Bifunctional carbazole derivatives for simultaneous therapy and fluorescence imaging in prion disease murine cell models

Eur J Med Chem. 2023 Jan 5;245(Pt 1):114923. doi: 10.1016/j.ejmech.2022.114923. Epub 2022 Nov 15.


Prion diseases are characterized by the self-assembly of pathogenic misfolded scrapie isoforms (PrPSc) of the cellular prion protein (PrPC). In an effort to achieve a theranostic profile, symmetrical bifunctional carbazole derivatives were designed as fluorescent rigid analogues of GN8, a pharmacological chaperone that stabilizes the native PrPC conformation and prevents its pathogenic conversion. A focused library was synthesized via a four-step route, and a representative member was confirmed to have native fluorescence, including a band in the near-infrared region. After a cytotoxicity study, compounds were tested on the RML-infected ScGT1 neuronal cell line, by monitoring the levels of protease-resistant PrPSc. Small dialkylamino groups at the ends of the molecule were found to be optimal in terms of therapeutic index, and the bis-(dimethylaminoacetamido)carbazole derivative 2b was selected for further characterization. It showed activity in two cell lines infected with the mouse-adapted RML strain (ScGT1 and ScN2a). Unlike GN8, 2b did not affect PrPC levels, which represents a potential advantage in terms of toxicity. Amyloid Seeding Assay (ASA) experiments showed the capacity of 2b to delay the aggregation of recombinant mouse PrP. Its ability to interfere with the amplification of the scrapie RML strain by Protein Misfolding Cyclic Amplification (PMCA) was shown to be higher than that of GN8, although 2b did not inhibit the amplification of human vCJD prion. Fluorescent staining of PrPSc aggregates by 2b was confirmed in living cells. 2b emerges as an initial hit compound for further medicinal chemistry optimization towards strain-independent anti-prion compounds.

Keywords: Carbazoles; GN8; Prion protein; Prions; Theranostics.

MeSH terms

  • Animals
  • Carbazoles* / chemistry
  • Carbazoles* / pharmacology
  • Carbazoles* / therapeutic use
  • Cell Line
  • Mice
  • Optical Imaging
  • PrPC Proteins* / antagonists & inhibitors
  • PrPC Proteins* / chemistry
  • Prion Diseases* / diagnosis
  • Prion Diseases* / drug therapy
  • Protein Aggregates* / drug effects


  • Carbazoles
  • PrPC Proteins
  • Protein Aggregates