Limitations in current acetylcholinesterase structure-based design of oxime antidotes for organophosphate poisoning

Ann N Y Acad Sci. 2016 Aug;1378(1):41-49. doi: 10.1111/nyas.13128. Epub 2016 Jul 2.

Abstract

Acetylcholinesterase (AChE; EC 3.1.1.7), an essential enzyme of cholinergic neurotransmission in vertebrates, is a primary target in acute nerve agent and organophosphate (OP) pesticide intoxication. Catalytically inactive OP-AChE conjugates formed between the active-center serine and phosphorus of OPs can, in principle, be reactivated by nucleophilic oxime antidotes. Antidote efficacy is limited by the structural diversity of OP-AChE conjugates resulting from differences in the structure of the conjugated OP, the different active-center volumes they occupy when conjugated to the active-center serine of AChE, and the distinct chemical characteristics of both OPs and oximes documented in numerous X-ray structures of OP-conjugated AChEs. Efforts to improve oxime reactivation efficacy by AChE structure-based enhancement of oxime structure have yielded only limited success. We outline here the potential limitations of available AChE X-ray structures that preclude an accurate prediction of oxime structures, which are necessary for association in the OP-AChE gorge and nucleophilic attack of the OP-conjugated phosphorus.

Keywords: X-ray structure; acetylcholinesterase; nucleophilic reactivation; organophosphate; oxime antidote; protein backbone flexibility.

Publication types

  • Review

MeSH terms

  • Acetylcholinesterase / chemistry*
  • Acetylcholinesterase / metabolism
  • Animals
  • Antidotes / chemistry*
  • Antidotes / metabolism
  • Antidotes / therapeutic use
  • Cholinesterase Inhibitors / chemistry*
  • Cholinesterase Inhibitors / metabolism
  • Cholinesterase Inhibitors / therapeutic use
  • Cholinesterase Reactivators / chemistry*
  • Cholinesterase Reactivators / metabolism
  • Cholinesterase Reactivators / therapeutic use
  • Crystallography, X-Ray
  • Drug Design
  • Humans
  • Organophosphate Poisoning / drug therapy*
  • Organophosphate Poisoning / enzymology
  • Oximes / chemistry*
  • Oximes / metabolism
  • Oximes / therapeutic use
  • Protein Structure, Tertiary
  • Structure-Activity Relationship

Substances

  • Antidotes
  • Cholinesterase Inhibitors
  • Cholinesterase Reactivators
  • Oximes
  • Acetylcholinesterase