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Sanchez-Gonzalez C, Pérez BS, Reyes MP, Aguilar JLF, Villalba JS, Santoyo JS. Recipient With Influenza A Infection: Contraindication to Transplant? A Case Report. Transplant Proc 2023; 55:2299-2300. [PMID: 37827900 DOI: 10.1016/j.transproceed.2023.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/29/2023] [Indexed: 10/14/2023]
Abstract
Active infections in recipients are considered an absolute contraindication to liver transplantation due to the risk of severe disease caused by the required immunosuppression. Even though viral infections, such as Influenza A, have been treated in liver transplant patients both in the immediate and late postoperative period with favorable outcomes, no cases of prediagnosed Influenza A have been described in which the decision to proceed with the indication had to be made. In certain viral infections, like Influenza A, the paucisymptomatic state and the availability of appropriate treatment could open the door to performing liver transplants with positive results.
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Affiliation(s)
- Claudia Sanchez-Gonzalez
- General Surgery and Digestive System Department, Regional University Hospital of Málaga, Málaga, Spain
| | - Belinda Sánchez Pérez
- General Surgery and Digestive System Department, Regional University Hospital of Málaga, Málaga, Spain.
| | - María Pérez Reyes
- General Surgery and Digestive System Department, Regional University Hospital of Málaga, Málaga, Spain
| | | | - Julio Santoyo Villalba
- General Surgery and Digestive System Department, Regional University Hospital of Málaga, Málaga, Spain
| | - Julio Santoyo Santoyo
- General Surgery and Digestive System Department, Regional University Hospital of Málaga, Málaga, Spain
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2
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Ju H, Hou L, Zhao F, Zhang Y, Jia R, Guizzo L, Bonomini A, Zhang J, Gao Z, Liang R, Bertagnin C, Kong X, Ma X, Kang D, Loregian A, Huang B, Liu X, Zhan P. Iterative Optimization and Structure-Activity Relationship Studies of Oseltamivir Amino Derivatives as Potent and Selective Neuraminidase Inhibitors via Targeting 150-Cavity. J Med Chem 2022; 65:11550-11573. [PMID: 35939763 DOI: 10.1021/acs.jmedchem.1c01970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
With our continuous endeavors in seeking neuraminidase (NA) inhibitors, we reported herein three series of novel oseltamivir amino derivatives with the goal of exploring the druggable chemical space inside the 150-cavity of influenza virus NAs. Among them, around half of the compounds in series C were demonstrated to be better inhibitors against both wild-type and oseltamivir-resistant group-1 NAs than oseltamivir carboxylate (OSC). Notably, compounds 12d, 12e, 15e, and 15i showed more potent or equipotent antiviral activity against H1N1, H5N1, and H5N8 viruses compared to OSC in cellular assays. Furthermore, compounds 12e and 15e exhibited high metabolic stability in human liver microsomes (HLMs) and low inhibitory effect on main cytochrome P450 (CYP) enzymes, as well as low acute/subacute toxicity and certain antiviral efficacy in vivo. Also, pharmacokinetic (PK) and molecular docking studies were performed. Overall, 12e and 15e possess great potential to serve as anti-influenza candidates and are worthy of further investigation.
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Affiliation(s)
- Han Ju
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Culture Road, 250012 Jinan, Shandong, P. R. China
| | - Lingxin Hou
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Culture Road, 250012 Jinan, Shandong, P. R. China
| | - Fabao Zhao
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Culture Road, 250012 Jinan, Shandong, P. R. China
| | - Ying Zhang
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Culture Road, 250012 Jinan, Shandong, P. R. China
| | - Ruifang Jia
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Culture Road, 250012 Jinan, Shandong, P. R. China
| | - Laura Guizzo
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35121 Padova, Italy
| | - Anna Bonomini
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35121 Padova, Italy
| | - Jiwei Zhang
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Culture Road, 250012 Jinan, Shandong, P. R. China
| | - Zhen Gao
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Culture Road, 250012 Jinan, Shandong, P. R. China
| | - Ruipeng Liang
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Culture Road, 250012 Jinan, Shandong, P. R. China
| | - Chiara Bertagnin
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35121 Padova, Italy
| | - Xiujie Kong
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Culture Road, 250012 Jinan, Shandong, P. R. China
| | - Xiuli Ma
- Institute of Poultry Science, Shandong Academy of Agricultural Sciences, 202 North Gongye Road, 250100 Jinan, Shandong, P. R. China
| | - Dongwei Kang
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Culture Road, 250012 Jinan, Shandong, P. R. China
| | - Arianna Loregian
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35121 Padova, Italy
| | - Bing Huang
- Institute of Poultry Science, Shandong Academy of Agricultural Sciences, 202 North Gongye Road, 250100 Jinan, Shandong, P. R. China
| | - Xinyong Liu
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Culture Road, 250012 Jinan, Shandong, P. R. China
| | - Peng Zhan
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 West Culture Road, 250012 Jinan, Shandong, P. R. China
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3
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Medeiros JJS, Costa TM, Carmo MP, Nascimento DD, Lauro ENC, Oliveira CA, Duque MD, Prado LD. Efficient drug development of oseltamivir capsules based on process control, bioequivalence and PBPK modeling. Drug Dev Ind Pharm 2022; 48:146-157. [DOI: 10.1080/03639045.2022.2102647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Juliana J. S. Medeiros
- Coordenação de Desenvolvimento Tecnológico, Instituto de Tecnologia em Farmacos, Farmanguinhos, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Thiago M. Costa
- Laboratório de Tecnologia Farmacêutica, Instituto de Tecnologia em Farmacos, Farmanguinhos, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Mariana P. Carmo
- Laboratório de Tecnologia Farmacêutica, Instituto de Tecnologia em Farmacos, Farmanguinhos, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Diogo D. Nascimento
- Laboratório de Desenvolvimento e Validação Analítica, Instituto de Tecnologia em Farmacos, Farmanguinhos, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Eduardo N. C. Lauro
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo, Diadema, Brazil
| | - Camila A. Oliveira
- Laboratório de Desenvolvimento e Validação Analítica, Instituto de Tecnologia em Farmacos, Farmanguinhos, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marcelo D. Duque
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo, Diadema, Brazil
| | - Livia D. Prado
- Laboratório de Desenvolvimento e Validação Analítica, Instituto de Tecnologia em Farmacos, Farmanguinhos, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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4
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Li J, Yang Z, Mao LF, Chen RH, Yu XF, Yang XH, Zhang GZ, Wang HQ, Chen SC, Zhao G. Reverse transcription recombinase-aided amplification assay for rapid detection of the influenza A(H1N1)pdm09 H275Y mutation that confers oseltamivir resistance. Mol Cell Probes 2021; 60:101771. [PMID: 34560257 DOI: 10.1016/j.mcp.2021.101771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/02/2021] [Accepted: 09/17/2021] [Indexed: 11/30/2022]
Abstract
The emergence of the influenza A(H1N1)pdm09 virus with the NA-H275Y mutation, which confers oseltamivir resistance, must be monitored, especially in patients undergoing neuraminidase inhibitor treatment. In this study, we developed a reverse transcription recombinase-aided amplification assay that has high sensitivity (detection limit: 1.0 × 101 copies/μL) and specificity for detecting the oseltamivir-resistant H275Y mutation; the assay is performed within 30 min at a constant temperature of 39° Celsius using an isothermal device. This method is suitable for the clinical application of targeted testing, thereby providing technical support for precision medicine in individual drug applications for patients with severe infection or immunosuppression.
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Affiliation(s)
- Jun Li
- Microbiology Laboratory, Hangzhou Centre for Disease Control and Prevention, Zhejiang, 310021, China
| | - Zi Yang
- Dali University, Yunnan, 671003, China
| | - Ling-Feng Mao
- Hangzhou Baocheng Biotechnology Co., Ltd., Zhejiang, 310052, China
| | - Ren-Hua Chen
- Department of Infectious Diseases, Hangzhou Centre for Disease Control and Prevention, Zhejiang, 310021, China
| | - Xin-Fen Yu
- Microbiology Laboratory, Hangzhou Centre for Disease Control and Prevention, Zhejiang, 310021, China
| | - Xu-Hui Yang
- Department of Infectious Diseases, Hangzhou Centre for Disease Control and Prevention, Zhejiang, 310021, China
| | - Guo-Zhong Zhang
- Microbiology Laboratory, Hangzhou Centre for Disease Control and Prevention, Zhejiang, 310021, China
| | - Hao-Qiu Wang
- Microbiology Laboratory, Hangzhou Centre for Disease Control and Prevention, Zhejiang, 310021, China
| | - Shu-Chang Chen
- Microbiology Laboratory, Hangzhou Centre for Disease Control and Prevention, Zhejiang, 310021, China
| | - Gang Zhao
- Microbiology Laboratory, Hangzhou Centre for Disease Control and Prevention, Zhejiang, 310021, China.
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5
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Ağagündüz D, Çelik MN, Çıtar Dazıroğlu ME, Capasso R. Emergent Drug and Nutrition Interactions in COVID-19: A Comprehensive Narrative Review. Nutrients 2021; 13:nu13051550. [PMID: 34064534 PMCID: PMC8147951 DOI: 10.3390/nu13051550] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 01/08/2023] Open
Abstract
Coronaviruses are a large family of viruses that are known to cause respiratory tract infections ranging from colds to more severe diseases, such as Middle East Respiratory Syndrome (MERS) and the Severe Acute Respiratory Syndrome (SARS). New Coronavirus Disease 2019 (COVID-19), which led to deaths as well as social and economic disruptions, is an ongoing worldwide pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Currently, there is no approved treatment for COVID-19. Hence, only supportive care has been approved by the World Health Organization (WHO) for now. Pharmacological agents used for the adjunctive treatment of COVID-19 following the current literature and clinical experiences include antiviral, anti-inflammatory, and anti-malaria drugs, and other traditional or untraditional treatments. However, it has been reported that the use of these drugs may have some negative effects and comorbidities. Moreover, the current data have indicated that the risk of drug-drug interactions may also be high in polypharmacy cases, especially in elderly people, some comorbidity situations, and intensive care unit (ICU) patients. It is highly possible that these situations can not only increase the risk of drug-drug interactions but also increase the risk of food/nutrition-drug interactions and affect the nutritional status. However, this issue has not yet been entirely discussed in the literature. In this review, current information on the possible mechanisms as well as pharmacokinetic and pharmacodynamic effects of some pharmacological agents used in the treatment of COVID-19 and/or their secondary interactions with nutrition were evaluated and some future directions were given.
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Affiliation(s)
- Duygu Ağagündüz
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Emek, Ankara 06490, Turkey; (M.N.Ç.); (M.E.Ç.D.)
- Correspondence: (D.A.); (R.C.)
| | - Menşure Nur Çelik
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Emek, Ankara 06490, Turkey; (M.N.Ç.); (M.E.Ç.D.)
| | - Merve Esra Çıtar Dazıroğlu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Emek, Ankara 06490, Turkey; (M.N.Ç.); (M.E.Ç.D.)
| | - Raffaele Capasso
- Department of Agricultural Sciences, University of Naples Federico II, 80055 Naples, Italy
- Correspondence: (D.A.); (R.C.)
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6
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Kang HR, Jang SC, Shin JY. Association between oseltamivir use and neuropsychiatric adverse events in influenza patients: a nationwide population-based cohort study. Expert Opin Drug Saf 2020; 20:245-253. [PMID: 33183123 DOI: 10.1080/14740338.2021.1850690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: A potential risk of neuropsychiatric adverse events (NPAEs) of oseltamivir has remained controversial by retrospective cohort studies. This nationwide population-based cohort study aimed to assess the risk of NPAEs in influenza patients undergoing oseltamivir treatment (users) compared with a propensity score-matched cohort of patients not receiving oseltamivir (non-users). Research design and methods: Using the Korean National Health Service-Sample Cohort Database, patients diagnosed with incident influenza during 2003-2013 were divided into two cohorts: oseltamivir users and non-users. We calculated adjusted hazard ratios (aHRs) for the 5-day treatment course with oseltamivir using Cox regression analysis. Results: The incidence rate of NPAEs during 5-day oseltamivir treatment was 0.0029 and 0.0023 in oseltamivir users and non-users, respectively. The risk of NPAEs was different according to age, with an increased risk in patients aged 10-19 years (aHR 2.69, 95% CI 1.05-6.93) and a decreased risk in patients aged 0-9 years (aHR 0.46, 95% CI 0.24-0.88). The non-significant positive associations were observed in patients aged 20-64 years and those aged greater than 65 years. Conclusions: Although the reason for the inverse association in children aged 0-9 years is unknown, oseltamivir could increase the risk of NPAEs for children or adolescents aged greater than 10 years.
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Affiliation(s)
- Hye-Rim Kang
- School of Pharmacy, Sungkyunkwan University , Suwon, Gyeonggi-do, South Korea
| | - Suk-Chan Jang
- School of Pharmacy, Sungkyunkwan University , Suwon, Gyeonggi-do, South Korea
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University , Suwon, Gyeonggi-do, South Korea
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7
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Kaddoura M, AlIbrahim M, Hijazi G, Soudani N, Audi A, Alkalamouni H, Haddad S, Eid A, Zaraket H. COVID-19 Therapeutic Options Under Investigation. Front Pharmacol 2020; 11:1196. [PMID: 32848795 PMCID: PMC7424051 DOI: 10.3389/fphar.2020.01196] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/22/2020] [Indexed: 12/15/2022] Open
Abstract
Since its emergence in China in December 2019, COVID-19 has quickly spread around the globe causing a pandemic. Vaccination or the development of herd immunity seems the only way to slow down the spread of the virus; however, both are not achievable in the near future. Therefore, effective treatments to mitigate the burden of this pandemic and reduce mortality rates are urgently needed. Preclinical and clinical studies of potential antiviral and immunomodulatory compounds and molecules to identify safe and efficacious therapeutics for COVID-19 are ongoing. Two compounds, remdesivir, and dexamethasone have been so far shown to reduce COVID-19-associated death. Here, we provide a review of the potential therapeutic agents being considered for the treatment and management of COVID-19 patients.
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Affiliation(s)
- Malak Kaddoura
- Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Infectious Disease Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Malak AlIbrahim
- Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Infectious Disease Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ghina Hijazi
- Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Infectious Disease Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nadia Soudani
- Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Infectious Disease Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Amani Audi
- Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Infectious Disease Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Habib Alkalamouni
- Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Infectious Disease Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Salame Haddad
- Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Infectious Disease Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ali Eid
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Hassan Zaraket
- Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Center for Infectious Disease Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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8
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Santos J, Brierley S, Gandhi MJ, Cohen MA, Moschella PC, Declan ABL. Repurposing Therapeutics for Potential Treatment of SARS-CoV-2: A Review. Viruses 2020; 12:v12070705. [PMID: 32629804 PMCID: PMC7412090 DOI: 10.3390/v12070705] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/26/2020] [Accepted: 06/27/2020] [Indexed: 02/06/2023] Open
Abstract
The need for proven disease-specific treatments for the novel pandemic coronavirus SARS-CoV-2 necessitates a worldwide search for therapeutic options. Since the SARS-CoV-2 virus shares extensive homology with SARS-CoV and MERS-CoV, effective therapies for SARS-CoV and MERS-CoV may also have therapeutic potential for the current COVID-19 outbreak. To identify therapeutics that might be repositioned for treatment of the SARS-CoV-2 disease COVID-19, we strategically reviewed the literature to identify existing therapeutics with evidence of efficacy for the treatment of the three coronaviruses that cause severe respiratory illness (SARS-CoV, MERS-CoV, and SARS-CoV-2). Mechanistic and in vitro analyses suggest multiple promising therapeutic options with potential for repurposing to treat patients with COVID-19. Therapeutics with particularly high potential efficacy for repurposing include camostat mesylate, remdesivir, favipiravir, tocilizumab, baricitinib, convalescent plasma, and humanized monoclonal antibodies. Camostat mesylate has shown therapeutic potential, likely by preventing viral entry into epithelial cells. In early research, the targeted antivirals remdesivir and favipiravir appear to benefit patients by decreasing viral replication; clinical trials suggest that remdesivir speeds recovery from COVID-19. Tocilizumab and baricitinib appear to improve mortality by preventing a severe cytokine storm. Convalescent plasma and humanized monoclonal antibodies offer passive immunity and decreased recovery time. This review highlights potential therapeutic options that may be repurposed to treat COVID-19 and suggests opportunities for further research.
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Affiliation(s)
- Jennifer Santos
- University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA; (J.S.); (S.B.); (M.J.G.)
| | - Stephanie Brierley
- University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA; (J.S.); (S.B.); (M.J.G.)
| | - Mohit J. Gandhi
- University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA; (J.S.); (S.B.); (M.J.G.)
| | - Michael A. Cohen
- Department of Pharmacy, Prisma Health Upstate, Greenville, SC 29605, USA;
| | - Phillip C. Moschella
- Department of Emergency Medicine Prisma Health Upstate, Greenville, SC 29605, USA;
| | - Arwen B. L. Declan
- Department of Emergency Medicine Prisma Health Upstate, Greenville, SC 29605, USA;
- Correspondence: ; Tel.: +1-864-455-6029
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Loukotková L, Basavarajappa M, Lumen A, Roberts R, Mattison D, Morris SM, Fisher J, Beland FA, Gamboa da Costa G. Pharmacokinetics of oseltamivir phosphate and oseltamivir carboxylate in non-pregnant and pregnant rhesus monkeys. Regul Toxicol Pharmacol 2020; 112:104569. [PMID: 31927005 DOI: 10.1016/j.yrtph.2019.104569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 12/24/2019] [Indexed: 11/25/2022]
Abstract
Oseltamivir is an antiviral drug approved to treat influenza in humans. Although the dosing regimen of this drug is well established for non-pregnant patients, it is not clear if the significant physiological alterations associated with pregnancy affect the pharmacokinetics of oseltamivir and, thus, warrant different dosing regimens to assure efficacy. In this study, we investigated the suitability of rhesus macaques as an animal model for studying oseltamivir pharmacokinetics during all trimesters of pregnancy in comparison to pre-pregnant conditions. Specifically, we compared the pharmacokinetics of oseltamivir and its pharmacologically active metabolite oseltamivir carboxylate in rhesus monkeys after intravenous and nasogastric administration of 2.5 mg oseltamivir phosphate/kg body weight given prior to and during the first, second, and third trimesters of pregnancy. Pregnancy had only a modest effect upon the pharmacokinetic parameters of oseltamivir and oseltamivir carboxylate. Monkeys treated intravenously in the third trimester had a reduction in Vd and CL, compared to non-pregnant monkeys. These changes did not occur in the other two trimesters. Pregnant monkeys treated intravenously had 20-25% decrease in AUC0-∞ of oseltamivir carboxylate and a corresponding increase in Vd and CL. Pregnant monkeys treated nasogastrically with oseltamivir phosphate demonstrated a pattern that recapitulated intravenous dosing. Taken together these data indicate that rhesus monkeys are an acceptable model for studying drug-pregnancy interactions.
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Affiliation(s)
- Lucie Loukotková
- FDA National Center for Toxicological Research, Jefferson, AR, USA
| | | | - Annie Lumen
- FDA National Center for Toxicological Research, Jefferson, AR, USA
| | - Rosemary Roberts
- FDA Center for Drug Evaluation and Research, Silver Spring, MD, USA
| | - Donald Mattison
- Risk Sciences International, Ottawa, Ontario, Canada and Hilton Head Island, SC USA and University of Ottawa, Ontario, Canada
| | - Suzanne M Morris
- FDA National Center for Toxicological Research, Jefferson, AR, USA
| | - Jeffrey Fisher
- FDA National Center for Toxicological Research, Jefferson, AR, USA
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10
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Reich S, Guilligay D, Cusack S. An in vitro fluorescence based study of initiation of RNA synthesis by influenza B polymerase. Nucleic Acids Res 2017; 45:3353-3368. [PMID: 28126917 PMCID: PMC5399792 DOI: 10.1093/nar/gkx043] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 01/17/2017] [Indexed: 12/20/2022] Open
Abstract
Influenza polymerase replicates, via a complementary RNA intermediate (cRNA), and transcribes the eight viral RNA (vRNA) genome segments. To initiate RNA synthesis it is bound to the conserved 5΄ and 3΄ extremities of the vRNA or cRNA (the ‘promoter’). 5΄-3΄ base-pairing in the distal promoter region is essential to position the template RNA at the polymerase active site, as shown by a new crystal structure with the 3΄ end threading through the template entry tunnel. We develop fluorescence polarization assays to quantify initiation of cap-primed (transcription) or unprimed (replication) RNA synthesis by recombinant influenza B polymerase bound to the vRNA or cRNA promoter. The rate-limiting step is formation of a primed initiation complex with minimally ApG required to stabilize the 3΄ end of the template within the active-site. Polymerase bound to the vRNA promoter initiates RNA synthesis terminally, while the cRNA promoter directs internal initiation at a significantly lower rate. Progression to elongation requires breaking the promoter 5΄-3΄ base-pairing region and favourable compensation by the emerging template-product base-pairs. The RNA synthesis assay is adaptable to high-throughput screening for polymerase inhibitors. In a pilot study, we find that initiation at the cRNA promoter is unusually susceptible to inhibition by 2΄F-2΄dNTPs.
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Affiliation(s)
- Stefan Reich
- Grenoble Outstation, European Molecular Biology Laboratory, Grenoble 38042, France.,Unit of Virus-Host Cell Interactions, EMBL-UGA-CNRS, Grenoble 38042, France
| | - Delphine Guilligay
- Unit of Virus-Host Cell Interactions, EMBL-UGA-CNRS, Grenoble 38042, France
| | - Stephen Cusack
- Grenoble Outstation, European Molecular Biology Laboratory, Grenoble 38042, France.,Unit of Virus-Host Cell Interactions, EMBL-UGA-CNRS, Grenoble 38042, France
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11
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Financial competing interests were associated with favorable conclusions and greater author productivity in nonsystematic reviews of neuraminidase inhibitors. J Clin Epidemiol 2016; 80:43-49. [DOI: 10.1016/j.jclinepi.2016.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 06/30/2016] [Accepted: 07/18/2016] [Indexed: 11/24/2022]
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12
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Gillman A. Risk of resistant avian influenza A virus in wild waterfowl as a result of environmental release of oseltamivir. Infect Ecol Epidemiol 2016; 6:32870. [PMID: 27733236 PMCID: PMC5061866 DOI: 10.3402/iee.v6.32870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/12/2016] [Accepted: 09/13/2016] [Indexed: 12/15/2022] Open
Abstract
Oseltamivir is the best available anti-influenza drug and has therefore been stockpiled worldwide in large quantities as part of influenza pandemic preparedness planning. The active metabolite oseltamivir carboxylate (OC) is stable and is not removed by conventional sewage treatment. Active OC has been detected in river water at concentrations up to 0.86 µg/L. Although the natural reservoir hosts of influenza A virus (IAV) are wild waterfowl that reside in aquatic environments, the ecologic risks associated with environmental OC release and its potential to generate resistant viral variants among wild birds has largely been unknown. However, in recent years a number of in vivo mallard (Anas platyrhynchos) studies have been conducted regarding the potential of avian IAVs to become resistant to OC in natural reservoir birds if these are drug exposed. Development of resistance to OC was observed both in Group 1 (N1) and Group 2 (N2, N9) neuraminidase subtypes, when infected ducks were exposed to OC at concentrations between 0.95 and 12 µg/L in their water. All resistant variants maintained replication and transmission between ducks during drug exposure. In an A(H1N1)/H274Y virus, the OC resistance mutation persisted without selective drug pressure, demonstrating the potential of an IAV with a permissive genetic background to acquire and maintain OC resistance, potentially allowing circulation of the resistant variant among wild birds. The experimental studies have improved the appreciation of the risks associated with the environmental release of OC related to resistance development of avian IAVs among wild birds. Combined with knowledge of efficient methods for improved sewage treatment, the observations warrant implementation of novel efficient wastewater treatment methods, rational use of anti-influenza drugs, and improved surveillance of IAV resistance in wild birds.
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Affiliation(s)
- Anna Gillman
- Section for Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Zoonosis Science Centre, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden;
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13
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14-Deoxy-11,12-didehydroandrographolide attenuates excessive inflammatory responses and protects mice lethally challenged with highly pathogenic A(H5N1) influenza viruses. Antiviral Res 2016; 133:95-105. [DOI: 10.1016/j.antiviral.2016.07.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 07/18/2016] [Accepted: 07/26/2016] [Indexed: 11/19/2022]
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14
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Affiliation(s)
- Bart L. DeCorte
- Janssen Pharmaceutical Companies of Johnson & Johnson, 1400 McKean Road, Spring House, Pennsylvania 19477, United States
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15
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Çiftçi E, Karbuz A, Kendirli T. Influenza and the use of oseltamivir in children. Turk Arch Pediatr 2016; 51:63-71. [PMID: 27489462 DOI: 10.5152/turkpediatriars.2016.2359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 02/15/2016] [Indexed: 11/22/2022]
Abstract
Influenza is an infectious disease which causes significant morbidity and mortality. In the USA, approximately 200 000 hospital admissions and 36 000 deaths occur annualy due to severe influenza infections. Although influenza often causes a simple respiratory infection, it sometimes causes disorders affecting several organs including the lung, heart, brain, liver and muscles or serious life-threatening primary viral or secondary bacterial pneumonia. Currently, oseltamivir is the most important and effective drug for severe influenza infections. Severe influenza infections can be controlled and related deaths may be prevented with initiation of this drug especially within first 2 days. Oseltamivir is usually well tolerated and its most commonly reported side effect is related with the gastrointestinal system. In conclusion, the course of influenza changes in a positive direction and the rates of complications and mortality significantly reduce in patients in whom oseltamivir treatment is initiated as soon as possible.
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Affiliation(s)
- Ergin Çiftçi
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Adem Karbuz
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Tanıl Kendirli
- Division of Pediatric Intensive Care, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
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16
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Harit VK, Ramesh NG. Amino-functionalized iminocyclitols: synthetic glycomimetics of medicinal interest. RSC Adv 2016. [DOI: 10.1039/c6ra23513a] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A review on the syntheses and biological activities of unnatural glycomimetics highlighting the effect of replacement of hydroxyl groups of natural iminosugars by amino functionalities is presented.
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Affiliation(s)
- Vimal Kant Harit
- Department of Chemistry
- Indian Institute of Technology Delhi
- New Delhi - 110016
- India
| | - Namakkal G. Ramesh
- Department of Chemistry
- Indian Institute of Technology Delhi
- New Delhi - 110016
- India
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17
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Patel K, Rayner CR, Giraudon M, Kamal MA, Morcos PN, Robson R, Kirkpatrick CM. Pharmacokinetics and safety of oseltamivir in patients with end-stage renal disease treated with automated peritoneal dialysis. Br J Clin Pharmacol 2015; 79:624-35. [PMID: 25289522 DOI: 10.1111/bcp.12526] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 09/25/2014] [Indexed: 11/27/2022] Open
Abstract
AIMS Patients with end-stage renal disease (ESRD) are at increased risk of developing complications associated with influenza infection. Oseltamivir is indicated for influenza treatment in ESRD patients, but the disposition is poorly understood in this patient population. This study aimed to characterize the pharmacokinetics and tolerability of oseltamivir in automated peritoneal dialysis (APD) and construct a pharmacokinetic model to assist with optimized dosing. METHODS Ten adults with ESRD were prescribed an aggressive APD regimen consisting of three continuous cycler-assisted peritoneal dialysis (CCPD) sessions during the day and two continuous ambulatory (CAPD) sessions overnight. Oseltamivir was administered as a single 75 mg dose, immediately before APD treatment. RESULTS Oseltamivir was rapidly eliminated via first-pass metabolism, with most of the dose (Fraction metabolized = 0.964) reaching the circulation as the active metabolite, oseltamivir carboxylate. This metabolite was cleared slowly and was quantifiable throughout the sampling interval. The disposition of oseltamivir and oseltamivir carboxylate was described by a two- and a one-compartment model, respectively. Metabolite clearance by CCPD [0.32 l h(-1) (70 kg)(-1) ] was 1.9-fold faster than via CAPD [0.17 l h(-1) (70 kg)(-1) ], with renal elimination being dominant in patients with residual urine production. Model simulations showed that a single 75 mg dose attained target exposures in patients with negligible or low urine clearance. However, higher doses are recommended for further investigation in patients with high residual renal function. In all patients, oseltamivir was well tolerated. CONCLUSIONS In APD patients with anuria or low residual renal elimination, a single 75 mg dose of oseltamivir produced exposures at the upper end of the safety margin.
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18
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Reddy MB, Yang KH, Rao G, Rayner CR, Nie J, Pamulapati C, Marathe BM, Forrest A, Govorkova EA. Oseltamivir Population Pharmacokinetics in the Ferret: Model Application for Pharmacokinetic/Pharmacodynamic Study Design. PLoS One 2015; 10:e0138069. [PMID: 26460484 PMCID: PMC4603953 DOI: 10.1371/journal.pone.0138069] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 08/25/2015] [Indexed: 11/19/2022] Open
Abstract
The ferret is a suitable small animal model for preclinical evaluation of efficacy of antiviral drugs against various influenza strains, including highly pathogenic H5N1 viruses. Rigorous pharmacokinetics/pharmacodynamics (PK/PD) assessment of ferret data has not been conducted, perhaps due to insufficient information on oseltamivir PK. Here, based on PK data from several studies on both uninfected and influenza-infected groups (i.e., with influenza A viruses of H5N1 and H3N2 subtypes and an influenza B virus) and several types of anesthesia we developed a population PK model for the active compound oseltamivir carboxylate (OC) in the ferret. The ferret OC population PK model incorporated delayed first-order input, two-compartment distribution, and first-order elimination to successfully describe OC PK. Influenza infection did not affect model parameters, but anesthesia did. The conclusion that OC PK was not influenced by influenza infection must be viewed with caution because the influenza infections in the studies included here resulted in mild clinical symptoms in terms of temperature, body weight, and activity scores. Monte Carlo simulations were used to determine that administration of a 5.08 mg/kg dose of oseltamivir phosphate to ferret every 12 h for 5 days results in the same median OC area under the plasma concentration-time curve 0–12 h (i.e., 3220 mg h/mL) as that observed in humans during steady state at the approved dose of 75 mg twice daily for 5 days. Modeling indicated that PK variability for OC in the ferret model is high, and can be affected by anesthesia. Therefore, for proper interpretation of PK/PD data, sparse PK sampling to allow the OC PK determination in individual animals is important. Another consideration in appropriate design of PK/PD studies is achieving an influenza infection with pronounced clinical symptoms and efficient virus replication, which will allow adequate evaluation of drug effects.
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Affiliation(s)
- Micaela B. Reddy
- Department of Drug Metabolism and Pharmacokinetics, Hoffmann-La Roche Inc., Nutley, New Jersey, United States of America
- * E-mail: (MBR); (EAG)
| | - Kuo-Hsiung Yang
- Department of Drug Metabolism and Pharmacokinetics, Hoffmann-La Roche Inc., Nutley, New Jersey, United States of America
- Department of Pharmacy Practice, University of Buffalo, Buffalo, New York, United States of America
| | - Gauri Rao
- Department of Pharmacy Practice, University of Buffalo, Buffalo, New York, United States of America
| | - Craig R. Rayner
- Department of Drug Metabolism and Pharmacokinetics, Hoffmann-La Roche Inc., Nutley, New Jersey, United States of America
| | - Jing Nie
- Department of Drug Metabolism and Pharmacokinetics, Hoffmann-La Roche Inc., Nutley, New Jersey, United States of America
| | - Chandrasena Pamulapati
- Department of Drug Metabolism and Pharmacokinetics, Hoffmann-La Roche Inc., Nutley, New Jersey, United States of America
| | - Bindumadhav M. Marathe
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America
| | - Alan Forrest
- Department of Pharmacy Practice, University of Buffalo, Buffalo, New York, United States of America
| | - Elena A. Govorkova
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, United States of America
- * E-mail: (MBR); (EAG)
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Rasmussen HB, Bjerre D, Linnet K, Jürgens G, Dalhoff K, Stefansson H, Hankemeier T, Kaddurah-Daouk R, Taboureau O, Brunak S, Houmann T, Jeppesen P, Pagsberg AK, Plessen K, Dyrborg J, Hansen PR, Hansen PE, Hughes T, Werge T. Individualization of treatments with drugs metabolized by CES1: combining genetics and metabolomics. Pharmacogenomics 2015; 16:649-65. [PMID: 25896426 DOI: 10.2217/pgs.15.7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
CES1 is involved in the hydrolysis of ester group-containing xenobiotic and endobiotic compounds including several essential and commonly used drugs. The individual variation in the efficacy and tolerability of many drugs metabolized by CES1 is considerable. Hence, there is a large interest in individualizing the treatment with these drugs. The present review addresses the issue of individualized treatment with drugs metabolized by CES1. It describes the composition of the gene encoding CES1, reports variants of this gene with focus upon those with a potential effect on drug metabolism and provides an overview of the protein structure of this enzyme bringing notice to mechanisms involved in the regulation of enzyme activity. Subsequently, the review highlights drugs metabolized by CES1 and argues that individual differences in the pharmacokinetics of these drugs play an important role in determining drug response and tolerability suggesting prospects for individualized drug therapies. Our review also discusses endogenous substrates of CES1 and assesses the potential of using metabolomic profiling of blood to identify proxies for the hepatic activity of CES1 that predict the rate of drug metabolism. Finally, the combination of genetics and metabolomics to obtain an accurate prediction of the individual response to CES1-dependent drugs is discussed.
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Affiliation(s)
- Henrik Berg Rasmussen
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, 2 Boserupvej, DK-4000 Roskilde, Denmark
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Handel A, Ebell MH. Neuraminidase inhibitors for influenza: fully evaluating benefits and harms. THE LANCET RESPIRATORY MEDICINE 2015; 3:e7-8. [PMID: 25773218 DOI: 10.1016/s2213-2600(15)00066-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 02/16/2015] [Accepted: 02/23/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Andreas Handel
- Department of Epidemiology & Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA.
| | - Mark H Ebell
- Department of Epidemiology & Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA
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21
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Role of therapeutic drug monitoring in pulmonary infections: use and potential for expanded use of dried blood spot samples. Bioanalysis 2015; 7:481-95. [DOI: 10.4155/bio.14.318] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Respiratory tract infections are among the most common infections in men. We reviewed literature to document their pharmacological treatments, and the extent to which therapeutic drug monitoring (TDM) is needed during treatment. We subsequently examined potential use of dried blood spots as sample procedure for TDM. TDM was found to be an important component of clinical care for many (but not all) pulmonary infections. For gentamicin, linezolid, voriconazole and posaconazole dried blood spot methods and their use in TDM were already evident in literature. For glycopeptides, β-lactam antibiotics and fluoroquinolones it was determined that development of a dried blood spot (DBS) method could be useful. This review identifies specific antibiotics for which development of DBS methods could support the optimization of treatment of pulmonary infections.
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22
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Rath BA, Brzostek J, Guillén S, Niranjan V, Chappey C, Rayner CR, Clinch B. Safety, virology and pharmacokinetics of oseltamivir in infants with laboratory-confirmed influenza: a Phase I/II, prospective, open-label, multi-centre clinical trial. Antivir Ther 2015; 20:815-25. [DOI: 10.3851/imp2967] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2015] [Indexed: 10/23/2022]
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23
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Traditional Chinese medicine for the treatment of influenza: a systematic review and meta-analysis of randomized controlled trials. J TRADIT CHIN MED 2014; 34:527-31. [PMID: 25417400 DOI: 10.1016/s0254-6272(15)30057-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To justify the clinical use of Traditional Chinese Medicine (TCM) in the treatment of influenza. METHODS MEDLINE, EMBASE, Chinese Biomedical Literature Database, China National Knowledgeln-frastructure Database, China Science and Technology Journal Database, Wanfang Database and the Cochrane Database of Systematic Reviews were searched from the date of inception until January 1, 2013, for the literature on treatment of influenza with TCM. RESULTS A total of 7 randomized controlled trials were identified and reviewed. Of these trials, 2 compared a (modified) prescription of TCM with oseltacmivir and 5 compared a patent traditional Chinese drug with oseltamivir. Based on the Meta-analysis, compared to oseltamivir, the (modified) prescription had similar effect in defervescence [WMD = 5.66, 95% CI (- 32.02, 43.35), P = 0.77] and viral sheddingWMD = - 6.21, 95% CI (- 84.19, 71.76), P = 0.88], and the patent traditional Chinese drug also had similar effect in viral shedding [WMD = - 0.24, 95% CI (- 4.79, 4.31), P = 0.92] but more effective in defervescence [WMD = - 4.65, 95%CI (- 8.91, - 0.38),P = 0.03]. CONCLUSION TCM has potential positive effects in the treatment of influenza.
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Citations alone were enough to predict favorable conclusions in reviews of neuraminidase inhibitors. J Clin Epidemiol 2014; 68:87-93. [PMID: 25450452 DOI: 10.1016/j.jclinepi.2014.09.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 09/03/2014] [Accepted: 09/12/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To examine the use of supervised machine learning to identify biases in evidence selection and determine if citation information can predict favorable conclusions in reviews about neuraminidase inhibitors. STUDY DESIGN AND SETTING Reviews of neuraminidase inhibitors published during January 2005 to May 2013 were identified by searching PubMed. In a blinded evaluation, the reviews were classified as favorable if investigators agreed that they supported the use of neuraminidase inhibitors for prophylaxis or treatment of influenza. Reference lists were used to identify all unique citations to primary articles. Three classification methods were tested for their ability to predict favorable conclusions using only citation information. RESULTS Citations to 4,574 articles were identified in 152 reviews of neuraminidase inhibitors, and 93 (61%) of these reviews were graded as favorable. Primary articles describing drug resistance were among the citations that were underrepresented in favorable reviews. The most accurate classifier predicted favorable conclusions with 96.2% accuracy, using citations to only 24 of 4,574 articles. CONCLUSION Favorable conclusions in reviews about neuraminidase inhibitors can be predicted using only information about the articles they cite. The approach highlights how evidence exclusion shapes conclusions in reviews and provides a method to evaluate citation practices in a corpus of reviews.
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Rath BA, Blumentals WA, Miller MK, Starzyk K, Tetiurka B, Wollenhaupt M. A prospective observational study of oseltamivir safety and tolerability in infants and young children ≤24 months. Pharmacoepidemiol Drug Saf 2014; 24:286-96. [PMID: 25331369 DOI: 10.1002/pds.3707] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 07/23/2014] [Accepted: 08/12/2014] [Indexed: 11/08/2022]
Abstract
PURPOSE Infants and young children are at elevated risk of influenza-associated complications, but information on the safety of antiviral therapies is limited in this age group. METHODS In this prospective open-label observational safety study, children aged ≤24 months with a clinical diagnosis of influenza in routine practice received either no antiviral treatment ('unexposed' group) or oseltamivir treatment or prophylaxis ('exposed' group), according to the physician's judgment. Patients were followed up for 30 days after the baseline visit. RESULTS Adverse events (AEs) were analysed in 1065 patients; they were reported in 390/711 (54.9%) in the unexposed group, 167/340 (49.1%) patients in the exposed group, and 6/14 prophylaxis patients. Cough and rhinitis were the most common events, reported more often in unexposed children (22.9 and 20.3% respectively) than in exposed children (13.2 and 10.0%; p < 0.001); pyrexia, diarrhoea and vomiting were less common, occurring at similar rates in exposed and unexposed patients. Nasal congestion (3.5%), bronchitis (5.6%) and upper respiratory tract infection (1.5%) were reported more frequently in exposed patients than in unexposed patients (0.7, 2.7 and 0.1% respectively; p < 0.05). In the exposed group, 11.2% of patients (n = 38) experienced 41 AEs considered at least possibly related to oseltamivir, none being assessed as serious. Overall, there were 79 serious AEs in 59 patients. Eleven discontinued treatment because of an AE. CONCLUSIONS Oseltamivir has a good tolerability profile in infants and children aged ≤24 months. These findings contributed to the recent FDA approval of oseltamivir for treating infants aged 2-51 weeks.
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The Posology of Oseltamivir in Infants With Influenza Infection Using a Population Pharmacokinetic Approach. Clin Pharmacol Ther 2014; 96:380-9. [DOI: 10.1038/clpt.2014.120] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 05/21/2014] [Indexed: 11/09/2022]
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López-Medrano F, Fariñas MC, Payeras A, Pachón J. Antiviral treatment and vaccination for influenza A(H1N1)pdm09 virus: lessons learned from the pandemic. Enferm Infecc Microbiol Clin 2013; 30 Suppl 4:49-53. [PMID: 23116793 DOI: 10.1016/s0213-005x(12)70105-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The influenza pandemic that was declared by the World Health Organization in June 2009 created a new scenario for the use of influenza antivirals and vaccination. The new strain, influenza A(H1N1)pdm09, was resistant to amantadine and rimantadine, and the most frequently used antiviral was oseltamivir. Randomized studies were not performed comparing neuraminidase inhibitors with placebo. Nevertheless, experience from prospective and retrospective cohorts indicated that these drugs were useful for improving the prognosis of patients admitted to hospitals, especially for those with more severe disease. Treatment with oseltamivir was associated with a reduction in days of fever, length of hospital stay, use of mechanical ventilation and mortality. Treatment was more effective if it was begun within the first 48 h after the onset of symptoms, but it was also useful if begun later. A safe and effective vaccine to prevent disease from this new influenza strain was available in developed countries soon after the pandemic began; thus, the rate of adverse effects was comparable to that of seasonal influenza vaccines. The main barrier to its use was the concern of target populations about its necessity and safety. Therefore, the challenges for future pandemics will be to increase the population coverage of the vaccine in developed countries and to make it affordable for developing countries.
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Affiliation(s)
- Francisco López-Medrano
- Infectious Diseases Unit, Hospital Universitario 12 de Octubre, Department of Medicine, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
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Surveillance of the first case of human avian influenza A (H7N9) virus in Beijing, China. Infection 2013; 42:127-33. [PMID: 24129555 PMCID: PMC7102393 DOI: 10.1007/s15010-013-0533-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 09/10/2013] [Indexed: 11/25/2022]
Abstract
Purpose Human infections with avian influenza A (H7N9) virus manifested in China in March 2013. The first case infected with H7N9 virus in Beijing involved a family member of a chicken dealer and was reported in April 2013. The clinical and epidemiological characteristics of this case and her parents were examined to illustrate some key traits regarding this novel H7N9 virus. Methods The index case was subjected to intensive clinical examination in order to observed the clinical process. Real-time PCR was used to confirm cases infected with H7N9 virus. The index case was administered oseltamivir (45 mg, twice daily) at the early stage of the infection. Sera were collected from the index case and her parents from the onset of illness onwards. The subjects were followed for 4 weeks. Results
The sera were confirmed by neutralizing antibody tests. The index case’s clinical manifestation progressed quickly. The pharyngeal swab tested positive for influenza A based on the detection of influenza A antigen (rapid influenza diagnostic test) 15 h after the onset of fever and was positive for H7N9 virus. The patient’s temperature dropped to 36.2 °C 18 h after treatment by oseltamivir (32 h after fever). Cough and other symptoms alleviated rapidly. A number of specimens from the environment of this cluster and from the feces specimens tested positive for viral RNA of the H7N9 virus on the fourth day following onset of the index case’s illness. Pharyngeal swabs of the mother tested positive for H7N9 virus twice, but she showed no clinical symptoms. Four weeks after disease onset, the family did not present any clinical symptoms, and the results of the physical examination and blood tests were normal. The mother and the case’s sera had a fourfold increased neutralizing antibody titer. Conclusion Early diagnosis and early initiation of the treatment of confirmed infections is the most effective strategy for managing H7N9 virus infection. Human beings exposed to H7N9 virus may develop asymptomatic infection.
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Abstract
AIM To determine whether the treatment with oseltamivir improves the outcome of children with confirmed influenza infection and no other underlying disease. METHODS Multicentric, retrospective study performed in 10 hospitals of Madrid between September 2010 and June 2012. All children admitted to the hospitals with confirmed influenza infections were eligible. Children with risk factors for serious disease and nosocomial influenza infections were excluded. Asthma was not considered an exclusion factor. The study compared patients treated and untreated with oseltamivir. Fever duration, oxygen support, antibiotics administration, length of hospital stay, intensive care admission and bacterial complications were analyzed. To compare variables, χ(2) test, Fisher exact test, ANOVA or Mann-Whitney U test were used. RESULTS Two hundred eighty-seven children were included and 93 of them were treated with oseltamivir (32%). There were no significant differences between treated and untreated patients in days of fever after admission (1.7 ± 2; 2.1 ± 2.9, P > 0.05), length of stay (5.2 ± 3.6; 5.5 ± 3.4, P > 0.05), days of hypoxia (1.6 ± 2.3; 2.1 ± 2.9, P > 0.05), diagnosis of bacterial pneumonia (10%; 17%, P > 0.05), intensive care admission (6.5%; 1.5%,P > 0.05) or antibiotic prescription (44%; 51%, P > 0.05). There were no differences when the population was stratified by age (below or over 1 year) or by the presence or absence of asthma. CONCLUSIONS There were no proven benefits of treatment with oseltamivir in hospitalized pediatric patients without the underlying diseases or risk factors for developing a serious illness, including those with asthma.
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30
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Comparison of the FilmArray RP, Verigene RV+, and Prodesse ProFLU+/FAST+ multiplex platforms for detection of influenza viruses in clinical samples from the 2011-2012 influenza season in Belgium. J Clin Microbiol 2013; 51:2977-85. [PMID: 23824777 DOI: 10.1128/jcm.00911-13] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Respiratory tract infections (RTIs) are caused by a plethora of viral and bacterial pathogens. In particular, lower RTIs are a leading cause of hospitalization and mortality. Timely detection of the infecting respiratory pathogens is crucial to optimize treatment and care. In this study, three U.S. Food and Drug Administration-approved molecular multiplex platforms (Prodesse ProFLU+/FAST+, FilmArray RP, and Verigene RV+) were evaluated for influenza virus detection in 171 clinical samples collected during the Belgian 2011-2012 influenza season. Sampling was done using mid-turbinate flocked swabs, and the collected samples were stored in universal transport medium. The amount of viral RNA present in the swab samples ranged between 3.07 and 8.82 log10 copies/ml. Sixty samples were concordant influenza A virus positive, and 8 samples were found to be concordant influenza B virus positive. Other respiratory viruses that were detected included human rhinovirus/enterovirus, respiratory syncytial virus, parainfluenza virus type 1, human metapneumovirus, and coronavirus NL63. Twenty-five samples yielded discordant results across the various assays which required further characterization by sequencing. The FilmArray RP and Prodesse ProFLU+/FAST+ assays were convenient to perform with regard to sensitivity, ease of use, and low percentages of invalid results. Although the limit of sensitivity is of utmost importance, many other factors should be taken into account in selecting the most convenient molecular diagnostic assay for the detection of respiratory pathogens in clinical samples.
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Abstract
Influenza is a common virus whose ability to change its genetic makeup allows for disease of pandemic proportion. This article summarizes the different strains of influenza circulating in the United States for the past century, the diagnosis and treatment of influenza, as well as the different ways to prevent disease. This information will be of value to clinicians caring for patients both in the hospital and in the community.
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Affiliation(s)
- Angelena M Labella
- Section of Hospital Medicine, Division of General Medicine, Department of Medicine, New York Presbyterian, Columbia University Medical Center, 177 Fort Washington Avenue, New York, NY 10032, USA.
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Masuet‐Aumatell C, Toovey S, Zuckerman JN. Prevention of influenza among travellers attending at a UK travel clinic: beliefs and perceptions. A cross-sectional study. Influenza Other Respir Viruses 2013; 7:574-83. [PMID: 22998606 PMCID: PMC5781004 DOI: 10.1111/irv.12010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Travellers' compliance with measures to prevent influenza through the use of antivirals and influenza vaccine remains very poor despite influenza being one of the commonest travel and vaccine-preventable diseases. A study was undertaken to assess travellers' beliefs, perceptions and intentions to take antivirals for the treatment and prevention of influenza during the H1N1 pandemic. METHODS A cross-sectional survey (n = 96) of travellers who attended the Royal Free Travel Health Centre, London, UK was undertaken in September 2009. A self-administered questionnaire was completed by a traveller in advance of their pre-travel health consultation. Logistic regression identified variables independently associated with compliance. RESULTS Influenza vaccination uptake for the 5 years preceding the study was found to be 20·8%. This was statistically significantly higher for older travellers and those with underlying health conditions (P < 0·005). Mean intention to comply with antiviral drugs on a preventive and therapeutic basis was 58% and 72%, respectively, and this varied markedly with age and with dispensed antimalarial chemoprophylaxis. CONCLUSION This study identifies some beliefs and perceptions travellers consider with regard to the therapeutic and preventive influenza use of antivirals during the H1N1 pandemic; it underscores the importance of travellers receiving hemisphere appropriate influenza vaccination. The external validity of these study findings requires further corroboration involving other travel clinics and different cohorts of travellers during seasonal activity or outbreaks of influenza. These findings could guide the development of future strategies for the prevention of influenza in travellers.
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Affiliation(s)
- Cristina Masuet‐Aumatell
- Bellvitge Biomedical Research Institute (IDIBELL), International Health Centre and Travel Medicine Clinic, Department of Preventive Medicine, University Hospital of Bellvitge, L’Hospitalet de Llobregat, Spain
| | - Stephen Toovey
- Academic Centre for Travel Medicine & Vaccines, WHO Collaborating Centre for Reference, Research and Training in Travel Medicine University College London Medical School, London, UK
| | - Jane N. Zuckerman
- Academic Centre for Travel Medicine & Vaccines, WHO Collaborating Centre for Reference, Research and Training in Travel Medicine University College London Medical School, London, UK
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Development of cellular signaling pathway inhibitors as new antivirals against influenza. Antiviral Res 2013; 98:457-68. [DOI: 10.1016/j.antiviral.2013.04.008] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 03/23/2013] [Accepted: 04/08/2013] [Indexed: 01/04/2023]
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Michiels B, Van Puyenbroeck K, Verhoeven V, Vermeire E, Coenen S. The value of neuraminidase inhibitors for the prevention and treatment of seasonal influenza: a systematic review of systematic reviews. PLoS One 2013; 8:e60348. [PMID: 23565231 PMCID: PMC3614893 DOI: 10.1371/journal.pone.0060348] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 02/26/2013] [Indexed: 11/19/2022] Open
Abstract
Controversy has arisen regarding the effectiveness of neuraminidase inhibitors (NIs), especially against influenza-related complications. A literature search was performed to critically assess the evidence collected by the available systematic reviews (SRs) regarding the benefits and disadvantages of NIs (oseltamivir, zanamivir) compared to placebos in healthy and at-risk individuals of all ages for prophylaxis and treatment of seasonal influenza. A SR was done using the Cochrane Database of Systematic Reviews, Health Technology Assessment Database, Database of Abstracts of Reviews of Effects, and Medline (January 2006-July 2012). Two reviewers selected SRs based on randomized clinical trials, which were restricted to intention-to-treat results, and they assessed review (AMSTAR) and study quality indicators (GRADE). The SRs included (N = 9) were of high quality. The efficacy of NIs in prophylaxis ranged from 64% (16-85) to 92% (37-99); the absolute risk reduction ranged from 1.2% to 12.1% (GRADE moderate to low). Clinically relevant treatment benefits of NIs were small in healthy adults and children suffering from influenza-like illness (GRADE high to moderate). Oseltamivir reduced antibiotic usage in healthy adults according to one SR, but this was not confirmed by other reviews (GRADE low). Zanamivir showed a preventive effect on antibiotic usage in children (95% (77-99);GRADE moderate) and on the occurrence of bronchitis in at-risk individuals (59% (30-76);GRADE moderate). No evidence was available on the treatment benefits of NIs in elderly and at-risk groups and their effects on hospitalization and mortality. In oseltamivir trials, nausea, vomiting and diarrhea were significant side-effects. For zanamivir trials, no adverse effects have been reported. The combination of diagnostic uncertainty, the risk for virus strain resistance, possible side effects and financial cost outweigh the small benefits of oseltamivir or zanamivir for the prophylaxis and treatment of healthy individuals. No relevant benefits of these NIs on complications in at-risk individuals have been established.
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Affiliation(s)
- Barbara Michiels
- Department of Primary and Interdisciplinary Care Antwerp, Centre for General Practice, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
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Baldo A, Leunda A, Thi CDD, Breyer D, Pauwels K, Welby S, Van Vaerenbergh B, Herman P. Biosafety Risk Assessment and Management of Laboratory-Derived Influenza A (H5N1) Viruses Transmissible in Ferrets. APPLIED BIOSAFETY 2013. [DOI: 10.1177/153567601301800102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Aline Baldo
- Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium and
| | - Amaya Leunda
- Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium and
| | - Chuong Dai Do Thi
- Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium and
| | - Didier Breyer
- Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium and
| | - Katia Pauwels
- Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium and
| | - Sarah Welby
- Veterinary and Agrochemical Research Center (CODA-CERVA), Brussels, Belgium
| | | | - Philippe Herman
- Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium and
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Oseltamivir inhibits both viral entry and release but enhances apoptosis of cells infected with influenza A H1N1. Biochem Biophys Res Commun 2013; 431:788-95. [DOI: 10.1016/j.bbrc.2013.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 01/07/2013] [Indexed: 11/17/2022]
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Curtis N, Finn A, Pollard AJ. Elucidation and clinical role of emerging viral respiratory tract infections in children. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 764:191-204. [PMID: 23654068 PMCID: PMC7123406 DOI: 10.1007/978-1-4614-4726-9_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 03/29/2024]
Abstract
Acute respiratory viral infections (ARVI's) are the most common infectious disease in humans. With the appearance of molecular techniques the recovery of viruses has dramatically increased. Nowadays virologists can quickly discriminate virological families and related viruses from emerging viruses and consequently identify novel viruses. Many new respiratory viruses have been identified in children in the past 15 years. In this review we shortly discuss novel respiratory viruses and their pathogenic role in pediatric respiratory disease. Advantages and drawbacks of the technique and our current knowledge will be discussed. We will conclude this review with a general discussion on the future role of molecular diagnostic virology in the clinic.
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Affiliation(s)
- Nigel Curtis
- Royal Children's Hospital, Dept. Pediatrics, University of Melbourne, Flemington Road, Parkville, 3052 Victoria Australia
| | - Adam Finn
- Institute of Child Life and Health, UBHT Education Centre, University of Bristol, Upper Maudlin Street, Bristol, BS28AE UK
| | - Andrew J. Pollard
- University of Oxford, Level 4,John Radcliffe Hospital, Oxford, OX3 9DU UK
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Smee DF, Julander JG, Tarbet EB, Gross M, Nguyen J. Treatment of oseltamivir-resistant influenza A (H1N1) virus infections in mice with antiviral agents. Antiviral Res 2012; 96:13-20. [PMID: 22809862 DOI: 10.1016/j.antiviral.2012.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 06/11/2012] [Accepted: 07/06/2012] [Indexed: 12/13/2022]
Abstract
Influenza A/Mississippi/03/2001 (H1N1) and A/Hong Kong/2369/2009 (H1N1) viruses containing the neuraminidase gene mutation H275Y (conferring resistance to oseltamivir) were adapted to mice and evaluated for suitability as models for lethal infection and antiviral treatment. The viral neuraminidases were resistant to peramivir and oseltamivir carboxylate but sensitive to zanamivir. Similar pattern of antiviral activity were seen in MDCK cell assays. Lethal infections were achieved in mice with the two viruses. Oral oseltamivir at 100 and 300mg/kg/day bid for 5day starting at -2h gave 30% and 60% protection from death, respectively, due to the A/Mississippi/03/2001 infection. Intraperitoneal treatments with zanamivir at 30 and 100mg/kg/day starting at -2h gave 60% and 90% protection, respectively. Neither compound at <300mg/kg/day protected mice when treatments began at +24h. Amantadine was effective at 10, 30, and 100mg/kg/day, rimantadine was protective at 10 and 30mg/kg/day (highest dose tested), and ribavirin was active at 30 and 75mg/kg/day, with survival ranging from 60-100% for oral treatments initiated at -2h. For treatments begun at +24h, amantadine was protective at 30 and 100mg/kg/day, rimantadine showed efficacy at 10 and 30mg/kg/day, and ribavirin was active at 75mg/kg/day, with 60-100% survival per group. In the A/Hong Kong/2369/2009 infection, oral oseltamivir at 100 and 300mg/kg/day starting at -2h gave 50% and 70% protection from death, respectively. These infection models will be useful to study newly discovered anti-influenza virus agents and to evaluate compounds in combination.
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Affiliation(s)
- Donald F Smee
- Institute for Antiviral Research, Utah State University, Logan, UT 84322, USA.
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Commentary on “Experience with Pandemic 2009 H1N1 Influenza in a Large Pediatric Hospital”. South Med J 2012; 105:181-3. [DOI: 10.1097/smj.0b013e31825015dc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The ability to produce an H5N1 influenza virus that can be transmitted from human to human raises both biosecurity and biosafety concerns. After analyzing the biosafety risks of such a virus, we propose that it be handled at biosafety level 4 (BSL4) containment until and unless it becomes clear that the risks to humans and other mammals can be mitigated.
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