Fast-Killing Tyrosine Amide (()-SW228703) with Blood- and Liver-Stage Antimalarial Activity Associated with the Cyclic Amine Resistance Locus (CARL).

Current malaria treatments are threatened by drug resistance, and new drugs are urgently needed. In a phenotypic screen for new antimalarials, we identified ()-SW228703 (()-SW703), a tyrosine amide with asexual blood and liver stage activity and a fast-killing profile. Resistance to ()-SW703 is associated with mutations in the cyclic amine resistance locus (CARL) and acetyl CoA transporter (ACT), similarly to several other compounds that share features such as fast activity and liver-stage activity. Compounds with these resistance mechanisms are thought to act in the ER, though their targets are unknown. The tyramine of ()-SW703 is shared with some reported CARL-associated compounds; however, we observed that strict S-stereochemistry was required for the activity of ()-SW703, suggesting differences in the mechanism of action or binding mode. ()-SW703 provides a new chemical series with broad activity for multiple life-cycle stages and a fast-killing mechanism of action, available for lead optimization to generate new treatments for malaria.