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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Cell. Infect. Microbiol.</journal-id>
<journal-title>Frontiers in Cellular and Infection Microbiology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Cell. Infect. Microbiol.</abbrev-journal-title>
<issn pub-type="epub">2235-2988</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fcimb.2018.00409</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Cellular and Infection Microbiology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Discovery of Antiamebic Compounds That Inhibit Cysteine Synthase From the Enteric Parasitic Protist <italic>Entamoeba histolytica</italic> by Screening of Microbial Secondary Metabolites</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Mori</surname> <given-names>Mihoko</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/599474/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Tsuge</surname> <given-names>Satoshi</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Fukasawa</surname> <given-names>Wataru</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Jeelani</surname> <given-names>Ghulam</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Nakada-Tsukui</surname> <given-names>Kumiko</given-names></name>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Nonaka</surname> <given-names>Kenichi</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Matsumoto</surname> <given-names>Atsuko</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>&#x0014C;mura</surname> <given-names>Satoshi</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Nozaki</surname> <given-names>Tomoyoshi</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x0002A;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/193644/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Shiomi</surname> <given-names>Kazuro</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="corresp" rid="c002"><sup>&#x0002A;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/193787/overview"/>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup><institution>Graduate School of Infection Control Sciences, Kitasato University</institution>, <addr-line>Tokyo</addr-line>, <country>Japan</country></aff>
<aff id="aff2"><sup>2</sup><institution>Kitasato Institute for Life Sciences, Kitasato University</institution>, <addr-line>Tokyo</addr-line>, <country>Japan</country></aff>
<aff id="aff3"><sup>3</sup><institution>Graduate School of Medicine, The University of Tokyo</institution>, <addr-line>Tokyo</addr-line>, <country>Japan</country></aff>
<aff id="aff4"><sup>4</sup><institution>Department of Parasitology, National Institute of Infectious Diseases</institution>, <addr-line>Tokyo</addr-line>, <country>Japan</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: Anjan Debnath, University of California, San Diego, United States</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: Elisa Azuara-Liceaga, Universidad Aut&#x000F3;noma de la Ciudad de M&#x000E9;xico, Mexico; Mark Butler, The University of Queensland, Australia</p></fn>
<corresp id="c001">&#x0002A;Correspondence: Tomoyoshi Nozaki <email>nozaki&#x00040;m.u-tokyo.ac.jp</email></corresp>
<corresp id="c002">Kazuro Shiomi <email>shiomi&#x00040;lisci.kitasato-u.ac.jp</email></corresp>
<fn fn-type="other" id="fn001"><p>This article was submitted to Parasite and Host, a section of the journal Frontiers in Cellular and Infection Microbiology</p></fn></author-notes>
<pub-date pub-type="epub">
<day>05</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="collection">
<year>2018</year>
</pub-date>
<volume>8</volume>
<elocation-id>409</elocation-id>
<history>
<date date-type="received">
<day>29</day>
<month>08</month>
<year>2018</year>
</date>
<date date-type="accepted">
<day>01</day>
<month>11</month>
<year>2018</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2018 Mori, Tsuge, Fukasawa, Jeelani, Nakada-Tsukui, Nonaka, Matsumoto, &#x0014C;mura, Nozaki and Shiomi.</copyright-statement>
<copyright-year>2018</copyright-year>
<copyright-holder>Mori, Tsuge, Fukasawa, Jeelani, Nakada-Tsukui, Nonaka, Matsumoto, &#x0014C;mura, Nozaki and Shiomi</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license>
</permissions>
<abstract><p>Amebiasis is caused by infection with the protozoan parasite <italic>Entamoeba histolytica</italic>. Although metronidazole has been a drug of choice against amebiasis for decades, it shows side effects and low efficacy against asymptomatic cyst carriers. In addition, metronidazole resistance has been documented for bacteria and protozoa that share its targets, anaerobic energy metabolism. Therefore, drugs with new mode of action or targets are urgently needed. L-cysteine is the major thiol and an essential amino acid for proliferation and anti-oxidative defense of <italic>E. histolytica</italic> trophozoites. <italic>E. histolytica</italic> possesses the <italic>de novo</italic> L-cysteine biosynthetic pathway, consisting of two reactions catalyzed by serine acetyltransferase and cysteine synthase (CS, <italic>O</italic>-acetylserine sulfhydrylase). As the pathway is missing in humans, it is considered to be a rational drug target against amebiasis. In this study, we established a protocol to screen both a library of structurally known compounds and microbial culture extracts to discover compounds that target <italic>de novo</italic> cysteine biosynthesis of <italic>E. histolytica</italic>. The new screening system allowed us to identify the compounds that differentially affect the growth of the trophozoites in the cysteine-deprived medium compared to the cysteine-containing medium. A total of 431 structurally defined compounds of the Kitasato Natural Products Library and 6,900 microbial culture broth extracts were screened on the system described above. Five compounds, aspochalasin B, chaetoglobosin A, prochaetoglobosin III, cerulenin, and deoxyfrenolicin, from the Kitasato Natural Products Library, showed differential antiamebic activities in the cysteine-deprived medium when compared to the growth in the cysteine-containing medium. The selectivity of three cytochalasans apparently depends on their structural instability. Eleven microbial extracts showed selective antiamebic activities, and one fungal secondary metabolite, pencolide, was isolated. Pencolide showed cysteine deprivation-dependent antiamebic activity (7.6 times lower IC<sub>50</sub> in the absence of cysteine than that in the presence of cysteine), although the IC<sub>50</sub> value in the cysteine-deprived medium was rather high (283 &#x003BC;M). Pencolide also showed inhibitory activity against both CS1 and CS3 isoenzymes with comparable IC<sub>50</sub> values (233 and 217 &#x003BC;M, respectively). These results indicated that antiamebic activity of pencolide is attributable to inhibition of CS. Cytotoxicity of pencolide was 6.7 times weaker against mammalian MRC-5 cell line than <italic>E. histotytica</italic>. Pencolide has the maleimide structure, which is easily attacked by Michael donors including the thiol moiety of cysteine. The cysteine-adducts of pencolide were detected by mass spectrometric analysis as predicted. As CS inhibition by the pencolide adducts was weak and their IC<sub>50</sub> values to CS was comparable to that to the parasite in the cysteine-containing medium, the cysteine-adducts of pencolide likely contribute to toxicity of pencolide to the parasite in the cysteine-rich conditions. However, we cannot exclude a possibility that pencolide inactivates a variety of targets other than CSs in the absence of cysteine. Taken together, pencolide is the first compound that inhibits CS and amebic cell growth in a cysteine-dependent manner with relatively low mammalian cytotoxicity.</p></abstract>
<kwd-group>
<kwd>amebiasis</kwd>
<kwd>antiamebic compounds</kwd>
<kwd>cysteine synthase</kwd>
<kwd><italic>Entamoeba histolytica</italic></kwd>
<kwd>microbial secondary metabolites</kwd>
<kwd>natural products</kwd>
</kwd-group>
<counts>
<fig-count count="2"/>
<table-count count="4"/>
<equation-count count="0"/>
<ref-count count="48"/>
<page-count count="9"/>
<word-count count="7144"/>
</counts>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="s1">
<title>Introduction</title>
<p>Amebiasis is a diarrheal disease in humans, caused by infection with a protozoan parasite <italic>Entamoeba histolytica</italic>. WHO estimates 50 million cases of amebiasis, resulting in 40,000&#x02013;100,000 deaths annually worldwide (Harque et al., <xref ref-type="bibr" rid="B10">2003</xref>; Stanley, <xref ref-type="bibr" rid="B38">2003</xref>; Xim&#x000E9;nez et al., <xref ref-type="bibr" rid="B46">2009</xref>). Transmission occurs via the fecal-oral route, either directly by person-to-person contact or indirectly through ingestion of contaminated food or water. In East Asia and Australia, domestic infections are increasing among men who have sex with men, particularly those infected with HIV (James et al., <xref ref-type="bibr" rid="B16">2010</xref>; Watanabe et al., <xref ref-type="bibr" rid="B45">2011</xref>; Hung et al., <xref ref-type="bibr" rid="B11">2012</xref>; Lo et al., <xref ref-type="bibr" rid="B22">2014</xref>; Ishikane et al., <xref ref-type="bibr" rid="B14">2016</xref>; Yanagawa et al., <xref ref-type="bibr" rid="B48">2016</xref>). Metronidazole has been used as a drug of choice against amebiasis for decades despite its low efficacy against asymptomatic cyst carriers (Ali and Nozaki, <xref ref-type="bibr" rid="B1">2007</xref>). For the treatment of cyst carriers, combination of metronidazole and paromomycin is currently recommended as a standard regimen. However, both compounds have a teratogenic effect and several adverse side effects, such as nausea, vomiting, and a metallic taste (Ohnishi et al., <xref ref-type="bibr" rid="B31">2014</xref>). Moreover, it has been shown that <italic>E. histolytica</italic> is capable of surviving sub-therapeutic levels of metronidazole <italic>in vitro</italic> (Samarawickrema et al., <xref ref-type="bibr" rid="B33">1997</xref>; Wassmann et al., <xref ref-type="bibr" rid="B44">1999</xref>). Therefore, new drugs with different targets or modes of action have been needed.</p>
<p>L-Cysteine is essential for <italic>E. histolytica</italic>, and implicated in various important biological processes including attachment, motility, proliferation, and anti-oxidative defense (Gillin and Diamond, <xref ref-type="bibr" rid="B9">1981</xref>; Fahey et al., <xref ref-type="bibr" rid="B7">1984</xref>; Jeelani et al., <xref ref-type="bibr" rid="B17">2010</xref>, <xref ref-type="bibr" rid="B19">2014</xref>; Hussain et al., <xref ref-type="bibr" rid="B12">2011</xref>). <italic>E. histolytica</italic> is cysteine autotrophic, and capable of <italic>de novo</italic> biosynthesis of L-cysteine by so called the sulfur-assimilatory <italic>de novo</italic> L-cysteine synthetic pathway, which does not exist in humans. This pathway consists of two reactions catalyzed by serine acetyltransferase (SAT, EC 2.3.1.30) and cysteine synthase (CS, <italic>O</italic>-acetylserine sulfhydrylase, EC 2.5.1.47) (Nozaki et al., <xref ref-type="bibr" rid="B29">1998</xref>, <xref ref-type="bibr" rid="B30">1999</xref>, <xref ref-type="bibr" rid="B28">2005</xref>), and exists in bacteria, plants, and some parasitic protozoa (Ali and Nozaki, <xref ref-type="bibr" rid="B1">2007</xref>). <italic>E. histolytica</italic> has three SAT (EhSAT1-3) and two CS (EhCS1 and 3) isotypes, and these enzymes have unique features when compared to those from bacteria and plants (Nozaki et al., <xref ref-type="bibr" rid="B29">1998</xref>, <xref ref-type="bibr" rid="B30">1999</xref>; Hussain et al., <xref ref-type="bibr" rid="B13">2009</xref>). Recently, it was demonstrated that <italic>CS</italic> gene-silenced lines displayed a severe growth effect in an L-cysteine-lacking medium, whereas <italic>SAT1/2</italic> or <italic>SAT3</italic> gene silencing caused no or only mild growth defect in L-cysteine lacking medium (Jeelani et al., <xref ref-type="bibr" rid="B18">2017</xref>), suggestive of the central role CS plays. As CS is essential for the parasite survival, this enzyme could be a promising drug target. In a few previous studies, EhCS inhibitors have been discovered. <italic>In silico</italic> prediction assisted to discover one compound that showed EhCS inhibition at the IC<sub>50</sub> value of 100 &#x003BC;M (Nagpal et al., <xref ref-type="bibr" rid="B26">2012</xref>), and a series of pyrazolo[3,4-<italic>d</italic>]pyrimidines with <italic>in vitro</italic> antiamebic activity at the IC<sub>50</sub> value of around 1 &#x003BC;M might inhibit EhCS (Yadava et al., <xref ref-type="bibr" rid="B47">2015</xref>). We previously conducted an enzymatic screening of the Kitasato Natural Products Library and microbial culture broth extracts (Mori et al., <xref ref-type="bibr" rid="B25">2015</xref>). We found nine EhCS inhibitors from the Kitasato Natural Products Library and isolated two compounds (xanthofulvin and exophillic acid) from microbial culture broth extracts with the IC<sub>50</sub> value ranging 0.31&#x02013;490 &#x003BC;M (Mori et al., <xref ref-type="bibr" rid="B25">2015</xref>). However, none of these compounds showed <italic>in vitro</italic> amebicidal activity with the comparable IC<sub>50</sub> values except for deacetylkinamycin C, which showed cytotoxicity to MRC-5.</p>
<p>In order to overcome this problem, we took advantage of a cell-based phenotypic screening using two culture conditions (cysteine-deprived and cysteine-supplemented conditions). If a compound inhibits CS leading to intracellular cysteine deprivation, trophozoites are not able to grow or killed without externally supplied L-cysteine; in other words, trophozoites should grow only in the cysteine-supplemented medium, but not in the cysteine-deprived medium. Using this strategy, we obtained pencolide from a fungal culture broth extract, which inhibits CS activity and cell growth at a comparable range of the IC<sub>50</sub> values, from microbial culture broth extracts.</p>
</sec>
<sec sec-type="materials and methods" id="s2">
<title>Materials and Methods</title>
<sec>
<title>Organism and Culture</title>
<p>Trophozoites of <italic>E. histolytica</italic> clonal strain HM-1:IMSS cl6 were cultured axenically in Diamond&#x00027;s BI-S-33 medium at 37&#x000B0;C (Clark and Diamond, <xref ref-type="bibr" rid="B5">2002</xref>).</p>
</sec>
<sec>
<title>Production of Recombinant <italic>E. histolytica</italic> CSs and Measurement of CS Inhibitory Activity</title>
<p>Expression and purification of recombinant <italic>E. histolytica</italic> CS1 and CS3, and measurement of inhibitory activity against both enzymes were described previously (Mori et al., <xref ref-type="bibr" rid="B25">2015</xref>).</p>
</sec>
<sec>
<title><italic>In vitro</italic> Evaluation of Antiamebic Activity</title>
<p>Trophozoites were harvested in a logarithmic growth phase 3 or 4 days after inoculation of 1/30&#x02013;1/12 volume of the seed culture. After the cultures were chilled on ice for 5 min, trophozoites were collected by centrifugation at 500 &#x000D7; <italic>g</italic> for 10 min at 4&#x000B0;C. The trophozoites were resuspended in BI-S-33 medium containing 1% (v/v) penicillin/streptomycin (Life Technologies, Grand Islands, NY, U.S.A.), with a final concentration of 5 &#x000D7; 10<sup>4</sup> cells/ml. Approximately 200 &#x003BC;l of the trophozoite suspension (1 &#x000D7; 10<sup>4</sup> trophozoites) was dispensed into each well of a 96-well plate and incubated at 35.5&#x000B0;C for 2 h under anaerobic conditions with Anaeropak (Mitsubishi Chemical, Tokyo, Japan). After incubation, the medium was removed and 180 &#x003BC;l of either L-cysteine-deprived or L-cysteine (9 mM) supplemented BI-S-33 medium, 10 &#x003BC;l of 2% (v/v) penicillin/streptomycin together, and 10 &#x003BC;l of sample solution [dissolved in 20% dimethylsulfoxide (DMSO) and 80% H<sub>2</sub>O] were added to each well. The plates were incubated under anaerobic conditions with Anaeropak for 48 hrs. After incubation, the medium was removed and 90 &#x003BC;l of pre-warmed Opti-MEM I (Life Technologies) and 10 &#x003BC;l of WST-1 solution (Dojindo, Kumamoto, Japan) were added to each well. Optical absorbance at 450 nm was measured on a photospectrometer (SH-9000Lab, Corona Electric, Ibaraki, Japan). Metronidazole (Sigma-Aldrich, MO, USA) was used as positive control. Antiamebic assays were done in triplicate. ED<sub>50</sub> values were calculated by the equation described previously (Arita-Morioka et al., <xref ref-type="bibr" rid="B2">2015</xref>). The cysteine dependence of the antiamebic activities was calculated as ED<inline-formula><mml:math id="M1"><mml:msubsup><mml:mrow></mml:mrow><mml:mrow><mml:mn>50</mml:mn></mml:mrow><mml:mrow><mml:mtext>Cys</mml:mtext><mml:mrow><mml:mo stretchy="false">(</mml:mo><mml:mrow><mml:mo>&#x0002B;</mml:mo></mml:mrow><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:mrow></mml:msubsup></mml:math></inline-formula>/ED<inline-formula><mml:math id="M2"><mml:msubsup><mml:mrow></mml:mrow><mml:mrow><mml:mn>50</mml:mn></mml:mrow><mml:mrow><mml:mtext>Cys</mml:mtext><mml:mrow><mml:mo stretchy="false">(</mml:mo><mml:mrow><mml:mo>-</mml:mo></mml:mrow><mml:mo stretchy="false">)</mml:mo></mml:mrow></mml:mrow></mml:msubsup></mml:math></inline-formula> and expressed as &#x0201C;cysteine dependence index.&#x0201D;</p>
</sec>
<sec>
<title>Evaluation of Cytotoxicity Against MRC-5 Cells</title>
<p>Human fibroblast cell line, MRC-5, was used for cytotoxicity evaluation. MRC-5 cells were plated on 96-well flat bottom plates at a density of 1.5 &#x000D7; 10<sup>4</sup> cells/well in 100 &#x003BC;l of MEM medium each well (Life Technologies) containing 10% fetal bovine serum (Hana-nesco Bio, Tokyo, Japan) and 1% penicillin-streptomycin (Life Technologies) and incubated at 37&#x000B0;C with 5% CO<sub>2</sub> for 2 days. Test compounds in 5 &#x003BC;l of 50% DMSO and 50% H<sub>2</sub>O and 100 &#x003BC;l of MEM medium were mixed and added to each well. After cultivation at 37&#x000B0;C with 5% CO<sub>2</sub> for 2 days, cell density and morphological changes were observed under a microscope. After observation, 10 &#x003BC;l of WST-8 solution (Dojindo) was added to the cells and the plate was incubated at 37&#x000B0;C with 5% CO<sub>2</sub> for 2 h. Then, absorbance at 450 nm was measured as above. Cytotoxicity against MRC-5 cells was measured in triplicate. ED<sub>50</sub> values were calculated as previously described (Arita-Morioka et al., <xref ref-type="bibr" rid="B2">2015</xref>).</p>
</sec>
<sec>
<title>Screening Sources</title>
<p>The Kitasato Natural Products Library consists of 431 natural and semisynthetic compounds. The compounds were dissolved at 1 mg/ml with DMSO and kept at &#x02212;20&#x000B0;C. The microbes for the cell-based screening were collected in Japan. Fungal strains were isolated from soil samples that had been collected from a close proximity to plants. Actinomycetes were isolated from plants and soil samples attached to plant roots. Each microbe was cultured in 10 ml of two to four different media whose main carbon sources were glucose, sucrose, starch, and rice, using 50-ml glass or disposable plastic tubes for 6 days (shaking culture for liquid media) or 13 days (static culture for rice medium). In total, 6,900 broth extract samples (3,224 fungi and 3,676 actinomycetes) were prepared. After cultivation, the same amount of EtOH was added to each broth, and the mixtures were then centrifuged at 1,630 &#x000D7; g for 10 min. The supernatants were used for screening.</p>
</sec>
<sec>
<title>Primary Screening of Antiamebic Compounds From the Kitasato Natural Products Library and Microbial Culture Broths for Antiamebic Acitivities</title>
<p>Approximately 2 &#x003BC;l of the compound solution (1 mg/ml, in DMSO) of the Kitasato Natural Products Library or 10 &#x003BC;l of EtOH extracts of microbial culture broth extracts was added to each well of <italic>E. histolytica</italic> trophozoite-seeded 96-well microtiter plates (final concentrations, 10 &#x003BC;g/ml). Compounds showing more than 80% growth inhibition and having no cytotoxicity against MRC-5 cells were selected for further evaluation.</p>
</sec>
<sec>
<title>Isolation of Pencolide From a Culture Broth of Unidentified Fungus FKI-7363</title>
<sec>
<title>Producing Strain and Cultivation</title>
<p>The unidentified fungal strain FKI-7363 was isolated from a soil sample collected in Tokushima city, Tokushima Prefecture, Japan. FKI-7363 strain was isolated after cultivation on a malt extract agar plate consisting 2% malt extract, 2% glucose, 0.1% peptone, and 2% agar (pH was adjusted to 6.0 before sterilization) for 7 days. The genus of FKI-7363 strain could not be assigned by its morphological features. FKI-7363 strain was maintained on an LcA slant consisting of 0.1% glycerol, 0.08% KH<sub>2</sub>PO<sub>4</sub>, 0.02% K<sub>2</sub>HPO<sub>4</sub>, 0.02% MgSO<sub>4</sub>&#x000B7;7H<sub>2</sub>O, 0.02% KCl, 0.2% NaNO<sub>3</sub>, 0.02% yeast extract, and 1.5% agar (pH 6.0). A loopful of spores were inoculated into six 50-ml tubes containing each 10 ml of the seed medium consisting of 2% glucose, 0.5% Polypepton (Nihon Pharmaceutical, Tokyo, Japan), 0.2% yeast extract, 0.2% KH<sub>2</sub>PO<sub>4</sub>, 0.05% MgSO<sub>4</sub>&#x000B7;7H<sub>2</sub>O, and 0.1% agar (pH 6.0). The tubes were shaken on a reciprocal shaker at 27&#x000B0;C for 3 days. Thirty milliliters of the seed culture were inoculated into each of two Ulpack 47 bags (Hokken Co. Ltd, Tochigi, Japan), each containing 300 g of sodden rice with 3 g of kobucha (Japanese kelp tea) and the cultures were incubated statically at 25&#x000B0;C for 14 days.</p>
</sec>
<sec>
<title>Isolation of Pencolide From the Culture Broth</title>
<p>The obtained culture (600 g) was mixed and extracted with 600 ml of EtOH with an electric mixer for 30 min. The mixture was centrifuged at 3,000 &#x000D7; g for 10 min and the supernatant was filtered with a filter paper (No.2; Toyo Roshi Kaisha, Ltd., Tokyo, Japan). After the filtrate was concentrated and EtOH was removed in vacuo, the residue was applied to an ODS column (25 &#x003C6; &#x000D7; 110 mm). The samples were eluted with a H<sub>2</sub>O-MeCN gradient system to give 7 fractions (100:0, 90:10, 80:20, 70:30, 60:40, 40:60 and 0:100, 500 ml each). The active 90:10 fraction (733 mg) was applied to an ODS column (20 &#x003C6; &#x000D7; 110 mm). An H<sub>2</sub>O-MeCN system described above but containing 0.1% trifluoroacetic acid (TFA) was used as eluent. The active component was eluted in 10&#x02013;20% MeCN fractions. The active fractions were mixed and dried, and then yielded 225 mg amorphous residues. This crude material was purified by preparative HPLC (column, Develosil ODS-C30-UG-5, 20 &#x003C6; &#x000D7; 250 mm, Nomura Chemical, Japan; solvent, 15% MeCN-H<sub>2</sub>O containing 0.1%TFA; flow rate, 7.0 ml/min; detection, UV at 210 nm). The peak eluted at 40 min was collected and concentrated to dryness to afford pencolide (70.3 mg). The NMR and MS data shown below were in agreement with those reported previously (Sutherland, <xref ref-type="bibr" rid="B39">1963</xref>; Wang et al., <xref ref-type="bibr" rid="B42">2010</xref>).</p>
</sec>
<sec>
<title>Pencolide</title>
<p>White amorphous. <sup>13</sup>C NMR (100 MHz, CDCl<sub>3</sub>) &#x003B4; ppm: 11.2, 14.6, 122.6, 128.1, 146.0, 146.5, 167.4, 168.8, 169.9 ppm. <sup>1</sup>H NMR (400 MHz, CDCl<sub>3</sub>) &#x003B4; ppm (Int., mult., <italic>J</italic> in Hz): 7.42 (1H, q, 7.0), 6.45 (1H, q, 2.0), 2.14 (3H, d, 2.0), 1.82 (3H, d, 7.0). ESI-MS: 194.0646 ([M&#x02013;H]<sup>&#x02212;</sup>), 196.0622 ([M&#x0002B;H]<sup>&#x0002B;</sup>).</p>
</sec>
</sec>
<sec>
<title>Evaluation of the Effect of L-Cysteine on the Antiamebic Effects of Epoxide-Containing Compounds</title>
<p>Each 5 &#x003BC;l of 1 mg/ml DMSO solution of cytochalasan compounds and cerulenin was dispensed into each well of a 96-well microtiter plate and 200 &#x003BC;l of 9 mM L-cysteine solution (L-cysteine HCl salt in pure water) or water was added to each well. After mixing well with plate mixer for 3 min, the plate was incubated at 37&#x000B0;C axenically with Anaeropak (Mitsubishi Chemical, Tokyo, Japan) for 2 days. The reaction mixtures were evaluated by HPLC analysis (column, Senshupak Pegasil ODS SP100, 4.6 &#x003C6; &#x000D7; 250 mm, Senshu Scientific Co. Ltd., Japan; solvent, MeCN-H<sub>2</sub>O gradient system, 10&#x02013;90% MeCN per 0&#x02013;30 min; flow rate, 1.0 ml/min; detection, UV at 210 nm) and LC-ESI-MS analysis (column, Capcellcore C18, 2.1 &#x003C6; &#x000D7; 50 mm, Osaka soda, Japan; solvent, MeCN-H<sub>2</sub>O-0.1% HCO<sub>2</sub>H gradient system, 5&#x02013;100% MeCN per 0&#x02013;8 min, 100%MeCN per 8&#x02013;10 min; flow rate, 0.4 ml/min; ESI-MS data was obtained by JEOL JMS-T100LP, JEOL, Japan).</p>
</sec>
<sec>
<title>Purification of L-Cysteine Adducts of Pencolide and Measurement of the CS1 Inhibitory Activity</title>
<p>Pencolide (5.5 mg) was dissolved in 1 ml of 0.25 M L-cysteine aqueous solution (L-cysteine HCl salt in H<sub>2</sub>O) and left at room temperature for overnight. The reaction mixture was purified by Seppak ODS (Waters co., Massachusetts, USA) and the cysteine adducts were eluted with 30%MeCN-70%H<sub>2</sub>O containing 0.1%TFA. The obtained fraction was further purified by preparative HPLC (column, Senshupak Pegasil ODS SP100, 20 &#x003C6; &#x000D7; 250 mm, Senshu Scientific Co. Ltd.; solvent, 0.1%TFA-MeCN-H<sub>2</sub>O gradient system, 10&#x02013;50% MeCN per 0&#x02013;30 min; flow rate, 7.0 ml/min; detection, UV at 210 nm). The cysteine adducts were eluted at 12 min. The fraction was dried <italic>in vacuo</italic> and colorless amorphous compounds (7.3 mg) were obtained. The methanol solution of the obtained adducts was used for measurement of the CS1 inhibitory activity.</p>
</sec>
</sec>
<sec id="s3">
<title>Results and Discussion</title>
<sec>
<title>A New Screening System to Discover Antiamebic Compounds That Inhibit <italic>de novo</italic> Cysteine Biosynthesis in <italic>E. histolytica</italic></title>
<p>Although in our previous study, we identified, by an enzyme assay-based screening, two natural fungal secondary metabolites, xanthofulvin and exophillic acid, which inhibited CS, these compounds did not show the antiamebic activity <italic>in vitro</italic> (Mori et al., <xref ref-type="bibr" rid="B25">2015</xref>). The failure can be due to several possible reasons including low permeability of the compounds to the cell and low solubility of the compounds in aqueous culture media.</p>
<p>We aimed to improve the screening system in order to specifically identify the compounds that inhibit growth of or kill the amebic trophozoites through inhibition of the <italic>de novo</italic> cysteine biosynthetic pathway. The rationale was as follows: the amebicidal activity and/or the growth inhibition should be more pronounced when the cells are cultured in the absence of L-cysteine than in the L-cysteine-supplemented conditions because under L-cysteine deprived conditions, the cells depends on the <italic>de novo</italic> cysteine biosynthesis for survival. Thus, we carried out primary cell-based phenotypic screening in both the presence and absence of L-cysteine and selected hits that showed differential amebicidal effects between the two conditions. The essentiality of <italic>CS</italic> genes for the growth and survival of trophozoites in the L-cysteine-lacking conditions has been demonstrated (Jeelani et al., <xref ref-type="bibr" rid="B18">2017</xref>).</p>
</sec>
<sec>
<title>Discovery of CS-Dependent Amebicidal Compounds From the Kitasato Natural Compounds Library</title>
<p>We screened the Kitasato Natural Compounds Library composed of 431 compounds. In the first screening, the compounds that showed 80% growth inhibition against <italic>E. histolytica</italic> trophozoites at 10 &#x003BC;g/ml in the L-cysteine-deprived medium were selected. In the second screening, the compounds that showed more than two-fold difference in the IC<sub>50</sub> value of antiamebic activities between the L-cysteine-supplemented [Cys (&#x0002B;)] medium and the cysteine-deprived [Cys (&#x02013;)] medium (i.e., higher static or amebicidal activity without L-cysteine than with L-cysteine). Five compounds were identified: aspochalasin B, chaetoglobosin A, prochaetoglobosin III, cerulenin, and deoxyfrenolicin (Figure <xref ref-type="fig" rid="F1">1</xref>, Table <xref ref-type="table" rid="T1">1</xref>). Three of these five hits, aspochalasin B, chaetoglobosin A, and prochaetoglobosin III, were cytochalasans. Cytochalasans are fungal metabolites and known to inhibit actin polymerization (Scherlach et al., <xref ref-type="bibr" rid="B34">2010</xref>). The growth inhibitory effect of cytochalasans against the reptilian <italic>E. invadens</italic> trophozoites were previously demonstrated; most of them showed growth inhibition at 10 &#x003BC;M (Makioka et al., <xref ref-type="bibr" rid="B24">2004</xref>). Cerulenin is known to inhibit fatty acid biosynthesis (Vance et al., <xref ref-type="bibr" rid="B41">1972</xref>). Deoxyfrenolicin has antifungal and anti-<italic>Mycoplasma</italic> activity (Iwai et al., <xref ref-type="bibr" rid="B15">1978</xref>), and mammalian cytotoxicity of deoxyfrenolicin was also reported (Wang et al., <xref ref-type="bibr" rid="B43">2013</xref>). Next, inhibitory effects of these five antiamebic compounds on the CS activity were examined. We used two <italic>E. histolytica</italic> enzymes, CS1 and CS3, which are 83% identical at the amino acid levels, but likely plays distinct physiological roles (Jeelani et al., <xref ref-type="bibr" rid="B18">2017</xref>). Deoxyfrenolicin showed mild inhibition toward both CS1 and CS3 as previously reported (Mori et al., <xref ref-type="bibr" rid="B25">2015</xref>); its antiamebic activity was, however, much higher than the CS inhibitory activity, suggesting (1) that the observed antiamebic activity was unlikely attributable to the CS inhibition, or (2) deoxyfrenolicin is converted to more CS-inhibitory secondary derivative(s) after metabolized in the amebas. Interestingly, deoxyfrenolicin has a naphthoquinone moiety in the structure, which was frequently found in CS inhibitors as previously reported (Mori et al., <xref ref-type="bibr" rid="B25">2015</xref>). On the other hand, neither three cytochalasans nor cerulenin showed the inhibitory activity at 100 &#x003BC;g/ml against both EhCSs (Table <xref ref-type="table" rid="T1">1</xref>).</p>
<fig id="F1" position="float">
<label>Figure 1</label>
<caption><p>Five compounds which found in Kitasato Natural Products Library.</p></caption>
<graphic xlink:href="fcimb-08-00409-g0001.tif"/>
</fig>
<table-wrap position="float" id="T1">
<label>Table 1</label>
<caption><p>CS inhibitory activity and anti-amebic activity of five compounds screened from Kitasato Natural Compounds Library.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="top" align="left"><bold>Compounds</bold></th>
<th valign="top" align="center" colspan="3" style="border-bottom: thin solid #000000;"><bold>Anti-amebic activity</bold></th>
<th valign="top" align="center" colspan="2" style="border-bottom: thin solid #000000;"><bold>CS inhibitory activity</bold></th>
</tr>
<tr>
<th/>
<th valign="top" align="center" colspan="2" style="border-bottom: thin solid #000000;"><bold>ED</bold><sub>50</sub> <bold>(</bold>&#x003BC;<bold>g/ml)</bold></th>
<th valign="top" align="center" style="border-bottom: thin solid #000000;"><bold>Selectivity</bold></th>
<th valign="top" align="center" colspan="2" style="border-bottom: thin solid #000000;"><bold>IC</bold><sub>50</sub> <bold>(</bold>&#x003BC;<bold>g/ml)</bold></th>
</tr>
<tr style="border-bottom: thin solid #000000;">
<th/>
<th valign="top" align="center"><bold>Cys (</bold>&#x0002B;<bold>)</bold></th>
<th valign="top" align="center"><bold>Cys (&#x02013;)</bold></th>
<th valign="top" align="center"><bold>Cys(</bold>&#x0002B;<bold>)/Cys(&#x02013;)</bold></th>
<th valign="top" align="center"><bold>CS1</bold></th>
<th valign="top" align="center"><bold>CS3</bold></th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Aspochalasin B</td>
<td valign="top" align="center">27</td>
<td valign="top" align="center">9.6</td>
<td valign="top" align="center">3</td>
<td valign="top" align="center">&#x0003E;100</td>
<td valign="top" align="center">&#x0003E;100</td>
</tr>
<tr>
<td valign="top" align="left">Chaetoglobosin A</td>
<td valign="top" align="center">&#x0003E;50</td>
<td valign="top" align="center">1.0</td>
<td valign="top" align="center">&#x0003E;50</td>
<td valign="top" align="center">&#x0003E;100</td>
<td valign="top" align="center">&#x0003E;100</td>
</tr>
<tr>
<td valign="top" align="left">Prochaetoglobosin III</td>
<td valign="top" align="center">44</td>
<td valign="top" align="center">2.6</td>
<td valign="top" align="center">17</td>
<td valign="top" align="center">&#x0003E;100</td>
<td valign="top" align="center">&#x0003E;100</td>
</tr>
<tr>
<td valign="top" align="left">Cerulenin</td>
<td valign="top" align="center">8.2</td>
<td valign="top" align="center">1.1</td>
<td valign="top" align="center">7</td>
<td valign="top" align="center">&#x0003E;100</td>
<td valign="top" align="center">&#x0003E;100</td>
</tr>
<tr>
<td valign="top" align="left">Deoxyfrenolicin</td>
<td valign="top" align="center">3.9</td>
<td valign="top" align="center">1.7</td>
<td valign="top" align="center">2</td>
<td valign="top" align="center">24</td>
<td valign="top" align="center">25</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec>
<title>The Cysteine-Dependent Cell-Based Assay is Prone to False Hits for L-Cysteine-Sensitive Compounds</title>
<p>Two of the three cytochalasans showed good L-cysteine dependence, but did not show CS inhibition. We speculated if the growth inhibition by these cytochalasans was masked or abolished by L-cysteine supplementation in the assay. Three cytochalasans that were identified as hits have &#x003B1;,&#x003B2;-unsaturated ketone moiety in their structures (Figure <xref ref-type="fig" rid="F1">1</xref>). In previous studies, involvement of &#x003B1;,&#x003B2;-unsaturated ketone moiety in the biological activity and cytotoxicity of cytochalasans was indicated (Flashner et al., <xref ref-type="bibr" rid="B8">1982</xref>; Tomikawa et al., <xref ref-type="bibr" rid="B40">2002</xref>). This moiety is easily attacked by the thiol moiety of L-cysteine, resulting in 1,4-addition (Michael addition) of cysteine (Flashner et al., <xref ref-type="bibr" rid="B8">1982</xref>). Therefore, we considered a possibility that in the Cys (&#x0002B;) medium, abundantly present cysteine attacked on the &#x003B1;,&#x003B2;-unsaturated moiety of each cytochalasan and consequently canceled their amebicidal activity. To test this hypothesis, two representative cytochalasans (chaetoglobosin A and prochaetoglobosin III) were incubated in both cysteine-supplemented (9 mM) and cysteine-lacking water at 37&#x000B0;C for 2 days. After incubation, components of each solution were determined by HPLC analysis. In cysteine-supplemented water, the peaks of cytochalasans were totally lost (Supplemental Figures <xref ref-type="supplementary-material" rid="SM1">1</xref>, <xref ref-type="supplementary-material" rid="SM1">s2</xref>), although the peaks corresponding to their cysteine adducts were not detected by LC-MS (Supplemental Figures <xref ref-type="supplementary-material" rid="SM1">5</xref>&#x02013;<xref ref-type="supplementary-material" rid="SM1">20</xref>). Newly appeared peaks showed the same molecular weight as corresponding parent cytochalasans. It is known that chaetoglobosin A is unstable and isomerized into another form of chaetoglobosin in acidic and basic conditions (Sekita et al., <xref ref-type="bibr" rid="B35">1973</xref>, <xref ref-type="bibr" rid="B36">1982a</xref>,<xref ref-type="bibr" rid="B37">b</xref>). As our cysteine-supplemented water was acidic (because L-cysteine hydrochloric acid was used in the assay), chaetoglobosin A was likely derived into chaetoglobosins B and D as demonstrated (Sekita et al., <xref ref-type="bibr" rid="B36">1982a</xref>,<xref ref-type="bibr" rid="B37">b</xref>). Since prochaetoglobosin III and chaetoglobosin A structurally resemble (Figure <xref ref-type="fig" rid="F1">1</xref>), they were likely converted into their corresponding isomers in cysteine-rich water. On the other hand, the pH of the amebic culture medium was neutral (&#x0007E;6.8). Thus, the dependence of cytochalasans&#x00027; amebicidal activity on cysteine deprivation cannot be well-explained, although the structural unstability of cytochalasans seems to be a possible reason. The epoxide moiety of cytochalasans was also implicated in mammalian cytotoxicity (Li et al., <xref ref-type="bibr" rid="B20">2014</xref>). Since some isomers of chaetoglobosin A lack an epoxide in their structures, these environment-driven structural changes of cytochalasans could be a cause of the selectivity in the cysteine-dependent antiamebic activity.</p>
<p>Cerulenin does not contain &#x003B1;,&#x003B2;-unsaturated ketone moiety; instead, it has an epoxide moiety in the structure. We also tested reactivity of cerulenin to cysteine. Although cerulenin was relatively stable in this condition (Supplemental Figure <xref ref-type="supplementary-material" rid="SM1">3</xref>), the IC<sub>50</sub> values of the compound against CS1 and CS3 were &#x0003E;10- to 100-fold higher than the ED<sub>50</sub> values against the cells. A possible mode of action of cerulenin and the dependence of antiamebic activity on L-cysteine remain elusive.</p>
</sec>
<sec>
<title>Discovery of Microbial Broth Extracts Showing CS-Dependent Amebicidal Activities</title>
<p>Next, we screened microbial broth extracts to discover antiamebic agents with CS inhibitory activity. The extracts of 3,224 fungal broths and 3,676 actinomycetes broths were screened. The results are shown in Table <xref ref-type="table" rid="T2">2</xref>. In the first screening, 214 microbial broth extracts (152 fungal and 62 actinomycetes) showed antiamebic activity in the Cys (&#x02013;) medium. In the second screening, only 11 fungal broth extracts showed &#x0003E;10 times differentially reduced antiamebic activity in the Cys (&#x0002B;) medium compared to that in the Cys (&#x02013;) medium. Inhibitory activities of these 11 fungal broth extracts were evaluated against CS1 and CS3, and 6 samples showed inhibitory activity against both CSs. We roughly chromatographed these samples with small-scale ODS column and measured antiamebic activity of obtained fractions. As five samples showed the same trend, we selected one fungal strain FKI-7363 as a representative. This strain was further subjected to purification of active compounds. Purification of active compounds from remaining strains will be described elsewhere.</p>
<table-wrap position="float" id="T2">
<label>Table 2</label>
<caption><p>EhCS inhibitory samples found in microbial broth extracts.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="top" align="left"><bold>Origin</bold></th>
<th valign="top" align="center"><bold>Number of samples</bold></th>
<th valign="top" align="center" colspan="2" style="border-bottom: thin solid #000000;"><bold>Antiamebic samples</bold></th>
<th valign="top" align="center"><bold>EhCSs inhibitory samples</bold></th>
</tr>
<tr style="border-bottom: thin solid #000000;">
<th/>
<th/>
<th valign="top" align="center"><bold>in Cys (&#x02013;)</bold></th>
<th valign="top" align="center"><bold>in Cys (</bold>&#x0002B;<bold>)</bold></th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Fungi</td>
<td valign="top" align="center">3,224</td>
<td valign="top" align="center">152</td>
<td valign="top" align="center">11</td>
<td valign="top" align="center">6</td>
</tr>
<tr>
<td valign="top" align="left">Actinomycetes</td>
<td valign="top" align="center">3,676</td>
<td valign="top" align="center">62</td>
<td valign="top" align="center">0</td>
<td valign="top" align="center">0</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec>
<title>Pencolide Was Identified as an CS-Inhibiting Antiamebic Agent Isolated From a Cultured Broth of FKI-7363</title>
<p>One broth extract produced by an unidentified fungus, FKI-7363, showed selective inhibitory activity in the Cys (&#x02013;) medium. Five &#x003BC;l of the broth extract (50% EtOH broth extract) showed 50% amebicidal activity in the Cys (&#x02013;) medium, on the other hand, 50 &#x003BC;l of the extract showed no measurable antiamebic activity in the Cys (&#x0002B;) medium, suggesting that the cysteine dependence index was &#x0003E;10.</p>
<p>An extract of FKI-7363 was produced from the 14-day large size cultures on the rice medium for purification. The culture was extracted with EtOH, and the concentrated extract was purified by repetitive column chromatography with acidic MeCN-H<sub>2</sub>O system. The active fractions were purified by preparative HPLC, and finally, 70 mg of an active compound were obtained from 600 g of cultured rice. The structure of active compound was determined by <sup>1</sup>H and <sup>13</sup>C NMR spectra and ESI-MS spectra (see Materials and Methods), and the active compound was identified as pencolide (Figure <xref ref-type="fig" rid="F2">2</xref>). The reported producer of pencolide was <italic>Penicillium multicolor</italic> (Birkinshaw et al., <xref ref-type="bibr" rid="B3">1963</xref>), and its weak antimicrobial biological activity was previously described against some Gram positive/negative bacteria and <italic>Candida albicans</italic> (Lucas et al., <xref ref-type="bibr" rid="B23">2007</xref>).</p>
<fig id="F2" position="float">
<label>Figure 2</label>
<caption><p>Structure of pencolide.</p></caption>
<graphic xlink:href="fcimb-08-00409-g0002.tif"/>
</fig>
</sec>
<sec>
<title>Antiamebic and CS Inhibitory Activities of Pencolide</title>
<p>We measured antiamebic activity of pencolide in both the Cys (&#x0002B;) and Cys (&#x02013;) media (Table <xref ref-type="table" rid="T3">3</xref>). The IC<sub>50</sub> values of pencolide are 283 &#x003BC;M in the Cys (&#x02013;) medium and 2,140 &#x003BC;M in the Cys (&#x0002B;) medium, respectively, and the cysteine dependence index of 7.6 [7.6-fold more potent in the Cys (&#x02013;) medium than in the Cys (&#x0002B;) medium]. Pencolide caused apoptosis-like cell death against <italic>E. histolytica</italic> in Cys (&#x02013;) medium as observed under a light microscope; the pencolide-treated trophozoites was morphologically similar to those treated with metronidazole (Supplemental Figure <xref ref-type="supplementary-material" rid="SM1">27</xref>). Pencolide showed low cytotoxicity (EC<sub>50</sub> &#x0003D; 1,900 &#x003BC;M) against a mammalian cell line, MRC-5. The selectivity index of pencolide against the ameba relative to MRC-5 cells is 6.7. CS inhibitory activity of pencolide was also measured. The IC<sub>50</sub> values of pencolide against CS1 and CS3 are 233 and 217 &#x003BC;M, respectively, which are comparable to the levels of the ED<sub>50</sub> value against the ameba cultured without L-cysteine (Table <xref ref-type="table" rid="T4">4</xref>), reinforcing that CS inhibition is likely the cause of antiamebic activity.</p>
<table-wrap position="float" id="T3">
<label>Table 3</label>
<caption><p><italic>In vitro</italic> antiamebic activities and cytotoxicity against MRC-5 cells of pencolide.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="top" align="center" colspan="3" style="border-bottom: thin solid #000000;"><bold>Cytotoxicity IC</bold><sub><bold>50</bold></sub> <bold>(</bold>&#x003BC;<bold>M)</bold></th>
<th valign="top" align="center" colspan="2"><bold>Selectivity</bold></th>
</tr>
<tr>
<th valign="top" align="left" colspan="2"><bold>Against</bold> <italic><bold>Entamoeba histolytica</bold></italic></th>
<th valign="top" align="left"><bold>Against MRC-5</bold></th>
<th/>
<th/>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">in Cys (&#x0002B;)</td>
<td valign="top" align="left">in Cys (&#x02013;)</td>
<td/>
<td valign="top" align="left">Cys (&#x0002B;)/Cys (&#x02013;)</td>
<td valign="top" align="left">MRC-5/Cys (&#x02013;)</td>
</tr>
<tr style="border-top: thin solid #000000;">
<td valign="top" align="left">2,140 &#x000B1; 173</td>
<td valign="top" align="left">283 &#x000B1; 44</td>
<td valign="top" align="left">1,900 &#x000B1; 52</td>
<td valign="top" align="left">7.6</td>
<td valign="top" align="left">6.7</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap position="float" id="T4">
<label>Table 4</label>
<caption><p>Cysteine synthase inhibitory activities of pencolide and its cysteine adducts.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="top" align="center" colspan="3" style="border-bottom: thin solid #000000;"><bold>CS inhibitory activity IC</bold><sub><bold>50</bold></sub> <bold>(</bold>&#x003BC;<bold>M)</bold></th>
</tr>
<tr>
<th valign="top" align="center" colspan="2"><bold>Pencolide</bold></th>
<th valign="top" align="left"><bold>Cys-adducts of pencolide</bold></th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">CS1</td>
<td valign="top" align="left">CS3</td>
<td valign="top" align="left">CS1</td>
</tr>
<tr style="border-top: thin solid #000000;">
<td valign="top" align="left">233 &#x000B1; 19</td>
<td valign="top" align="left">217 &#x000B1; 25</td>
<td valign="top" align="left">2,340 &#x000B1; 66</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec>
<title>Pencolide is Able to Become the Michael Acceptor in Cys (&#x0002B;) Medium</title>
<p>Pencolide showed antiamebic activity in a cysteine-dependent manner and CS inhibitory activity. However, pencolide has a maleimide structure which is known to be reactive with the thiol moiety. The Michael-type addition reaction between the thiol moiety of cysteine and maleimide is fast; this reaction is often utilized for labeling biomolecules (Boyatzis et al., <xref ref-type="bibr" rid="B4">2017</xref>). We tested the reactivity and stability of pencolide in cysteine-supplemented conditions. After incubation with 9 mM aqueous cysteine solution for 2 days, we confirmed that most of pencolide was changed to the cysteine adducts by Michael-type addition reaction (Supplemental Figures <xref ref-type="supplementary-material" rid="SM1">4</xref>, <xref ref-type="supplementary-material" rid="SM1">21</xref>&#x02013;<xref ref-type="supplementary-material" rid="SM1">26</xref>). Thus, the cysteine-dependent loss of anti-amebic activity of pencolide was apparently caused by adduct formation of pencolide. Pencolide inhibited CS and showed antiamebic activity in cysteine-deprived conditions with comparable concentrations. Furthermore, we purified cysteine adducts of pencolide and measured their CS inhibitory activity. The IC<sub>50</sub> value of the cysteine adducts against CS1 was estimated to be 2,340 &#x003BC;M (740 &#x003BC;g/ml; the apparent molecular weight of cysteine adduct was 316; Supplemental Figures <xref ref-type="supplementary-material" rid="SM1">25</xref>, <xref ref-type="supplementary-material" rid="SM1">26</xref>). This IC<sub>50</sub> value is comparable to ED<sub>50</sub> value against <italic>E. histolytica</italic> trophozoites of pencolide in Cys (&#x0002B;) medium. From these results, we concluded that the amebicidal activity of pencolide was attributable to CS inhibition. Since the maleimide moiety of pencolide easily accepts Michael donors, this labile moiety must be substituted with another stable structure in order to further utilize pencolide as a seed compound of new antiamebic drugs with a novel mode of action.</p>
</sec>
<sec>
<title>The First Identification of the Antiamebic Compounds With CS Inhibitory Activity by Screening of Microbial Culture Broths</title>
<p>In this study, we have identified for the first time pencolide as an antiamebic compound with comparable CS inhibitory activity by screening about 7,000 microbial culture broths using a new protocol for L-cysteine-dependent antiamebic assay. In the previous study, we identified deacetylkinamycin C showing the ED<sub>50</sub> value against amebic trophozoites and the IC<sub>50</sub> value against CSs of ca. 20 &#x003BC;M, from the Kitasato Natural Products Library. However, the compound showed strong (&#x0003E;10 times higher) cytotoxicity against MRC-5 cells (Mori et al., <xref ref-type="bibr" rid="B25">2015</xref>). Furthermore, no new CS inhibitors that showed anti-amebic activity in an L-cysteine-dependent manner, were discovered through CS-based screening of the microbial culture broth extracts (Mori et al., <xref ref-type="bibr" rid="B25">2015</xref>). Thus, we claim that our new screening protocol of the L-cysteine-dependent phenotypic screening has provided a first proof-of-concept for a screening of CS-inhibiting antiamebic compounds. Although we successfully screened both a chemical library and microbial culture extracts using our L-cysteine-dependent screening platform to identify pencolide, it should be noted that our proposed protocol for L-cysteine-dependent cell-based screening is prone to an artifact for the compounds that are inactivated or structurally altered by L-cysteine, as shown for some cytochalasans.</p>
<p>Although pencolide showed only moderate potency at this stage, it has good potential for full organic synthesis and further derivatizations based on its low molecular weight. For rational modifications of pencolide for better efficacy, it is necessary to elucidate the co-crystal structures of CS together with pencolide. We should also emphasize the fact that natural products, especially microbial secondary metabolites, have rich structural diversity (Newman and Cragg, <xref ref-type="bibr" rid="B27">2016</xref>). Furthermore, there has still existed many undiscovered microbes which have potential to produce novel compounds (Ling et al., <xref ref-type="bibr" rid="B21">2015</xref>). A few natural compounds whose structures are related to that of pencolide have been reported. Fungal metabolites, farinomaleins, have a maleimide structure similar in pencolide (Putri et al., <xref ref-type="bibr" rid="B32">2009</xref>; El Amrani et al., <xref ref-type="bibr" rid="B6">2012</xref>). Farinomalein showed antifungal activity against a plant pathogen <italic>Phytophthora sojae</italic> (Putri et al., <xref ref-type="bibr" rid="B32">2009</xref>). Farinomaleins also showed no cytotoxicity against mammalian cells, and therefore, pencolide-related natural compounds appear to be a safe seed compounds to further develop antiamebic agents although we have to conquer the problem that the maleimide moiety tends to be attacked by various Michael donors.</p>
<p>In summary, we introduced a new L-cysteine- (and CS-) dependent cell-based phenotypic screening system for the discovery of antiamebic agents. We screened 431 compounds of the Kitasato Natural Products Library and 6,900 samples of microbial broth extracts. We identified from the Kitasato Natural Products Library, a naphtoquinone compound, deoxyfrenolicin, inhibited <italic>E. histolytica</italic> CS among six compounds showing L-cysteine-dependent anti-amebic activity. However, CS inhibition-mediated anti-amebic activity by the compound was not validated. Pencolide was purified and identified from microbial broth extracts to be a fair antiamebic lead compound as it showed L-cysteine-dependent anti-amebic activity against <italic>E. histolytica</italic> trophozoites in cysteine-deprived medium and CS inhibition at comparable concentrations with lesser cytotoxicity against mammalian cells. Therefore, pencolide may be a seed compound to develop a new class of antiamebic agents that target CS.</p>
</sec>
</sec>
<sec id="s4">
<title>Author Contributions</title>
<p>MM designed and conducted this study. ST and WF also conducted this study under MM. GJ and KN-T contributed to design the assay system. KN and AM contributed to identify microbes and provided microbial cultured broths. S&#x0014C; provided advices and facilities of the study. TN and KS were supervisors of this study.</p>
<sec>
<title>Conflict of Interest Statement</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
</sec>
</body>
<back>
<ack><p>We thank Dr. Kenichiro Nagai, School of Pharmacy, Kitasato University for the measurement of mass spectra. This work was supported by JSPS Grant-in-Aid for Scientific Research (C) (26460129 and 17K08344) and Kitasato University Research Grant for Young Researchers (to MM), a grant from The Japan Agency for Medical Research and Development (AMED) (JP17fk0108119), a grant for Science and Technology Research Partnership for Sustainable Development (SATREPS) from AMED (17jm0110009h0004) and Japan International Cooperation Agency (to MM, KS, and TN).</p>
</ack>
<sec sec-type="supplementary-material" id="s5">
<title>Supplementary Material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fcimb.2018.00409/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fcimb.2018.00409/full#supplementary-material</ext-link></p>
<supplementary-material xlink:href="Data_Sheet_1.pdf" id="SM1" mimetype="application/pdf" xmlns:xlink="http://www.w3.org/1999/xlink"/>
</sec>
<ref-list>
<title>References</title>
<ref id="B1">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ali</surname> <given-names>V.</given-names></name> <name><surname>Nozaki</surname> <given-names>T.</given-names></name></person-group> (<year>2007</year>). <article-title>Current therapeutics, their problems, and sulfur-containing-amino-acid metabolism as a novel target against infections by &#x0201C;amitochondriate&#x0201D; protozoan parasites</article-title>. <source>Clin. Microbiol. Rev.</source> <volume>20</volume>, <fpage>164</fpage>&#x02013;<lpage>187</lpage>. <pub-id pub-id-type="doi">10.1128/CMR.00019-06</pub-id><pub-id pub-id-type="pmid">17223627</pub-id></citation></ref>
<ref id="B2">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Arita-Morioka</surname> <given-names>K.</given-names></name> <name><surname>Yamanaka</surname> <given-names>K.</given-names></name> <name><surname>Mizunoe</surname> <given-names>Y.</given-names></name> <name><surname>Ogura</surname> <given-names>T.</given-names></name> <name><surname>Sugimoto</surname> <given-names>S.</given-names></name></person-group> (<year>2015</year>). <article-title>Novel strategy for biofilm inhibition by using small molecules targeting molecular chaperone DnaK</article-title>. <source>Antimicrob. Agents Chemother.</source> <volume>59</volume>, <fpage>633</fpage>&#x02013;<lpage>641</lpage>. <pub-id pub-id-type="doi">10.1128/AAC.04465-14</pub-id><pub-id pub-id-type="pmid">25403660</pub-id></citation></ref>
<ref id="B3">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Birkinshaw</surname> <given-names>J. H.</given-names></name> <name><surname>Kalyanpur</surname> <given-names>M. G.</given-names></name> <name><surname>Stickings</surname> <given-names>C. E.</given-names></name></person-group> (<year>1963</year>). <article-title>Studies in the biochemistry of Micro-organisms. 113. Pencolide, a nitrogen-containing metabolite of <italic>Penicillium multicolor</italic> Grigorieva-Manilova and Poradielova</article-title>. <source>Biochem. J.</source> <volume>86</volume>, <fpage>237</fpage>&#x02013;<lpage>243</lpage>. <pub-id pub-id-type="doi">10.1042/bj0860237</pub-id><pub-id pub-id-type="pmid">13971137</pub-id></citation></ref>
<ref id="B4">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Boyatzis</surname> <given-names>A. E.</given-names></name> <name><surname>Bringans</surname> <given-names>S. D.</given-names></name> <name><surname>Piggott</surname> <given-names>M. J.</given-names></name> <name><surname>Duong</surname> <given-names>M. N.</given-names></name> <name><surname>Lipscombe</surname> <given-names>R. J.</given-names></name> <name><surname>Arthur</surname> <given-names>P. G.</given-names></name></person-group> (<year>2017</year>). <article-title>Limiting the hydrolysis and oxidation of maleimide-peptide adducts improves detection of protein thiol oxidation</article-title>. <source>J. Proteome Res</source>. <volume>16</volume>, <fpage>2004</fpage>&#x02013;<lpage>2015</lpage>. <pub-id pub-id-type="doi">10.1021/acs.jproteome.6b01060</pub-id><pub-id pub-id-type="pmid">28349699</pub-id></citation></ref>
<ref id="B5">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Clark</surname> <given-names>C. G.</given-names></name> <name><surname>Diamond</surname> <given-names>L. S.</given-names></name></person-group> (<year>2002</year>). <article-title>Methods for cultivation of luminal parasitic protists of clinical importance</article-title>. <source>Clin. Microbiol. Rev.</source> <volume>15</volume>, <fpage>329</fpage>&#x02013;<lpage>341</lpage>. <pub-id pub-id-type="doi">10.1128/CMR.15.3.329-341.2002</pub-id><pub-id pub-id-type="pmid">12097242</pub-id></citation></ref>
<ref id="B6">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>El Amrani</surname> <given-names>M.</given-names></name> <name><surname>Debbab</surname> <given-names>A.</given-names></name> <name><surname>Aly</surname> <given-names>A. H.</given-names></name> <name><surname>Wray</surname> <given-names>V.</given-names></name> <name><surname>Dobretsov</surname> <given-names>S.</given-names></name> <name><surname>M&#x000FC;ller</surname> <given-names>W. E. G.</given-names></name> <etal/></person-group>. (<year>2012</year>). <article-title>Farinomalein derivatives from an unidentified endophytic fungus isolated from the mangrove plant <italic>Avicennia marina</italic></article-title>. <source>Tetrahedron Lett</source>. <volume>53</volume>, <fpage>6721</fpage>&#x02013;<lpage>6724</lpage>. <pub-id pub-id-type="doi">10.1016/j.tetlet.2012.10.011</pub-id></citation></ref>
<ref id="B7">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Fahey</surname> <given-names>R. C.</given-names></name> <name><surname>Newton</surname> <given-names>G. L.</given-names></name> <name><surname>Arrick</surname> <given-names>B.</given-names></name> <name><surname>Overdank-Bogart</surname> <given-names>T.</given-names></name> <name><surname>Aley</surname> <given-names>S. B.</given-names></name></person-group> (<year>1984</year>). <article-title><italic>Entamoeba histolytica</italic>: a eukaryote without glutathione metabolism</article-title>. <source>Science</source> <volume>224</volume>, <fpage>70</fpage>&#x02013;<lpage>72</lpage>. <pub-id pub-id-type="doi">10.1126/science.6322306</pub-id><pub-id pub-id-type="pmid">6322306</pub-id></citation></ref>
<ref id="B8">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Flashner</surname> <given-names>M.</given-names></name> <name><surname>Rasmussen</surname> <given-names>J.</given-names></name> <name><surname>Patwardhan</surname> <given-names>B. H.</given-names></name> <name><surname>Tanenbaum</surname> <given-names>S. W.</given-names></name></person-group> (<year>1982</year>). <article-title>Structural features of cytochalasins responsible for Gram-positive bacterial inhibitions</article-title>. <source>J. Antibiot</source>. <volume>35</volume>, <fpage>1345</fpage>&#x02013;<lpage>1350</lpage>. <pub-id pub-id-type="doi">10.7164/antibiotics.35.1345</pub-id><pub-id pub-id-type="pmid">7174519</pub-id></citation></ref>
<ref id="B9">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gillin</surname> <given-names>F. D.</given-names></name> <name><surname>Diamond</surname> <given-names>L. S.</given-names></name></person-group> (<year>1981</year>). <article-title><italic>Entamoeba histolytica</italic> and <italic>Giardia lamblia</italic>: effects of cysteine and oxygen tension on trophozoite attachment to glass and survival in culture media</article-title>. <source>Exp. Parasitol</source>. <volume>52</volume>, <fpage>9</fpage>&#x02013;<lpage>17</lpage>. <pub-id pub-id-type="doi">10.1016/0014-4894(81)90055-2</pub-id><pub-id pub-id-type="pmid">6263667</pub-id></citation></ref>
<ref id="B10">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Harque</surname> <given-names>R.</given-names></name> <name><surname>Huston</surname> <given-names>C. D.</given-names></name> <name><surname>Hughes</surname> <given-names>M.</given-names></name> <name><surname>Houpt</surname> <given-names>E.</given-names></name> <name><surname>Petri</surname> <given-names>W. A.</given-names> <suffix>Jr.</suffix></name></person-group> (<year>2003</year>). <article-title>Amebiasis</article-title>. <source>N. Engl. J. Med.</source> <volume>348</volume>, <fpage>1565</fpage>&#x02013;<lpage>1573</lpage>. <pub-id pub-id-type="doi">10.1056/NEJMra022710</pub-id></citation></ref>
<ref id="B11">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hung</surname> <given-names>C. C.</given-names></name> <name><surname>Chang</surname> <given-names>S. Y.</given-names></name> <name><surname>Ji</surname> <given-names>D. D.</given-names></name></person-group> (<year>2012</year>). <article-title><italic>Entamoeba histolytica</italic> infection in men who have sex with men</article-title>. <source>Lancet</source> <volume>12</volume>, <fpage>729</fpage>&#x02013;<lpage>736</lpage>. <pub-id pub-id-type="doi">10.1016/S1473-3099(12)70147-0</pub-id><pub-id pub-id-type="pmid">22917103</pub-id></citation></ref>
<ref id="B12">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hussain</surname> <given-names>A.</given-names></name> <name><surname>Jeelani</surname> <given-names>G.</given-names></name> <name><surname>Sato</surname> <given-names>D.</given-names></name> <name><surname>Nozaki</surname> <given-names>T.</given-names></name></person-group> (<year>2011</year>). <article-title>Global analysis of gene expression in response to L-cysteine deprivation in the anaerobic protozoan parasite <italic>Entamoeba histolytica</italic></article-title>. <source>BMC Genomics</source> <volume>12</volume>:<fpage>275</fpage>. <pub-id pub-id-type="doi">10.1186/1471-2164-12-275</pub-id></citation></ref>
<ref id="B13">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hussain</surname> <given-names>S.</given-names></name> <name><surname>Ali</surname> <given-names>V.</given-names></name> <name><surname>Jeelani</surname> <given-names>G.</given-names></name> <name><surname>Nozaki</surname> <given-names>T.</given-names></name></person-group> (<year>2009</year>). <article-title>Isoform-dependent feedback regulation of serine <italic>O</italic>-acetyltransferase isoenzymes involved in L-cysteine biosynthesis of <italic>Entamoeba histolytica</italic></article-title>. <source>Mol. Biochem. Parasitol</source>. <volume>163</volume>, <fpage>39</fpage>&#x02013;<lpage>47</lpage>. <pub-id pub-id-type="doi">10.1016/j.molbiopara.2008.09.006</pub-id><pub-id pub-id-type="pmid">18851994</pub-id></citation></ref>
<ref id="B14">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ishikane</surname> <given-names>M.</given-names></name> <name><surname>Arima</surname> <given-names>Y.</given-names></name> <name><surname>Kanayama</surname> <given-names>A.</given-names></name> <name><surname>Takahashi</surname> <given-names>T.</given-names></name> <name><surname>Yamagishi</surname> <given-names>T.</given-names></name> <name><surname>Yahata</surname> <given-names>Y.</given-names></name> <etal/></person-group>. (<year>2016</year>). <article-title>Epidemiology of domestically acquired amebiasis in Japan, 2000&#x02013;2013</article-title>. <source>Am. J. Trop. Med. Hyg</source>. <volume>94</volume>, <fpage>1008</fpage>&#x02013;<lpage>1014</lpage>. <pub-id pub-id-type="doi">10.4269/ajtmh.15-0560</pub-id><pub-id pub-id-type="pmid">26976888</pub-id></citation></ref>
<ref id="B15">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Iwai</surname> <given-names>Y.</given-names></name> <name><surname>Kora</surname> <given-names>A.</given-names></name> <name><surname>Takahashi</surname> <given-names>Y.</given-names></name> <name><surname>Hayashi</surname> <given-names>T.</given-names></name> <name><surname>Awaya</surname> <given-names>J.</given-names></name> <name><surname>Masuma</surname> <given-names>R.</given-names></name> <etal/></person-group>. (<year>1978</year>). <article-title>Production of deoxyfrenolicin and a new antibiotic, frenolicin B by <italic>Streptomyces roseofulvus</italic> strain AM-3867</article-title>. <source>J. Antibiot</source>. <volume>31</volume>, <fpage>959</fpage>&#x02013;<lpage>965</lpage>. <pub-id pub-id-type="doi">10.7164/antibiotics.31.959</pub-id><pub-id pub-id-type="pmid">711620</pub-id></citation></ref>
<ref id="B16">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>James</surname> <given-names>R.</given-names></name> <name><surname>Barratt</surname> <given-names>J.</given-names></name> <name><surname>Marriott</surname> <given-names>D.</given-names></name> <name><surname>Harkness</surname> <given-names>J.</given-names></name> <name><surname>Stark</surname> <given-names>D.</given-names></name></person-group> (<year>2010</year>). <article-title>Short report: seroprevalence of <italic>Entamoeba histolytica</italic> infection among men who have sex with men in Sydney, Australia</article-title>. <source>Am. J. Trop. Med. Hyg.</source>, <volume>83</volume>, <fpage>914</fpage>&#x02013;<lpage>916</lpage>. <pub-id pub-id-type="doi">10.4269/ajtmh.2010.10-0231</pub-id></citation></ref>
<ref id="B17">
<citation citation-type="thesis"><person-group person-group-type="author"><name><surname>Jeelani</surname> <given-names>G.</given-names></name> <name><surname>Husain</surname> <given-names>A.</given-names></name> <name><surname>Sato</surname> <given-names>D.</given-names></name> <name><surname>Ali</surname> <given-names>V.</given-names></name> <name><surname>Suematsu</surname> <given-names>M.</given-names></name> <name><surname>Soga</surname> <given-names>T.</given-names></name> <etal/></person-group>. (<year>2010</year>). <article-title>Two atypical L-cysteine-regulated NADPH-dependent oxidoreductases involved in redox maintenance, L-cystine and iron reduction, and metronidazole activation in the enteric protozoan <italic>Entamoeba histolytica</italic></article-title>. <source>J. Biol. Chem</source>. <volume>285</volume>, <fpage>26889</fpage>&#x02013;<lpage>26899</lpage>. <pub-id pub-id-type="doi">10.1074/jbc.M110.106310</pub-id><pub-id pub-id-type="pmid">20592025</pub-id></citation></ref>
<ref id="B18">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Jeelani</surname> <given-names>G.</given-names></name> <name><surname>Sato</surname> <given-names>D.</given-names></name> <name><surname>Soga</surname> <given-names>T.</given-names></name> <name><surname>Nozaki</surname> <given-names>T.</given-names></name></person-group> (<year>2017</year>). <article-title>Genetic, metabolomics and transcriptomic analyses of the de novo L-cysteine biosynthetic pathway in the enteric protozoan parasite <italic>Entamoeba histolytica</italic></article-title>. <source>Sci. Rep.</source> <volume>7</volume>:<fpage>15649</fpage>. <pub-id pub-id-type="doi">10.1038/s41598-017-15923-3</pub-id></citation></ref>
<ref id="B19">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Jeelani</surname> <given-names>G.</given-names></name> <name><surname>Sato</surname> <given-names>D.</given-names></name> <name><surname>Soga</surname> <given-names>T.</given-names></name> <name><surname>Watanabe</surname> <given-names>H.</given-names></name> <name><surname>Nozaki</surname> <given-names>T.</given-names></name></person-group> (<year>2014</year>). <article-title>Mass spectrometric analysis of L-cysteine metabolism: physiological role and fate of L-cysteine in the enteric protozoan parasite <italic>Entamoeba histolytica</italic></article-title>. <source>MBio</source> <volume>5</volume>, <fpage>e01995</fpage>&#x02013;<lpage>e01914</lpage>. <pub-id pub-id-type="doi">10.1128/mBio.01995-14</pub-id><pub-id pub-id-type="pmid">25370494</pub-id></citation></ref>
<ref id="B20">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Li</surname> <given-names>H.</given-names></name> <name><surname>Xiao</surname> <given-names>J.</given-names></name> <name><surname>Gao</surname> <given-names>Y. Q.</given-names></name> <name><surname>Tang</surname> <given-names>J. J.</given-names></name> <name><surname>Zhang</surname> <given-names>A. L.</given-names></name> <name><surname>Gao</surname> <given-names>J. M.</given-names></name></person-group> (<year>2014</year>). <article-title>Chaetoglobosins from <italic>Chaetomium globosum</italic>, an endophytic fungus in <italic>Ginkgo biloba</italic>, and their phytotoxic and cytotoxic activities</article-title>. <source>J. Agric. Food Chem.</source> <volume>62</volume>, <fpage>3734</fpage>&#x02013;<lpage>3741</lpage>. <pub-id pub-id-type="doi">10.1021/jf500390h</pub-id><pub-id pub-id-type="pmid">24708412</pub-id></citation></ref>
<ref id="B21">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ling</surname> <given-names>L. L.</given-names></name> <name><surname>Schneider</surname> <given-names>T.</given-names></name> <name><surname>Peoples</surname> <given-names>A. J.</given-names></name> <name><surname>Spoering</surname> <given-names>A. L.</given-names></name> <name><surname>Engels</surname> <given-names>I.</given-names></name> <name><surname>Conlon</surname> <given-names>B. P.</given-names></name> <etal/></person-group>. (<year>2015</year>). <article-title>A new antibiotic kills pathogens without detectable resistance</article-title>. <source>Nature</source> <volume>517</volume>, <fpage>455</fpage>&#x02013;<lpage>459</lpage>. <pub-id pub-id-type="doi">10.1038/nature14098</pub-id><pub-id pub-id-type="pmid">25561178</pub-id></citation></ref>
<ref id="B22">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lo</surname> <given-names>Y. C.</given-names></name> <name><surname>Ji</surname> <given-names>D. D.</given-names></name> <name><surname>Hung</surname> <given-names>C. C.</given-names></name></person-group> (<year>2014</year>). <article-title>Prevalent and incident HIV diagnoses among <italic>Entamoeba histolytica</italic>-infected adult males: a changing epidemiology associated with sexual transmission &#x02014;Taiwan, 2006&#x02013;2013</article-title>. <source>PLoS Negl. Trop. Dis</source>. <volume>8</volume>:<fpage>e3222</fpage>. <pub-id pub-id-type="doi">10.1371/journal.pntd.0003222</pub-id><pub-id pub-id-type="pmid">25299178</pub-id></citation></ref>
<ref id="B23">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lucas</surname> <given-names>E. M. F.</given-names></name> <name><surname>Monteiro de Castro</surname> <given-names>M. C.</given-names></name> <name><surname>Takahashi</surname> <given-names>J. A.</given-names></name></person-group> (<year>2007</year>). <article-title>Antimicrobial properties of sclerotiorin, isochromophilone VI and pencolide, metabolites from a Brazilian cerrado isolate of <italic>Penicillium sclerotiorum</italic> van Beyma</article-title>. <source>Braz. J. Microbiol</source>. <volume>38</volume>, <fpage>785</fpage>&#x02013;<lpage>789</lpage>. <pub-id pub-id-type="doi">10.1590/S1517-83822007000400036</pub-id></citation></ref>
<ref id="B24">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Makioka</surname> <given-names>A.</given-names></name> <name><surname>Kumagai</surname> <given-names>M.</given-names></name> <name><surname>Kobayashi</surname> <given-names>S.</given-names></name> <name><surname>Takeuchi</surname> <given-names>T.</given-names></name></person-group> (<year>2004</year>). <article-title>Different effects of cytochalasins on the growth and differentiation of <italic>Entoamoeba invadens</italic></article-title>. <source>Parasitol. Res.</source> <volume>93</volume>, <fpage>68</fpage>&#x02013;<lpage>71</lpage>. <pub-id pub-id-type="doi">10.1007/s00436-004-1106-8</pub-id><pub-id pub-id-type="pmid">15103555</pub-id></citation></ref>
<ref id="B25">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mori</surname> <given-names>M.</given-names></name> <name><surname>Jeelani</surname> <given-names>G.</given-names></name> <name><surname>Masuda</surname> <given-names>Y.</given-names></name> <name><surname>Sakai</surname> <given-names>K.</given-names></name> <name><surname>Tsukui</surname> <given-names>K.</given-names></name> <name><surname>Waluyo</surname> <given-names>D.</given-names></name> <etal/></person-group>. (<year>2015</year>). <article-title>Identification of natural inhibitors of <italic>Entamoeba histolytica</italic> cysteine synthase from microbial secondary metabolites</article-title>. <source>Frontiers Microbiol.</source> <volume>6</volume>:<fpage>962</fpage>. <pub-id pub-id-type="doi">10.3389/fmicb.2015.00962</pub-id><pub-id pub-id-type="pmid">26441896</pub-id></citation></ref>
<ref id="B26">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Nagpal</surname> <given-names>I.</given-names></name> <name><surname>Raj</surname> <given-names>I.</given-names></name> <name><surname>Subbarao</surname> <given-names>N.</given-names></name> <name><surname>Gourinath</surname> <given-names>S.</given-names></name></person-group> (<year>2012</year>). <article-title>Virtual screening, identification and <italic>in vitro</italic> testing of novel inhibitors of <italic>O</italic>-acetyl-L-serine sulfhydrylase of <italic>Entamoeba histolytica</italic></article-title>. <source>PLoS ONE</source> <volume>7</volume>:<fpage>e30305</fpage>. <pub-id pub-id-type="doi">10.1371/journal.pone.0030305</pub-id><pub-id pub-id-type="pmid">22355310</pub-id></citation></ref>
<ref id="B27">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Newman</surname> <given-names>D. J.</given-names></name> <name><surname>Cragg</surname> <given-names>G. M.</given-names></name></person-group> (<year>2016</year>). <article-title>Natural products as sources of new drugs from 1981 to 2014</article-title>. <source>J. Nat. Prod.</source> <volume>79</volume>, <fpage>629</fpage>&#x02013;<lpage>661</lpage>. <pub-id pub-id-type="doi">10.1021/acs.jnatprod.5b01055</pub-id><pub-id pub-id-type="pmid">26852623</pub-id></citation></ref>
<ref id="B28">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Nozaki</surname> <given-names>T.</given-names></name> <name><surname>Ali</surname> <given-names>V.</given-names></name> <name><surname>Tokoro</surname> <given-names>M.</given-names></name></person-group> (<year>2005</year>). <article-title>Sulfur-containing amino acid metabolism in parasitic protozoa</article-title>. <source>Adv. Parasitol</source>. <volume>60C</volume>, <fpage>1</fpage>&#x02013;<lpage>99</lpage>. <pub-id pub-id-type="doi">10.1016/S0065-308X(05)60001-2</pub-id></citation></ref>
<ref id="B29">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Nozaki</surname> <given-names>T.</given-names></name> <name><surname>Asai</surname> <given-names>T.</given-names></name> <name><surname>Kobayashi</surname> <given-names>S.</given-names></name> <name><surname>Ikegami</surname> <given-names>F.</given-names></name> <name><surname>Noji</surname> <given-names>M.</given-names></name> <name><surname>Saito</surname> <given-names>K.</given-names></name> <etal/></person-group>. (<year>1998</year>). <article-title>Molecular cloning and characterization of the genes encoding two isoforms of cysteine synthase in the enteric protozoan parasite <italic>Entamoeba histolytica</italic></article-title>. <source>Mol. Biochem. Parasitol</source>. <volume>97</volume>, <fpage>33</fpage>&#x02013;<lpage>44</lpage>. <pub-id pub-id-type="doi">10.1016/S0166-6851(98)00129-7</pub-id><pub-id pub-id-type="pmid">9879885</pub-id></citation></ref>
<ref id="B30">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Nozaki</surname> <given-names>T.</given-names></name> <name><surname>Asai</surname> <given-names>T.</given-names></name> <name><surname>Sanchez</surname> <given-names>L. B.</given-names></name> <name><surname>Kobayashi</surname> <given-names>S.</given-names></name> <name><surname>Nakazawa</surname> <given-names>M.</given-names></name> <name><surname>Takeuchi</surname> <given-names>T.</given-names></name></person-group> (<year>1999</year>). <article-title>Characterization of the gene encoding serine acetyltransferase, a regulated enzyme of cysteine biosynthesis from the protist parasites <italic>Entamoeba histolytica</italic> and <italic>Entamoeba dispar</italic>. Regulation and possible function of the cysteine biosynthetic pathway in Entamoeba</article-title>. <source>J. Biol. Chem.</source> <volume>274</volume>, <fpage>32445</fpage>&#x02013;<lpage>32452</lpage>. <pub-id pub-id-type="doi">10.1074/jbc.274.45.32445</pub-id><pub-id pub-id-type="pmid">10542289</pub-id></citation></ref>
<ref id="B31">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ohnishi</surname> <given-names>K.</given-names></name> <name><surname>Sakamoto</surname> <given-names>N.</given-names></name> <name><surname>Kobayashi</surname> <given-names>K.</given-names></name> <name><surname>Iwabuchi</surname> <given-names>S.</given-names></name> <name><surname>Nakamura-Uchiyama</surname> <given-names>F.</given-names></name> <name><surname>Ajisawa</surname> <given-names>A.</given-names></name> <etal/></person-group>. (<year>2014</year>). <article-title>Subjective adverse reactions to metronidazole in patients with amebiasis</article-title>. <source>Parasitol. Int.</source> <volume>63</volume>, <fpage>698</fpage>&#x02013;<lpage>700</lpage>. <pub-id pub-id-type="doi">10.1016/j.parint.2014.05.006</pub-id><pub-id pub-id-type="pmid">24929036</pub-id></citation></ref>
<ref id="B32">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Putri</surname> <given-names>S. P.</given-names></name> <name><surname>Kinoshita</surname> <given-names>H.</given-names></name> <name><surname>Ihara</surname> <given-names>F.</given-names></name> <name><surname>Igarashi</surname> <given-names>Y.</given-names></name> <name><surname>Nihira</surname> <given-names>T.</given-names></name></person-group> (<year>2009</year>). <article-title>Farinomalein, a maleimide-bearing compound from the entomopathogenic fungus <italic>Paecilomyces farinosus</italic></article-title>. <source>J. Nat. Prod</source>. <volume>72</volume>, <fpage>1544</fpage>&#x02013;<lpage>1546</lpage>. <pub-id pub-id-type="doi">10.1021/np9002806</pub-id><pub-id pub-id-type="pmid">19670877</pub-id></citation></ref>
<ref id="B33">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Samarawickrema</surname> <given-names>N. A.</given-names></name> <name><surname>Brown</surname> <given-names>D. M.</given-names></name> <name><surname>Upcroft</surname> <given-names>J. A.</given-names></name> <name><surname>Thammapalerd</surname> <given-names>N.</given-names></name> <name><surname>Upcroft</surname> <given-names>P.</given-names></name></person-group> (<year>1997</year>). <article-title>Involvement of superoxide dismutase and pyruvate: ferredoxin oxidoreductase in mechanisms of metronidazole resistance in <italic>Entamoeba histolytica</italic></article-title>. <source>J. Antimicrob. Chemother</source>. <volume>40</volume>, <fpage>833</fpage>&#x02013;<lpage>840</lpage>. <pub-id pub-id-type="doi">10.1093/jac/40.6.833</pub-id><pub-id pub-id-type="pmid">9462435</pub-id></citation></ref>
<ref id="B34">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Scherlach</surname> <given-names>K.</given-names></name> <name><surname>Boettger</surname> <given-names>D.</given-names></name> <name><surname>Remme</surname> <given-names>N.</given-names></name> <name><surname>Hertweck</surname> <given-names>C.</given-names></name></person-group> (<year>2010</year>). <article-title>The chemistry and biology of cytochalasans</article-title>. <source>Nat. Prod. Rep.</source> <volume>27</volume>, <fpage>869</fpage>&#x02013;<lpage>886</lpage>. <pub-id pub-id-type="doi">10.1039/b903913a</pub-id><pub-id pub-id-type="pmid">20411198</pub-id></citation></ref>
<ref id="B35">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sekita</surname> <given-names>S.</given-names></name> <name><surname>Yoshihira</surname> <given-names>K.</given-names></name> <name><surname>Natori</surname> <given-names>S.</given-names></name></person-group> (<year>1973</year>). <article-title>Structures of chaetoglobosin A and B, cytotoxic metabolites of <italic>Chaetomium globosum</italic></article-title>. <source>Tetrahedron Lett</source>. <volume>14</volume>, <fpage>2109</fpage>&#x02013;<lpage>2112</lpage>. <pub-id pub-id-type="doi">10.1016/S0040-4039(01)86820-9</pub-id></citation></ref>
<ref id="B36">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sekita</surname> <given-names>S.</given-names></name> <name><surname>Yoshihira</surname> <given-names>K.</given-names></name> <name><surname>Natori</surname> <given-names>S.</given-names></name> <name><surname>Kuwano</surname> <given-names>H.</given-names></name></person-group> (<year>1982a</year>). <article-title>Chaetoglobosins, cytotoxic 10-(indol-3-yl)-[13]cytochalasans from <italic>Chaetomium</italic> spp. II. Structures of chaetoglobosins A, B, and D</article-title>. <source>Chem. Pharm. Bull.</source> <volume>30</volume>, <fpage>1618</fpage>&#x02013;<lpage>1628</lpage>. <pub-id pub-id-type="doi">10.1248/cpb.30.1618</pub-id></citation></ref>
<ref id="B37">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sekita</surname> <given-names>S.</given-names></name> <name><surname>Yoshihira</surname> <given-names>K.</given-names></name> <name><surname>Natori</surname> <given-names>S.</given-names></name> <name><surname>Kuwano</surname> <given-names>H.</given-names></name></person-group> (<year>1982b</year>). <article-title>Chaetoglobosins, cytotoxic 10-(indol-3-yl)-[13]cytochalasans from Chaetomium spp. III. Structures of chaetoglobosins C, E, F, G, and J</article-title>. <source>Chem. Pharm. Bull.</source> <volume>30</volume>, <fpage>1629</fpage>&#x02013;<lpage>1638</lpage>. <pub-id pub-id-type="doi">10.1248/cpb.30.1629</pub-id></citation></ref>
<ref id="B38">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Stanley</surname> <given-names>S. L.</given-names> <suffix>Jr.</suffix></name></person-group> (<year>2003</year>). <article-title>Amoebiasis</article-title>. <source>Lancet</source> <volume>361</volume>, <fpage>1025</fpage>&#x02013;<lpage>1034</lpage>. <pub-id pub-id-type="doi">10.1016/S0140-6736(03)12830-9</pub-id><pub-id pub-id-type="pmid">12660071</pub-id></citation></ref>
<ref id="B39">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sutherland</surname> <given-names>J. K.</given-names></name></person-group> (<year>1963</year>). <article-title>The proton-magnetic resonance spectrum of pencolide</article-title>. <source>Biochem. J</source>. <volume>86</volume>:<fpage>243</fpage>. <pub-id pub-id-type="doi">10.1042/bj0860243</pub-id><pub-id pub-id-type="pmid">13979396</pub-id></citation></ref>
<ref id="B40">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tomikawa</surname> <given-names>T.</given-names></name> <name><surname>Shin-ya</surname> <given-names>K.</given-names></name> <name><surname>Seto</surname> <given-names>H.</given-names></name> <name><surname>Okusa</surname> <given-names>N.</given-names></name> <name><surname>Kajiura</surname> <given-names>T.</given-names></name> <name><surname>Hayakawa</surname> <given-names>Y.</given-names></name></person-group> (<year>2002</year>). <article-title>Structure of Aspochalasin H, a new member of the aspochalasin family</article-title>. <source>J. Antibiot.</source> <volume>55</volume>, <fpage>666</fpage>&#x02013;<lpage>668</lpage>. <pub-id pub-id-type="doi">10.7164/antibiotics.55.666</pub-id><pub-id pub-id-type="pmid">12243459</pub-id></citation></ref>
<ref id="B41">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Vance</surname> <given-names>D.</given-names></name> <name><surname>Goldberg</surname> <given-names>I.</given-names></name> <name><surname>Mitsuhashi</surname> <given-names>O.</given-names></name> <name><surname>Bloch</surname> <given-names>K.</given-names></name></person-group> (<year>1972</year>). <article-title>Inhibition of fatty acid synthetases by the antibiotic cerulenin</article-title>. <source>Biochem. Biophys. Res. Commun.</source> <volume>48</volume>, <fpage>649</fpage>&#x02013;<lpage>656</lpage>. <pub-id pub-id-type="doi">10.1016/0006-291X(72)90397-X</pub-id><pub-id pub-id-type="pmid">4625866</pub-id></citation></ref>
<ref id="B42">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname> <given-names>X.</given-names></name> <name><surname>Sena Filho</surname> <given-names>J. G.</given-names></name> <name><surname>Hoover</surname> <given-names>A. R.</given-names></name> <name><surname>King</surname> <given-names>J. B.</given-names></name> <name><surname>Ellis</surname> <given-names>T. K.</given-names></name> <name><surname>Powell</surname> <given-names>D. R.</given-names></name> <etal/></person-group>. (<year>2010</year>). <article-title>Chemical epigenetics alters the secondary metabolite composition of guttate excreted by an atlantic-forest-soil-derived <italic>Penicillium citreonigrum</italic></article-title>. <source>J. Nat. Prod.</source> <volume>73</volume>, <fpage>942</fpage>&#x02013;<lpage>948</lpage>. <pub-id pub-id-type="doi">10.1021/np100142h</pub-id><pub-id pub-id-type="pmid">20450206</pub-id></citation></ref>
<ref id="B43">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname> <given-names>X.</given-names></name> <name><surname>Shaaban</surname> <given-names>K. A.</given-names></name> <name><surname>Elshahawi</surname> <given-names>S. I.</given-names></name> <name><surname>Ponomareva</surname> <given-names>L. V.</given-names></name> <name><surname>Sunkara</surname> <given-names>M.</given-names></name> <name><surname>Zhang</surname> <given-names>Y.</given-names></name> <etal/></person-group>. (<year>2013</year>). <article-title>Frenolicins C-G, pyranonaphthoquinones from <italic>Streptomyces</italic> sp. RM-4-15</article-title>. <source>J. Nat. Prod</source>. <volume>76</volume>, <fpage>1441</fpage>&#x02013;<lpage>1447</lpage>. <pub-id pub-id-type="doi">10.1021/np400231r</pub-id><pub-id pub-id-type="pmid">23944931</pub-id></citation></ref>
<ref id="B44">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wassmann</surname> <given-names>C.</given-names></name> <name><surname>Hellberg</surname> <given-names>A.</given-names></name> <name><surname>Tannich</surname> <given-names>E.</given-names></name> <name><surname>Bruchhaus</surname> <given-names>I.</given-names></name></person-group> (<year>1999</year>). <article-title>Metronidazole resistance in the protozoan parasite <italic>Entamoeba histolytica</italic> is associated with increased expression of iron-containing superoxide dismutase and peroxiredoxin and decreased expression of ferredoxin 1 and flavin reductase</article-title>. <source>J. Biol. Chem.</source> <volume>274</volume>, <fpage>26051</fpage>&#x02013;<lpage>26056</lpage>. <pub-id pub-id-type="doi">10.1074/jbc.274.37.26051</pub-id><pub-id pub-id-type="pmid">10473552</pub-id></citation></ref>
<ref id="B45">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Watanabe</surname> <given-names>K.</given-names></name> <name><surname>Gatanaga</surname> <given-names>H.</given-names></name> <name><surname>Escueta-de Cadiz</surname> <given-names>A.</given-names></name> <name><surname>Tanuma</surname> <given-names>J.</given-names></name> <name><surname>Nozaki</surname> <given-names>T.</given-names></name> <name><surname>Oka</surname> <given-names>S.</given-names></name></person-group> (<year>2011</year>). <article-title>Amebiasis in HIV-1-infected Japanese men: clinical features and response to therapy</article-title>. <source>PLoS Negl. Trop. Dis.</source> <volume>5</volume>:<fpage>e1318</fpage>. <pub-id pub-id-type="doi">10.1371/journal.pntd.0001318</pub-id><pub-id pub-id-type="pmid">21931875</pub-id></citation></ref>
<ref id="B46">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Xim&#x000E9;nez</surname> <given-names>C.</given-names></name> <name><surname>Mor&#x000E1;n</surname> <given-names>P.</given-names></name> <name><surname>Rojas</surname> <given-names>L.</given-names></name> <name><surname>Valadaz</surname> <given-names>A.</given-names></name> <name><surname>Gomez</surname> <given-names>A.</given-names></name></person-group> (<year>2009</year>). <article-title>Reassessment of the epidemiology of amebiasis: state of the art</article-title>. <source>Infect. Gen. Evol.</source> <volume>9</volume>, <fpage>1023</fpage>&#x02013;<lpage>1032</lpage>. <pub-id pub-id-type="doi">10.1016/j.meegid.2009.06.008</pub-id><pub-id pub-id-type="pmid">19540361</pub-id></citation></ref>
<ref id="B47">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Yadava</surname> <given-names>U.</given-names></name> <name><surname>Shukla</surname> <given-names>B. K.</given-names></name> <name><surname>Roychoudhury</surname> <given-names>M.</given-names></name> <name><surname>Kumar</surname> <given-names>D.</given-names></name></person-group> (<year>2015</year>). <article-title>Pyrazolo[3,4-<italic>d</italic>]pyrimidines as novel inhibitors of <italic>O</italic>-acetyl-L-serine sulfhydrylase of <italic>Entamoeba histolytica</italic>: an <italic>in silico</italic> study</article-title>. <source>J. Mol. Model.</source> <volume>21</volume>:<fpage>96</fpage>. <pub-id pub-id-type="doi">10.1007/s00894-015-2631-3</pub-id><pub-id pub-id-type="pmid">25799964</pub-id></citation></ref>
<ref id="B48">
<citation citation-type="journal"><person-group person-group-type="author"><name><surname>Yanagawa</surname> <given-names>Y.</given-names></name> <name><surname>Nagata</surname> <given-names>N.</given-names></name> <name><surname>Watanabe</surname> <given-names>K.</given-names></name> <name><surname>Tsukada</surname> <given-names>K.</given-names></name> <name><surname>Teruya</surname> <given-names>K.</given-names></name> <name><surname>Kikuchi</surname> <given-names>Y.</given-names></name> <etal/></person-group>. (<year>2016</year>). <article-title>Increases in <italic>Entamoeba histolytica</italic> antibody&#x02013;positive rates in human immunodeficiency virus&#x02013;infected and noninfected patients in Japan: a 10-year hospital-based study of 3,514 patients</article-title>. <source>Am. J. Trop. Med. Hyg.</source> <volume>95</volume>, <fpage>604</fpage>&#x02013;<lpage>609</lpage>. <pub-id pub-id-type="doi">10.4269/ajtmh.16-0134</pub-id><pub-id pub-id-type="pmid">27296390</pub-id></citation></ref>
</ref-list> 
</back>
</article>