Immunopotentiating substances with antiviral activity

Chapter 3 Antiviral drugs: general considerations

The development of an antiviral drug as well as of other drugs is a long process. In most programmes the screening and evaluation start using inhibition of virus multiplication in cell cultures, but in some instances the screening starts in animal models of different viral diseases. In these cases, the mechanism of action has to be analyzed after the in vivo effect has been found. It is not possible to specify precisely the time and resources required in a newly started project to find a compound active against a virus infection but 5-10 years is a reasonable estimation. For some viruses such as herpesviruses, where a number of active inhibitors are already known, the task is simpler than it is to find inhibitors of a virus such as influenza against which only a few active inhibitors have been reported. Evaluation of clinical efficacy in humans is a large and difficult part of the development of an antiviral drug. The number of uncontrolled clinical studies claiming efficacy of different drugs against viral diseases is depressingly large. It is essential to perform double-blind, placebo-controlled and statistically well evaluated studies to be able to judge the clinical efficacy of an antiviral drug. As the knowledge of the detailed natural history and molecular biology of viral diseases and viruses themselves increases, one will obviously have better opportunities to find new drugs. Methods such as X-ray diffraction measurement and NMR determinations will probably lead to a detailed understanding of the structures and interactions taking place at the active site of viral enzymes and their cellular counterparts.

Enhancement of host resistance against virus infections by MTP-PE, a synthetic lipophilic muramyl peptide--I. Increased survival in mice and guinea pigs after single drug administration prior to infection, and the effect of MTP-PE on interferon levels in sera and lungs

Muramyl tripeptide-phosphatidylethanolamine (MTP-PE, CGP 19835) displays prophylactic antiviral activity in mice infected with influenza viruses A and B, parainfluenza 1 virus or herpes simplex type 1 viruses (HSV/1) and in guinea pigs infected with herpes simplex type 2 viruses (HSV/2). MTP-PE is effective when given in a single intranasal dose as early as 1-4 weeks before infection. In the case of HSV/2 infections, prophylactic effectiveness can be demonstrated after a single topical application into the vagina seven days before infection. Antiviral effects are observed in response to doses as little as 0.001 mg/kg bodyweight. The activity of the substance seems to be inversely related to the size of the viral inoculum, but poor dose-effect relation is demonstrable in a dose-range extending over four to five orders of magnitude. Furthermore, the compound is devoid of antiviral effects in vitro. MTP-PE does not induce interferon (IFN) in serum and lung, nor does it influence kinetics or quantity of serum and lung IFN content in the course of viral infections. However, when given intranasally 7 days before an oral dose of tilorone, increased levels of IFN in lung suspensions are observed.

Treatment of subacute sclerosing panencephalitis: an overview

Subacute sclerosing panencephalitis (SSPE) is a rare central nervous system degenerative disease that occurs primarily in children and adolescents. It is believed to be caused by a measles-like virus. Initial symptoms usually present as a variety of personality changes followed by myoclonus with progression of mental and motor deterioration, which leads to death within a few months to years. New experimental treatment with inosiplex has been shown to be helpful for patients stricken with this progressive neurological disease. A response to inosiplex therapy is best in patients with a slowly progressing form of the disease. Inosiplex treatment is safe with few adverse effects. The duration of treatment appears to be lifelong since many patients relapse when inosiplex therapy is discontinued. This article reviews the etiology, pathogenesis, and experimental treatment of SSPE.

Immunomodulatory activity of isoprinosine on experimental viral infections in avian models

The immunomodulatory activity of Isoprinosine treatments have been experimentally verified on chicken infected by three different viruses: Newcastle disease, fowl plague and avian infectious bronchitis. In protection tests, positive variations in the mean day of death rather than in the mortality rate were found depending on the modality of treatment. A stimulatory influence on primary anti-Newcastle disease virus antibody response was observed. In the avian model the Isoprinosine antiviral effect appears as due mainly to the enhancement of interferon production and to a synergistic interferon-isoprinosine interaction.