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Stauffer WT, Goodman AZ, Gallay PA. Cyclophilin inhibition as a strategy for the treatment of human disease. Front Pharmacol 2024; 15:1417945. [PMID: 39045055 PMCID: PMC11264201 DOI: 10.3389/fphar.2024.1417945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/14/2024] [Indexed: 07/25/2024] Open
Abstract
Cyclophilins (Cyps), characterized as peptidyl-prolyl cis-trans isomerases (PPIases), are highly conserved and ubiquitous, playing a crucial role in protein folding and cellular signaling. This review summarizes the biochemical pathways mediated by Cyps, including their involvement in pathological states such as viral replication, inflammation, and cancer progression, to underscore the therapeutic potential of Cyp inhibition. The exploration of Cyp inhibitors (CypI) in this review, particularly non-immunosuppressive cyclosporine A (CsA) derivatives, highlights their significance as therapeutic agents. The structural and functional nuances of CsA derivatives are examined, including their efficacy, mechanism of action, and the balance between therapeutic benefits and off-target effects. The landscape of CypI is evaluated to emphasize the clinical need for targeted approaches to exploit the complex biology of Cyps and to propose future directions for research that may enhance the utility of non-immunosuppressive CsA derivatives in treating diseases where Cyps play a key pathological role.
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Affiliation(s)
| | | | - Philippe A. Gallay
- Department of Immunology & Microbiology, The Scripps Research Institute, La Jolla, CA, United States
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2
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Świerczyńska M, Tronina A, Filipek E. Aicardi-Goutières Syndrome with Congenital Glaucoma Caused by Novel TREX1 Mutation. J Pers Med 2023; 13:1609. [PMID: 38003924 PMCID: PMC10672266 DOI: 10.3390/jpm13111609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Aicardi-Goutières syndrome (AGS) is a rare genetic disorder characterized by microcephaly, white matter lesions, numerous intracranial calcifications, chilblain skin lesions and high levels of interferon-α (IFN-α) in the cerebrospinal fluid (CSF). However, ocular involvement is reported significantly less frequently. CASE PRESENTATION We present a case of a neonate with hypotrophy, microcephaly, frostbite-like skin lesions, thrombocytopenia, elevated liver enzymes and hepatosplenomegaly. Magnetic resonance imaging (MRI) of the brain showed multiple foci of calcification, white matter changes, cerebral atrophy, and atrophic dilatation of the ventricular system. The inflammatory parameters were not elevated, and the infectious etiology was excluded. Instead, elevated levels of IFN-α in the serum were detected. Based on the related clinical symptoms, imaging and test findings, the diagnosis of AGS was suspected. Genetic testing revealed two pathogenic mutations, c.490C>T and c.222del (novel mutation), in the three prime repair exonuclease 1 (TREX1) gene, confirming AGS type 1 (AGS1). An ophthalmologic examination of the child at 10 months of age revealed an impaired pupillary response to light, a corneal haze with Haab lines in the right eye (RE), pale optic nerve discs and neuropathy in both eyes (OU). The intraocular pressure (IOP) was 51 mmHg in the RE and 49 in the left eye (LE). The flash visual evoked potential (FVEP) showed prolonged P2 latencies of up to 125% in the LE and reduced amplitudes of up to approximately 10% OU. This girl was diagnosed with congenital glaucoma, and it was managed with a trabeculectomy with a basal iridectomy of OU, resulting in a reduction and stabilization in the IOP to 12 mmHg in the RE and 10 mmHg in the LE without any hypotensive eyedrops. CONCLUSIONS We present the clinical characteristics, electrophysiological and imaging findings, as well as the genetic test results of a patient with AGS1. Our case contributes to the extended ophthalmic involvement of the pathogenic c.490C>T and c.222del mutations in TREX1.
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Affiliation(s)
- Marta Świerczyńska
- Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-514 Katowice, Poland
- Department of Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia, 40-514 Katowice, Poland
| | - Agnieszka Tronina
- Department of Pediatric Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-514 Katowice, Poland; (A.T.); (E.F.)
- Department of Pediatric Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia, 40-514 Katowice, Poland
| | - Erita Filipek
- Department of Pediatric Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-514 Katowice, Poland; (A.T.); (E.F.)
- Department of Pediatric Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia, 40-514 Katowice, Poland
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3
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Chowdhary S, Deka R, Panda K, Kumar R, Solomon AD, Das J, Kanoujiya S, Gupta AK, Sinha S, Ruokolainen J, Kesari KK, Gupta PK. Recent Updates on Viral Oncogenesis: Available Preventive and Therapeutic Entities. Mol Pharm 2023; 20:3698-3740. [PMID: 37486263 PMCID: PMC10410670 DOI: 10.1021/acs.molpharmaceut.2c01080] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/25/2023]
Abstract
Human viral oncogenesis is a complex phenomenon and a major contributor to the global cancer burden. Several recent findings revealed cellular and molecular pathways that promote the development and initiation of malignancy when viruses cause an infection. Even, antiviral treatment has become an approach to eliminate the viral infections and prevent the activation of oncogenesis. Therefore, for a better understanding, the molecular pathogenesis of various oncogenic viruses like, hepatitis virus, human immunodeficiency viral (HIV), human papillomavirus (HPV), herpes simplex virus (HSV), and Epstein-Barr virus (EBV), could be explored, especially, to expand many potent antivirals that may escalate the apoptosis of infected malignant cells while sparing normal and healthy ones. Moreover, contemporary therapies, such as engineered antibodies antiviral agents targeting signaling pathways and cell biomarkers, could inhibit viral oncogenesis. This review elaborates the recent advancements in both natural and synthetic antivirals to control viral oncogenesis. The study also highlights the challenges and future perspectives of using antivirals in viral oncogenesis.
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Affiliation(s)
- Shivam Chowdhary
- Department
of Industrial Microbiology, Sam Higginbottom
University of Agriculture, Technology and Sciences, Prayagraj 211007, Uttar Pradesh India
| | - Rahul Deka
- Department
of Bioengineering and Biotechnology, Birla
Institute of Technology, Mesra, Ranchi 835215, Jharkhand, India
| | - Kingshuk Panda
- Department
of Applied Microbiology, Vellore Institute
of Technology, Vellore 632014, Tamil Nadu, India
| | - Rohit Kumar
- Department
of Life Sciences, Sharda School of Basic Sciences and Research, Sharda University, Greater Noida 201310, Uttar Pradesh, India
| | - Abhishikt David Solomon
- Department
of Molecular & Cellular Engineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj 211007, Uttar Pradesh, India
| | - Jimli Das
- Centre
for
Biotechnology and Bioinformatics, Dibrugarh
University, Assam 786004, India
| | - Supriya Kanoujiya
- School
of
Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India
| | - Ashish Kumar Gupta
- Department
of Biophysics, All India Institute of Medical
Sciences, New Delhi 110029, India
| | - Somya Sinha
- Department
of Biotechnology, Graphic Era Deemed to
Be University, Dehradun 248002, Uttarakhand, India
| | - Janne Ruokolainen
- Department
of Applied Physics, School of Science, Aalto
University, 02150 Espoo, Finland
| | - Kavindra Kumar Kesari
- Department
of Applied Physics, School of Science, Aalto
University, 02150 Espoo, Finland
- Division
of Research and Development, Lovely Professional
University, Phagwara 144411, Punjab, India
| | - Piyush Kumar Gupta
- Department
of Life Sciences, Sharda School of Basic Sciences and Research, Sharda University, Greater Noida 201310, Uttar Pradesh, India
- Department
of Biotechnology, Graphic Era Deemed to
Be University, Dehradun 248002, Uttarakhand, India
- Faculty
of Health and Life Sciences, INTI International
University, Nilai 71800, Malaysia
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4
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Kale A, Shelke V, Dagar N, Anders HJ, Gaikwad AB. How to use COVID-19 antiviral drugs in patients with chronic kidney disease. Front Pharmacol 2023; 14:1053814. [PMID: 36843922 PMCID: PMC9947246 DOI: 10.3389/fphar.2023.1053814] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
Antiviral drugs such as Remdesivir (Veklury), Nirmatrelvir with Ritonavir (Paxlovid), Azvudine, and Molnupiravir (Lagevrio) can reduce the risk for severe and fatal Coronavirus Disease (COVID)-19. Although chronic kidney disease is a highly prevalent risk factor for severe and fatal COVID-19, most clinical trials with these drugs excluded patients with impaired kidney function. Advanced CKD is associated with a state of secondary immunodeficiency (SIDKD), which increases the susceptibility to severe COVID-19, COVID-19 complications, and the risk of hospitalization and mortality among COVID-19 patients. The risk to develop COVID-19 related acute kidney injury is higher in patients with precedent CKD. Selecting appropriate therapies for COVID-19 patients with impaired kidney function is a challenge for healthcare professionals. Here, we discuss the pharmacokinetics and pharmacodynamics of COVID-19-related antiviral drugs with a focus on their potential use and dosing in COVID-19 patients with different stages of CKD. Additionally, we describe the adverse effects and precautions to be taken into account when using these antivirals in COVID-19 patients with CKD. Lastly, we also discuss about the use of monoclonal antibodies in COVID-19 patients with kidney disease and related complications.
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Affiliation(s)
- Ajinath Kale
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, India
| | - Vishwadeep Shelke
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, India
| | - Neha Dagar
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, India
| | - Hans-Joachim Anders
- Division of Nephrology, Department of Internal Medicine IV, Hospital of the Ludwig Maximilians University Munich, Munich, Germany
| | - Anil Bhanudas Gaikwad
- Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science Pilani, Pilani Campus, Rajasthan, India,*Correspondence: Anil Bhanudas Gaikwad,
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5
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Masalova OV, Lesnova EI, Andreev SM, Shershakova NN, Kozlov VV, Permyakova KY, Demidova NA, Valuev-Elliston VT, Turetskiy EA, Ivanov AV, Nikolaeva TN, Khaitov MR, Pronin AV, Kushch AA. [Adjuvant effect of dispersed fullerene C60 on the immune response to constructs harboring amino acid and nucleotide sequences of hepatitis C virus nonstructural NS5B protein]. Vopr Virusol 2023; 67:516-526. [PMID: 37264841 DOI: 10.36233/0507-4088-149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Indexed: 06/03/2023]
Abstract
INTRODUCTION A vaccine against hepatitis C has not yet been developed. Recombinant proteins and plasmids encoding hepatitis C virus (HCV) proteins, the components of candidate vaccines, induce a weak immune response and require the use of adjuvants. The aim of the work was to study the adjuvant action of an aqueous solution of fullerene C60 during immunization of mice with HCV recombinant protein NS5B (rNS5B) that is an RNA-dependent RNA polymerase, or with NS5B-encoding pcNS5B plasmid. MATERIALS AND METHODS An aqueous solution of dispersed fullerene (dnC60) was obtained by ultrafiltration. C57BL/6 mice were immunized with rNS5B subcutaneously, pcNS5B intramuscularly mixed with different doses of dnC60 three times, then the humoral and cellular response to HCV was evaluated. RESULTS Mice immunization with rNS5B in a mixture with dnC60 at doses of 250 g/mouse significantly induced humoral response: a dose-dependent increase in IgG1 antibody titers was 720 times higher than in the absence of fullerene. There was no increase in the cellular response to rNS5B when administered with dnC60. The humoral response to DNA immunization was weak in mice of all groups receiving pcNS5B. The cellular response was suppressed when the plasmid was injected in a mixture with dnC60. CONCLUSIONS Dispersed fullerene dnC60 is a promising adjuvant for increasing the immunostimulating activity of weakly immunogenic proteins including surface and other HCV proteins, important for a protective response. Further research is needed to enhance the ability of dnC60 to boost the cellular immune response to the components of the candidate vaccine.
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Affiliation(s)
- O V Masalova
- Gamaleya NRC of Epidemiology and Microbiology, Ministry of Health of the Russian Federation
| | - E I Lesnova
- Gamaleya NRC of Epidemiology and Microbiology, Ministry of Health of the Russian Federation
| | | | | | - V V Kozlov
- Gamaleya NRC of Epidemiology and Microbiology, Ministry of Health of the Russian Federation
| | - K Y Permyakova
- Gamaleya NRC of Epidemiology and Microbiology, Ministry of Health of the Russian Federation
- Federal State Budgetary Educational Institution of Higher Education «Moscow State Academy of Veterinary Medicine and Biotechnology - MVA by K.I. Skryabin»
| | - N A Demidova
- Gamaleya NRC of Epidemiology and Microbiology, Ministry of Health of the Russian Federation
| | | | - E A Turetskiy
- NRC Institute of Immunology FMBA of Russia
- Sechenov First Moscow State Medical University (Sechenov University)
| | - A V Ivanov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences
| | - T N Nikolaeva
- Gamaleya NRC of Epidemiology and Microbiology, Ministry of Health of the Russian Federation
| | - M R Khaitov
- NRC Institute of Immunology FMBA of Russia
- Pirogov Russian National Research Medical University
| | - A V Pronin
- Gamaleya NRC of Epidemiology and Microbiology, Ministry of Health of the Russian Federation
| | - A A Kushch
- Gamaleya NRC of Epidemiology and Microbiology, Ministry of Health of the Russian Federation
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6
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Mangrio GR, Maneengam A, Khalid Z, Jafar TH, Chanihoon GQ, Nassani R, Unar A. RP-HPLC Method Development, Validation, and Drug Repurposing of Sofosbuvir Pharmaceutical Dosage Form: A Multidimensional Study. ENVIRONMENTAL RESEARCH 2022; 212:113282. [PMID: 35487258 DOI: 10.1016/j.envres.2022.113282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 06/14/2023]
Abstract
A smooth, exceptionally sensitive, correct, and extra reproducible RP-HPLC technique was developed and demonstrated to estimate Sofosbuvir (SOF) in pharmaceutical dosage formulations. This process was carried out by Agilent High-Pressure Liquid Chromatograph 1260 with GI311C Quat. Pump, Phenomenex Luna C-18 (150 mm × 4.6 mm × 5 μm) (USA), and Photodiode Array Detector (PDA) G1315D. The cell section, including acetonitrile and methanol with 80:20 v/v and solution (B) 0.1% phosphoric acid (40:60), was used for the study. However, 10 μL of the sample was injected with a drift flow of 1 mL/min. The separation occurred at a column temperature of 30 °C, and the eluents used PDA set at 260 nm. The retention time of SOF was 5 min. The calibration curve was modified linearly within the range of 0.05-0.15 mg/mL with a correlation coefficient of 0.99 and genuine linear dating among top vicinity and consciousness in the calibration curve. The detection and quantification restrictions were 0.001 and 0.003 mg/mL, respectively. SOF recovery from pharmaceutical components ranged from 98% to 99%. The percentage assay of SOF was 99%. Analytical validation parameters, such as specificity, linearity, precision, accuracy, and selectivity, were studied, and the percentage relative standard deviation (%RSD) was less than 2%. All other key parameters were observed within the desired thresholds. Hence, the proposed RP-HPLC technique was proven effective for developing SOF in bulk and pharmaceutical pill dosage forms. SOF was found to interact with SARS-COV-2 nsp12, and molecular docking results revealed its high affinity and firm binding within the active site groove of nsp12. The key interacting residues include; LYS-72, GLN-75, MET-80 ALA-99, ASN-99, TRP-100, TYR-101 with ASN-99 and TRP-100 forming hydrogen bonds. Molecular Dynamics simulation of SOF and nsp12 complex elucidated that the system was stable throughout 20ns. Therefore, this drug repurposing strategy for SOF can be used for treating COVID-19 infections by performing animal experiments and accurate clinical trials in the future.
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Affiliation(s)
| | - Apichit Maneengam
- Department of Mechanical Engineering Technology, College of Industrial Technology, King Mongkut's University of Technology North Bangkok, Wongsawang, Bangsue, Bangkok, 10800, Thailand
| | - Zunera Khalid
- School of Life Sciences, University of Science and Technology of China, Hefei, 230027, PR China
| | | | - Ghulam Qadir Chanihoon
- National Center of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76090, Pakistan
| | - Rayan Nassani
- Center for Computational Biology, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Ahsanullah Unar
- School of Life Sciences, University of Science and Technology of China, Hefei, 230027, PR China.
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7
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Jonsdottir HR, Siegrist D, Julien T, Padey B, Bouveret M, Terrier O, Pizzorno A, Huang S, Samby K, Wells TNC, Boda B, Rosa-Calatrava M, Engler OB, Constant S. Molnupiravir combined with different repurposed drugs further inhibits SARS-CoV-2 infection in human nasal epithelium in vitro. Biomed Pharmacother 2022; 150:113058. [PMID: 35658229 PMCID: PMC9057985 DOI: 10.1016/j.biopha.2022.113058] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/08/2022] [Accepted: 04/26/2022] [Indexed: 01/08/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a worldwide pandemic with unprecedented economic and societal impact. Currently, several vaccines are available and multitudes of antiviral treatments have been proposed and tested. Although many of the vaccines show clinical efficacy, they are not equally accessible worldwide. Additionally, due to the continuous emergence of new variants and generally short duration of immunity, the development of effective antiviral treatments remains of the utmost importance. Since the emergence of SARS-CoV-2, substantial efforts have been undertaken to repurpose existing drugs for accelerated clinical testing and emergency use authorizations. However, drug-repurposing studies using cellular assays often identify hits that later prove ineffective clinically, highlighting the need for more complex screening models. To this end, we evaluated the activity of single compounds that have either been tested clinically or already undergone extensive preclinical profiling, using a standardized in vitro model of human nasal epithelium. Furthermore, we also evaluated drug combinations based on a sub-maximal concentration of molnupiravir. We report the antiviral activity of 95 single compounds and 30 combinations. We show that only a few single agents are highly effective in inhibiting SARS-CoV-2 replication while selected drug combinations containing 10 µM molnupiravir boosted antiviral activity compared to single compound treatment. These data indicate that molnupiravir-based combinations are worthy of further consideration as potential treatment strategies against coronavirus disease 2019 (COVID-19). Not many single compounds exhibit antiviral activity against SARS-CoV-2. The RdRp inhibitor, molnupiravir, inhibits SARS-CoV-2 at various concentrations. Combinations containing 10 µM molnupiravir boost antiviral activity. Combination treatment might provide additional therapeutic benefit against COVID-19.
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Affiliation(s)
- Hulda R Jonsdottir
- Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland; Department of Rheumatology, Immunology, and Allergology, Inselspital University Hospital, Bern, Switzerland; Department of BioMedical Research, University of Bern, Bern, Switzerland.
| | - Denise Siegrist
- Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland
| | - Thomas Julien
- VirNext, Faculté de Médecine RTH Laennec, Université Claude Bernard Lyon 1, Université de Lyon, 69008, Lyon, France; CIRI, Centre International de Recherche en Infectiologie, (Team VirPath), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | - Blandine Padey
- CIRI, Centre International de Recherche en Infectiologie, (Team VirPath), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | | | - Olivier Terrier
- CIRI, Centre International de Recherche en Infectiologie, (Team VirPath), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | | | - Song Huang
- Epithelix Sàrl, Plan-les-Ouates, Switzerland
| | | | | | | | - Manuel Rosa-Calatrava
- VirNext, Faculté de Médecine RTH Laennec, Université Claude Bernard Lyon 1, Université de Lyon, 69008, Lyon, France; CIRI, Centre International de Recherche en Infectiologie, (Team VirPath), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
| | - Olivier B Engler
- Spiez Laboratory, Federal Office for Civil Protection, Spiez, Switzerland
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8
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Permanasari AA, Aoki-Utsubo C, Wahyuni TS, Tumewu L, Adianti M, Widyawaruyanti A, Hotta H, Hafid AF. An in vitro study of an Artocarpus heterophyllus substance as a hepatitis C antiviral and its combination with current anti-HCV drugs. BMC Complement Med Ther 2021; 21:260. [PMID: 34641875 PMCID: PMC8507375 DOI: 10.1186/s12906-021-03408-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 08/13/2021] [Indexed: 12/15/2022] Open
Abstract
Background Current therapy of chronic hepatitis C virus (HCV) with direct-acting antivirals (DAAs) has dramatically improved the sustained virologic response (SVR) of affected patients; however, treatment with DAAs remains expensive, and drug-resistant HCV variants remain a threat. As a result, there is still a need to continue to develop affordable and effective drugs for the treatment of HCV. Previously, we have demonstrated that a crude extract from Artocarpus heterophyllus leaves is a potential anti-HCV candidate. In this study, we have further purified this crude extract, examined which sub-fraction possesses the highest antiviral activity, and then explored its efficacy at different HCV life cycle stages. We also assessed synergistic antiviral effects between the A. heterophyllus extract and commercially available anti-HCV drugs. Methods We used vacuum liquid chromatography (VLC) and high-performance liquid chromatography (HPLC) to fractionate a dichloromethane extract of A. heterophyllus leaves. We then examined the anti-HCV activity of the fractions using HCV genotype 2a, JFH1a; the antiviral mode of action was determined by exploring adding the treatments at different times. We examined the antiviral effects on the viral entry stage through a virucidal activity test, viral adsorption examination, and pretreatment of cells with the drug. The effects on the post-viral entry stage were determined by the levels of HCV protein expression and HCV RNA expression in infected cells. Results Through activity guided purification, we identified the sub-fraction FR3T3 as possessing the most robust anti-HCV activity with an IC50 value of 4.7 ± 1.0 μg/mL. Mode-of-action analysis revealed that FR3T3 inhibited post-viral entry stages such as HCV NS3 protein expression and HCV RNA replication with marginal effects on the viral entry stage. Thin-layer Chromatography (TLC) indicated that FR3T3 contained terpenoids and chlorophyll-related compounds. We also found a synergistic antiviral activity when the DCM extract of A. heterohyllus was used in combination therapy with commercial anti-HCV drugs; Ribavirin, Simeprevir, Cyclosporin A. Conclusions The extract of A. heterophyllus and its sub-fraction, FR3T3, presented here have anti-HCV activities and could be candidate drugs for add-on-therapy for treatment of chronic HCV infections.
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Affiliation(s)
| | - Chie Aoki-Utsubo
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2, Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
| | - Tutik Sri Wahyuni
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, 60115, Indonesia.,Department of Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Airlangga, Surabaya, 60115, Indonesia
| | - Lidya Tumewu
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, 60115, Indonesia
| | - Myrna Adianti
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, 60115, Indonesia.,Department of Health, Study Program Traditional Medicine, Vocational Faculty, Universitas Airlangga, Surabaya, Indonesia
| | - Aty Widyawaruyanti
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, 60115, Indonesia.,Department of Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Airlangga, Surabaya, 60115, Indonesia
| | - Hak Hotta
- Faculty of Clinical Nutrition and Dietetics, Konan Women's University, 6-2-23, Morikita-machi, Higashida-ku, Kobe, 658-0001, Japan
| | - Achmad Fuad Hafid
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, 60115, Indonesia. .,Department of Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Airlangga, Surabaya, 60115, Indonesia.
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9
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Rodríguez AA, Otero-González A, Ghattas M, Ständker L. Discovery, Optimization, and Clinical Application of Natural Antimicrobial Peptides. Biomedicines 2021; 9:1381. [PMID: 34680498 PMCID: PMC8533436 DOI: 10.3390/biomedicines9101381] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 09/28/2021] [Indexed: 12/12/2022] Open
Abstract
Antimicrobial peptides (AMPs) are widespread in multicellular organisms. These structurally diverse molecules are produced as the first line of defense against pathogens such as bacteria, viruses, fungi, and parasites. Also known as host defense peptides in higher eukaryotic organisms, AMPs display immunomodulatory and anticancer activities. During the last 30 years, technological advances have boosted the research on antimicrobial peptides, which have also attracted great interest as an alternative to tackling the antimicrobial resistance scenario mainly provoked by some bacterial and fungal pathogens. However, the introduction of natural AMPs in clinical trials faces challenges such as proteolytic digestion, short half-lives, and cytotoxicity upon systemic and oral application. Therefore, some strategies have been implemented to improve the properties of AMPs aiming to be used as effective therapeutic agents. In the present review, we summarize the discovery path of AMPs, focusing on preclinical development, recent advances in chemical optimization and peptide delivery systems, and their introduction into the market.
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Affiliation(s)
- Armando A. Rodríguez
- Core Facility for Functional Peptidomics, Ulm University Medical Center, 89081 Ulm, Germany
- Core Unit of Mass Spectrometry and Proteomics, Ulm University Medical Center, 89081 Ulm, Germany
| | | | - Maretchia Ghattas
- Faculty of Pharmacy and Biotechnology, German University in Cairo (GUC), Cairo 11511, Egypt;
| | - Ludger Ständker
- Core Facility for Functional Peptidomics, Ulm University Medical Center, 89081 Ulm, Germany
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10
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Shyr ZA, Cheng YS, Lo DC, Zheng W. Drug combination therapy for emerging viral diseases. Drug Discov Today 2021; 26:2367-2376. [PMID: 34023496 PMCID: PMC8139175 DOI: 10.1016/j.drudis.2021.05.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/14/2021] [Accepted: 05/16/2021] [Indexed: 12/17/2022]
Abstract
Effective therapeutics to combat emerging viral infections are an unmet need. Historically, treatments for chronic viral infections with single drugs have not been successful, as exemplified by human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections. Combination therapy for these diseases has led to improved clinical outcomes with dramatic reductions in viral load, morbidity, and mortality. Drug combinations can enhance therapeutic efficacy through additive, and ideally synergistic, effects for emerging and re-emerging viruses, such as influenza, severe acute respiratory syndrome-coronavirus (SARS-CoV), Middle East respiratory syndrome (MERS)-CoV, Ebola, Zika, and SARS-coronavirus 2 (CoV-2). Although novel drug development through traditional pipelines remains a priority, in the interim, effective synergistic drug candidates could be rapidly identified by drug-repurposing screens, facilitating accelerated paths to clinical testing and potential emergency use authorizations.
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Affiliation(s)
- Zeenat A Shyr
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA.
| | - Yu-Shan Cheng
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Donald C Lo
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Wei Zheng
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA.
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11
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Abdel Karim SE, Youssef YH, Abdel-Halim M, Frakolaki E, Vassilaki N, Zoidis G, Ahmed NS, Abadi AH. Symmetric benzidine derivatives as anti-HCV agents: Insight into the nature, stereochemistry of the capping amino acid and the size of the terminal capping carbamates. Bioorg Chem 2020; 102:104089. [PMID: 32717691 DOI: 10.1016/j.bioorg.2020.104089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/30/2020] [Accepted: 07/07/2020] [Indexed: 12/22/2022]
Abstract
Novel symmetric molecules, bearing a benzidine prolinamide core, two terminal carbamate caps of variable sizes and nature, including natural and unnatural amino acids were developed. Several terminal N-carbamate substituents of the core structure, ranging from linear methyl, ethyl and butyl groups to branching isobutyl group; and an aromatic substituent were also synthesized. Series 1 has hydrophobic AA residues, namely S and R phenylglycine and a terminal carbamate capping group, whereas Series 2 bears sulphur containing amino acids, specifically S and R methionine and the natural R methylcysteine. The novel compounds were tested for their inhibitory activity (EC50) and their cytotoxicity (CC50), using an HCV 1b (Con1) reporter replicon cell line. Compound 4 with the unnatural capping residue, bearing d-Phenylglycine amino acid residue and N-isobutyloxycarbonyl capping group, was the most active within the two series, with EC50 = 0.0067 nM. Moreover, it showed high SI50 > 14788524 and was not cytotoxic at the highest tested concentration (100 μΜ), indicating its safety profile. Compound 4 also inhibited HCV genotypes 2a, 3a and 4a. Compared to the clinically approved NS5A inhibitor Daclatasvir, compound 4 shows higher activity against genotypes 1b and 3a, as well as improved safety profile.
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Affiliation(s)
- Shereen E Abdel Karim
- Faculty of Pharmacy and Biotechnology, Department of Pharmaceutical Chemistry, German University in Cairo, 11835 Cairo, Egypt
| | - Youssef H Youssef
- Faculty of Pharmacy and Biotechnology, Department of Pharmaceutical Chemistry, German University in Cairo, 11835 Cairo, Egypt
| | - Mohammad Abdel-Halim
- Faculty of Pharmacy and Biotechnology, Department of Pharmaceutical Chemistry, German University in Cairo, 11835 Cairo, Egypt
| | - Efseveia Frakolaki
- Molecular Virology Laboratory, Hellenic Pasteur Institute, Vas. Sofias Avenue, 11521 Athens, Greece
| | - Niki Vassilaki
- Molecular Virology Laboratory, Hellenic Pasteur Institute, Vas. Sofias Avenue, 11521 Athens, Greece
| | - Grigoris Zoidis
- Department of Pharmacy, Division of Pharmaceutical Chemistry, School of Health Sciences, National and Kapodistrian University of Athens, GR-15771 Athens, Greece
| | - Nermin S Ahmed
- Faculty of Pharmacy and Biotechnology, Department of Pharmaceutical Chemistry, German University in Cairo, 11835 Cairo, Egypt
| | - Ashraf H Abadi
- Faculty of Pharmacy and Biotechnology, Department of Pharmaceutical Chemistry, German University in Cairo, 11835 Cairo, Egypt.
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12
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Masalova OV, Lesnova EI, Klimova RR, Momotyuk ED, Kozlov VV, Ivanova AM, Payushina OV, Butorina NN, Zakirova NF, Narovlyansky AN, Pronin AV, Ivanov AV, Kushch AA. Genetically Modified Mouse Mesenchymal Stem Cells Expressing Non-Structural Proteins of Hepatitis C Virus Induce Effective Immune Response. Vaccines (Basel) 2020; 8:E62. [PMID: 32024236 PMCID: PMC7158691 DOI: 10.3390/vaccines8010062] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 02/08/2023] Open
Abstract
Hepatitis C virus (HCV) is one of the major causes of chronic liver disease and leads to cirrhosis and hepatocarcinoma. Despite extensive research, there is still no vaccine against HCV. In order to induce an immune response in DBA/2J mice against HCV, we obtained modified mouse mesenchymal stem cells (mMSCs) simultaneously expressing five nonstructural HCV proteins (NS3-NS5B). The innate immune response to mMSCs was higher than to DNA immunization, with plasmid encoding the same proteins, and to naïve unmodified MSCs. mMSCs triggered strong phagocytic activity, enhanced lymphocyte proliferation, and production of type I and II interferons. The adaptive immune response to mMSCs was also more pronounced than in the case of DNA immunization, as exemplified by a fourfold stronger stimulation of lymphocyte proliferation in response to HCV, a 2.6-fold higher rate of biosynthesis, and a 30-fold higher rate of secretion of IFN-γ, as well as by a 40-fold stronger production of IgG2a antibodies to viral proteins. The immunostimulatory effect of mMSCs was associated with pronounced IL-6 secretion and reduction in the population of myeloid derived suppressor cells (MDSCs). Thus, this is the first example that suggests the feasibility of using mMSCs for the development of an effective anti-HCV vaccine.
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Affiliation(s)
- Olga V. Masalova
- Gamaleya National Research Center of Epidemiology and Microbiology, Ministry of Health of the Russian Federation, Moscow 123098, Russia; (E.I.L.); (R.R.K.); (E.D.M.); (V.V.K.); (A.M.I.); (A.N.N.); (A.V.P.); (A.A.K.)
| | - Ekaterina I. Lesnova
- Gamaleya National Research Center of Epidemiology and Microbiology, Ministry of Health of the Russian Federation, Moscow 123098, Russia; (E.I.L.); (R.R.K.); (E.D.M.); (V.V.K.); (A.M.I.); (A.N.N.); (A.V.P.); (A.A.K.)
| | - Regina R. Klimova
- Gamaleya National Research Center of Epidemiology and Microbiology, Ministry of Health of the Russian Federation, Moscow 123098, Russia; (E.I.L.); (R.R.K.); (E.D.M.); (V.V.K.); (A.M.I.); (A.N.N.); (A.V.P.); (A.A.K.)
| | - Ekaterina D. Momotyuk
- Gamaleya National Research Center of Epidemiology and Microbiology, Ministry of Health of the Russian Federation, Moscow 123098, Russia; (E.I.L.); (R.R.K.); (E.D.M.); (V.V.K.); (A.M.I.); (A.N.N.); (A.V.P.); (A.A.K.)
| | - Vyacheslav V. Kozlov
- Gamaleya National Research Center of Epidemiology and Microbiology, Ministry of Health of the Russian Federation, Moscow 123098, Russia; (E.I.L.); (R.R.K.); (E.D.M.); (V.V.K.); (A.M.I.); (A.N.N.); (A.V.P.); (A.A.K.)
| | - Alla M. Ivanova
- Gamaleya National Research Center of Epidemiology and Microbiology, Ministry of Health of the Russian Federation, Moscow 123098, Russia; (E.I.L.); (R.R.K.); (E.D.M.); (V.V.K.); (A.M.I.); (A.N.N.); (A.V.P.); (A.A.K.)
| | - Olga V. Payushina
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow 119991, Russia;
| | - Nina N. Butorina
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow 119334, Russia;
| | - Natalia F. Zakirova
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow 119991, Russia;
| | - Alexander N. Narovlyansky
- Gamaleya National Research Center of Epidemiology and Microbiology, Ministry of Health of the Russian Federation, Moscow 123098, Russia; (E.I.L.); (R.R.K.); (E.D.M.); (V.V.K.); (A.M.I.); (A.N.N.); (A.V.P.); (A.A.K.)
| | - Alexander V. Pronin
- Gamaleya National Research Center of Epidemiology and Microbiology, Ministry of Health of the Russian Federation, Moscow 123098, Russia; (E.I.L.); (R.R.K.); (E.D.M.); (V.V.K.); (A.M.I.); (A.N.N.); (A.V.P.); (A.A.K.)
| | - Alexander V. Ivanov
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow 119991, Russia;
| | - Alla A. Kushch
- Gamaleya National Research Center of Epidemiology and Microbiology, Ministry of Health of the Russian Federation, Moscow 123098, Russia; (E.I.L.); (R.R.K.); (E.D.M.); (V.V.K.); (A.M.I.); (A.N.N.); (A.V.P.); (A.A.K.)
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13
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Shen Z, Zhu X, Zhang H, Chen H, Niu J, Chen G, Li X, Ding Y. Pharmacokinetic Profile of a Generic Formulation of Sofosbuvir and Its Metabolite GS-331007 in Healthy Chinese Subjects. Clin Pharmacol Drug Dev 2019; 8:1073-1080. [PMID: 30900816 DOI: 10.1002/cpdd.674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 02/26/2019] [Indexed: 01/08/2023]
Abstract
Sofosbuvir is an NS5B nucleotide inhibitor for the treatment of hepatitis C viral infection. In this study the pharmacokinetics (PK) and safety of single and multiple doses of generic sofosbuvir were investigated in healthy Chinese subjects. Twelve subjects (6 male and 6 female) were enrolled in this study. The PK parameters of sofosbuvir and its metabolite (GS-331007) in both blood and urine samples were analyzed after dosing by the established liquid chromatography tandem mass spectrometry analytical method. The safety/tolerability assessment consisted of documenting adverse events, vital signs, electrocardiogram, and laboratory test results. Sofosbuvir was well tolerated. Major PK parameters of the generic formulation of sofosbuvir were similar to those found in previous reports. These data support further clinical evaluation of this generic formulation of sofosbuvir.
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Affiliation(s)
- Zhenwei Shen
- Institute of Immunology, Academy of Translational Medicine, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
| | - Xiaoxue Zhu
- Phase I Clinical Trial Unit, China-Frontage USA, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
| | - Hong Zhang
- Phase I Clinical Trial Unit, China-Frontage USA, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
| | - Hong Chen
- Phase I Clinical Trial Unit, China-Frontage USA, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
| | - Junqi Niu
- Phase I Clinical Trial Unit, China-Frontage USA, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
| | - Guiling Chen
- Phase I Clinical Trial Unit, China-Frontage USA, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
| | - Xiaojiao Li
- Phase I Clinical Trial Unit, China-Frontage USA, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
| | - Yanhua Ding
- Phase I Clinical Trial Unit, China-Frontage USA, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
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14
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Yaghobi R, Kazemi MJ, Geramizadeh B, Malek Hosseini SA, Moayedi J. Significance of Occult Hepatitis C Virus Infection in Liver Transplant Patients With Cryptogenic Cirrhosis. EXP CLIN TRANSPLANT 2018; 18:206-209. [PMID: 30346262 DOI: 10.6002/ect.2017.0332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Investigations into the viral causes of end-stage liver disease in liver transplant patients with cryptogenic underlying disease remain of interest. Hepatitis C virus infection, especially in its silent (occult) form, may play a key role in the introduction and development of cryptogenic cirrhosis. We aimed to determine the prevalence of occult hepatitis C virus infection in liver transplant recipients with cryptogenic cirrhosis. MATERIALS AND METHODS In this cross-sectional study, 127 liver transplant recipients confirmed to have cryptogenic cirrhosis were included. Plasma samples of the patients underwent evaluation for hepatitis C virus antibody using the enzyme-linked immunosorbent assay method. Plasma samples and paraffin-embedded liver tissue samples were tested for hepatitis C virus RNA using nested reverse transcriptase-polymerase chain reaction. RESULTS Hepatitis C virus RNA was detected in liver tissue sections of 10 patients (7.9%). However, none of the cryptogenic patients had hepatitis C virus RNA or antibody in their plasma samples. None of the patients had hepatitis C or G virus coinfection, but simultaneous detection of hepatitis B and hepatitis C virus was diagnosed in 4 liver tissue samples. CONCLUSIONS A finding of hepatitis C virus RNA in liver tissue samples of transplant recipients presents the historical possibility of occult hepatitis C virus infection as underlying disease in our patients with cryptogenic cirrhosis. Results present an important and determinative role of occult hepatitis C virus infection in the pathogenesis of cryptogenic cirrhosis, which needs further confirmation in additional studies.
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Affiliation(s)
- Ramin Yaghobi
- >From the Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Bi Y, Zhang W, Sun J, Gao R. Therapeutic and immune function improvement of vitamin D combined with IFN-α on mouse with hepatitis B infection. Int J Immunopathol Pharmacol 2018; 32:2058738418775250. [PMID: 29745286 PMCID: PMC5952286 DOI: 10.1177/2058738418775250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This study aims to investigate the therapeutic effect of vitamin D (VD) combined
with interferon (IFN) type I (IFN-α) on mice with hepatitis B and to explore the
possible mechanism. The mice were divided into control group, model group, IFN-α
group, and IFN-α + VD group. After 4 weeks, the mice of four groups
were weighed, and the thymus and spleen indexes were calculated. The activity of
alanine transaminase (ALT) and aspartate transaminase (AST) in the serum was
detected while pathological changes of the liver were observed. The levels of
interferon-γ (IFN-γ), interleukin-2 (IL-2), and interleukin-4 (IL-4) in serum
were measured by enzyme-linked immunosorbent assay (ELISA). The proliferation of
spleen lymphocytes was detected by MTT assay. Flow cytometry was used to detect
the level of CD4+, CD8+, and
CD4+/CD8+ in peripheral blood. The levels of ALT and
AST in serum were significantly lower in the IFN-α + VD group than
those in the IFN-α group, but the thymus and spleen indexes were significantly
higher. Although both IFN-α and IFN-α + VD can improve the damaged
structure of live tissue, IFN-α + VD achieved higher efficacy than
IFN-α alone. The serum IFN-γ, TNF-α, and IL-2 levels were lower in the
IFN-α + VD group compared with the IFN-α group, and no
significant difference was found in IL-4. Compared with the IFN-α group, the
percentage of CD4+ and the D4+/CD8+ ratio were
significantly increased, but the percentage of CD8+ was reduced. The
proliferation rate of splenic lymphocytes was higher in the
IFN-α + VD group compared with the IFN-α group. IFN-α + VD
was found to achieve higher efficacy than IFN-α alone for the treatment of
hepatitis B in mice, possibly through increasing the immune level of mice.
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Affiliation(s)
- Yonghui Bi
- 1 Department of Hepatobiliary Surgery, Weihai Municipal Hospital, Weihai, China
| | - Weiguo Zhang
- 2 Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Jian Sun
- 3 Department of Surgery, Weihai City Chinese Medicine Hospital, Weihai, China
| | - Ruohui Gao
- 1 Department of Hepatobiliary Surgery, Weihai Municipal Hospital, Weihai, China
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16
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Krol E, Wandzik I, Pastuch-Gawolek G, Szewczyk B. Anti-Hepatitis C Virus Activity of Uridine Derivatives of 2-Deoxy Sugars. Molecules 2018; 23:molecules23071547. [PMID: 29954068 PMCID: PMC6099588 DOI: 10.3390/molecules23071547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 12/16/2022] Open
Abstract
Hepatitis C virus (HCV), the etiological agent of the most common and dangerous diseases of the liver, is a major health problem worldwide. Despite many attempts, there is still no vaccine available. Although many drugs have been approved for use mostly in combination regimen, their high costs make them out of reach in less developed regions. Previously, we have synthesized a series of compounds belonging to uridine derivatives of 2-deoxy sugars and have proved that some of them possess antiviral activity against influenza A virus associated with N-glycosylation inhibition. Here, we analyze the antiviral properties of these compounds against HCV. Using cell culture-derived HCV (HCVcc), HCV pseudoparticles (HCVpp), and replicon cell lines, we have shown high anti-HCV activity of two compounds. Our results indicated that compounds 2 and 4 significantly reduced HCVcc propagation with IC50 values in low μM range. Further experiments using the HCVpp system confirmed that both compounds significantly impaired the infectivity of produced HCVpp due to the inhibition of the correct maturation of viral glycoproteins. Overall, our results suggest that inhibiting the glycosylation process might be a good target for new therapeutics not only against HCV, but other important viral pathogens which contain envelopes with highly glycosylated proteins.
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Affiliation(s)
- Ewelina Krol
- Department of Recombinant Vaccines, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Abrahama 58, 80-307 Gdansk, Poland.
| | - Ilona Wandzik
- Department of Organic Chemistry, Bioorganic Chemistry and Biotechnology, Faculty of Chemistry, Silesian University of Technology, Krzywoustego 4, 44-100 Gliwice, Poland.
- Biotechnology Center, Silesian University of Technology, Krzywoustego 8, 44-100 Gliwice, Poland.
| | - Gabriela Pastuch-Gawolek
- Department of Organic Chemistry, Bioorganic Chemistry and Biotechnology, Faculty of Chemistry, Silesian University of Technology, Krzywoustego 4, 44-100 Gliwice, Poland.
- Biotechnology Center, Silesian University of Technology, Krzywoustego 8, 44-100 Gliwice, Poland.
| | - Boguslaw Szewczyk
- Department of Recombinant Vaccines, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Abrahama 58, 80-307 Gdansk, Poland.
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17
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Krol E, Pastuch-Gawolek G, Chaubey B, Brzuska G, Erfurt K, Szewczyk B. Novel Uridine Glycoconjugates, Derivatives of 4-Aminophenyl 1-Thioglycosides, as Potential Antiviral Compounds. Molecules 2018; 23:molecules23061435. [PMID: 29899276 PMCID: PMC6100568 DOI: 10.3390/molecules23061435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 06/02/2018] [Accepted: 06/10/2018] [Indexed: 01/19/2023] Open
Abstract
A novel series of uridine glycoconjugates, derivatives of 4-aminophenyl 1-thioglycosides, was designed and synthesized. All compounds were evaluated in vitro for their antiviral activity against hepatitis C virus (HCV) and classical swine fever virus (CSFV), two important human and animal viral pathogens for which new or improved therapeutic options are needed. The antiviral activity of all synthesized compounds was confirmed using pseudo-plaque reduction assays in which a significant arrest of CSFV and HCV growth was observed in the presence of these compounds. Two of the synthesized compounds, 9 and 12, displayed a significant inhibitory effect on HCV and CSFV propagation with IC50 values of 4.9 and 13.5 µM for HCV and 4.2 and 4 µM for CSFV, respectively, with low cytotoxicity. Using various infection and replication models, we have shown that both compounds were able to significantly reduce viral genome replication by up to 90% with IC50 values in the low micromolar range. A structure activity analysis of the synthesized compounds showed that the high antiviral activity was attributed to the hydrophobicity of glycoconjugates and the introduction of elements capable to coordinate metal ions into the spacer connecting the sugar and uridine moiety, which can be useful in the development of new antiviral compounds in the future.
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Affiliation(s)
- Ewelina Krol
- Department of Recombinant Vaccines, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Abrahama 58, 80-307 Gdansk, Poland.
| | - Gabriela Pastuch-Gawolek
- Department of Organic Chemistry, Bioorganic Chemistry and Biotechnology, Faculty of Chemistry, Silesian University of Technology, Krzywoustego 4, 44-100 Gliwice, Poland.
- Biotechnology Center, Silesian University of Technology, Krzywoustego 8, 44-100 Gliwice, Poland.
| | - Binay Chaubey
- Department of Recombinant Vaccines, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Abrahama 58, 80-307 Gdansk, Poland.
- Functional Genomics Lab., Centre for Advanced Study, Department of Botany, University of Calcutta, 35, Ballygunge Circular Road, 700019 Kolkata, India.
| | - Gabriela Brzuska
- Department of Recombinant Vaccines, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Abrahama 58, 80-307 Gdansk, Poland.
| | - Karol Erfurt
- Department of Chemical Organic Technology and Petrochemistry, Faculty of Chemistry, Silesian University of Technology, Krzywoustego 4, 44-100 Gliwice, Poland.
| | - Boguslaw Szewczyk
- Department of Recombinant Vaccines, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Abrahama 58, 80-307 Gdansk, Poland.
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18
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Ramsis TM, Abdel Karim SE, Vassilaki N, Frakolaki E, Kamal AAM, Zoidis G, Ahmed NS, Abadi AH. Expanding the chemical space of anti-HCV NS5A inhibitors by stereochemical exchange and peptidomimetic approaches. Arch Pharm (Weinheim) 2018; 351:e1800017. [PMID: 29799645 DOI: 10.1002/ardp.201800017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/28/2018] [Accepted: 05/02/2018] [Indexed: 02/05/2023]
Abstract
Here we report a series of potent anti-HCV agents bearing a symmetrical benzidine l-prolinamide backbone with different capping groups including alkyl/aryl carbamates of natural and unnatural valine and leucine amino acids. All compounds were investigated for their inhibitory activity in an HCV replicon assay on genotype 1b. The novel compounds share some chemical and clinical attributes of commercially available NS5A inhibitors. Compounds 5 and 6 with unnatural capping residue and ethyl and isobutyl carbamates showed EC50 values in the picomolar range with a low toxicity profile and selectivity indices of several orders of magnitude. These findings enlarge the chemical space from which NS5A inhibitors may be discovered by adopting unnatural amino acids, amino acids other than valine and carbamates other than methyl as the capping groups.
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Affiliation(s)
- Triveena M Ramsis
- Faculty of Pharmacy and Biotechnology, Department of Pharmaceutical Chemistry, German University in Cairo, Cairo, Egypt
| | - Shereen E Abdel Karim
- Faculty of Pharmacy and Biotechnology, Department of Pharmaceutical Chemistry, German University in Cairo, Cairo, Egypt
| | - Niki Vassilaki
- Molecular Virology Laboratory, Hellenic Pasteur Institute, Athens, Greece
| | - Efseveia Frakolaki
- Molecular Virology Laboratory, Hellenic Pasteur Institute, Athens, Greece
| | - Ahmed A M Kamal
- Pharmaceutical and Medicinal Chemistry, Department of Drug Design Optimization, Saarland University and Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Saarbrücken, Germany
| | - Grigoris Zoidis
- Faculty of Pharmacy, Department of Pharmaceutical Chemistry, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Nermin S Ahmed
- Faculty of Pharmacy and Biotechnology, Department of Pharmaceutical Chemistry, German University in Cairo, Cairo, Egypt
| | - Ashraf H Abadi
- Faculty of Pharmacy and Biotechnology, Department of Pharmaceutical Chemistry, German University in Cairo, Cairo, Egypt
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19
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Neoboutonia melleri var velutina Prain: in vitro and in vivo hepatoprotective effects of the aqueous stem bark extract on acute hepatitis models. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:24. [PMID: 29357846 PMCID: PMC5778785 DOI: 10.1186/s12906-018-2091-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 01/15/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hepatitis is a liver inflammation caused by different agents and remains a public health problem worldwide. Medicinal plants are an important source of new molecules being considered for treatment of this disease. Our work aims at evaluating the hepatoprotective properties of Neoboutonia velutina, a Cameroonian medicinal plant. METHODS The aqueous extract has been prepared using phytochemical methods. HepG2 cells were used to assess anti-inflammatory properties of the extract at different concentrations. Acute hepatitis models (Carbon tetrachloride and Concanavalin A) were performed in mice receiving or not receiving, different extract doses by gavage. Liver injury was assessed using histology, transaminases and pro-inflammatory markers. Extract antioxidant and radical scavenging capacities were evaluated. RESULTS The extract led to a significant decrease in pro-inflammatory cytokine expression in vitro and to a remarkable protection of mice from carbon tetrachloride-induced liver injury, as shown by a significant decrease in dose-dependent transaminases level. Upon extract treatment, inflammatory markers were significantly decreased and liver injuries were limited as well. In the Concanavalin A model, the extract displayed weak effects. CONCLUSIONS Taking into account underlying mechanisms in both hepatitis models, we demonstrate the extract's radical scavenging capacity. Neoboutonia velutina displays a potent hepatoprotective effect mediated through radical scavenging properties.
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20
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A Bayesian Approach for Population Pharmacokinetic Modeling of Pegylated Interferon α-2a in Hepatitis C Patients. Clin Pharmacokinet 2017; 56:1369-1379. [DOI: 10.1007/s40262-017-0527-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Design, synthesis and biological evaluation of gentiopicroside derivatives as potential antiviral inhibitors. Eur J Med Chem 2017; 130:308-319. [DOI: 10.1016/j.ejmech.2017.02.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 02/10/2017] [Accepted: 02/11/2017] [Indexed: 11/18/2022]
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22
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Xu S, Doehle B, Rajyaguru S, Han B, Barauskas O, Feng J, Perry J, Dvory-Sobol H, Svarovskaia ES, Miller MD, Mo H. In vitro selection of resistance to sofosbuvir in HCV replicons of genotype-1 to -6. Antivir Ther 2017; 22:587-597. [PMID: 28248189 DOI: 10.3851/imp3149] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Sofosbuvir is a nucleoside analogue inhibitor of the HCV NS5B polymerase approved for treatment of HCV-infected patients in combination with ribavirin or with other antivirals. It has activity against all genotypes of HCV. Resistance to sofosbuvir in genotype-1 and -2 HCV is conferred by the S282T substitution in NS5B. METHODS To begin to define the correlates of resistance to sofosbuvir in other genotypes, we performed selection experiments in cell culture using cell lines containing subgenomic replicons derived from genotypes-1b, -2a, -3a and -4a, or chimeric replicons in a genotype-1b background but encoding genotype-2b, -5a and -6a NS5B polymerase. RESULTS In every case, S282T was selected following passage in the presence of increasing concentrations of sofosbuvir for 10 to 15 weeks. When introduced as a site-directed mutant, S282T conferred reductions in sofosbuvir susceptibility of between 2.4 and 19.4-fold. Other substitutions observed during the selections had relatively less impact on susceptibility, such as N237S in genotype-6a (2.5-fold). Replication capacity was affected by the introduction of S282T in all genotypes to variable extents (3.2% to 22% of wild type). CONCLUSIONS These results confirm that S282T is the primary sofosbuvir resistance-associated substitution and that replication capacity is reduced when it is present in all genotypes of HCV.
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Affiliation(s)
- Simin Xu
- Gilead Sciences, Foster City, CA, USA
| | | | | | - Bin Han
- Gilead Sciences, Foster City, CA, USA
| | | | - Joy Feng
- Gilead Sciences, Foster City, CA, USA
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23
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Ahmed M, Pal A, Houghton M, Barakat K. A Comprehensive Computational Analysis for the Binding Modes of Hepatitis C Virus NS5A Inhibitors: The Question of Symmetry. ACS Infect Dis 2016; 2:872-881. [PMID: 27933783 DOI: 10.1021/acsinfecdis.6b00113] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Direct-acting antivirals (DAAs) form the current standard of care (SOC) against hepatitis C virus (HCV). These drugs selectively target the viral proteins, offering a unique mechanism to avoid toxicity, to increase their efficacy, and to evolve from decades of interferon- and ribavirin-based therapy. Among the promising HCV targets for DAAs is the NS5A protein, and daclatasvir (DCV) forms a first-in-class compound that selectively targets this protein. Despite the exceptional potency of DCV (∼picomolar IC50) and although several DCV derivatives have been approved for human use or are close to approval, the exact mode of action of these drugs is still incomplete. This is simply due to the vast complexity of cocrystallizing DCV with NS5A in the absence of two amphipathic helices that are required for DCV binding. In this context, computational modeling provides a unique alternative to solve this problem. Here, we build upon our recent discovery of a completely symmetrical interaction between DCV and NS5A and investigate the mode of binding of six other structures similar to DCV. The selected compounds include both symmetric and asymmetric molecules. In addition, we show that our model correlates very well with mutations that can confer resistance to DCV. The current study enhances our understanding of the mode of action of this class of HCV inhibitors and helps in defining the origin of resistance to these drugs.
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Affiliation(s)
- Marawan Ahmed
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 116 Street & 85 Avenue, Edmonton, Alberta, Canada T6G 2R3
| | - Abhishek Pal
- Indian Institute of Technology, Kharagpur, West Bengal 721302, India
| | - Michael Houghton
- Li Ka Shing Institute of Virology, University of Alberta, 116 Street & 85 Avenue, Edmonton, Alberta, Canada T6G 2R3
- Li Ka Shing Applied Virology Institute, University of Alberta, 116 Street & 85 Avenue, Edmonton, Alberta, Canada T6G 2R3
| | - Khaled Barakat
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 116 Street & 85 Avenue, Edmonton, Alberta, Canada T6G 2R3
- Li Ka Shing Institute of Virology, University of Alberta, 116 Street & 85 Avenue, Edmonton, Alberta, Canada T6G 2R3
- Li Ka Shing Applied Virology Institute, University of Alberta, 116 Street & 85 Avenue, Edmonton, Alberta, Canada T6G 2R3
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24
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Ilyas F, Singh H, Anand N, Ahmed IIK. Intraocular pressure rise in the course of peginterferon alpha-2a, ribavirin, and boceprevir therapy for hepatitis C. Can J Ophthalmol 2016; 50:e112-4. [PMID: 26651317 DOI: 10.1016/j.jcjo.2015.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 07/15/2015] [Accepted: 08/11/2015] [Indexed: 02/07/2023]
Affiliation(s)
- Faizah Ilyas
- Faculty of Medicine, University of Toronto, Toronto
| | - Harmanjit Singh
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto
| | - Navin Anand
- Trillium Health Partners, Mississauga, Ontario
| | - Iqbal Ike K Ahmed
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto; Trillium Health Partners, Mississauga, Ontario; Credit Valley EyeCare, Mississauga, Ontario, Canada.
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25
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Manolakopoulos S, Zacharakis G, Zissis M, Giannakopoulos V. Safety and efficacy of daclatasvir in the management of patients with chronic hepatitis C. Ann Gastroenterol 2016; 29:282-96. [PMID: 27366028 PMCID: PMC4923813 DOI: 10.20524/aog.2016.0041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/22/2016] [Indexed: 02/06/2023] Open
Abstract
Daclatasvir (Daklinza™), a new oral direct-acting antiviral, is an inhibitor of hepatitis C virus NS5A protein and has recently been approved in the United States, Europe and Japan in chronic hepatitis C. It shows potent pangenotypic activity and moderately high genetic barrier to resistance improving the sustained virological response (SVR) rates. In COMMAND phase 2 trials, daclatasvir demonstrated high SVR rates in HCV genotype 1-4 chronically infected patients treated with peginterferon-a (pegIFNα) plus ribavirin (RBV). Furthermore, it produced even higher response rates in all-oral combination with sofosbuvir, an interferon-free regimen, with or without ribavirin, in patients with advanced liver disease, HCV/HIV coinfection, liver transplantation in ALLY studies and other real-world studies. This narrative review provides information on the pharmacological properties, role, efficacy and safety of daclatasvir-containing regimens in chronic hepatitis C patients. Daclatasvir administered once-daily in combination with sofosbuvir is an effective 12-week treatment in adult patients with chronic hepatitis C and is generally safe and well tolerated.
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Affiliation(s)
- Spilios Manolakopoulos
- 2 Department of Internal Medicine, Hippocration General Hospital, Athens Greece (Spilios Manolakopoulos)
| | - George Zacharakis
- Endoscopy Unit, Limassol General Hospital and St George’s University of London Medical School at the University of Nicosia, Republic of Cyprus (George Zacharakis)
- Department of Internal Medicine, University Hospital, Prince Sattam Bin Abdulaziz University, Al Kharj, KSA (George Zacharakis)
| | - Miltiadis Zissis
- Medical Affairs Department, Bristol-Myers Squibb, Athens Greece (Miltiadis Zissis, Vassilis Giannakopoulos)
| | - Vassilis Giannakopoulos
- Medical Affairs Department, Bristol-Myers Squibb, Athens Greece (Miltiadis Zissis, Vassilis Giannakopoulos)
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26
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Kaushik-Basu N, Ratmanova NK, Manvar D, Belov DS, Cevik O, Basu A, Yerukhimovich MM, Lukyanenko ER, Andreev IA, Belov GM, Manfroni G, Cecchetti V, Frick DN, Kurkin AV, Altieri A, Barreca ML. Bicyclic octahydrocyclohepta[b]pyrrol-4(1H)one derivatives as novel selective anti-hepatitis C virus agents. Eur J Med Chem 2016; 122:319-325. [PMID: 27376494 DOI: 10.1016/j.ejmech.2016.06.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/01/2016] [Accepted: 06/21/2016] [Indexed: 01/27/2023]
Abstract
We report the discovery of the bicyclic octahydrocyclohepta[b]pyrrol-4(1H)-one scaffold as a new chemotype with anti-HCV activity on genotype 1b and 2a subgenomic replicons. The most potent compound 34 displayed EC50 values of 1.8 μM and 4.5 μM in genotype 1b and 2a, respectively, coupled with the absence of any antimetabolic effect (gt 1b SI = 112.4; gt 2a SI = 44.2) in a cell-based assay. Compound 34 did not target HCV NS5B, IRES, NS3 helicase, or selected host factors, and thus future work will involve the unique mechanism of action of these new antiviral compounds.
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Affiliation(s)
- Neerja Kaushik-Basu
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers, The State University of New Jersey, New Jersey Medical School, NJ 07103, USA.
| | - Nina K Ratmanova
- Chemistry Department of Lomonosov Moscow State University, Moscow 119991, GSP-2, Leninskie gory, 1/3, Russia
| | - Dinesh Manvar
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers, The State University of New Jersey, New Jersey Medical School, NJ 07103, USA
| | - Dmitry S Belov
- Chemistry Department of Lomonosov Moscow State University, Moscow 119991, GSP-2, Leninskie gory, 1/3, Russia; EDASA Scientific srls., Via Stingi, 37, 66050 San Salvo, CH, Italy
| | - Ozge Cevik
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers, The State University of New Jersey, New Jersey Medical School, NJ 07103, USA
| | - Amartya Basu
- Department of Microbiology, Biochemistry and Molecular Genetics, Rutgers, The State University of New Jersey, New Jersey Medical School, NJ 07103, USA
| | - Mark M Yerukhimovich
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, 3210 N. Cramer St., Milwaukee, WI 53211, USA
| | - Evgeny R Lukyanenko
- Chemistry Department of Lomonosov Moscow State University, Moscow 119991, GSP-2, Leninskie gory, 1/3, Russia; EDASA Scientific srls., Via Stingi, 37, 66050 San Salvo, CH, Italy
| | - Ivan A Andreev
- Chemistry Department of Lomonosov Moscow State University, Moscow 119991, GSP-2, Leninskie gory, 1/3, Russia; EDASA Scientific srls., Via Stingi, 37, 66050 San Salvo, CH, Italy
| | - Grigory M Belov
- Chemistry Department of Lomonosov Moscow State University, Moscow 119991, GSP-2, Leninskie gory, 1/3, Russia; EDASA Scientific srls., Via Stingi, 37, 66050 San Salvo, CH, Italy
| | - Giuseppe Manfroni
- Department of Pharmaceutical Sciences, University of Perugia, Via A. Fabretti, 48, 06123 Perugia, Italy
| | - Violetta Cecchetti
- Department of Pharmaceutical Sciences, University of Perugia, Via A. Fabretti, 48, 06123 Perugia, Italy
| | - David N Frick
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, 3210 N. Cramer St., Milwaukee, WI 53211, USA
| | - Alexander V Kurkin
- Chemistry Department of Lomonosov Moscow State University, Moscow 119991, GSP-2, Leninskie gory, 1/3, Russia.
| | - Andrea Altieri
- EDASA Scientific srls., Via Stingi, 37, 66050 San Salvo, CH, Italy.
| | - Maria Letizia Barreca
- Department of Pharmaceutical Sciences, University of Perugia, Via A. Fabretti, 48, 06123 Perugia, Italy.
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27
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Shuldiner SR, Gong L, Muir AJ, Altman RB, Klein TE. PharmGKB summary: peginterferon-α pathway. Pharmacogenet Genomics 2015; 25:465-74. [PMID: 26111151 PMCID: PMC4757589 DOI: 10.1097/fpc.0000000000000158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Li Gong
- Department of Genetics, Stanford University, Stanford, California
| | - Andrew J. Muir
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Russ B. Altman
- Department of Genetics, Stanford University, Stanford, California
- Department of Bioengineering, Stanford University, Stanford, California
| | - Teri E. Klein
- Department of Genetics, Stanford University, Stanford, California
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28
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Fabrizi F, Martin P, Cacoub P, Messa P, Donato FM. Treatment of hepatitis C-related kidney disease. Expert Opin Pharmacother 2015; 16:1815-27. [DOI: 10.1517/14656566.2015.1066333] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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29
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Li HC, Lo SY. Hepatitis C virus: Virology, diagnosis and treatment. World J Hepatol 2015; 7:1377-1389. [PMID: 26052383 PMCID: PMC4450201 DOI: 10.4254/wjh.v7.i10.1377] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 12/22/2014] [Accepted: 04/02/2015] [Indexed: 02/06/2023] Open
Abstract
More than twenty years of study has provided a better understanding of hepatitis C virus (HCV) life cycle, including the general properties of viral RNA and proteins. This effort facilitates the development of sensitive diagnostic tools and effective antiviral treatments. At present, serologic screening test is recommended to perform on individuals in the high risk groups and nucleic acid tests are recommended to confirm the active HCV infections. Quantization and genotyping of HCV RNAs are important to determine the optimal duration of anti-viral therapy and predict the likelihood of response. In the early 2000s, pegylated interferon plus ribavirin became the standard anti-HCV treatment. However, this therapy is not ideal. To 2014, boceprevir, telaprevir, simeprevir, sofosbuvir and Harvoni are approved by Food and Drug Administration for the treat of HCV infections. It is likely that the new all-oral, interferon-free, pan-genotyping anti-HCV therapy will be available within the next few years. Majority of HCV infections will be cured by these anti-viral treatments. However, not all patients are expected to be cured due to viral resistance and the high cost of antiviral treatments. Thus, an efficient prophylactic vaccine will be the next challenge in the fight against HCV infection.
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30
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Bioactive nucleoside analogues possessing selected five-membered azaheterocyclic bases. Eur J Med Chem 2015; 97:409-18. [DOI: 10.1016/j.ejmech.2014.11.057] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/25/2014] [Accepted: 11/27/2014] [Indexed: 11/23/2022]
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31
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Yang N, Sun Q, Xu Z, Wang X, Zhao X, Cao Y, Chen L, Fan G. LC-ESI-MS/MS analysis and pharmacokinetics of GP205, an innovative potent macrocyclic inhibitor of hepatitis C virus NS3/4A protease in rats. Molecules 2015; 20:4319-36. [PMID: 25756650 PMCID: PMC6272426 DOI: 10.3390/molecules20034319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 02/12/2015] [Accepted: 02/25/2015] [Indexed: 12/12/2022] Open
Abstract
A high-throughput, sensitive and specific LC-ESI-MS/MS method was established for the quantitative determination of GP205, a potent inhibitor of hepatitis C virus NS3/4A protease, in rat. The analyte was isolated from 25 μL plasma sample by 96-well LLE. Good linearity was achieved within the concentration range of 2–5000 ng/mL (r2 > 0.996). The intra- and inter-day precision was less than 10%. The accuracy ranged from 0.8% to 5.5% for GP205 in quality control samples at three levels. GP205 was stable during the analysis and the storage period. The method was successfully applied to pharmacokinetic studies of GP205 in Sprague-Dawley rats. The pharmacokinetic profiles of GP205 at three dose levels with oral administration and one dose level with intravenous administration were successfully studied for the first time in SD rats, respectively. After single oral administration of GP205 at the doses of 2.5, 5, 10 mg/kg, respectively, Cmax and AUC0-τ were proportional to the doses given. The absolute bioavailability was estimated as 34% based on the AUCs of oral administration at the dose of 5 mg/kg and intravenous administration at the dose of 1 mg/kg. The data presented in this study provides useful information for further study for GP205.
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Affiliation(s)
- Nan Yang
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China.
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China.
| | - Qiushi Sun
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China.
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China.
| | - Zihua Xu
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China.
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China.
| | - Xiuyun Wang
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China.
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China.
- Fujian University of Traditional Chinese Medicine, Fuzhou 350108, China.
| | - Xin Zhao
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China.
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China.
| | - Yuqing Cao
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China.
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China.
| | - Li Chen
- Ginkgo Pharma Co. Ltd., Suzhou 205125, China.
| | - Guorong Fan
- School of Pharmacy, Second Military Medical University, Shanghai 200433, China.
- Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai 200433, China.
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32
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El-Shenawy R, Tabll A, Bader El Din NG, El Abd Y, Mashaly M, Abdel Malak CA, Dawood R, El-Awady M. Antiviral activity of virocidal peptide derived from NS5A against two different HCV genotypes: an in vitro study. J Immunoassay Immunochem 2015; 36:63-79. [PMID: 24606010 DOI: 10.1080/15321819.2014.896264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study aimed at assessment of the antiviral activity of an amphipathic α-helical peptide derived from the hepatitis C virus NS5A known as C5A virocidal peptide against different HCV genotypes. Two sources of HCV virus for in vitro study: HCV genotype 4 sera samples and JFH-1 infectious culture system genotype 2a were used. Several virocidal peptide concentrations were tested to determine the concentration that inhibits HCV propagation in Huh 7.5 cells according to three different prortocols (pre-infection, coinfection, and post infection). The capacity of the virocidal peptide to block HCV in Huh7.5 cells infected with different 10 individual serum samples was evaluated. In the pre-infection protocol, virocidal concentration (20, 50, and 75 μM) showed no viral RNA. In the co-infection protocol, virocidal concentrations (10, 20, 50, 75 μM) showed no viral RNA while in post-infection protocol, 75 μM was the only concentration that blocked the HCV activity. Results of Huh7.5 cell line transfected with HCV cc J6/JFH and treated with virocidal peptide revealed that only the higher virocidal concentration (75 μM) showed no amplification. The percentage of virocidal blocking in the 10 HCV individual serum samples was 60%. In conclusion, the C5A virocidal peptide has potent antiviral activity against HCV.
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Affiliation(s)
- Reem El-Shenawy
- a Department of Microbial Biotechnology , National Research Center , Giza , Egypt
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33
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Tyndall EM, Draffan AG, Frey B, Pool B, Halim R, Jahangiri S, Bond S, Wirth V, Luttick A, Tilmanis D, Thomas J, Porter K, Tucker SP. Prodrugs of imidazotriazine and pyrrolotriazine C-nucleosides can increase anti-HCV activity and enhance nucleotide triphosphate concentrations in vitro. Bioorg Med Chem Lett 2014; 25:869-73. [PMID: 25592710 DOI: 10.1016/j.bmcl.2014.12.069] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 12/17/2014] [Accepted: 12/19/2014] [Indexed: 11/26/2022]
Abstract
A number of prodrugs of HCV-active purine nucleoside analogues 2'-C-methyl 4-aza-9-deaza adenosine 1, 2'-C-methyl 4-aza-7,9-dideaza adenosine 2, 2'-C-methyl 4-aza-9-deaza guanosine 3 and 2'-C-methyl 4-aza-7,9-dideaza guanosine 4 were prepared and evaluated to improve potency, selectivity and liver targeting. Phosphoramidate guanosine prodrugs (3a-3k and 4a, b) showed insufficient cell activity for further profiling. Striking enhancement in replicon activity relative to the parent was observed for phosphoramidate imidazo[2,1-f][1,2,4]triazine-4-amine adenosine prodrugs (1a-1p), but this was accompanied by an increase in cytotoxicity. Improved or similar potency without a concomitant increase in toxicity relative to the parent was demonstrated for phosphoramidate pyrrolo[2,1-f][1,2,4]triazine-4-amine adenosine prodrugs (2a-2k). Carbamate, ester and mixed prodrugs of 2 showed mixed results. Selected prodrugs of 2 were analysed for activation to the triphosphate, with most demonstrating much better activation in hepatocytes over replicon cells. The best activation was observed for a mixed phosphoramidate-3'ester (11) followed by a simple 3'-ester (10).
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Affiliation(s)
- Edward M Tyndall
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Alistair G Draffan
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Barbara Frey
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Brett Pool
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Rosliana Halim
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Saba Jahangiri
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Silas Bond
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Veronika Wirth
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Angela Luttick
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Danielle Tilmanis
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Jesse Thomas
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Kate Porter
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Simon P Tucker
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
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34
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Ishihara T, Kaneko K, Ishihara T, Mizushima T. Development of biodegradable nanoparticles for liver-specific ribavirin delivery. J Pharm Sci 2014; 103:4005-4011. [PMID: 25335768 DOI: 10.1002/jps.24219] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 09/19/2014] [Accepted: 09/26/2014] [Indexed: 12/17/2022]
Abstract
Ribavirin is an antiviral drug used for the treatment of chronic hepatitis C. However, ribavirin induces severe side effects such as hemolytic anemia. In this study, we prepared biodegradable nanoparticles as ribavirin carriers to modulate the pharmacokinetics of the drug. The nanoparticles encapsulating ribavirin monophosphate (RMP) were prepared from the blend of poly(d,l-lactic acid) homopolymer and arabinogalactan (AG)-poly(l-lysine) conjugate by using the solvent diffusion method in the presence of iron (III). RMP was efficiently and stably embedded in the nanoparticles and gradually released for 37 days in phosphate-buffered saline at 37°C. The coating of AG on the nanoparticles surfaces was verified by measuring the zeta potentials and performing an aggregation test of the nanoparticles using galactose-binding lectin. Moreover, the nanoparticles were efficiently internalized in cultured HepG2 cells. Ribavirin was drastically accumulated to the liver of mice after intravenous administration of the RMP-loaded nanoparticles, after which the ribavirin content gradually decreased for at least 7 days. Our results indicated successful development of nanoparticles with dual functions, targeting to the liver and sustained release of ribavirin, and suggested that the present strategy could help to advance the clinical application of ribavirin as a therapeutic agent for chronic hepatitis C.
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Affiliation(s)
- Tsutomu Ishihara
- Department of Chemical Biology and Applied Chemistry, College of Engineering, Nihon University, Fukushima 963-8642, Japan.
| | - Kohei Kaneko
- Department of Chemical Biology and Applied Chemistry, College of Engineering, Nihon University, Fukushima 963-8642, Japan
| | - Tomoaki Ishihara
- Department of Analytical Chemistry, Faculty of Pharmacy, Keio University, Tokyo 105-8512, Japan
| | - Tohru Mizushima
- Department of Analytical Chemistry, Faculty of Pharmacy, Keio University, Tokyo 105-8512, Japan
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35
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Lim PJ, Gallay PA. Hepatitis C NS5A protein: two drug targets within the same protein with different mechanisms of resistance. Curr Opin Virol 2014; 8:30-7. [PMID: 24879295 PMCID: PMC4195798 DOI: 10.1016/j.coviro.2014.04.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 04/29/2014] [Accepted: 04/30/2014] [Indexed: 12/18/2022]
Abstract
The era of interferon-free antiviral treatments for hepatitis C virus infection has arrived. With increasing numbers of approved antivirals, evaluating all parameters that may influence response is necessary to choose optimal combinations for treatment success. Targeting NS5A has become integral in antiviral combinations in clinical development. Daclatasvir and ledipasvir belong to the NS5A inhibitor class, which directly target the NS5A protein. Alisporivir, a host-targeting antiviral, is a cyclophilin inhibitor that indirectly targets NS5A by blocking NS5A/cyclophilin A interaction. Resistance to daclatasvir and ledipasvir differs from alisporivir, with mutations arising in NS5A domains I and II, respectively. Combining these two classes acting on distinct NS5A domains represents an attractive strategy for potentially effective interferon-free treatments for chronic hepatitis C infection.
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Affiliation(s)
- Precious J Lim
- Department of Immunology & Microbial Science, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Philippe A Gallay
- Department of Immunology & Microbial Science, The Scripps Research Institute, La Jolla, CA 92037, USA.
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36
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Svarovskaia ES, Dvory-Sobol H, Parkin N, Hebner C, Gontcharova V, Martin R, Ouyang W, Han B, Xu S, Ku K, Chiu S, Gane E, Jacobson IM, Nelson DR, Lawitz E, Wyles DL, Bekele N, Brainard D, Symonds WT, McHutchison JG, Miller MD, Mo H. Infrequent development of resistance in genotype 1-6 hepatitis C virus-infected subjects treated with sofosbuvir in phase 2 and 3 clinical trials. Clin Infect Dis 2014; 59:1666-74. [PMID: 25266287 DOI: 10.1093/cid/ciu697] [Citation(s) in RCA: 173] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Sofosbuvir is a chain-terminating nucleotide analogue inhibitor of the hepatitis C virus (HCV) NS5B RNA polymerase that is efficacious in subjects with HCV genotype 1-6 infection. Sofosbuvir resistance is primarily conferred by the S282T substitution in NS5B. METHODS NS5B sequencing and susceptibility testing of HCV from subjects infected with genotypes 1-6 who participated in phase 2 and 3 sofosbuvir clinical trials was performed. RESULTS No NS5B variants present at baseline among 1645 sofosbuvir-treated subjects were associated with treatment failure; sofosbuvir susceptibility was within 2-fold of reference. Among 282 subjects who did not achieve sustained virologic response, no novel sofosbuvir resistance-associated variants were identified, and the NS5B changes observed did not confer significant reductions in sofosbuvir susceptibility. In 1 subject with S282T observed at relapse 4 weeks after sofosbuvir monotherapy, the resistant variant (13.5-fold reduced sofosbuvir susceptibility, replication capacity <2% of control) became undetectable by deep sequencing 12 weeks after treatment. L159F and V321A were identified as treatment-emergent variants but did not confer resistance to sofosbuvir in the replicon system. CONCLUSIONS These data demonstrate a uniform susceptibility of subject-derived HCV to sofosbuvir, and also show that selection of sofosbuvir-resistant HCV is exceedingly rare and is associated with a significant reduction in viral fitness.
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Affiliation(s)
| | | | - Neil Parkin
- Data First Consulting Inc, Belmont, California
| | | | | | | | | | - Bin Han
- Gilead Sciences, Foster City
| | | | | | | | - Edward Gane
- University of Auckland, Auckland City Hospital, New Zealand
| | | | | | | | - David L Wyles
- Division of Infectious Diseases, University of California, San Diego
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37
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Draffan AG, Frey B, Fraser BH, Pool B, Gannon C, Tyndall EM, Cianci J, Harding M, Lilly M, Hufton R, Halim R, Jahangiri S, Bond S, Jeynes TP, Nguyen VTT, Wirth V, Luttick A, Tilmanis D, Pryor M, Porter K, Morton CJ, Lin B, Duan J, Bethell RC, Kukolj G, Simoneau B, Tucker SP. Derivatives of imidazotriazine and pyrrolotriazine C-nucleosides as potential new anti-HCV agents. Bioorg Med Chem Lett 2014; 24:4984-8. [PMID: 25288185 DOI: 10.1016/j.bmcl.2014.09.030] [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: 07/08/2014] [Revised: 09/08/2014] [Accepted: 09/10/2014] [Indexed: 01/10/2023]
Abstract
Previous investigations identified 2'-C-Me-branched ribo-C-nucleoside adenosine analogues, 1, which contains a pyrrolo[2,1-f][1,2,4]triazin-4-amine heterocyclic base, and 2, which contains an imidazo[2,1-f][1,2,4]triazin-4-amine heterocyclic base as two compounds with promising anti-HCV in vitro activity. This Letter describes the synthesis and evaluation of a series of novel analogues of these compounds substituted at the 2-, 7-, and 8-positions of the heterocyclic bases. A number of active new HCV inhibitors were identified but most compounds also demonstrated unacceptable cytotoxicity. However, the 7-fluoro analogue of 1 displayed good potency with a promising cytotherapeutic margin.
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Affiliation(s)
- Alistair G Draffan
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Barbara Frey
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Benjamin H Fraser
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Brett Pool
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Carlie Gannon
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Edward M Tyndall
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Julia Cianci
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Michael Harding
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Michael Lilly
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Richard Hufton
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Rosliana Halim
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Saba Jahangiri
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Silas Bond
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Tyrone P Jeynes
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Van T T Nguyen
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Veronika Wirth
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Angela Luttick
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Danielle Tilmanis
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Melinda Pryor
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Kate Porter
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Craig J Morton
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Bo Lin
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Jianmin Duan
- Boehringer Ingelheim (Canada) Ltd, Research and Development, 2100 rue Cunard, Laval, Québec H7S 2G5, Canada
| | - Richard C Bethell
- Boehringer Ingelheim (Canada) Ltd, Research and Development, 2100 rue Cunard, Laval, Québec H7S 2G5, Canada
| | - George Kukolj
- Boehringer Ingelheim (Canada) Ltd, Research and Development, 2100 rue Cunard, Laval, Québec H7S 2G5, Canada
| | - Bruno Simoneau
- Boehringer Ingelheim (Canada) Ltd, Research and Development, 2100 rue Cunard, Laval, Québec H7S 2G5, Canada
| | - Simon P Tucker
- Biota Scientific Management Pty. Ltd, 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
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Meta-analysis of patients with hepatitis C virus genotype 6: 48 weeks with pegylated interferon and ribavirin is superior to 24 weeks. Hepatol Int 2014. [PMID: 26202759 DOI: 10.1007/s12072-014-9570-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hepatitis C virus genotype 6 (HCV-6) is common in patients from Southeast Asia and the surrounding regions. Optimal treatment duration for HCV-6 is unknown given the inconclusive evidence from studies with varying methodologies and small sample sizes. METHODS A literature search for 'genotype 6' in MEDLINE and EMBASE in October 2013 produced 161 and 251 articles, respectively. Additional abstracts were identified from four major international GI/liver conferences in 2012/2013. Inclusion criteria were original studies with ≥10 HCV-6 treatment-naïve patients treated with pegylated interferon + ribavirin (PEG IFN+RBV). Exclusion criteria were coinfections with HBV, HIV, other HCV genotypes, and/or other liver diseases. Primary outcome was pooled sustained virologic response (SVR). Heterogeneity was defined by Cochrane Q test (p value of 0.10) and I (2) statistic (≥50 %). RESULTS A total of 13 studies with 641 patients were included. The pooled SVR estimate was 77 % (CI 70-83 %) (Q value = 38.4, p value <0.001, I (2) = 68.7 %) overall, 79 % (CI 73-84 %) for the 48-week group and 59 % (CI 46-70 %) for 24-week group, respectively. In studies with direct comparison of the two groups, SVR was superior in patients treated for 48 versus 24 weeks, OR 1.9 (CI 1.08-3.2, p = 0.026). In studies with direct comparison of patients with rapid virologic response (RVR), there was no difference in SVR between 48 versus 24 weeks, OR 1.74 (CI 0.65-4.64, p = 0.27). CONCLUSION Hepatitis C virus genotype 6 patients should be treated for 48 weeks, and those who achieve RVR may receive the shorter 24-week treatment duration. The high SVR (~80 %) with 48 weeks of PEG IFN+RBV therapy may be a cost-effective option for HCV-6 patients from resource-poor regions.
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Replication priority of hepatitis C virus genotype 2a in a Chinese cohort. Acta Pharm Sin B 2014; 4:266-9. [PMID: 26579394 PMCID: PMC4629081 DOI: 10.1016/j.apsb.2014.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 06/11/2014] [Accepted: 06/18/2014] [Indexed: 12/12/2022] Open
Abstract
HCV genotypes have been documented in clinical practice. The aim of this study was to determine the replication priority of different HCV genotypes in a Chinese HCV positive cohort. Serum samples from 491 apparently healthy Chinese blood donors testing positive for HCV antibodies and naive to antiviral drug therapy were tested. Genotyping analysis showed that genotypes 1b and 2a were predominant and accounted for 77.6% of the HCV infections. Among the genotype groups, individuals infected with genotype 2a had an HCV RNA viral load (108 copies/mL) about 200-fold (lg, 2.3) greater than those infected with other genotypes (104–105 copies/mL) indicating a replication priority of genotype 2a. However, there was no correlation between HCV genotype and antibody response suggesting that the amplification advantage of genotype 2a results from a favorable interaction with the host cellular environment. In conclusion, HCV genotypes 1b and 2a are the predominant genotypes in China and genotype 2a possesses a significant replication priority compared with the other genotypes. This suggests the existence of host cellular factors that may act as drug-targets for entirely clearing HCV infection in the future.
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40
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Ahmed-Belkacem A, Guichou JF, Brillet R, Ahnou N, Hernandez E, Pallier C, Pawlotsky JM. Inhibition of RNA binding to hepatitis C virus RNA-dependent RNA polymerase: a new mechanism for antiviral intervention. Nucleic Acids Res 2014; 42:9399-409. [PMID: 25053847 PMCID: PMC4132742 DOI: 10.1093/nar/gku632] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The hepatitis C virus (HCV) RNA-dependent RNA polymerase (RdRp) is a key target for antiviral intervention. The goal of this study was to identify the binding site and unravel the molecular mechanism by which natural flavonoids efficiently inhibit HCV RdRp. Screening identified the flavonol quercetagetin as the most potent inhibitor of HCV RdRp activity. Quercetagetin was found to inhibit RdRp through inhibition of RNA binding to the viral polymerase, a yet unknown antiviral mechanism. X-ray crystallographic structure analysis of the RdRp-quercetagetin complex identified quercetagetin's binding site at the entrance of the RNA template tunnel, confirming its original mode of action. This antiviral mechanism was associated with a high barrier to resistance in both site-directed mutagenesis and long-term selection experiments. In conclusion, we identified a new mechanism for non-nucleoside inhibition of HCV RdRp through inhibition of RNA binding to the enzyme, a mechanism associated with broad genotypic activity and a high barrier to resistance. Our results open the way to new antiviral approaches for HCV and other viruses that use an RdRp based on RNA binding inhibition, that could prove to be useful in human, animal or plant viral infections.
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Affiliation(s)
- Abdelhakim Ahmed-Belkacem
- Inserm U955, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Jean-François Guichou
- Centre de Biochimie Structurale, Inserm U1054, CNRS UMR5048, Universités Montpellier 1 et 2, 29 rue de Navacelles, 34090 Montpellier, France
| | - Rozenn Brillet
- Inserm U955, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Nazim Ahnou
- Inserm U955, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Eva Hernandez
- Inserm U955, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Coralie Pallier
- Inserm U955, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France Department of Virology, Hôpital Paul Brousse, 12 avenue Paul Vaillant Couturier, 94800 Villejuif, France
| | - Jean-Michel Pawlotsky
- Inserm U955, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France National Reference Center for Viral Hepatitis B, C, and Delta, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
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41
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Ding K, Wang A, Boerneke MA, Dibrov SM, Hermann T. Aryl-substituted aminobenzimidazoles targeting the hepatitis C virus internal ribosome entry site. Bioorg Med Chem Lett 2014; 24:3113-7. [PMID: 24856063 PMCID: PMC4096041 DOI: 10.1016/j.bmcl.2014.05.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 05/01/2014] [Accepted: 05/05/2014] [Indexed: 02/07/2023]
Abstract
We describe the exploration of N1-aryl-substituted benzimidazoles as ligands for the hepatitis C virus (HCV) internal ribosome entry site (IRES) RNA. The design of the compounds was guided by the co-crystal structure of a benzimidazole viral translation inhibitor in complex with the RNA target. Structure-binding activity relationships of aryl-substituted benzimidazole ligands were established that were consistent with the crystal structure of the translation inhibitor complex.
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Affiliation(s)
- Kejia Ding
- Department of Chemistry and Biochemistry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Annie Wang
- Department of Chemistry and Biochemistry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Mark A Boerneke
- Department of Chemistry and Biochemistry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Sergey M Dibrov
- Department of Chemistry and Biochemistry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Thomas Hermann
- Department of Chemistry and Biochemistry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States.
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42
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Hou L, Jie Z, Liang Y, Desai M, Soong L, Sun J. Type 1 interferon-induced IL-7 maintains CD8+ T-cell responses and homeostasis by suppressing PD-1 expression in viral hepatitis. Cell Mol Immunol 2014; 12:213-21. [PMID: 25027969 DOI: 10.1038/cmi.2014.49] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 05/28/2014] [Accepted: 05/28/2014] [Indexed: 12/12/2022] Open
Abstract
Type 1 interferon (IFN-I) promotes antigen-presenting cell maturation and was recently shown to induce hepatic IL-7 production during infection. Herein, we further explored the underlying mechanisms used by IFN-I to orchestrate antiviral immune responses in the liver. Acute viral hepatitis was induced by i.v. injection of adenovirus (Ad) in IFN-α receptor knockout (IFNAR(-/-)) and control mice. To disrupt signaling, monoclonal antibodies (mAbs) against IL-7 receptor alpha (IL-7Rα) or PD-L1 were i.p. injected. We found that CD8(+) T cells in IFNAR(-/-) mice were less effective than those in control mice. The reduced T-cell function was accompanied by increased levels of PD-1 expression, apoptosis and decreased IFN-γ production. The lack of IFN-I signaling also impaired the expression of accessory molecules in both intrahepatic dendritic cell (DCs) and hepatocytes. PD-L1 was comparably and highly expressed on hepatocytes in both IFNAR(-/-) and control mice. Injection of PD-L1-specific mAb in IFNAR(-/-) mice reversed the compromised immune responses in the liver. Further investigation showed that hepatic IL-7 elevation was less pronounced in IFNAR(-/-) mice compared to the controls. A treatment with recombinant IL-7 suppressed PD-1 expression on CD8(+) T cells in vitro. Accordingly, blocking IL-7R signaling in vivo resulted in increased PD-1 expression on CD8(+) T cells in Ad-infected mice. Collectively, the results suggest that IFN-I-induced hepatic IL-7 production maintains antiviral CD8(+) T-cell responses and homeostasis by suppressing PD-1 expression in acute viral hepatitis.
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Affiliation(s)
- Lifei Hou
- Department of Microbiology and Immunology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA
| | - Zuliang Jie
- Department of Microbiology and Immunology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA
| | - Yuejin Liang
- Department of Microbiology and Immunology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA
| | - Mayura Desai
- Department of Microbiology and Immunology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA
| | - Lynn Soong
- 1] Department of Microbiology and Immunology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA [2] Department of Pathology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA
| | - Jiaren Sun
- Department of Microbiology and Immunology, Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA
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43
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Draffan AG, Frey B, Pool B, Gannon C, Tyndall EM, Lilly M, Francom P, Hufton R, Halim R, Jahangiri S, Bond S, Nguyen VTT, Jeynes TP, Wirth V, Luttick A, Tilmanis D, Thomas JD, Pryor M, Porter K, Morton CJ, Lin B, Duan J, Kukolj G, Simoneau B, McKercher G, Lagacé L, Amad M, Bethell RC, Tucker SP. Discovery and Synthesis of C-Nucleosides as Potential New Anti-HCV Agents. ACS Med Chem Lett 2014; 5:679-84. [PMID: 24944743 DOI: 10.1021/ml500077j] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 04/10/2014] [Indexed: 02/08/2023] Open
Abstract
Nucleoside analogues have long been recognized as prospects for the discovery of direct acting antivirals (DAAs) to treat hepatitis C virus because they have generally exhibited cross-genotype activity and a high barrier to resistance. C-Nucleosides have the potential for improved metabolism and pharmacokinetic properties over their N-nucleoside counterparts due to the presence of a strong carbon-carbon glycosidic bond and a non-natural heterocyclic base. Three 2'CMe-C-adenosine analogues and two 2'CMe-guanosine analogues were synthesized and evaluated for their anti-HCV efficacy. The nucleotide triphosphates of four of these analogues were found to inhibit the NS5B polymerase, and adenosine analogue 1 was discovered to have excellent pharmacokinetic properties demonstrating the potential of this drug class.
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Affiliation(s)
- Alistair G. Draffan
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Barbara Frey
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Brett Pool
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Carlie Gannon
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Edward M. Tyndall
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Michael Lilly
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Paula Francom
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Richard Hufton
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Rosliana Halim
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Saba Jahangiri
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Silas Bond
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Van T. T. Nguyen
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Tyrone P. Jeynes
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Veronika Wirth
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Angela Luttick
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Danielle Tilmanis
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Jesse D. Thomas
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Melinda Pryor
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Kate Porter
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Craig J. Morton
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Bo Lin
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
| | - Jianmin Duan
- Research
and Development, Boehringer Ingelheim (Canada), Ltd., 2100 rue Cunard, Laval, Québec H7S 2G5, Canada
| | - George Kukolj
- Research
and Development, Boehringer Ingelheim (Canada), Ltd., 2100 rue Cunard, Laval, Québec H7S 2G5, Canada
| | - Bruno Simoneau
- Research
and Development, Boehringer Ingelheim (Canada), Ltd., 2100 rue Cunard, Laval, Québec H7S 2G5, Canada
| | - Ginette McKercher
- Research
and Development, Boehringer Ingelheim (Canada), Ltd., 2100 rue Cunard, Laval, Québec H7S 2G5, Canada
| | - Lisette Lagacé
- Research
and Development, Boehringer Ingelheim (Canada), Ltd., 2100 rue Cunard, Laval, Québec H7S 2G5, Canada
| | - Ma’an Amad
- Research
and Development, Boehringer Ingelheim (Canada), Ltd., 2100 rue Cunard, Laval, Québec H7S 2G5, Canada
| | - Richard C. Bethell
- Research
and Development, Boehringer Ingelheim (Canada), Ltd., 2100 rue Cunard, Laval, Québec H7S 2G5, Canada
| | - Simon P. Tucker
- Biota Scientific Management Pty. Ltd., 10/585 Blackburn Road, Notting Hill, Victoria 3168, Australia
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44
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Mingorance L, Friesland M, Coto-Llerena M, Pérez-del-Pulgar S, Boix L, López-Oliva JM, Bruix J, Forns X, Gastaminza P. Selective inhibition of hepatitis C virus infection by hydroxyzine and benztropine. Antimicrob Agents Chemother 2014; 58:3451-60. [PMID: 24709263 PMCID: PMC4068423 DOI: 10.1128/aac.02619-14] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 04/02/2014] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) infection is a major biomedical problem worldwide as it causes severe liver disease in millions of humans around the world. Despite the recent approval of specific drugs targeting HCV replication to be used in combination with alpha interferon (IFN-α) and ribavirin, there is still an urgent need for pangenotypic, interferon-free therapies to fight this genetically diverse group of viruses. In this study, we used an unbiased screening cell culture assay to interrogate a chemical library of compounds approved for clinical use in humans. This system enables identifying nontoxic antiviral compounds targeting every aspect of the viral life cycle, be the target viral or cellular. The aim of this study was to identify drugs approved for other therapeutic applications in humans that could be effective components of combination therapies against HCV. As a result of this analysis, we identified 12 compounds with antiviral activity in cell culture, some of which had previously been identified as HCV inhibitors with antiviral activity in cell culture and had been shown to be effective in patients. We selected two novel HCV antivirals, hydroxyzine and benztropine, to characterize them by determining their specificity and genotype spectrum as well as by defining the step of the replication cycle targeted by these compounds. We found that both compounds effectively inhibited viral entry at a postbinding step of genotypes 1, 2, 3, and 4 without affecting entry of other viruses.
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Affiliation(s)
- Lidia Mingorance
- Centro Nacional De Biotecnología-Consejo Superior de Investigaciones Científicas (CNB-CSIC), Madrid, Spain
| | - Martina Friesland
- Centro Nacional De Biotecnología-Consejo Superior de Investigaciones Científicas (CNB-CSIC), Madrid, Spain
| | | | | | - Loreto Boix
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic, IDIBAPS, CIBERehd, Barcelona, Spain
| | - Juan Manuel López-Oliva
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic, IDIBAPS, CIBERehd, Barcelona, Spain
| | - Jordi Bruix
- Barcelona Clinic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic, IDIBAPS, CIBERehd, Barcelona, Spain
| | - Xavier Forns
- Liver Unit, Hospital Clinic, IDIBAPS, CIBERehd, Barcelona, Spain
| | - Pablo Gastaminza
- Centro Nacional De Biotecnología-Consejo Superior de Investigaciones Científicas (CNB-CSIC), Madrid, Spain
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Ampuero J, Romero-Gómez M, Reddy KR. Review article: HCV genotype 3 – the new treatment challenge. Aliment Pharmacol Ther 2014; 39:686-98. [PMID: 24612116 DOI: 10.1111/apt.12646] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 12/27/2013] [Accepted: 01/13/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Over the past several years, hepatitis C therapy has been pegylated interferon and ribavirin based. Although protease inhibitor-based therapy has enhanced response rates in genotype 1, the recent advances in therapy have demonstrated a challenge in genotype 3, a highly prevalent infection globally. AIM To provide a comprehensive summary of the literature evaluating the unique characteristics and evolving therapies in genotype 3. METHODS A structured search in PubMed, the Cochrane Library and EMBASE was performed using defined key words, including only full text papers and abstracts in English. RESULTS HCV genotype 3 is more prevalent in Asia and among intra-venous drug users. Furthermore, it interferes with lipid and glucose metabolism, and the natural history involves a more rapid progression of liver disease and a higher incidence of hepatocellular carcinoma (HCC). New therapies with protease inhibitors have focused on genotype 1 largely and have demonstrated enhanced responses, but have limited activity against genotype 3. Thus far, in clinical trials, NS5B and NS5A inhibitors have performed more poorly in genotype 3, while a cyclophilin inhibitor, alisporivir, has shown promise. CONCLUSIONS As treatments for HCV have evolved, genotype 3 has become the most difficult to treat. Furthermore, genotype 3 has special characteristics, such as insulin resistance and alterations in lipid metabolism, which may partly explain the lower treatment responses. A great deal of emphasis on advancing therapy is needed in this population that appears to have a more rapid progression of liver disease and a higher incidence of HCC.
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