151
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Jancel T, Penzak SR. Antiviral Therapy in Patients With Hematologic Malignancies, Transplantation, and Aplastic Anemia. Semin Hematol 2009; 46:230-47. [DOI: 10.1053/j.seminhematol.2009.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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152
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Ekiert DC, Bhabha G, Elsliger MA, Friesen RHE, Jongeneelen M, Throsby M, Goudsmit J, Wilson IA. Antibody recognition of a highly conserved influenza virus epitope. Science 2009; 324:246-51. [PMID: 19251591 PMCID: PMC2758658 DOI: 10.1126/science.1171491] [Citation(s) in RCA: 1062] [Impact Index Per Article: 70.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Influenza virus presents an important and persistent threat to public health worldwide, and current vaccines provide immunity to viral isolates similar to the vaccine strain. High-affinity antibodies against a conserved epitope could provide immunity to the diverse influenza subtypes and protection against future pandemic viruses. Cocrystal structures were determined at 2.2 and 2.7 angstrom resolutions for broadly neutralizing human antibody CR6261 Fab in complexes with the major surface antigen (hemagglutinin, HA) from viruses responsible for the 1918 H1N1 influenza pandemic and a recent lethal case of H5N1 avian influenza. In contrast to other structurally characterized influenza antibodies, CR6261 recognizes a highly conserved helical region in the membrane-proximal stem of HA1 and HA2. The antibody neutralizes the virus by blocking conformational rearrangements associated with membrane fusion. The CR6261 epitope identified here should accelerate the design and implementation of improved vaccines that can elicit CR6261-like antibodies, as well as antibody-based therapies for the treatment of influenza.
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MESH Headings
- Antibodies, Viral/chemistry
- Antibodies, Viral/immunology
- Antibody Affinity
- Antigens, Viral/chemistry
- Antigens, Viral/immunology
- Binding Sites, Antibody
- Crystallization
- Crystallography, X-Ray
- Epitopes/immunology
- Glycosylation
- Hemagglutinin Glycoproteins, Influenza Virus/chemistry
- Hemagglutinin Glycoproteins, Influenza Virus/immunology
- Humans
- Hydrogen Bonding
- Hydrogen-Ion Concentration
- Hydrophobic and Hydrophilic Interactions
- Immunoglobulin Fab Fragments/chemistry
- Immunoglobulin Fab Fragments/immunology
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A Virus, H5N1 Subtype/immunology
- Influenza Vaccines
- Membrane Fusion
- Models, Molecular
- Neutralization Tests
- Protein Conformation
- Protein Structure, Secondary
- Protein Structure, Tertiary
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Affiliation(s)
- Damian C. Ekiert
- Department of Molecular Biology, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA
| | - Gira Bhabha
- Department of Molecular Biology, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA
| | - Marc-André Elsliger
- Department of Molecular Biology, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA
| | | | - Mandy Jongeneelen
- Crucell Holland BV, Archimedesweg 4–6, 2301 CA Leiden, The Netherlands
| | - Mark Throsby
- Crucell Holland BV, Archimedesweg 4–6, 2301 CA Leiden, The Netherlands
| | - Jaap Goudsmit
- Crucell Holland BV, Archimedesweg 4–6, 2301 CA Leiden, The Netherlands
| | - Ian A. Wilson
- Department of Molecular Biology, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA
- The Skaggs Institute for Chemical Biology, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA
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153
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Schirmer P, Holodniy M. Oseltamivir for treatment and prophylaxis of influenza infection. Expert Opin Drug Saf 2009; 8:357-71. [DOI: 10.1517/14740330902840519] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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154
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Quantification of peramivir (a novel anti-influenza drug) in human plasma by hydrophilic interaction chromatography/tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2009; 877:933-8. [DOI: 10.1016/j.jchromb.2009.02.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 01/28/2009] [Accepted: 02/18/2009] [Indexed: 11/24/2022]
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155
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Barnard DL. Animal models for the study of influenza pathogenesis and therapy. Antiviral Res 2009; 82:A110-22. [PMID: 19176218 PMCID: PMC2700745 DOI: 10.1016/j.antiviral.2008.12.014] [Citation(s) in RCA: 136] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2008] [Revised: 12/15/2008] [Accepted: 12/20/2008] [Indexed: 12/12/2022]
Abstract
Influenza A viruses causes a variety of illnesses in humans. The most common infection, seasonal influenza, is usually a mild, self-limited febrile syndrome, but it can be more severe in infants, the elderly, and immunodeficient persons, in whom it can progress to severe viral pneumonitis or be complicated by bacterial superinfection, leading to pneumonia and sepsis. Seasonal influenza also occasionally results in neurologic complications. Rarely, viruses that have spread from wild birds to domestic poultry can infect humans; such “avian influenza” can range in severity from mild conjunctivitis through the rapidly lethal disease seen in persons infected with the H5N1 virus that first emerged in Hong Kong in 1997. To develop effective therapies for this wide range of diseases, it is essential to have laboratory animal models that replicate the major features of illness in humans. This review describes models currently in use for elucidating influenza pathogenesis and evaluating new therapeutic agents.
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Affiliation(s)
- Dale L Barnard
- Institute for Antiviral Research, Utah State University, Logan, UT 84322-5600, USA.
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156
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Affiliation(s)
- Kam-Lun Hon
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
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157
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Hayden F. Developing New Antiviral Agents for Influenza Treatment: What Does the Future Hold? Clin Infect Dis 2009; 48 Suppl 1:S3-13. [DOI: 10.1086/591851] [Citation(s) in RCA: 202] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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158
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Antiviral Resistance in Influenza Viruses: Clinical and Epidemiological Aspects. ANTIMICROBIAL DRUG RESISTANCE 2009. [PMCID: PMC7122859 DOI: 10.1007/978-1-60327-595-8_23] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Two classes of anti-viral agents, the M2 ion channel inhibitors (amantadine, rimantadine) and neuraminidase (NA) inhibitors (oseltamivir, zanamivir) are available for treatment and prevention of infl uenza in most countries of the world. The principle concerns about emergence of antiviral resistance in infl uenza viruses are loss of drug effi cacy, transmission of resistant variants, and possible increased virulence or transmissibility of resistant variants (1). Because seasonal infl uenza is usually an acute, self-limited illness in which viral clearance occurs rapidly due to innate and adaptive host immune responses, the emergence of drug-resistant variants would be anticipated to have modest effects on clinical recovery, except perhaps in immunocompromised or immunologically naïve hosts, such as young infants or during the appearance of a novel strain. In contrast to the limited impact of resistance emergence in the treated immunocompetent individual, the epidemiologic impact of resistance emergence and transmission could be considerable, including loss of both prophylactic and therapeutic activity for a particular drug, at the household, community, or perhaps global level. Infl uenza epidemiology in temperate climates is expected to provide some protection against widespread circulation of resistant variants, as viruses do not persist between epidemics but rather are re-introduced each season and new variants appear often (2, 3).
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159
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Carlescu I, Scutaru D, Popa M, Uglea CV. Synthetic sialic-acid-containing polyvalent antiviral inhibitors. Med Chem Res 2008. [DOI: 10.1007/s00044-008-9139-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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160
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Abstract
PURPOSE OF REVIEW Neuraminidase inhibitor resistant influenza virus has recently emerged, and circulated, in untreated persons. Influenza virus evolution is causing antiviral susceptibility to change. We review the latest research in this rapidly moving field. RECENT FINDINGS Oseltamivir-resistant influenza H1N1 emerged globally, without drug selection pressure, during the 2007-2008 northern hemisphere influenza season. This unexpected event, coupled with reports of reducing susceptibilities of influenza B and H5N1, contradicts our understanding of the properties of neuraminidase inhibitor resistant influenza viruses. Knowledge of the structure of the neuraminidases and impact of mutations on drug binding has now expanded. Surveillance and clinical studies have identified key areas which require focused research such as the incidence of resistance in children and immunocompromised populations and the need for improved methodologies for detecting resistant virus on an individual and population level. SUMMARY Neuraminidase inhibitors, oseltamivir in particular, are the drugs of choice against seasonal influenza, zoonotic H5N1 and are stockpiled as the primary mitigating strategy for pandemic influenza containment and control. Further clinical and animal studies are essential to fully understand the capacity of neuraminidase inhibitor resistant influenza to be tolerated in the virus population, whilst retaining virulence and transmissibility. Vigilance, policy review and development of new anti-influenza drugs are essential.
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161
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Gabbard J, Velappan N, Di Niro R, Schmidt J, Jones CA, Tompkins SM, Bradbury ARM. A humanized anti-M2 scFv shows protective in vitro activity against influenza. Protein Eng Des Sel 2008; 22:189-98. [PMID: 19054791 DOI: 10.1093/protein/gzn070] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
M2 is one of the most conserved influenza proteins, and has been widely prospected as a potential universal vaccine target, with protection predominantly mediated by antibodies. In this paper we describe the creation of a humanized single chain Fv from 14C2, a potent monoclonal antibody against M2. We show that the humanized scFv demonstrates similar activity to the parental mAb: it is able to recognize M2 in its native context on cell surfaces and is able to show protective in vitro activity against influenza, and so represents a potential lead antibody candidate for universal prophylactic or therapeutic intervention in influenza.
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Affiliation(s)
- J Gabbard
- Department of Infectious Diseases, Animal Health Research Center, Influenza Pathogenesis and Immunology Research Center, University of Georgia, Athens, 30602-1563, USA
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162
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Tang JW, Ngai KLK, Chan PKS. Lack of cross-immune reactivity against influenza H5N1 from seasonal influenza vaccine in humans. J Med Virol 2008; 80:1992-6. [PMID: 18814271 DOI: 10.1002/jmv.21321] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In a small pilot study, sera from 10 healthy human volunteers were taken pre-vaccine, then 1, 3, and 6 months post-seasonal influenza immunization (using the 2005/2006 Northern hemisphere vaccine: A/New Caledonia/20/99(H1N1)-like, A/California/7/2004(H3N2)-like, and B/Shanghai/361/2002-like strains). Eight out of 10 subjects demonstrated satisfactory HAI titers (> or = 40) after seasonal influenza vaccination between 1 and 6 months post-vaccine. These sera were then tested for inhibitory activity against A/HK/483/97 and A/Thailand/1(KAN-1)/04 H5N1 influenza viruses using standard hemagglutination inhibition and microneutralization assays. In contrast to several other studies in both humans and animals on the cross-immunity between different influenza A viruses, antibodies produced to the influenza A(H1N1) component of the seasonal influenza vaccine showed no cross-reactivity to these avian influenza A(H5N1) viruses. Possible reasons for this contrasting result are discussed.
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Affiliation(s)
- Julian W Tang
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
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163
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164
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Basler CF, Aguilar PV. Progress in identifying virulence determinants of the 1918 H1N1 and the Southeast Asian H5N1 influenza A viruses. Antiviral Res 2008; 79:166-78. [PMID: 18547656 PMCID: PMC2547130 DOI: 10.1016/j.antiviral.2008.04.006] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2008] [Revised: 04/26/2008] [Accepted: 04/30/2008] [Indexed: 12/25/2022]
Abstract
The 1918 pandemic H1N1 influenza virus and the recently emerged Southeast Asian H5N1 avian influenza virus are unique among influenza A virus isolates in their high virulence for humans and their lethality for a variety of animal species without prior adaptation. Reverse genetic studies have implicated several viral genes as virulence determinants. For both the 1918 and H5N1 viruses, the hemagglutinin and the polymerase complex contribute to high virulence. Non-structural proteins NS1 and PB1-F2, which block host antiviral responses, also influence pathogenesis. Additionally, recent studies correlate high levels of viral replication and induction of strong proinflammatory responses with the high virulence of these viruses. Defining how individual viral proteins promote enhanced replication, inflammation and severe disease will provide insight into the pathogenesis of severe influenza virus infections and suggest novel therapeutic approaches.
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MESH Headings
- Animals
- Asia, Southeastern/epidemiology
- Disease Outbreaks/statistics & numerical data
- Ferrets
- Humans
- Immunotherapy
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/metabolism
- Influenza A Virus, H1N1 Subtype/pathogenicity
- Influenza A Virus, H5N1 Subtype/genetics
- Influenza A Virus, H5N1 Subtype/metabolism
- Influenza A Virus, H5N1 Subtype/pathogenicity
- Influenza, Human/epidemiology
- Influenza, Human/therapy
- Influenza, Human/virology
- Mice
- Orthomyxoviridae Infections/epidemiology
- Orthomyxoviridae Infections/therapy
- Orthomyxoviridae Infections/virology
- Viral Proteins/genetics
- Viral Proteins/metabolism
- Virulence
- Virulence Factors/genetics
- Virulence Factors/metabolism
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Affiliation(s)
- Christopher F Basler
- Department of Microbiology, Box 1124, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York, NY 10029, United States.
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165
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Yang Q, Zhang X, Bao X, Lu H, Zhang W, Wu W, Miao H, Jiao B. Single cell determination of nitric oxide release using capillary electrophoresis with laser-induced fluorescence detection. J Chromatogr A 2008; 1201:120-7. [DOI: 10.1016/j.chroma.2008.06.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Revised: 05/29/2008] [Accepted: 06/02/2008] [Indexed: 10/22/2022]
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166
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Leyssen P, De Clercq E, Neyts J. Molecular strategies to inhibit the replication of RNA viruses. Antiviral Res 2008; 78:9-25. [PMID: 18313769 PMCID: PMC7114363 DOI: 10.1016/j.antiviral.2008.01.004] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Revised: 01/04/2008] [Accepted: 01/08/2008] [Indexed: 12/24/2022]
Abstract
There are virtually no antiviral drugs available for the treatment of infections with RNA viruses. This is particularly worrisome since most of the highly pathogenic and emerging viruses are, and will likely continue to be, RNA viruses. These viruses can cause acute, severe illness, including severe respiratory disease, hemorrhagic fever and encephalitis, with a high case fatality rate. It is important to have potent and safe drugs at hand that can be used for the treatment or prophylaxis of such infections. Drugs approved for the treatment of RNA virus infections (other than HIV) are the influenza M2 channel inhibitors, amantadine and rimantadine; the influenza neuraminidase inhibitors, oseltamivir and zanamivir, and ribavirin for the treatment of infections with respiratory syncytial virus and hepatitis C virus. The molecular mechanism(s) by which ribavirin inhibits viral replication, such as depletion of intracellular GTP pools and induction of error catastrophe, may not readily allow the design of analogues that are more potent/selective than the parent drug. Highly pathogenic RNA viruses belong to a variety of virus families, each having a particular replication strategy, thus offering a wealth of potential targets to selectively inhibit viral replication. We here provide a non-exhaustive review of potential experimental strategies, using small molecules, to inhibit the replication of several RNA viruses. Other approaches, such as the use of interferon or other host-response modifiers, immune serum or neutralizing antibodies, are not addressed in this review.
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Affiliation(s)
| | | | - Johan Neyts
- Rega Institute for Medical Research, Catholic University Leuven, Minderbroedersstraat 10, B-3000 Leuven, Belgium
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167
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Highly pathogenic RNA viral infections: Challenges for antiviral research. Antiviral Res 2008; 78:1-8. [DOI: 10.1016/j.antiviral.2007.12.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Revised: 12/12/2007] [Accepted: 12/13/2007] [Indexed: 12/23/2022]
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168
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Oligonucleotide antiviral therapeutics: antisense and RNA interference for highly pathogenic RNA viruses. Antiviral Res 2008; 78:26-36. [PMID: 18258313 PMCID: PMC7114189 DOI: 10.1016/j.antiviral.2007.12.008] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2007] [Revised: 12/05/2007] [Accepted: 12/06/2007] [Indexed: 11/21/2022]
Abstract
RNA viruses are a significant source of morbidity and mortality in humans every year. Additionally, the potential use of these viruses in acts of bioterrorism poses a threat to national security. Given the paucity of vaccines or postexposure therapeutics for many highly pathogenic RNA viruses, novel treatments are badly needed. Sequence-based drug design, under development for almost 20 years, is proving effective in animal models and has moved into clinical trials. Important advances in the field include the characterization of RNA interference in mammalian cells and chemical modifications that can dramatically increase the in vivo stability of therapeutic oligonucleotides. Antisense strategies utilize single-stranded DNA oligonucleotides that inhibit protein production by mediating the catalytic degradation of target mRNA, or by binding to sites on mRNA essential for translation. Double-stranded RNA oligonucleotides, known as short-interfering RNAs (siRNAs), also mediate the catalytic degradation of complementary mRNAs. As RNA virus infection is predicated on the delivery, replication, and translation of viral RNA, these pathogens present an obvious target for the rapidly advancing field of sequence-specific therapeutics. Antisense oligonucleotides or siRNAs can be designed to target the viral RNA genome or viral transcripts. This article reviews current knowledge on therapeutic applications of antisense and RNA interference for highly pathogenic RNA viral infections.
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