many new derivatives of Naumann's original two terms were subsequently introduced. Problems in the usage of some of the terms are often found in the literature, e.g., enantiomorphism is sometimes confused with chirality; enantiomeric is often misused; the meaning of some of the many derived terms, e.g., enantiosymmetric, enantioposition, etc., is unclear. All in all, Naumann should be remembered as the creator of essential terminology in the realm of chirality.

Determination of the absolute configuration and solution conformation of the antifungal agents ketoconazole, itraconazole, and miconazole with vibrational circular dichroism.

The absolute configuration assignments of three antifungal agents, (+)-(2R,4S)-ketoconazole, (+)-(2R,4S)-itraconazole (with (S)-configuration at the sec-butyl group) and (+)-(S)-miconazole nitrate have been confirmed by using vibrational circular dichroism (VCD). For these three antifungal drugs, this study also provides evidence for the most abundant conformations of miconazole and for the relative conformations of the azole, dichlorophenyl, and methoxyphenyl groups in ketoconazole and itraconazole, in chloroform solution.

Enantioselectivity of inhibition of cytochrome P450 3A4 (CYP3A4) by ketoconazole: Testosterone and methadone as substrates.

Racemic ketoconazole (KTZ) was the first orally active azole antifungal agent used in clinical practice and has become widely used in the treatment of mucosal fungal infections associated with AIDS immunosuppression and cancer chemotherapy. However, the use of KTZ has been limited because of adverse drug-drug interactions. KTZ blocks ergosterol biosynthesis by inhibiting the fungal cytochrome P450 (CYP51). KTZ is also a potent inhibitor of human cytochrome P450 3A4 (CYP3A4) enzyme, the major drug-metabolizing CYP isozyme in the human liver. We examined the enantioselective differences of KTZ in the inhibition of human CYP3A4 and in antifungal action. Dextro- and levo-KTZ exhibited modest enantioselective differences with respect to CYP3A4 inhibition of testosterone and methadone metabolism. For both substrates levo-KTZ was approximately a 2-fold more potent inhibitor. We examined the enantioselective differences in the in vitro activity of KTZ against medically relevant species of Candida and Aspergillus, as well as Cryptococcus neoformans. Overall, levo-KTZ was 2-4-fold more active than dextro-KTZ. Therefore, levo-KTZ is a more potent inhibitor of CYP3A4 and has stronger in vitro antifungal activity. Chirality 16:79-85, 2004.

Stereoselective metabolism of methadone N-demethylation by cytochrome P4502B6 and 2C19.

Methadone is a clinically used opioid agonist that is oxidatively metabolized by cytochrome P450 (CYP) isoforms to a stable metabolite, EDDP. Methadone is a chiral drug administered as the racemic mixture of (R)-(-)- and (S)-(+)-methadone, but (R)-methadone is the active isomer. The cytochrome P450 (CYP) isoform involved in methadone's metabolism is thought to be CYP3A4, but human drug-drug interaction studies are not consistent with this. The ability of the common human drug-metabolizing CYPs (obtained from baculovirus-infected insect cell supersomes) to generate 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrilidine (EDDP) from racemic methadone was examined and then determined if the CYP isoforms metabolized methadone stereoselectively. Only CYP2B6, 2C19, and 3A4 generated measurable EDDP from 1 microg/ml of racemic methadone. The hierarchy of EDDP generation was CYP2B6 > CYP2C19 >/= CYP3A4. At 10 microg/ml of methadone, CYP2C9 and CYP2D6 also generated EDDP, but in at least 10-fold lower quantities than CYP2B6. Michaelis-Menten kinetic data demonstrated that CYP2B6 had the highest V(max) (44 ng/min/10pmol) and the lowest K(m) (12.6 microg/ml) for EDDP formation of all the CYP isoforms. In human liver microsomes with high and low CYP2B6 expression but equivalent CYP3A4 expression, high CYP2B6 expression microsomes generated twice the amount of EDDP from 10 microg/ml of methadone than low CYP2B6 expression microsomes. When stereoselective metabolism of racemic methadone by CYP2B6, 2C19, and 3A4 was examined using an enantiospecific methadone assay, CYP2B6 preferentially metabolized (S)-methadone, CYP2C19 preferentially metabolized (R)-methadone, and CYP3A4 showed no preference. These data suggest that multiple CYPs metabolized methadone but CYP2B6 had the highest V(max)/K(m). In addition, only CYP2B6 and 2C19 showed stereoselective metabolism. Our data could explain why the plasma concentration ratio of R/S methadone is variable and why drugs that induce CYP2B6 such as nevirapine and efavirenz also induce methadone metabolism, while the CYP3A4 inducer rifabutin has no effect on methadone pharmacokinetics.

Single-isomer science: the phenomenon and its terminology.

Single-isomer drugs are of great importance in modern therapeutics. In this article, the basics of the underlying phenomenon are explained. Some molecules are chiral, ie, their mirror image is not superposable on the original. The most common element producing molecular chirality is a chiral center, typically a carbon atom carrying four different groups. The mirror-image molecules are termed enantiomers, but the less specific terms stereoisomers and isomers are also used. A substance consisting of only one of the two enantiomers is a single enantiomer or single isomer, and the 1:1 mixture of the enantiomers is the racemic mixture or racemate. A graphical convention that conveys the three-dimensional aspects of chiral molecules drawn in two dimensions, as well as two nongraphical conventions, based on optical rotation and configuration, are used to identify enantiomers. Optical rotation is a physical property of single enantiomers and involves rotation of the plane of plane-polarized light, each pure enantiomer rotating with equal magnitude but in the opposite direction (dextro and levo). Configuration is the actual arrangement in space of the atoms of chiral molecules. Two systems of indicating configuration are in use. One employs D and L to denote the respective enantiomers, and is applicable only to a-amino acids and carbohydrates. The other is a universal system using R and S as descriptors for the two possible arrangements, respectively, of the atoms around the chiral center. Interest in chiral drugs stems from the frequently observed biological differences between enantiomers. Such enantioselectivity is the result of different interactions of the drug enantiomers with target receptors that are themselves chiral and single-enantiomeric.

New single-isomer compounds on the horizon.

In 1992, the Food and Drug Administration (FDA) issued new guidelines governing stereoisomerism in new-drug development. The guidelines strongly encourage the development of single isomers and discourage stereoisomeric (eg, racemic) mixtures. As a result, most new chiral drugs are being developed as single enantiomers (ie, single isomers). There are three mechanisms for the identification and development of new single-isomer drugs: chiral switches (CS), chiral metashifts (CM), and new single-isomer chemical entities (NSICEs). In a CS, one of the two enantiomers of an established racemate is developed as a new drug, with the expectation that the single-isomer form has advantages over the racemic parent in terms of efficacy and/or adverse effects. Many new CS drugs are in development, eg, (S)-oxybutynin for urinary incontinence and escitalopram for depression. In a CM, a chiral metabolite of a drug is developed, in single-isomer form, as an agent with advantages over the parent. Among the current CM drugs in development are (+)-norcisapride (safer GI prokinetic agent than the racemic parent cisapride) and (S)-desmethylzopiclone (antianxiety agent, metabolite of the sedative-hypnotic zopiclone). Many NSICEs are in development, eg, rosuvastatin as an antihypercholesterolemic, posaconazole as an antifungal, sitafloxacin as a fluoroquinolone antibacterial, pregabalin as an anticonvulsant, abarelix as an antineoplastic, etc. As in the development of any new drug, not every single-isomer candidate will reach the clinic, but there is no doubt that the move to single-isomer agents is an important step forward in the search for better and safer drugs.