# Trypanocidal Activity of Dual Redox-Active Quinones: Trypanosoma cruzi Mitochondrion as a Target Organelle In Vitro and Anti-Inflammatory Properties In Vivo

## TL;DR

This study explores new quinone compounds that show strong trypanocidal activity and reduced toxicity compared to current treatments for Chagas disease.

## Contribution

The study introduces dual redox-active quinones with mitochondrial targeting and anti-inflammatory properties for Chagas disease.

## Key findings

- NQ1 and NQ2 showed higher trypanocidal activity than benznidazole with IC50 values between 0.8 to 3.1 µM.
- NQ1 caused mitochondrial damage and ROS production in T. cruzi and reduced parasitemia and myocarditis in vivo.
- Combining NQ1 with benznidazole showed additive effects, suggesting potential for improved treatment protocols.

## Abstract

Chagas disease is caused by the protozoan Trypanosoma cruzi, and its current treatment is limited to the use of two nitroderivatives, benznidazole (Bz) and nifurtimox; however, their toxicity often leads to discontinuation, justifying the search for new therapeutic options. The biological activity of quinones has long shown efficacy towards pathogenic microorganisms. In our previous investigations, two naphthoquinones combining ortho- and para-quinoidal moieties exhibited remarkable trypanocidal activity and presented low toxicity to host cells. Here, these two active compounds were further assessed. On trypomastigotes and epimastigotes, brominated (NQ1) and chlorinated (NQ2) nor-beta-lapachone-derived 1,2,3-triazoles were more active than Bz, presenting IC50/24 h values in the range of 0.8 to 3.1 µM. NQ1-treated epimastigotes showed a mitochondrial impairment and reactive oxygen species (ROS) production under electron microscopy and flow cytometry. The in vitro evaluation of both combinations of compounds with Bz indicated an additive interaction. In vivo, oral treatment with NQ1 reduced parasitemia in an acute model, with no evidence of toxicity. The treatment also led to a reduction in myocarditis, decreasing the PR interval in electrocardiographic analysis and reversing the sinus bradycardia caused by infection. These data suggest that T. cruzi mitochondrion are part of the NQ1 mechanism of action. In vivo, this compound presented moderate trypanocidal and promising anti-inflammatory activity. Its combination with Bz could enhance current therapeutic protocols and should be better explored in the future.