The intrinsic challenge of large molecules to cross the
cell membrane
and reach intracellular targets is a major obstacle for the development
of new medicines. We report how rotation along a single C–C
bond, between atropisomers of a drug in clinical trials, improves
cell uptake and therapeutic efficacy. The atropisomers of redaporfin
(a fluorinated sulfonamide bacteriochlorin photosensitizer of 1135
Da) are separable and display orders of magnitude differences in photodynamic
efficacy that are directly related to their differential cellular
uptake. We show that redaporfin atropisomer uptake is passive and
only marginally affected by ATP depletion, plasma proteins, or formulation
in micelles. The α
4
atropisomer, where
meso
-phenyl sulfonamide substituents are on the same side of the tetrapyrrole
macrocycle, exhibits the highest cellular uptake and phototoxicity.
This is the most amphipathic atropisomer with a conformation that
optimizes hydrogen bonding (H-bonding) with polar head groups of membrane
phospholipids. Consequently, α
4
binds to the phospholipids
on the surface of the membrane, flips into the membrane to adopt the
orientation of a surfactant, and eventually diffuses to the interior
of the cell (bind-flip mechanism). We observed increased α
4
internalization by cells of the tumor microenvironment in
vivo and correlated this to the response of photodynamic therapy when
tumor illumination was performed 24 h after α
4
administration.
These results show that properly orientated aryl sulfonamide groups
can be incorporated into drug design as efficient cell-penetrating
motifs in vivo and reveal the unexpected biological consequences of
atropisomerism.