Toxicity and antiviral activity of LY253963 against respiratory syncytial and parainfluenza type 3 viruses in tissue culture and in cotton rats

The Intracellular Formation of a Mononucleotide of the Anti-Influenza Agent 1,3,4-thiadiazol-2-ylcyanamide (LY217896)

LY217896 is a substituted thiadiazole compound with anti-influenza activity in vitro and in the mouse model of infection. LY297336 is a ribosylated (N-4) derivative of LY217896. A highly polar intracellular metabolite of LY217896 was isolated by HPLC, and mass spectral analysis and treatment of the metabolite with alkaline phosphatase showed that it was a monophosphate (LY307987) derived from LY217896. The formation of LY307987 was inhibited by 43 and 63% when 10 μm of LY217896 was incubated with 100 μM of 8-aminoguanosine (8AGuo) and guanine (Gua), respectively, whereas inosine (Ino) and hypoxanthine (Hx) had no effect on the formation of LY307987. LY217896 inhibited the incorporation of [14C]-Hx into nucleic acids in cells which metabolize LY217896; however, LY217896 did not inhibit the formation of inosine 5′-monophosphate (IMP) from Hx in a cell-free HGPRT (hypoxanthine-guanine phosphoribosyltransferase)-catalysed reaction. Incubation of MDCK cells with 10 μm of LY217896 resulted in an 8-fold increase in the level of intracellular IMP. At 100 μm, neither LY217896 nor LY297336 inhibited inosine 5′-monophosphate dehydrogenase (IMPDH) and only cellular extracts which contained intracellular metabolites of LY217896 inhibited IMPDH. Quantification of the 5-phosphorylribose pyrophosphate (PRPP) levels in BS-C-1, MDCK, and MCN cells showed a positive correlation between PRPP concentration and cellular metabolism of LY217896. Combination studies of LY217896 with 2′,3′-dideoxyinosine (ddlno) or 2′,3′-dideoxyguanosine (ddGuo) showed that LY217896 enhanced the antiretroviral activities of these dideoxynucleosides, which is consistent with an inhibitory effect on IMPDH.

Cellular Metabolism and Anti-Influenza Activity of 1,3,4-Thiadiazol-2-Ylcyanamide (LY217896)

LY217896 (1,3,4-thiadiazol-2-ylcyanamide) is a 2-substituted thiadiazole that is an effective inhibitor of influenza A and B viruses in vitro and in the mouse infection model. The in vitro anti-influenza activity of LY217896 is reversed by a 10-fold excess amount of guanine or guanosine. LY217896 (1 or 10μg ml−1) effected a selective 60% decrease in the levels of intracellular pools of GTP in MDCK cells. The extent of cytotoxicity of LY217896 is positively correlated with the amount of LY217896 metabolite formed intracellularly. A cell line, derived from parental MDCK cells, was selected for resistance to 50 ng of LY217896 per ml. Unlike parental MDCK cells, the resistant cells were able to undergo log phase replication in LY217896 (25 g ml−1) and were unable to metabolize the compound. Furthermore, LY217896 had no antiviral activity against influenza A/Ann Arbor (IC50 >200μg ml−1) or vaccinia virus (IC50 = 13 μg ml−1) in resistant cells. In contrast, LY217896 inhibited influenza A/Ann Arbor (IC50 = 0.5 μg ml−1) or vaccinia virus (IC50 = 0.13 μg ml−1) in the parental MDCK cells. A thiadiazole, with a guanidinyl group in the 2 position, and ribavirin were active in both the parental cells and resistant cells. Nicotinamide (up to 240-fold excess) did not reverse the anti-influenza activity of LY217896 in vitro or in the mouse infection model. A 10-fold excess of nicotinamide reversed the cytotoxicity of 2-aminothiadiazole but not that of LY217896.

Viral infections of the respiratory tract: prevention and treatment

The rapid discovery of specific viral agents as the cause of many acute respiratory diseases was accompanied by considerable optimism that vaccines or other control measures could be developed quickly. Subsequent experience has demonstrated that effective control of these important public health problems has been an elusive goal. However, recent exciting developments in our understanding of the molecular biology and immunology of these viruses may provide the basis for more effective strategies in the future.

Novel therapies for an old virus: treatment of RSV infections in the 21st Century

Respiratory syncytial virus (RSV) is a pathogen whose existence has been known for decades, causing mild-to-severe upper and lower respiratory tract infections that bear the risk of subsequent asthma and can even lead to a fatal outcome. RSV infects all groups of patients and is a major cause of hospitalization in children and in the elderly. This review briefly summarizes the current status of RSV drug development and clinical trials for drugs available for the treatment of RSV infections.

A new assay system for evaluation of developmental immunotoxicity of chemical compounds using respiratory syncytial virus infection to offspring mice

We evaluated the effect of 6-propyl-2-thiouracil (PTU), an anti-thyroid agent, on developmental immunity using respiratory syncytial virus (RSV) infection to offspring mice as a new risk assessment for brominated flame retardants (BFRs), because some BFRs are suspected of affecting the thyroid system. Pregnant mice were exposed to PTU in drinking water from gestation day 10 to weaning on postnatal day 21. Their offspring mice were infected intranasally with RSV. Exposure of 100ppm PTU significantly increased virus titers in the lungs of RSV-infected offspring compared with the control, and the 10ppm also elevated levels of interferon-γ, a marker of pneumonia, in the bronchoalveolar lavage fluids of offspring. Histopathological analysis revealed that PTU-exposure exacerbated pneumonia in RSV-infected offspring. Thus, exacerbation of RSV infection suggested PTU-exposure of dams elicited developmental immune disorder in the offspring. The murine RSV infection model may be useful to evaluate the developmental immunotoxicity of BFRs.

Respiratory syncytial virus infections: Recent prospects for control

Respiratory syncytial virus (RSV) infections remain a significant public health problem throughout the world, although recently developed and clinically approved anti-RSV antibodies administered prophylactically to at-risk populations appear to have significantly affected the disease development. Much effort has been expended to develop effective anti-RSV therapies, using both in vitro assay systems and mouse, cotton rat, and primate models, with several products now in various stages of clinical study. Several products are also being considered for the treatment of clinical symptoms of RSV. In this review, updates on the status of the approved anti-RSV antibodies, ribavirin, and recent results of studies with potential new anti-RSV compounds are summarized and discussed.

Antisense approaches for inhibiting respiratory syncytial virus

Respiratory syncytial virus (RSV) continues as an emerging infectious disease not only among infants and children, but also for the immune-suppressed, hospitalised and the elderly. To date, ribavirin (Virazole, ICN Pharmaceuticals, Inc.) remains the only therapeutic agent approved for the treatment of RSV. However, its clinical benefits are small and occur only in a fraction of RSV-infected patients. The prophylactic administration of palivizumab (Synagis, MedImmune, Inc.) is problematic and costly and, therefore, only recommended for use in high-risk infants. Clearly, the need for an effective and safe drug remains high. This review discusses several different antisense approaches and compares them with traditional strategies, such as RSV-targeting antibodies and antivirals, as well as developments in vaccine research.

Contamination of a specific-pathogen-free rat breeding colony with Human parainfluenzavirus type 3

Routine antibody surveillance for Sendai virus in a breeding colony suggested viral invasion into laboratory rats. A more specific haemagglutination-inhibition test implied that the agent was related closely to Human parainfluenza virus type 3 (hPIV3), rather than Sendai virus. To isolate this virus, Vero cells were inoculated with lung homogenates of 30 young animals from the colony. One of the cultures became positive at the second passage by RT-PCR directed to the hPIV3 NP and L genes. Cytopathic effect with cell fusion was observed at the third passage. The HN gene of this virus (KK24) had >93 % similarity to those of other hPIV3 isolates, suggesting a human origin of KK24. Experimental intranasal inoculation of KK24 into SD rats showed virus replication in the lungs at 3–5 days post-infection (p.i.). Pathological examination of the lungs at day 5 p.i. indicated a moderate detachment, degradation and apoptosis of bronchial epitheliocytes with peribronchial mononuclear infiltrations. At day 7 p.i., these changes became less prominent, and no lesions were apparent at day 10 p.i. or later. The infected rats seroconverted at day 7 p.i. On the contrary, none of the 30 experimentally infected ICR mice showed any pathological lesions in their lungs, despite seroconversion at 7 days p.i. These results suggest that hPIV3 can invade rat colonies and has a moderate and transient pathogenicity in rats. This is the first report of non-experimental hPIV3 infection in laboratory rats, unexpectedly detected by antibody screening for Sendai virus.

Parainfluenza viruses

Human parainfluenza viruses (HPIV) were first discovered in the late 1950s. Over the last decade, considerable knowledge about their molecular structure and function has been accumulated. This has led to significant changes in both the nomenclature and taxonomic relationships of these viruses. HPIV is genetically and antigenically divided into types 1 to 4. Further major subtypes of HPIV-4 (A and B) and subgroups/genotypes of HPIV-1 and HPIV-3 have been described. HPIV-1 to HPIV-3 are major causes of lower respiratory infections in infants, young children, the immunocompromised, the chronically ill, and the elderly. Each subtype can cause somewhat unique clinical diseases in different hosts. HPIV are enveloped and of medium size (150 to 250 nm), and their RNA genome is in the negative sense. These viruses belong to the Paramyxoviridae family, one of the largest and most rapidly growing groups of viruses causing significant human and veterinary disease. HPIV are closely related to recently discovered megamyxoviruses (Hendra and Nipah viruses) and metapneumovirus.

Respiratory syncytial virus: recent progress towards the discovery of effective prophylactic and therapeutic agents

Although respiratory syncytial virus (RSV) was discovered in 1955, the burden associated with this infectious agent on all population groups is only now beginning to be fully appreciated. The successful launch of the humanized monoclonal antibody Synagis (developed by MedImmune, Gaithersburg, MD, USA), as a prophylactic in September 1998 has helped to heighten awareness of the extent of mortality and morbidity associated with annual RSV epidemics. Small, drug-like molecules that would provide the clinician with effective and conveniently administered prophylactic and therapeutic agents for the prevention and treatment of RSV have not yet advanced into clinical studies. This review will summarize recent developments in the area of RSV drug discovery and development.

Use of cotton rats to evaluate the efficacy of antivirals in treatment of measles virus infections

No practical animal models for the testing of chemotherapeutic or biologic agents identified in cell culture assays as being active against measles virus (MV) are currently available. Cotton rats may serve this purpose. To evaluate this possibility, 5-ethynyl-1-beta-D-ribofuranosylimidazole-4-carboxamide (EICAR) and poly(acrylamidomethyl propanesulfonate) (PAMPS), two compounds that have been reported to inhibit MV in vitro, and ribavirin, an established antiviral drug with MV-inhibitory activity, were evaluated for their antiviral activities against MV and respiratory syncytial virus (RSV) in tissue culture and in hispid cotton rats. A single administration of PAMPS markedly inhibited pulmonary RSV or MV replication (>3 log(10) reduction in pulmonary titer compared to that for controls), but only if this compound was administered intranasally at about the time of virus inoculation. Both EICAR and ribavirin exhibited therapeutic activity against RSV and MV in cotton rats when they were administered parenterally. However, both of these compounds were less effective against MV. On the basis of the pulmonary virus titers on day 4 after virus inoculation, the minimal efficacious dose of EICAR against MV (120 mg/kg of body weight/day when delivered intraperitoneally twice daily) appeared to be three times lower against this virus than that of ribavirin delivered at a similar dose (i.e., 360 mg/kg/day). These findings correlated with those obtained in vitro. The data obtained suggest that cotton rats may indeed be useful for the initial evaluation of the activities of antiviral agents against MV.

Chemotherapy of respiratory viruses: prospects and challenges

Billions of people are infected with respiratory viruses annually. Infants and young children, the elderly, immunocompromised individuals and those debilitated by other diseases or nutritional deficiencies are most at risk for serious disease. There are few vaccines available for use against these viruses, and even where there are (influenza, measles and adenovirus), infections remain common. The continued prevalence of respiratory virus infections has lead to renewed efforts to find safe agents effective against the most medically important respiratory viruses: influenza, respiratory syncytial, parainfluenza, measles, rhino- and adenovirus. Copyright 1999 Harcourt Publishers Ltd.

Approaches and strategies for the treatment of influenza virus infections

Influenza A and B viruses belong to the Orthomyxoviridae family of viruses. These viruses are responsible for severe morbidity and significant excess mortality each year. Infection with influenza viruses usually leads to respiratory involvement and can result in pneumonia and secondary bacterial infections. Vaccine approaches to the prophylaxis of influenza virus infections have been problematic owing to the ability of these viruses to undergo antigenic shift by exchanging genomic segments or by undergoing antigenic drift, consisting of point mutations in the haemagglutinin (HA) and neuraminidase (NA) genes as a result of an error-prone viral polymerase. Historically, antiviral approaches for the therapy of both influenza A and B viruses have been largely unsuccessful until the elucidation of the X-ray crystallographic structure of the viral NA, which has permitted structure-based drug design of inhibitors of this enzyme. In addition, recent advances in the elucidation of the structure and complex function of influenza HA have resulted in the discovery of a number of diverse compounds that target this viral protein. This review article will focus largely on newer antiviral agents including those that inhibit the influenza virus NA and HA. Other novel approaches that have entered clinical trials or been considered for their clinical utility will be mentioned.

Mouse model of respiratory syncytial virus infection to evaluate antiviral activity in vivo

In this study, we have developed a practical mouse model for evaluating in vivo the antiviral activity of compounds against respiratory syncytial virus (RSV) infection. BALB/c mice are not particularly susceptible to RSV infection; however, infection rates were improved by pretreatment with the immunosuppressive agent cyclophosphamide (CYP). When mice were inoculated intranasally with RSV A2 strain, the pulmonary RSV titres of CYP-pretreated 10-week-old mice were higher than those of untreated 10-week-old and 28-week-old mice, peaking on days 4 and 5 post-infection. Sections of lung from RSV-infected mice pretreated with CYP, taken on day 4 post-inoculation, showed widespread evidence of interstitial pneumonia and other significant pathological changes. We also confirmed that ribavirin, a representative antiviral agent, significantly reduced the pulmonary RSV titres of mice pretreated with CYP when administered intraperitoneally.

Efficacy of RD3-0028 aerosol treatment against respiratory syncytial virus infection in immunosuppressed mice

RD3-0028, a benzodithiin compound, has antiviral activity against respiratory syncytial virus (RSV) in cell culture. We used a mouse model of RSV infection to determine the in vivo effect of RD3-0028. Cyclophosphamide (CYP)-treated, immunosuppressed mice were inoculated intranasally. The lungs of the mice were removed on day 4. The virus titers of the lungs of RD3-0028-treated mice were compared to the virus titers of the lungs of virus-inoculated, untreated control mice. In an effort to increase the therapeutic effectiveness of this compound, RD3-0028 was administered by aerosol to RSV-infected mice by using a head-exposure system. Aerosols generated from reservoirs containing RD3-0028 (7 mg/ml) administered for 2 h twice daily for 3 days significantly reduced the pulmonary titer of RSV-infected mice. It is clear that the minimal effective dose of RD3-0028 for RSV-infected mice is significantly less than that of ribavirin, the only compound currently available for use against RSV disease. Furthermore, the RD3-0028 aerosol administration appeared to protect the lungs of infected, CYP-treated mice against tissue damage, as evidenced by the preservation of the lung architecture and a reduction in pulmonary inflammatory infiltrates. RD3-0028 aerosol was not toxic for mice at the therapeutic dose. The present study demonstrates the effectiveness of aerosol administration of RD3-0028 for RSV-infected mice.

Oral LY217896 for prevention of experimental influenza A virus infection and illness in humans

The efficacy and safety of oral LY217896 for prevention of experimental influenza A/Kawasaki/86 (H1N1) virus infection were assessed in susceptible males randomly assigned to receive LY217896 (75 mg) or placebo once daily for 7 days beginning 24 h prior to viral challenge. The rates of virus shedding (100% in both groups), days of viral shedding (3.1 +/- 1.3 for the LY217896 group; 2.8 +/- 1.3 for the placebo group), and titers of virus in nasal washings did not differ between the groups. Mild upper respiratory tract illness (72% in the LY217896 group; 69% in the placebo group) developed in similar proportions of each group. LY217896 was associated with asymptomatic rises in serum uric acid levels and was ineffective in modifying the virologic or clinical course of experimental influenza A (H1N1) virus infection.