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Giorgi J, Simon B, Destras G, Semanas Q, Ginevra C, Boyer T, Regue H, Billaud G, Ducastelle S, Ader F, Morfin F, Josset L, Frobert E. Novel UL23 and UL30 substitutions in HSV1 and HSV2 viruses related to polymorphism or drug resistance. Antiviral Res 2023:105672. [PMID: 37453453 DOI: 10.1016/j.antiviral.2023.105672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023]
Abstract
Data on herpes simplex virus (HSV) polymorphism as well as acyclovir (ACV) and foscarnet (FOS) resistance mutations are not exhaustive and may hinder accurate diagnosis by next-generation sequencing (NGS). Here, we report novel UL23 and UL30 substitutions for HSV1 and HSV2 identified in immunocompromised patients treated for hematological malignancies during the last 6 years of HSV resistance surveillance at the University Hospital of Lyon. For HSV1, 35 novel UL23 substitutions and 52 novel UL30 substitutions were identified. For HSV2, 2 novel UL23 substitutions and 12 novel UL30 substitutions were identified. These results allow to complete the database of HSV1 and HSV2 substitutions, related either to polymorphism or to ACV and FOS resistance.
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Affiliation(s)
- J Giorgi
- Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France
| | - B Simon
- Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France; GenEPII Sequencing Platform, Institut des Agents Infectieux, Hospices Civils de Lyon, 69004, Lyon, France
| | - G Destras
- Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France; GenEPII Sequencing Platform, Institut des Agents Infectieux, Hospices Civils de Lyon, 69004, Lyon, France; Université Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, 69008, Lyon, France
| | - Q Semanas
- Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France; GenEPII Sequencing Platform, Institut des Agents Infectieux, Hospices Civils de Lyon, 69004, Lyon, France
| | - C Ginevra
- GenEPII Sequencing Platform, Institut des Agents Infectieux, Hospices Civils de Lyon, 69004, Lyon, France; Laboratoire de Bactériologie, Centre National de Référence des Légionnelles, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France
| | - T Boyer
- Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France; GenEPII Sequencing Platform, Institut des Agents Infectieux, Hospices Civils de Lyon, 69004, Lyon, France
| | - H Regue
- Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France; GenEPII Sequencing Platform, Institut des Agents Infectieux, Hospices Civils de Lyon, 69004, Lyon, France
| | - G Billaud
- Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France
| | - S Ducastelle
- Service d'Hématologie Clinique, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 69495, Pierre-Bénite, France
| | - F Ader
- Université Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, 69008, Lyon, France; Service de Maladies Infectieuses et Tropicales, Groupement Hospitalier Nord, Hospices Civils de Lyon, France
| | - F Morfin
- Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France; Université Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, 69008, Lyon, France
| | - L Josset
- Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France; GenEPII Sequencing Platform, Institut des Agents Infectieux, Hospices Civils de Lyon, 69004, Lyon, France; Université Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, 69008, Lyon, France
| | - E Frobert
- Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France; Université Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, 69008, Lyon, France.
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Labetoulle M, Boutolleau D, Burrel S, Haigh O, Rousseau A. Herpes simplex virus, varicella-zoster virus and cytomegalovirus keratitis: Facts for the clinician. Ocul Surf 2023; 28:336-350. [PMID: 34314898 DOI: 10.1016/j.jtos.2021.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/05/2021] [Accepted: 07/18/2021] [Indexed: 01/16/2023]
Abstract
Keratitis due to Herpes simplex virus (HSK), Varicella-Zoster virus (VZK) and Cytomegalovirus remains a frequent source of concern for many ophthalmologists. They are a frequent cause of emergency consultations at eye care centers and carry the risk of permanent loss of visual acuity or visual quality and/or chronic neurotrophic keratitis, resulting in a significant decrease in the quality of life. HSK and VZK can affect the corneal epithelium, stroma, or endothelium or a combination of layers. In contrast, most cases of CMV keratitis present as isolated endothelitis (CMVE), a clinical entity that has been described within the last 2 decades. These three types of viral keratitis are characterized by a high frequency of recurrences and each new episode increases the risk of sequelae. Hence, ophthalmologists must adapt the treatment to the clinical presentation of each recurrent episode in order to mitigate the immediate consequences of viral replication and the immune response on corneal transparency. In patients with frequent recurrences, preventive long-term antiviral treatment is strongly recommended. However, in some rare cases, continuous exposure to antivirals may promote the emergence of resistant viral strains, which can be difficult to manage. In the future, the introduction of new antiviral drugs, with differing modes of action compared to current medical therapy, could be an alternative until a truly effective preventive solution, such as a vaccine, is available.
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Affiliation(s)
- Marc Labetoulle
- Ophthalmologie Department, Hôpital Bicêtre, APHP, Université Paris Sud, 94275, Le Kremlin-Bicêtre, France; Center for Immunology of Viral Infections and Autoimmune Diseases (IMVA), IDMIT Infrastructure, CEA, Université Paris Sud, Inserm U1184 18 Route Du Panorama, 92265, Fontenay-aux-Roses Cedex, France.
| | - David Boutolleau
- Virology Department, Hôpital Pitié-Salpétrière, APHP, National Reference Center for Herperviruses (Associated Laboratory), Paris, France; Sorbonne University, INSERM UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health (IPLESP), Paris, France
| | - Sonia Burrel
- Virology Department, Hôpital Pitié-Salpétrière, APHP, National Reference Center for Herperviruses (Associated Laboratory), Paris, France; Sorbonne University, INSERM UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health (IPLESP), Paris, France
| | - Oscar Haigh
- Center for Immunology of Viral Infections and Autoimmune Diseases (IMVA), IDMIT Infrastructure, CEA, Université Paris Sud, Inserm U1184 18 Route Du Panorama, 92265, Fontenay-aux-Roses Cedex, France
| | - Antoine Rousseau
- Ophthalmologie Department, Hôpital Bicêtre, APHP, Université Paris Sud, 94275, Le Kremlin-Bicêtre, France; Center for Immunology of Viral Infections and Autoimmune Diseases (IMVA), IDMIT Infrastructure, CEA, Université Paris Sud, Inserm U1184 18 Route Du Panorama, 92265, Fontenay-aux-Roses Cedex, France
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3
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Acyclovir resistance in herpes simplex viruses: Prevalence and therapeutic alternatives. Biochem Pharmacol 2022; 206:115322. [DOI: 10.1016/j.bcp.2022.115322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 11/19/2022]
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Acyclovir-Resistant Herpes Simplex Virus 1 Keratitis: A Concerning and Emerging Clinical Challenge. Am J Ophthalmol 2022; 238:110-119. [PMID: 35033543 DOI: 10.1016/j.ajo.2022.01.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/31/2021] [Accepted: 01/04/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE To describe the clinical and virological profiles of patients with herpes simplex keratitis (HSK) caused by acyclovir-resistant (ACVR) strains of herpes simplex virus 1 (HSV-1). DESIGN Multicenter retrospective case series. METHODS HSV-1 resistance to ACV was confirmed using sequencing of genes encoding HSV-1 thymidine kinase (TK) and DNA polymerase (DNA pol). Data were collected on the number of HSK episodes before and after the diagnosis of resistance, ocular findings including the type of HSK, immune status of patients, antiviral treatments, and HSV-1 genotypic resistance profiles. RESULTS This study evaluated 18 HSK patients (13 male and 5 female, aged 66.8 ± 4.7 years) with ACVR HSV-1-positive ocular samples. Genotypic resistance testing was performed because of frequent recurrences despite adequate antiviral prophylaxis (AVP) (n = 13, 72%), or poor response to suppressive antiviral therapy (n = 5, 28%). Resistance mutations were found in the TK (n = 15, 83%) or in the DNA pol gene (n = 3, 17%). Prior to the diagnosis of resistance, the duration of disease was 29.8 ± 20.4 years, with more than 10 HSK recurrences in 15 patients (83%). The number of recurrences between the first episode and the diagnosis of resistance was significantly lower in immunocompromised patients (n = 6, 33%) than in immunocompetent patients (n = 12; 67%) (11.5 ± 4.9 vs 16.4 ± 1.9, P = .05). CONCLUSION HSV-1 resistance to ACV must be suspected in HSK patients with recurrences despite AVP and/or in cases that respond poorly to a suppressive antiviral regimen. Immunocompromised patients and/or those with longstanding disease may be particularly at risk for developing resistance.
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Banni GAHD, Nehmé R. Capillary electrophoresis for enzyme-based studies: Applications to lipases and kinases. J Chromatogr A 2021; 1661:462687. [PMID: 34864234 DOI: 10.1016/j.chroma.2021.462687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 11/05/2021] [Accepted: 11/14/2021] [Indexed: 10/19/2022]
Abstract
Capillary electrophoresis (CE) is a powerful technique continuously expanding into new application fields. One of these applications involves the study of enzymes, their catalytic activities and the alteration of this activity by specific ligands. In this review, two model enzymes, lipases and kinases, will be used since they differ substantially in their modes of action, reaction requirements and applications making them perfect subjects to demonstrate the advantages and limitations of CE-based enzymatic assays. Indeed, the ability to run CE in various operation modes and hyphenation to different detectors is essential for lipase-based studies. Additionally, the low sample consumption provided by CE promotes it as a promising technique to assay human and viral nucleoside kinases. Undeniably, these are rarely commercially available enzymes and must be frequently produced in the laboratory, a process which requires special sets of skills. CE-based lipase and kinase reactions can be performed outside the capillary (pre-capillary) where the reactants are mixed in a vial prior to their separation or, inside the capillary (in-capillary) where the reactants are mixed before the electrophoretic analysis. These enzyme-based applications of CE will be compared to those of liquid chromatography-based applications in terms of advantages and limitations. Binding assays based on affinity CE and the compelling microscale thermophoresis (MST) will be briefly presented as they allow a broad understanding of the molecular mechanism behind ligand binding and of the resulting modulation in activity.
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Affiliation(s)
- Ghassan Al Hamoui Dit Banni
- Institut de Chimie Organique et Analytique (ICOA), CNRS FR 2708 - UMR 7311, Université d'Orléans, Orléans 45067, France
| | - Reine Nehmé
- Institut de Chimie Organique et Analytique (ICOA), CNRS FR 2708 - UMR 7311, Université d'Orléans, Orléans 45067, France.
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Piret J, Boivin G. Antiviral Drugs Against Herpesviruses. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1322:1-30. [PMID: 34258735 DOI: 10.1007/978-981-16-0267-2_1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The discovery of the nucleoside analogue, acyclovir, represented a milestone in the management of infections caused by herpes simplex virus and varicella-zoster virus. Ganciclovir, another nucleoside analogue, was then used for the management of systemic and organ-specific human cytomegalovirus diseases. The pyrophosphate analogue, foscarnet, and the nucleotide analogue, cidofovir, have been approved subsequently and constitute the second-line antiviral drugs. However, the viral DNA polymerase is the ultimate target of all these antiviral agents with a possible emergence of cross-resistance between these drugs. Recently, letermovir that targets the viral terminase complex was approved for the prophylaxis of human cytomegalovirus infections in hematopoietic stem cell transplant recipients. Other viral targets such as the protein kinase and the helicase-primase complex are also evaluated for the development of novel potent inhibitors against herpesviruses.
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Affiliation(s)
| | - Guy Boivin
- CHU de Québec-Laval University, Quebec City, QC, Canada.
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7
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Labrunie T, Ducastelle S, Domenech C, Ader F, Morfin F, Frobert E. UL23, UL30, and UL5 characterization of HSV1 clinical strains isolated from hematology department patients. Antiviral Res 2019; 168:114-120. [DOI: 10.1016/j.antiviral.2019.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/17/2019] [Accepted: 05/27/2019] [Indexed: 11/17/2022]
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Fajfr M, Pliskova L, Bolehovská R, Uhlířová Z, Vrbacký F. Herpes simplex virus resistant to acyclovir: A single-centre experience from the Czech Republic. J Glob Antimicrob Resist 2019; 19:269-273. [PMID: 31100505 DOI: 10.1016/j.jgar.2019.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 04/01/2019] [Accepted: 05/06/2019] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION AND AIM Infections caused by herpes simplex viruses (HSV) are frequent in the human population. Because of the widespread use of long-term treatment or prophylaxis by anti-herpetic antivirals in various specific medical contexts (immunosuppression, recurrent infections), the level of antiviral resistance is increasing. According to previous studies, there is a low resistance level in immunocompetent populations but a relatively high level in populations with immunodeficiency. However, there has been no study from the Czech Republic. This study presents results of a single-centre retrospective study from the Czech Republic. MATERIALS AND METHODS Deep frozen DNA from patients with suspected clinical antiviral failure over a long time period (2009-2016) - a total of 15 isolates of HSV1 and seven of HSV2 - were examined for the presence of mutations associated with antiviral resistance. Sequence analysis was performed using an ABI PRISM 3500xL Genetic Analyzer (Applied Biosystems®). RESULTS There were no mutations associated with resistance to antivirals inside the UL23 gene in HSV1 isolates. However, resistant mutation D672N (nucleotide change G2014A) was found inside the UL30 gene in seven of the isolates. One mutation associated with resistance to acyclovir (M183stop) was found inside the UL23 gene in one HSV2 isolate. Resistant mutation E678G (nucleotide change A2033G) was identified inside the UL30 gene in six of the HSV2 isolates. CONCLUSIONS This study confirmed the presence of resistance mutations within the Czech population, but it will be necessary to examine a higher number of isolates for further conclusions.
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Affiliation(s)
- Miroslav Fajfr
- Institute of Clinical Microbiology, University Hospital in Hradec Kralove, Czech Republic; Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic.
| | - Lenka Pliskova
- Department of Molecular Biology, Institute of Clinical Biochemistry and Diagnostics, University Hospital in Hradec Kralove, Czech Republic
| | - Radka Bolehovská
- Department of Molecular Biology, Institute of Clinical Biochemistry and Diagnostics, University Hospital in Hradec Kralove, Czech Republic
| | - Zuzana Uhlířová
- Institute of Clinical Microbiology, University Hospital in Hradec Kralove, Czech Republic
| | - Filip Vrbacký
- 4th Department of Internal Medicine - Haematology, Charles University, University Hospital Hradec Kralove, Czech Republic
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Antiviral resistance in herpes simplex virus and varicella-zoster virus infections: diagnosis and management. Curr Opin Infect Dis 2018; 29:654-662. [PMID: 27306564 DOI: 10.1097/qco.0000000000000288] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Aciclovir (ACV) is the first-line drug for the management of herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections. Long-term administration of ACV for the treatment of severe infections in immunocompromised patients can lead to the development of drug resistance. Furthermore, the emergence of isolates resistant to ACV is increasingly recognized in immunocompetent individuals with herpetic keratitis. This review describes the mechanisms involved in drug resistance for HSV and VZV, the laboratory diagnosis and management of patients with infections refractory to ACV therapy. RECENT FINDINGS Genotypic testing is more frequently performed for the diagnosis of infections caused by drug-resistant HSV or VZV isolates. Molecular biology-based systems for the generation of recombinant viruses have been developed to link unknown mutations with their drug phenotypes. Fast and sensitive methods based on next-generation sequencing will improve the detection of heterogeneous viral populations of drug-resistant viruses and their temporal changes during antiviral therapy, which could allow better patient management. Novel promising compounds acting on targets that differ from the viral DNA polymerase are under clinical development. SUMMARY Antiviral drug resistance monitoring for HSV and VZV is required for a rational use of antiviral therapy in high-risk populations.
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Kaspar M, Bohn-Wippert K, Bellstedt P, Häfner S, Görlach M, Sauerbrei A. Stepwise characterization of non-synonymous mutations in the HSV-1 thymidine kinase gene by different functional assays. J Virol Methods 2017; 247:51-57. [PMID: 28576448 DOI: 10.1016/j.jviromet.2017.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 05/08/2017] [Accepted: 05/21/2017] [Indexed: 11/28/2022]
Abstract
Twenty amino acid substitutions in the thymidine kinase (TK) of clinical herpes simplex virus type 1 strains were assessed for conferring acyclovir (ACV) resistance. Site-directed mutagenesis, cell-free protein synthesis and protein expression in Escherichia coli were performed to obtain recombinant TK proteins, which were authenticated by Western blotting. A modified enzyme-linked immunosorbent assay (ELISA) was carried out to determine the phosphorylation activity of the mutants towards 5-bromo-2'-deoxyuridine (BrdU). The activity against ACV and deoxythymidine (dT) was analyzed by high performance liquid chromatography/ultraviolet spectroscopy (HPLC/UV) following incubation of recombinant TK with ACV and dT. Using ELISA, seven substitutions (G61E, A93V, M121K, R163G, P173del, V238F, G264V) showing negative activity could be classified likely as resistance-related, eleven (Q15K, R20C, R32H, E43A, E43D, R89H, A156V, P269S, G271V, S276N, I326V) with high activity as natural polymorphisms, and two (N244H and N376stop) with low phosphorylation activity. Since the N244H protein did not show any activity towards ACV, but activity towards dT using HPLC/UV, it was classified as TK with altered substrate specificity. In conclusion, the ELISA determining activity towards BrdU is suitable for the characterization of substitutions regarding their significance for resistance. Ambiguous results can be re-assessed by HPLC/UV, which classifies TK with altered substrate specificity.
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Affiliation(s)
- Marisa Kaspar
- Section Experimental Virology, Institute of Medical Microbiology, German Consulting Laboratory for HSV and VZV, Jena University Clinic, Jena, Germany
| | - Kathrin Bohn-Wippert
- Department of Bioengineering, University of Illinois, Urbana-Champaign, United States
| | - Peter Bellstedt
- Institute of Organic and Macromolecular Chemistry, Friedrich Schiller University Jena, Jena, Germany
| | - Sabine Häfner
- Core Service Protein Production, Leibniz Institute on Aging/Fritz Lipman Institute e.V., Jena, Germany
| | - Matthias Görlach
- Core Service Protein Production, Leibniz Institute on Aging/Fritz Lipman Institute e.V., Jena, Germany
| | - Andreas Sauerbrei
- Section Experimental Virology, Institute of Medical Microbiology, German Consulting Laboratory for HSV and VZV, Jena University Clinic, Jena, Germany.
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Perrier M, Désiré N, Deback C, Agut H, Boutolleau D, Burrel S. Complementary assays for monitoring susceptibility of varicella-zoster virus resistance to antivirals. J Virol Methods 2016; 233:10-4. [DOI: 10.1016/j.jviromet.2016.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/10/2016] [Accepted: 03/15/2016] [Indexed: 12/19/2022]
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Mitterreiter JG, Titulaer MJ, van Nierop GP, van Kampen JJA, Aron GI, Osterhaus ADME, Verjans GMGM, Ouwendijk WJD. Prevalence of Intrathecal Acyclovir Resistant Virus in Herpes Simplex Encephalitis Patients. PLoS One 2016; 11:e0155531. [PMID: 27171421 PMCID: PMC4865163 DOI: 10.1371/journal.pone.0155531] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 04/29/2016] [Indexed: 11/18/2022] Open
Abstract
Herpes simplex encephalitis (HSE) is a life-threatening complication of herpes simplex virus (HSV) infection. Acyclovir (ACV) is the antiviral treatment of choice, but may lead to emergence of ACV-resistant (ACVR) HSV due to mutations in the viral UL23 gene encoding for the ACV-targeted thymidine kinase (TK) protein. Here, we determined the prevalence of intrathecal ACVR–associated HSV TK mutations in HSE patients and compared TK genotypes of sequential HSV isolates in paired cerebrospinal fluid (CSF) and blister fluid of mucosal HSV lesions. Clinical samples were obtained from 12 HSE patients, encompassing 4 HSV type 1 (HSV-1) and 8 HSV-2 encephalitis patients. HSV DNA load was determined by real-time PCR and complete HSV TK gene sequences were obtained by nested PCR followed by Sanger sequencing. All HSV-1 HSE patients contained viral TK mutations encompassing 30 unique nucleotide and 13 distinct amino acid mutations. By contrast, a total of 5 unique nucleotide and 4 distinct amino acid changes were detected in 7 of 8 HSV-2 patients. Detected mutations were identified as natural polymorphisms located in non-conserved HSV TK gene regions. ACV therapy did not induce the emergence of ACVR-associated HSV TK mutations in consecutive CSF and mucocutaneous samples of 5 individual patients. Phenotypic susceptibility analysis of these mucocutaneous HSV isolates demonstrated ACV-sensitive virus in 2 HSV-1 HSE patients, whereas in two HSV-2 HSE patients ACVR virus was detected in the absence of known ACVR-associated TK mutations. In conclusion, we did not detect intrathecal ACVR-associated TK mutations in HSV isolates obtained from 12 HSE patients.
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MESH Headings
- Acyclovir/pharmacology
- Adult
- Amino Acid Substitution/genetics
- Antiviral Agents/pharmacology
- Demography
- Drug Resistance, Viral/drug effects
- Encephalitis, Herpes Simplex/cerebrospinal fluid
- Encephalitis, Herpes Simplex/virology
- Female
- Herpesvirus 1, Human/drug effects
- Herpesvirus 1, Human/enzymology
- Herpesvirus 1, Human/isolation & purification
- Herpesvirus 1, Human/physiology
- Herpesvirus 2, Human/drug effects
- Herpesvirus 2, Human/enzymology
- Herpesvirus 2, Human/isolation & purification
- Herpesvirus 2, Human/physiology
- Humans
- Male
- Middle Aged
- Phenotype
- Polymorphism, Single Nucleotide/genetics
- Prevalence
- Spinal Cord/pathology
- Spinal Cord/virology
- Thymidine Kinase/genetics
- Young Adult
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Affiliation(s)
- Johanna G. Mitterreiter
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Hannover, Germany
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | | | - Gijsbert P. van Nierop
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
- Department of Neurology, Erasmus MC, Rotterdam, the Netherlands
| | | | - Georgina I. Aron
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Albert D. M. E. Osterhaus
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Hannover, Germany
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Georges M. G. M. Verjans
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Hannover, Hannover, Germany
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
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Silva-Mares D, Torres-López E, Rivas-Galindo VM. Antiherpetic Plants: A Review of Active Extracts, Isolated Compounds, and Bioassays. Nat Prod Commun 2016. [DOI: 10.1177/1934578x1601100434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Herpes simplex is a disease that is widely distributed throughout the world. It is caused by herpes simplex virus type 1 (HSV-1) and simplex virus type 2 (HSV-2). The drugs of choice for treatment are acyclovir (ACV), Penciclovir (PCV) and other guanine analogues, which have the same mechanism of action. However, due to the constant increase of ACV-resistant strains in immunocompromised patients, it is necessary to find new treatment alternatives. It has been shown that natural products are a good alternative for the treatment of these diseases as well as being an excellent source of compounds with anti-herpetic activity, which may be useful for the development of new drugs and act through a mechanism of action different from ACV and PCV. This paper compiles reports on extracts and compounds isolated from plants that have anti-herpetic activity. We present an analysis of the solvents most widely used for extraction from plants as well as cells and commonly used methods for evaluating cytotoxic and anti-herpetic activity. Families that have a higher number of plants with anti-herpetic activity are evaluated, and we also highlight the importance of studies of mechanisms of action of extracts and compounds with anti-herpetic activity.
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Affiliation(s)
- David Silva-Mares
- Departamento de Química Analítica, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey Nuevo León, México. C.P. 64460
| | - Ernesto Torres-López
- Departamento de Inmunología, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey Nuevo León, México. C.P. 64460
| | - Verónica M. Rivas-Galindo
- Departamento de Química Analítica, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey Nuevo León, México. C.P. 64460
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Sauerbrei A, Bohn-Wippert K, Kaspar M, Krumbholz A, Karrasch M, Zell R. Database on natural polymorphisms and resistance-related non-synonymous mutations in thymidine kinase and DNA polymerase genes of herpes simplex virus types 1 and 2. J Antimicrob Chemother 2015; 71:6-16. [PMID: 26433780 DOI: 10.1093/jac/dkv285] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The use of genotypic resistance testing of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) is increasing because the rapid availability of results significantly improves the treatment of severe infections, especially in immunocompromised patients. However, an essential precondition is a broad knowledge of natural polymorphisms and resistance-associated mutations in the thymidine kinase (TK) and DNA polymerase (pol) genes, of which the DNA polymerase (Pol) enzyme is targeted by the highly effective antiviral drugs in clinical use. Thus, this review presents a database of all non-synonymous mutations of TK and DNA pol genes of HSV-1 and HSV-2 whose association with resistance or natural gene polymorphism has been clarified by phenotypic and/or functional assays. In addition, the laboratory methods for verifying natural polymorphisms or resistance mutations are summarized. This database can help considerably to facilitate the interpretation of genotypic resistance findings in clinical HSV-1 and HSV-2 strains.
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Affiliation(s)
- Andreas Sauerbrei
- Institute of Virology and Antiviral Therapy, German Consulting Laboratory for HSV and VZV, Jena University Hospital, Jena, Germany
| | - Kathrin Bohn-Wippert
- Institute of Virology and Antiviral Therapy, German Consulting Laboratory for HSV and VZV, Jena University Hospital, Jena, Germany
| | - Marisa Kaspar
- Institute of Virology and Antiviral Therapy, German Consulting Laboratory for HSV and VZV, Jena University Hospital, Jena, Germany
| | - Andi Krumbholz
- Institute for Infection Medicine, Christian-Albrecht University and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Matthias Karrasch
- Institute of Medical Microbiology, Jena University Hospital, Jena, Germany
| | - Roland Zell
- Institute of Virology and Antiviral Therapy, German Consulting Laboratory for HSV and VZV, Jena University Hospital, Jena, Germany
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Frobert E, Burrel S, Ducastelle-Lepretre S, Billaud G, Ader F, Casalegno JS, Nave V, Boutolleau D, Michallet M, Lina B, Morfin F. Resistance of herpes simplex viruses to acyclovir: An update from a ten-year survey in France. Antiviral Res 2014; 111:36-41. [DOI: 10.1016/j.antiviral.2014.08.013] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 07/30/2014] [Accepted: 08/25/2014] [Indexed: 11/25/2022]
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Schubert A, Gentner E, Bohn K, Schwarz M, Mertens T, Sauerbrei A. Single nucleotide polymorphisms of thymidine kinase and DNA polymerase genes in clinical herpes simplex virus type 1 isolates associated with different resistance phenotypes. Antiviral Res 2014; 107:16-22. [PMID: 24747042 DOI: 10.1016/j.antiviral.2014.03.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 03/21/2014] [Accepted: 03/24/2014] [Indexed: 11/24/2022]
Abstract
The role of mutations in the thymidine kinase (TK, UL23) and DNA polymerase (pol, UL30) genes of herpes simplex virus (HSV) for development of different resistance phenotypes has to be exactly determined before genotypic resistance testing can be implemented in patient's care. Furthermore, the occurrence of cross-resistance is of utmost clinical importance. In this study, clinical HSV-1 isolates obtained between 2004 and 2011 from 26 patients after stem cell transplantation were examined in parallel by phenotypic and genotypic resistance testing. Thirteen isolates, which were phenotypically cross-resistant to acyclovir (ACV), penciclovir (PCV) and brivudin (BVDU), exhibited consistently frameshift or non-synonymous mutations in the TK gene known to confer resistance. One of these mutations (insertion of C at the nucleotide positions 1061-1065) has not been described before. Seven strains, phenotypically resistant to ACV and PCV and, except one each, sensitive to BVDU and resistant to foscarnet (FOS), carried uniformly resistance-related substitutions in the DNA pol gene. Finally, 3 isolates, resistant to ACV, PCV and 2 out of these also resistant to BVDU, had known but also unclear substitutions in the TK and DNA pol genes, and 3 isolates were completely sensitive. In conclusion, clinical ACV-resistant HSV-1 isolates, carrying resistance-associated mutations in the TK gene, can be regarded as cross-resistant to other nucleoside analogs such as BVDU. In contrast, clinical FOS-resistant HSV-1 strains which are cross-resistant to ACV may be sensitive to BVDU. This has to be considered for drug changes in antiviral treatment in case of ACV resistance.
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Affiliation(s)
- Axel Schubert
- Institute of Virology, German Reference Laboratory for CMV, University Hospital Ulm, Ulm, Germany
| | - Eva Gentner
- Institute of Virology, German Reference Laboratory for CMV, University Hospital Ulm, Ulm, Germany; Institute for Experimental Cancer Research, University Hospital Ulm, Ulm, Germany
| | - Kathrin Bohn
- Institute of Virology and Antiviral Therapy, German Reference Laboratory for HSV and VZV, Jena University Clinic, Jena, Germany
| | - Maximilian Schwarz
- Institute of Virology and Antiviral Therapy, German Reference Laboratory for HSV and VZV, Jena University Clinic, Jena, Germany
| | - Thomas Mertens
- Institute of Virology, German Reference Laboratory for CMV, University Hospital Ulm, Ulm, Germany
| | - Andreas Sauerbrei
- Institute of Virology and Antiviral Therapy, German Reference Laboratory for HSV and VZV, Jena University Clinic, Jena, Germany.
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17
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Piret J, Boivin G. Antiviral drug resistance in herpesviruses other than cytomegalovirus. Rev Med Virol 2014; 24:186-218. [DOI: 10.1002/rmv.1787] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 01/23/2014] [Accepted: 01/29/2014] [Indexed: 12/16/2022]
Affiliation(s)
- Jocelyne Piret
- Research Center in Infectious Diseases; Laval University; Quebec City QC Canada
| | - Guy Boivin
- Research Center in Infectious Diseases; Laval University; Quebec City QC Canada
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Burrel S, Aime C, Hermet L, Ait-Arkoub Z, Agut H, Boutolleau D. Surveillance of herpes simplex virus resistance to antivirals: A 4-year survey. Antiviral Res 2013; 100:365-72. [DOI: 10.1016/j.antiviral.2013.09.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/09/2013] [Accepted: 09/12/2013] [Indexed: 12/11/2022]
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19
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Burrel S, Bonnafous P, Hubacek P, Agut H, Boutolleau D. Impact of novel mutations of herpes simplex virus 1 and 2 thymidine kinases on acyclovir phosphorylation activity. Antiviral Res 2012; 96:386-90. [PMID: 23041200 DOI: 10.1016/j.antiviral.2012.09.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 08/29/2012] [Accepted: 09/24/2012] [Indexed: 10/27/2022]
Abstract
The acyclic analogue of guanosine acyclovir (ACV) constitutes the first-line drug for the treatment of herpes simplex virus (HSV) infections. ACV activation requires primophosphorylation by virus-encoded HSV thymidine kinase (TK). In 95% of cases, HSV resistance to ACV is associated with mutations located in TK. The aim of this work was to address the question of the potential involvement of novel HSV-1 and HSV-2 TK mutations in reduced susceptibility to ACV using a novel nonradioactive method, based on luminescent quantitation of ADP, for the evaluation of in vitro phosphorylation activity of TK. All recombinant TKs tested exhibited significantly lower ACV phosphorylation activities in comparison with those of reference KOS or gHSV-2 TKs (p<0.015), therefore indicating that amino acid changes Y53D, L170P, R176W, A207P (HSV-1) and S66P, A72S, I101S, M183I (HSV-2) were likely to be involved in HSV resistance to ACV.
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