Guanabenz Repurposed as an Antiparasitic with Activity against Acute and Latent Toxoplasmosis

Abstract

ABSTRACTToxoplasma gondiiis a protozoan parasite that persists as a chronic infection.Toxoplasmaevades immunity by forming tissue cysts, which reactivate to cause life-threatening disease during immune suppression. There is an urgent need to identify drugs capable of targeting these latent tissue cysts, which tend to form in the brain. We previously showed that translational control is critical during infections with both replicative and latent forms ofToxoplasma. Here we report that guanabenz, an FDA-approved drug that interferes with translational control, has antiparasitic activity against replicative stages ofToxoplasmaand the related apicomplexan parasitePlasmodium falciparum(a malaria agent). We also found that inhibition of translational control interfered with tissue cyst biologyin vitro.Toxoplasmabradyzoites present in these abnormal cysts were diminished and misconfigured, surrounded by empty space not seen in normal cysts. These findings prompted analysis of the efficacy of guanabenzin vivoby using established mouse models of acute and chronic toxoplasmosis. In addition to protecting mice from lethal doses ofToxoplasma, guanabenz has a remarkable ability to reduce the number of brain cysts in chronically infected mice. Our findings suggest that guanabenz can be repurposed into an effective antiparasitic with a unique ability to reduce tissue cysts in the brain.