Recent events involving nerve agents of the A-Series, a once elusive class of chemical warfare agents, have provoked a great concern in the international community. In this paper, continuing our research efforts in Medicinal Chemistry at the Brazilian Institute of Chemical, Biological, Radiological and Nuclear Defense (IDQBRN) (an OPCW-designated Laboratory for environmental samples), we explore ANMP, an A-230 surrogate, in the search for new treatment options for intoxications caused by these chemicals. Five isatin-pyridine oxime hybrids were evaluated as acetylcholinesterase (AChE) reactivators using a modified Ellman's assay. Our results indicate that monocationic hybrids with five methylene units, as well as its oxa-analog, are promising compounds for the design of new AChE reactivators.

• Keywords
• Acetylcholinesterase, Antidotes, Chemical Weapons Convention, Isatin hybrids, Nerve agents,
• MeSH
• Acetylcholinesterase metabolism   MeSH
• Chemical Warfare Agents * toxicity   chemistry   MeSH
• Cholinesterase Inhibitors * toxicity   chemistry   MeSH
• Isatin * chemistry   pharmacology   analogs & derivatives   MeSH
• Oximes * chemistry   pharmacology   MeSH
• Computer Simulation MeSH
• Pyridines * chemistry   pharmacology   MeSH
• Cholinesterase Reactivators * pharmacology   chemistry   MeSH
• Structure-Activity Relationship MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Acetylcholinesterase MeSH
• Chemical Warfare Agents * MeSH
• Cholinesterase Inhibitors * MeSH
• Isatin * MeSH
• Oximes * MeSH
• Pyridines * MeSH
• Cholinesterase Reactivators * MeSH

A-series agent A-234 belongs to a new generation of nerve agents. The poisoning of a former Russian spy Sergei Skripal and his daughter in Salisbury, England, in March 2018 led to the inclusion of A-234 and other A-series agents into the Chemical Weapons Convention. Even though five years have already passed, there is still very little information on its chemical properties, biological activities, and treatment options with established antidotes. In this article, we first assessed A-234 stability in neutral pH for subsequent experiments. Then, we determined its inhibitory potential towards human recombinant acetylcholinesterase (HssAChE; EC 3.1.1.7) and butyrylcholinesterase (HssBChE; EC 3.1.1.8), the ability of HI-6, obidoxime, pralidoxime, methoxime, and trimedoxime to reactivate inhibited cholinesterases (ChEs), its toxicity in rats and therapeutic effects of different antidotal approaches. Finally, we utilized molecular dynamics to explain our findings. The results of spontaneous A-234 hydrolysis showed a slow process with a reaction rate displaying a triphasic course during the first 72 h (the residual concentration 86.2%). A-234 was found to be a potent inhibitor of both human ChEs (HssAChE IC50 = 0.101 ± 0.003 µM and HssBChE IC50 = 0.036 ± 0.002 µM), whereas the five marketed oximes have negligible reactivation ability toward A-234-inhibited HssAChE and HssBChE. The acute toxicity of A-234 is comparable to that of VX and in the context of therapy, atropine and diazepam effectively mitigate A-234 lethality. Even though oxime administration may induce minor improvements, selected oximes (HI-6 and methoxime) do not reactivate ChEs in vivo. Molecular dynamics implies that all marketed oximes are weak nucleophiles, which may explain the failure to reactivate the A-234 phosphorus-serine oxygen bond characterized by low partial charge, in particular, HI-6 and trimedoxime oxime oxygen may not be able to effectively approach the A-234 phosphorus, while pralidoxime displayed low interaction energy. This study is the first to provide essential experimental preclinical data on the A-234 compound.

• Keywords
• Acute toxicity, Hydrolysis, Nerve agent A-234, Reactivation, Therapy,
• MeSH
• Acetylcholinesterase MeSH
• Antidotes pharmacology   MeSH
• Butyrylcholinesterase MeSH
• Cholinesterase Inhibitors toxicity   MeSH
• Phosphorus MeSH
• Rats MeSH
• Oxygen MeSH
• Humans MeSH
• Oximes pharmacology   MeSH
• Pralidoxime Compounds * MeSH
• Pyridinium Compounds pharmacology   MeSH
• Cholinesterase Reactivators * pharmacology   MeSH
• Taurine analogs & derivatives   MeSH
• Trimedoxime pharmacology   MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• 2-(N-cyclohexylamino)ethanesulfonic acid MeSH Browser
• Acetylcholinesterase MeSH
• Antidotes MeSH
• asoxime chloride MeSH Browser
• Butyrylcholinesterase MeSH
• Cholinesterase Inhibitors MeSH
• Phosphorus MeSH
• Oxygen MeSH
• N,N'-monomethylenebis(pyridiniumaldoxime) MeSH Browser
• Oximes MeSH
• pralidoxime MeSH Browser
• Pralidoxime Compounds * MeSH
• Pyridinium Compounds MeSH
• Cholinesterase Reactivators * MeSH
• Taurine MeSH
• Trimedoxime MeSH

Poisoning with organophosphorus compounds used as pesticides or misused as chemical weapons remains a serious threat to human health and life. Their toxic effects result from irreversible blockade of the enzymes acetylcholinesterase and butyrylcholinesterase, which causes overstimulation of the cholinergic system and often leads to serious injury or death. Treatment of organophosphorus poisoning involves, among other strategies, the administration of oxime compounds. Oximes reactivate cholinesterases by breaking the covalent bond between the serine residue from the enzyme active site and the phosphorus atom of the organophosphorus compound. Although the general mechanism of reactivation has been known for years, the exact molecular aspects determining the efficiency and selectivity of individual oximes are still not clear. This hinders the development of new active compounds. In our research, using relatively simple and widely available molecular docking methods, we investigated the reactivation of acetyl- and butyrylcholinesterase blocked by sarin and tabun. For the selected oximes, their binding modes at each step of the reactivation process were identified. Amino acids essential for effective reactivation and those responsible for the selectivity of individual oximes against inhibited acetyl- and butyrylcholinesterase were identified. This research broadens the knowledge about cholinesterase reactivation and demonstrates the usefulness of molecular docking in the study of this process. The presented observations and methods can be used in the future to support the search for new effective reactivators.

• Keywords
• acetylcholinesterase, butyrylcholinesterase, docking studies, molecular modeling, organophosphates, reactivation process, reactivators,
• MeSH
• Acetylcholinesterase metabolism   MeSH
• Enzyme Activation MeSH
• Butyrylcholinesterase metabolism   MeSH
• Cholinesterase Inhibitors pharmacology   MeSH
• Phosphorus chemistry   MeSH
• Catalytic Domain MeSH
• Protein Conformation MeSH
• Quantum Theory MeSH
• Humans MeSH
• Ligands MeSH
• Models, Molecular MeSH
• Mice MeSH
• Organophosphates chemistry   MeSH
• Oximes chemistry   MeSH
• Protein Biosynthesis MeSH
• Cholinesterase Reactivators pharmacology   MeSH
• Sarin chemistry   MeSH
• Cluster Analysis MeSH
• Molecular Docking Simulation * MeSH
• Protein Binding MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Mice MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Acetylcholinesterase MeSH
• Butyrylcholinesterase MeSH
• Cholinesterase Inhibitors MeSH
• Phosphorus MeSH
• Ligands MeSH
• Organophosphates MeSH
• Oximes MeSH
• Cholinesterase Reactivators MeSH
• Sarin MeSH
• tabun MeSH Browser

Organophosphorus (OP) compounds are used as both chemical weapons and pesticides. However, these agents are very dangerous and toxic to humans, animals, and the environment. Thus, investigations with reactivators have been deeply developed in order to design new antidotes with better efficiency, as well as a greater spectrum of action in the acetylcholinesterase (AChE) reactivation process. With that in mind, in this work, we investigated the behavior of trimedoxime toward the Mus musculus acetylcholinesterase (MmAChE) inhibited by a range of nerve agents, such as chemical weapons. From experimental assays, reactivation percentages were obtained for the reactivation of different AChE-OP complexes. On the other hand, theoretical calculations were performed to assess the differences in interaction modes and the reactivity of trimedoxime within the AChE active site. Comparing theoretical and experimental data, it is possible to notice that the oxime, in most cases, showed better reactivation percentages at higher concentrations, with the best result for the reactivation of the AChE-VX adduct. From this work, it was revealed that the mechanistic process contributes most to the oxime efficiency than the interaction in the site. In this way, this study is important to better understand the reactivation process through trimedoxime, contributing to the proposal of novel antidotes.

• Keywords
• acetylcholinesterase, computational methods, mechanistic studies, nerve agents, reactivation, trimedoxime,
• MeSH
• Acetylcholinesterase metabolism   MeSH
• Antidotes pharmacology   MeSH
• Cholinesterase Inhibitors metabolism   pharmacology   MeSH
• Rats MeSH
• Humans MeSH
• Mice MeSH
• Nerve Agents chemistry   MeSH
• Organophosphorus Compounds chemistry   MeSH
• Oximes chemistry   MeSH
• Cholinesterase Reactivators chemistry   pharmacology   MeSH
• Trimedoxime pharmacology   therapeutic use   MeSH
• Computational Biology methods   MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Humans MeSH
• Mice MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Acetylcholinesterase MeSH
• Antidotes MeSH
• Cholinesterase Inhibitors MeSH
• Nerve Agents MeSH
• Organophosphorus Compounds MeSH
• Oximes MeSH
• Cholinesterase Reactivators MeSH
• Trimedoxime MeSH