Artemisinins are the corner stone of anti-malarial drugs1. Emergence and spread of resistance to them2–4 raises risk of wiping out recent gains achieved in reducing world-wide malaria burden and threatens future malaria control and elimination on a global level. Genome wide association studies (GWAS) have revealed parasite genetic loci associated with artemisinin resistance5–10. However, there is no consensus on biochemical targets of artemisinin. Whether and how these targets interact with genes identified by GWAS, remains unknown. Here we provide biochemical and cellular evidence that artemisinins are potent inhibitors of Plasmodium falciparum phosphatidylinositol-3-kinase (PfPI3K), revealing an unexpected mechanism of action. In resistant clinical strains, increased PfPI3K was associated with the C580Y mutation in P. falciparum Kelch13 (PfKelch13), a primary marker of artemisinin resistance. Polyubiquitination of PfPI3K and its binding to PfKelch13 were reduced by PfKelch13 mutation, which limited proteolysis of PfPI3K and thus increased levels of the kinase as well as its lipid product phosphatidylinositol 3-phosphate (PI3P). We find PI3P levels to be predictive of artemisinin resistance in both clinical and engineered laboratory parasites as well as across non-isogenic strains. Elevated PI3P induced artemisinin resistance in absence of PfKelch13 mutations, but remained responsive to regulation by PfKelch13. Evidence is presented for PI3P-dependent signaling, where transgenic expression of an additional kinase confers resistance. Together these data present PI3P as the key mediator of artemisinin resistance and the sole PfPI3K as an important target for malaria elimination.

Selective inhibition of protein methyltransferases is a promising new approach to drug discovery. An attractive strategy towards this goal is the development of compounds that selectively inhibit binding of the cofactor, S-adenosylmethionine, within specific protein methyltransferases. Here we report the three-dimensional structure of the protein methyltransferase DOT1L bound to EPZ004777, the first S-adenosylmethionine-competitive inhibitor of a protein methyltransferase with in vivo efficacy. This structure and those of four new analogues reveal remodelling of the catalytic site. EPZ004777 and a brominated analogue, SGC0946, inhibit DOT1L in vitro and selectively kill mixed lineage leukaemia cells, in which DOT1L is aberrantly localized via interaction with an oncogenic MLL fusion protein. These data provide important new insight into mechanisms of cell-active S-adenosylmethioninecompetitive protein methyltransferase inhibitors, and establish a foundation for the further development of drug-like inhibitors of DOT1L for cancer therapy.

We present a kinetic study of OH(-) additions to several nitrosyl complexes containing mainly ruthenium and different coligands (polypyridines, amines, pyridines, cyanides). According to a first-order rate law in each reactant, we propose a fast ion pair formation equilibrium, followed by addition of OH(-) to the [MX(5)NO](n) moieties, with formation of the [MX(5)NO(2)H](n(-1)) intermediates. Additional attack by a second OH(-) gives the final products, [MX(5)NO(2)]((n-2)). A linear plot was found for ln k(4) (the addition rate constant) against the redox potential for nitrosyl reduction, E(NO+/-NO), showing a free-energy relationship with a slope close to 20 V(-1), consistent with an associative mechanism. Theoretical DFT calculated descriptors, as the charge density in the [MNO] moieties and the LUMO energies, qualitatively correlate with the rate constants. A linear to bent transformation was calculated for the nitrosyl complexes, as they evolve to the angular MNO(2)H and MNO(2) complexes. The geometries were optimized for the different complexes and adduct-intermediates, showing significant changes in the relevant distances and angles upon OH(-) addition. IR vibrations and electronic transitions were also calculated. The complete reaction profile was studied for the nitroprusside ion, including the description of the transition state structure. Experimental activation parameters revealed that both the activation enthalpies and entropies increase when going from the negatively charged to the positively charged complexes. As the rate constants increase in the same direction, we conclude that the reactions are entropically driven, compensating, this function, the increase in the activation enthalpies. The latter trend can be explained by the energies involved in angular reorganization after OH(-) coordination, which are larger as the positive charge in the nitrosyl moiety becomes larger. The use of E(NO+/-NO) as a predictive tool for electrophilic reactivity could be extended to similar reactions implying other nucleophiles, such as amines and thiolates.