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Rocher M, Duchesne M, Andouard D, Beral L, Labriffe M, Chainier D, Gomes-Mayeras M, Hantz S, Alain S, Robert PY. Cytomegalovirus detected by qPCR in iris and ciliary body of immunocompetent corneal donors. J Clin Virol 2024; 171:105636. [PMID: 38219682 DOI: 10.1016/j.jcv.2023.105636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/25/2023] [Accepted: 12/30/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Cytomegalovirus (CMV) can cause a wide panel of ocular infections. The involvement of CMV as a cause of anterior uveitis in the immunocompetent patient is recent and remains poorly understood. OBJECTIVE To investigate the presence of CMV in anterior uveal tissues of immunocompetent corneal donors. STUDY DESIGN We collected aqueous humor, iris, and ciliary body from both eyes of 25 donors died at the Limoges University Hospital between January 2020 and July 2021. CMV serology was determined for all patients from post-mortem blood sample. Ocular tissues were split in 2 fragments for qPCR and 2 for histological analysis. CMV genomes copies were quantified by Multiplex qPCR after DNA extraction. RESULTS 16 of 25 patients (64%) displayed positive CMV serology, with a median age of 67 years. Viremia was positive in 3 of 16 (19%) CMV-positive patients. No CMV DNA copies were found from the aqueous humor samples. CMV DNA was detected in iris and ciliary body of 28 of 32 eyes of seropositive donors, and 5 of 18 eyes of seronegative donors. The median viral copy number [IQR] was 2.41 × 102 [8.91 × 101 - 1.01 × 103] copies/1 × 106 cells in the CMV-positive group and 0.00 [0.00 - 3.54 × 102] copies/1 × 106 cells in the CMV-negative group (p<0.001). Histology and immunohistochemistry did not reveal any CMV lesions from any sample. CONCLUSION CMV DNA was found in iris and ciliary body of immunocompetent seropositive patients, but also, although less frequently, from seronegative donors. These results highlight mechanisms of infection, latency and reactivation of CMV in ocular tissues.
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Affiliation(s)
- Maxime Rocher
- Department of Ophthalmology, CHU Limoges, F-87000 Limoges, France; Univ. Limoges, INSERM, CHU Limoges, RESINFIT, U1092, F-87000 Limoges, France.
| | | | - Déborah Andouard
- Univ. Limoges, INSERM, CHU Limoges, RESINFIT, U1092, F-87000 Limoges, France; National Reference Center for Herpesviruses, Department of Bacteriology-Virology-Hygiene, CHU Limoges, F-87000 Limoges, France
| | - Laurence Beral
- Department of Ophthalmology, CHU Pointe-à-Pitre, F-97120 Guadeloupe, France
| | - Marc Labriffe
- Department of Pharmacology, CHU Limoges, F-87000 Limoges, France
| | - Delphine Chainier
- CRBioLim, Department of Bacteriology-Virology-Hygiene, CHU Limoges, F-87000 Limoges, France
| | - Mélissa Gomes-Mayeras
- Univ. Limoges, INSERM, CHU Limoges, RESINFIT, U1092, F-87000 Limoges, France; National Reference Center for Herpesviruses, Department of Bacteriology-Virology-Hygiene, CHU Limoges, F-87000 Limoges, France
| | - Sébastien Hantz
- Univ. Limoges, INSERM, CHU Limoges, RESINFIT, U1092, F-87000 Limoges, France; National Reference Center for Herpesviruses, Department of Bacteriology-Virology-Hygiene, CHU Limoges, F-87000 Limoges, France
| | - Sophie Alain
- Univ. Limoges, INSERM, CHU Limoges, RESINFIT, U1092, F-87000 Limoges, France; National Reference Center for Herpesviruses, Department of Bacteriology-Virology-Hygiene, CHU Limoges, F-87000 Limoges, France; CRBioLim, Department of Bacteriology-Virology-Hygiene, CHU Limoges, F-87000 Limoges, France
| | - Pierre-Yves Robert
- Department of Ophthalmology, CHU Limoges, F-87000 Limoges, France; Univ. Limoges, INSERM, CHU Limoges, RESINFIT, U1092, F-87000 Limoges, France
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2
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Gourin C, Alain S, Hantz S. Anti-CMV therapy, what next? A systematic review. Front Microbiol 2023; 14:1321116. [PMID: 38053548 PMCID: PMC10694278 DOI: 10.3389/fmicb.2023.1321116] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/06/2023] [Indexed: 12/07/2023] Open
Abstract
Human cytomegalovirus (HCMV) is one of the main causes of serious complications in immunocompromised patients and after congenital infection. There are currently drugs available to treat HCMV infection, targeting viral polymerase, whose use is complicated by toxicity and the emergence of resistance. Maribavir and letermovir are the latest antivirals to have been developed with other targets. The approval of letermovir represents an important innovation for CMV prevention in hematopoietic stem cell transplant recipients, whereas maribavir allowed improving the management of refractory or resistant infections in transplant recipients. However, in case of multidrug resistance or for the prevention and treatment of congenital CMV infection, finding new antivirals or molecules able to inhibit CMV replication with the lowest toxicity remains a critical need. This review presents a range of molecules known to be effective against HCMV. Molecules with a direct action against HCMV include brincidofovir, cyclopropavir and anti-terminase benzimidazole analogs. Artemisinin derivatives, quercetin and baicalein, and anti-cyclooxygenase-2 are derived from natural molecules and are generally used for different indications. Although they have demonstrated indirect anti-CMV activity, few clinical studies were performed with these compounds. Immunomodulating molecules such as leflunomide and everolimus have also demonstrated indirect antiviral activity against HCMV and could be an interesting complement to antiviral therapy. The efficacy of anti-CMV immunoglobulins are discussed in CMV congenital infection and in association with direct antiviral therapy in heart transplanted patients. All molecules are described, with their mode of action against HCMV, preclinical tests, clinical studies and possible resistance. All these molecules have shown anti-HCMV potential as monotherapy or in combination with others. These new approaches could be interesting to validate in clinical trials.
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Affiliation(s)
- Claire Gourin
- INSERM, CHU Limoges, University of Limoges, RESINFIT, Limoges, France
| | - Sophie Alain
- INSERM, CHU Limoges, University of Limoges, RESINFIT, Limoges, France
- CHU Limoges, Laboratoire de Bactériologie-Virologie-Hygiène, National Reference Center for Herpesviruses, Limoges, France
| | - Sébastien Hantz
- INSERM, CHU Limoges, University of Limoges, RESINFIT, Limoges, France
- CHU Limoges, Laboratoire de Bactériologie-Virologie-Hygiène, National Reference Center for Herpesviruses, Limoges, France
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Muller C, Alain S, Hantz S. Identification of a leucine-zipper motif in pUL51 essential for HCMV replication and potential target for antiviral development. Antiviral Res 2023; 217:105673. [PMID: 37478917 DOI: 10.1016/j.antiviral.2023.105673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/23/2023]
Abstract
Human cytomegalovirus (HCMV) can cause serious diseases in immunocompromised patients. Use of current antivirals is limited by their adverse effects and emergence of drug resistance mutations. Thus, new drugs are an urgent need. The terminase complex (pUL56-pUL89-pUL51) represents a target of choice for new antivirals development. pUL51 was shown to be crucial for the cleavage of concatemeric HCMV DNA and viral replication. Its C-terminal part plays a critical role for the terminase complex assembly. However, no interaction domain is clearly identified. Sequence comparison of herpesvirus homologs and protein modelling were performed on pUL51. Importance of a putative interaction domain is validated by the generation of recombinant viruses with specific alanine substitutions of amino acids implicated in the domain. We identified a Leucine-Zipper (LZ) domain involving the leucine residues L126-X6-L133-X6-L140-X6-L147 in C-terminal part of pUL51. These leucines are crucial for viral replication, suggesting the significance for pUL51 structure and function. A mimetic-peptide approach has been used and tested in antiviral assays to validate the interaction domain as a new therapeutic target. Cytotoxicity was evaluated by LDH release measurement. The peptide TAT-HK29, homologous to the pUL51-LZ domain, inhibits HCMV replication by 27% ± 9% at 1.25 μM concentration without cytotoxicity. Our results highlight the importance of a leucine zipper domain in the C-terminal part of pUL51 involving leucines L126, L133, L140 and L147. We also confirm the potential of mimetic peptides to inhibit HCMV replication and the importance to target interaction domains to develop antiviral agents.
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Affiliation(s)
- Clotilde Muller
- Univ. Limoges, INSERM, CHU Limoges, RESINFIT, U1092, F-87000, Limoges, France
| | - Sophie Alain
- Univ. Limoges, INSERM, CHU Limoges, RESINFIT, U1092, F-87000, Limoges, France; CHU Limoges, Laboratoire de Bactériologie-Virologie-Hygiène, National Reference Center for Herpesviruses (NRCHV), F-87000, Limoges, France
| | - Sébastien Hantz
- Univ. Limoges, INSERM, CHU Limoges, RESINFIT, U1092, F-87000, Limoges, France; CHU Limoges, Laboratoire de Bactériologie-Virologie-Hygiène, National Reference Center for Herpesviruses (NRCHV), F-87000, Limoges, France.
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Andouard D, Tilloy V, Ribot E, Mayeras M, Diaz-Gonzalez D, El Hamel C, Piras-Douce F, Mantel N, Alain S. Genetic and Functional Characterization of Congenital HCMV Clinical Strains in Ex Vivo First Trimester Placental Model. Pathogens 2023; 12:985. [PMID: 37623946 PMCID: PMC10460061 DOI: 10.3390/pathogens12080985] [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: 04/15/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/26/2023] Open
Abstract
Human cytomegalovirus (HCMV) is the leading cause of congenital viral infection, leading to a variety of symptoms in the unborn child that range from asymptomatic to death in utero. Our objective was to better understand the mechanisms of placental infection by HCMV clinical strains, particularly during the first trimester of pregnancy. We thus characterized and compared the replication kinetics of various HCMV clinical strains and laboratory strains by measuring viral loads in an ex vivo model of first trimester villi and decidua, and used NGS and PCA analysis to analyze the genes involved in cell tropism and virulence factors. We observed that first trimester villi and decidua are similarly permissive to laboratory and symptomatic strains, and that asymptomatic strains poorly replicate in decidua tissue. PCA analysis allowed us to segregate our clinical strains based on their clinical characteristics, suggesting a link between gene mutations and symptoms. All these results bring forth elements that can help better understand the mechanisms that induce the appearance of symptoms or in the congenitally infected newborn.
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Affiliation(s)
- Deborah Andouard
- Bacteriology-Virology-Hygien Department, National Reference Center for Herpesviruses, Centre Hospitalier Universitaire de Limoges, 87000 Limoges, France; (V.T.); (E.R.); (M.M.)
- RESINFIT—Antimicrobials: Molecular Supports of Resistances and Therapeutic Innovations, UMR Inserm 1092, University of Limoges, 87000 Limoges, France;
- Sanofi Vaccines R&D, 69280 Marcy-l’étoile, France; (F.P.-D.); (N.M.)
| | - Valentin Tilloy
- Bacteriology-Virology-Hygien Department, National Reference Center for Herpesviruses, Centre Hospitalier Universitaire de Limoges, 87000 Limoges, France; (V.T.); (E.R.); (M.M.)
- UF9481 Bioinformatics Department, CHU Dupuytren, 87000 Limoges, France
| | - Elodie Ribot
- Bacteriology-Virology-Hygien Department, National Reference Center for Herpesviruses, Centre Hospitalier Universitaire de Limoges, 87000 Limoges, France; (V.T.); (E.R.); (M.M.)
| | - Melissa Mayeras
- Bacteriology-Virology-Hygien Department, National Reference Center for Herpesviruses, Centre Hospitalier Universitaire de Limoges, 87000 Limoges, France; (V.T.); (E.R.); (M.M.)
| | - Daniel Diaz-Gonzalez
- RESINFIT—Antimicrobials: Molecular Supports of Resistances and Therapeutic Innovations, UMR Inserm 1092, University of Limoges, 87000 Limoges, France;
- UF8843 Medical Genomics Department, CHU Dupuytren, 87000 Limoges, France
| | - Chahrazed El Hamel
- Pediatric Department, Mother and Child Biobank (CB-HME), Hôpital de la Mère et de l’enfant, CHU Limoges, 87000 Limoges, France;
| | | | - Nathalie Mantel
- Sanofi Vaccines R&D, 69280 Marcy-l’étoile, France; (F.P.-D.); (N.M.)
| | - Sophie Alain
- Bacteriology-Virology-Hygien Department, National Reference Center for Herpesviruses, Centre Hospitalier Universitaire de Limoges, 87000 Limoges, France; (V.T.); (E.R.); (M.M.)
- RESINFIT—Antimicrobials: Molecular Supports of Resistances and Therapeutic Innovations, UMR Inserm 1092, University of Limoges, 87000 Limoges, France;
- UF8843 Medical Genomics Department, CHU Dupuytren, 87000 Limoges, France
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Coste Mazeau P, Berto L, Andouard D, El Hamel C, Chianea T, Hantz S, Alain S. New therapeutic perspective in the prevention of congenital cytomegalovirus infection. Antiviral Res 2023; 216:105661. [PMID: 37393055 DOI: 10.1016/j.antiviral.2023.105661] [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: 05/04/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/03/2023]
Abstract
INTRODUCTION Hyperimmune globulin Cytotect CP® is a candidate for cytomegalovirus congenital infection prevention. We previously demonstrated its efficacy to prevent villi infection in our first-trimester placenta explants up to day 7, but with an inefficiency at day 14 (Coste-Mazeau et al., Microorganisms, 2021). As this could impact clinical efficacy, we now study the effect of weekly administration of Cytotect CP® on the prevention of villi infection. METHODS Human embryonic lung fibroblast cells were infected at confluence with the endothelial strain TB40/E. Placentae were collected from voluntary pregnancy terminations (8-14 weeks of gestation) from cytomegalovirus-seronegative women. After 5 days of infection of the cells, villi explants were simultaneously added on sponges with Cytotect CP® at various concentrations. After 7 days, Cytotect CP® was renewed in only half of the plates. Villi were collected at days 7 and 14 with or without medium renewal. We compared the viral load by duplex quantitative PCR cytomegalovirus/albumin and the toxicity by measuring β-hCG concentrations in the supernatants with and without medium renewal. RESULTS We did not find any efficacy of Cytotect CP® at day 14 when Cytotect CP® is not renewed, but a regular decrease of the viral load when the immunoglobulins were renewed at day 7, with an EC50 = 0.52 U/mL. We did not observed toxicity of Cytotect CP® with or without renewal of the molecule. CONCLUSION Cytotect CP® is more effective when renewed at day 7. The prevention of congenital cytomegalovirus infection could be enhanced by reducing the spacing of doses.
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Affiliation(s)
- Perrine Coste Mazeau
- University of Limoges, Inserm, CHU Limoges, RESINFIT, U 1092, 1 Rue Du Pr Descottes, F-87000, Limoges, France; National Reference Center for Herpesviruses, Virology Department, CHU Limoges, 2 Avenue Martin Luther King, 87000, Limoges, France; Gynecology and Obstetrics Department, CHU Limoges, 87000, Limoges, France.
| | - Laurie Berto
- University of Limoges, Inserm, CHU Limoges, RESINFIT, U 1092, 1 Rue Du Pr Descottes, F-87000, Limoges, France
| | - Déborah Andouard
- National Reference Center for Herpesviruses, Virology Department, CHU Limoges, 2 Avenue Martin Luther King, 87000, Limoges, France
| | - Chahrazed El Hamel
- Mother and Child Biobank (CB-HME), Pediatric Department, Hôpital de la Mère et de l'Enfant, CHU Limoges, 87000, Limoges, France
| | - Thierry Chianea
- Department of Biochemistry and Molecular Genetics, CHU Limoges, 87000, Limoges, France
| | - Sébastien Hantz
- University of Limoges, Inserm, CHU Limoges, RESINFIT, U 1092, 1 Rue Du Pr Descottes, F-87000, Limoges, France; National Reference Center for Herpesviruses, Virology Department, CHU Limoges, 2 Avenue Martin Luther King, 87000, Limoges, France
| | - Sophie Alain
- University of Limoges, Inserm, CHU Limoges, RESINFIT, U 1092, 1 Rue Du Pr Descottes, F-87000, Limoges, France; National Reference Center for Herpesviruses, Virology Department, CHU Limoges, 2 Avenue Martin Luther King, 87000, Limoges, France.
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The Trimeric Artesunate Analog TF27, a Broadly Acting Anti-Infective Model Drug, Exerts Pronounced Anti-SARS-CoV-2 Activity Spanning Variants and Host Cell Types. Pharmaceutics 2022; 15:pharmaceutics15010115. [PMID: 36678744 PMCID: PMC9866877 DOI: 10.3390/pharmaceutics15010115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/12/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
Starting in 2019, the spread of respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated pandemic of the corona virus disease (COVID-19) has led to enormous efforts in the development of medical countermeasures. Although innovative vaccines have scaled back the number of severe COVID cases, the emergence of the omicron variant (B.1.1.529) illustrates how vaccine development struggles to keep pace with viral evolution. On the other hand, while the recently approved antiviral drugs remdesivir, molnupiravir, and Paxlovid are considered as broadly acting anti-coronavirus therapeutics, only molnupiravir and Paxlovid are orally available and none of these drugs are recommended for prophylactic use. Thus, so far unexploited small molecules, targeting strategies, and antiviral mechanisms are urgently needed to address issues in the current pandemic and in putative future outbreaks of newly emerging variants of concern. Recently, we and others have described the anti-infective potential and particularly the pronounced antiviral activity of artesunate and related compounds of the trioxane/sesquiterpene class. In particular, the trimeric derivative TF27 demonstrated strong anti-cytomegalovirus activity at nanomolar concentrations in vitro as well as in vivo efficacy after oral administration in therapeutic and even prophylactic treatment settings. Here, we extended this analysis by evaluating TF27 for its anti-SARS-CoV-2 potential. Our main findings are as follows: (i) compound TF27 exerted strong anti-SARS-CoV-2 activity in vitro (EC50 = 0.46 ± 0.20 µM), (ii) antiviral activity was clearly distinct from the induction of cytotoxicity, (iii) pretreatment with TF27 prevented virus replication in cultured cells, (iv) antiviral activity has likewise been demonstrated in Calu-3 human lung and Caco-2 human colon cells infected with wild-type, delta, or omicron SARS-CoV-2, respectively, and (v) analysis of TF27 combination treatments has revealed synergistic interaction with GC376, but antagonistic interaction with EIDD-1931. Combined, the data demonstrated the pronounced anti-SARS-CoV-2 activity of TF27 and thus highlight the potential of trioxane compounds for further pharmacologic development towards improved options for COVID-specific medication.
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Strang BL. Toward inhibition of human cytomegalovirus replication with compounds targeting cellular proteins. J Gen Virol 2022; 103. [PMID: 36215160 DOI: 10.1099/jgv.0.001795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Antiviral therapy for human cytomegalovirus (HCMV) currently relies upon direct-acting antiviral drugs. However, it is now well known that these drugs have shortcomings, which limit their use. Here I review the identification and investigation of compounds targeting cellular proteins that have anti-HCMV activity and could supersede those anti-HCMV drugs currently in use. This includes discussion of drug repurposing, for example the use of artemisinin compounds, and discussion of new directions to identify compounds that target cellular factors in HCMV-infected cells, for example screening of kinase inhibitors. In addition, I highlight developing areas such as the use of machine learning and emphasize how interaction with fields outside virology will be critical for development of anti-HCMV compounds.
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Affiliation(s)
- Blair L Strang
- Institute for Infection & Immunity, St George's, University of London, London, UK
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First clinical description of letermovir resistance mutation in cytomegalovirus UL51 gene and potential impact on the terminase complex structure. Antiviral Res 2022; 204:105361. [PMID: 35690130 DOI: 10.1016/j.antiviral.2022.105361] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Letermovir (LMV) is a human cytomegalovirus (HCMV) terminase inhibitor indicated as prophylaxis for HCMV-positive stem-cell recipients. Its mechanism of action involves at least the viral terminase proteins pUL56, pUL89 and pUL51. Despite its efficiency, resistance mutations were characterized in vitro and in vivo, largely focused on pUL56. To date, mutations in pUL51 in clinical resistance remain to be demonstrated. METHODS The pUL51 natural polymorphism was described by sequencing 54 LMV-naive strains and was compared to UL51 HCMV genes from 16 patients non-responding to LMV therapy (prophylaxis or curative). Recombinant viruses were built by «en-passant» mutagenesis to measure the impact of the new mutations on antiviral activity and viral growth. Structure prediction was performed by homology modeling. The pUL51 final-model was analyzed and aligned with the atomic coordinates of the monomeric HSV-1 terminase complex (PDB:6M5R). RESULTS Among the 16 strains from treated-patients with LMV, 4 never described substitutions in pUL51 (D12E, 17del, A95V, V113L) were highlighted. These substitutions had no impact on viral fitness. Only UL51-A95V conferred 13.8-fold increased LMV resistance level by itself (IC50 = 29.246 ± 0.788). CONCLUSION As an isolated mutation in pUL51 in a clinical isolate can lead to LMV resistance, genotyping for resistance should involve sequencing of the pUL51, pUL56 and pUL89 genes. With terminase modelling, we make the hypothesis that LMV could bind to domains were UL56-L257I and UL51-A95V mutations were localized.
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Coste Mazeau P, Jacquet C, Muller C, Courant M, El Hamel C, Chianea T, Hantz S, Alain S. Potential of Anti-CMV Immunoglobulin Cytotect CP® In Vitro and Ex Vivo in a First-Trimester Placenta Model. Microorganisms 2022; 10:microorganisms10040694. [PMID: 35456746 PMCID: PMC9030298 DOI: 10.3390/microorganisms10040694] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Congenital CMV infection is the leading cause of neonatal neurological deficit. We herein studied in vitro and ex vivo the potential of the hyperimmune globulin Cytotect CP® (Biotest, Germany) for congenital infection prevention and treatment. Methods: In vitro neutralization assays were conducted in fibroblasts and retinal epithelial cells on the CMV strains TB40/E and VHL/E to determine the 50% and 90% neutralizing doses (ND50 and ND90). The toxicity was assessed by measuring LDH release. Ex vivo assays were conducted in first-trimester villi explants with the TB40/E strain, namely, neutralization assays, the prevention of villi infection, and the inhibition of viral replication in infected villi. Viability was assessed by β-HCG quantification in supernatants. Results: The in vitro neutralization tests showed that Cytotect CP®® inhibits the development of infection foci (DN50: 0.011–0.014 U/mL for VHL/E and 0.032–0.033 U/mL for TB40E) without any toxicity. In the ex vivo neutralization assays, the DN50 were 0.011 U/mL on day 7 and 0.093 U/mL on day 14. For the prevention of villi infection, the EC50 was 0.024 U/mL on day 7. Cytotect-CP® did not inhibit viral growth in infected villi. No impact on villi viability was observed. Conclusions: These results sustained that Cytotect CP® has the potential to prevent CMV congenital infection.
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Affiliation(s)
- Perrine Coste Mazeau
- RESINFIT, UMR1092, University of Limoges, 2 Rue du Pr Descottes, 87000 Limoges, France; (C.J.); (C.M.); (S.H.)
- National Institute of Health and Medical Research INSERM, UMR 1092, 2 Rue du Pr Descottes, 87000 Limoges, France;
- National Reference Center for Herpesviruses, Virology Department, CHU Limoges, 2 Rue Martin Luther King, 87000 Limoges, France
- Gynecology and Obstetrics Department, CHU Limoges, 87000 Limoges, France
- Correspondence: (P.C.M.); (S.A.); Tel.: +33-5-5505-6164 (P.C.M.); +33-5-5505-6724 (S.A.); Fax: +33-5-5505-6722 (P.C.M. & S.A.)
| | - Chloé Jacquet
- RESINFIT, UMR1092, University of Limoges, 2 Rue du Pr Descottes, 87000 Limoges, France; (C.J.); (C.M.); (S.H.)
- National Institute of Health and Medical Research INSERM, UMR 1092, 2 Rue du Pr Descottes, 87000 Limoges, France;
- National Reference Center for Herpesviruses, Virology Department, CHU Limoges, 2 Rue Martin Luther King, 87000 Limoges, France
| | - Clotilde Muller
- RESINFIT, UMR1092, University of Limoges, 2 Rue du Pr Descottes, 87000 Limoges, France; (C.J.); (C.M.); (S.H.)
- National Institute of Health and Medical Research INSERM, UMR 1092, 2 Rue du Pr Descottes, 87000 Limoges, France;
| | - Mathis Courant
- National Institute of Health and Medical Research INSERM, UMR 1092, 2 Rue du Pr Descottes, 87000 Limoges, France;
| | - Chahrazed El Hamel
- Mother and Child Biobank (CB-HME), Pediatric Department, Hôpital de la Mère et de l’Enfant, CHU Limoges, 87000 Limoges, France;
| | - Thierry Chianea
- Department of Biochemistry and Molecular Genetics, CHU Limoges, 87000 Limoges, France;
| | - Sébastien Hantz
- RESINFIT, UMR1092, University of Limoges, 2 Rue du Pr Descottes, 87000 Limoges, France; (C.J.); (C.M.); (S.H.)
- National Institute of Health and Medical Research INSERM, UMR 1092, 2 Rue du Pr Descottes, 87000 Limoges, France;
- National Reference Center for Herpesviruses, Virology Department, CHU Limoges, 2 Rue Martin Luther King, 87000 Limoges, France
| | - Sophie Alain
- RESINFIT, UMR1092, University of Limoges, 2 Rue du Pr Descottes, 87000 Limoges, France; (C.J.); (C.M.); (S.H.)
- National Institute of Health and Medical Research INSERM, UMR 1092, 2 Rue du Pr Descottes, 87000 Limoges, France;
- National Reference Center for Herpesviruses, Virology Department, CHU Limoges, 2 Rue Martin Luther King, 87000 Limoges, France
- Correspondence: (P.C.M.); (S.A.); Tel.: +33-5-5505-6164 (P.C.M.); +33-5-5505-6724 (S.A.); Fax: +33-5-5505-6722 (P.C.M. & S.A.)
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Recent Advances in the Therapeutic Efficacy of Artesunate. Pharmaceutics 2022; 14:pharmaceutics14030504. [PMID: 35335880 PMCID: PMC8951414 DOI: 10.3390/pharmaceutics14030504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/17/2022] Open
Abstract
Artesunate, a semisynthetic artemisinin derivative, is well-known and used as the first-line drug for treating malaria. Apart from treating malaria, artesunate has also been found to have biological activity against a variety of cancers and viruses. It also exhibits antidiabetic, anti-inflammatory, anti-atherosclerosis, immunosuppressive activities, etc. During its administration, artesunate can be loaded in liposomes, alone or in combination with other therapeutic agents. Administration routes include intragastrical, intravenous, oral, and parenteral. The biological activity of artesunate is based on its ability to regulate some biological pathways. This manuscript reports a critical review of the recent advances in the therapeutic efficacy of artesunate.
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Wild M, Kicuntod J, Seyler L, Wangen C, Bertzbach LD, Conradie AM, Kaufer BB, Wagner S, Michel D, Eickhoff J, Tsogoeva SB, Bäuerle T, Hahn F, Marschall M. Combinatorial Drug Treatments Reveal Promising Anticytomegaloviral Profiles for Clinically Relevant Pharmaceutical Kinase Inhibitors (PKIs). Int J Mol Sci 2021; 22:ijms22020575. [PMID: 33430060 PMCID: PMC7826512 DOI: 10.3390/ijms22020575] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/24/2020] [Accepted: 01/04/2021] [Indexed: 12/11/2022] Open
Abstract
Human cytomegalovirus (HCMV) is a human pathogenic herpesvirus associated with a variety of clinical symptoms. Current antiviral therapy is not always effective, so that improved drug classes and drug-targeting strategies are needed. Particularly host-directed antivirals, including pharmaceutical kinase inhibitors (PKIs), may help to overcome problems of drug resistance. Here, we focused on utilizing a selection of clinically relevant PKIs and determined their anticytomegaloviral efficacies. Particularly, PKIs directed to host or viral cyclin-dependent kinases, i.e., abemaciclib, LDC4297 and maribavir, exerted promising profiles against human and murine cytomegaloviruses. The anti-HCMV in vitro activity of the approved anti-cancer drug abemaciclib was confirmed in vivo using our luciferase-based murine cytomegalovirus (MCMV) animal model in immunocompetent mice. To assess drug combinations, we applied the Bliss independence checkerboard and Loewe additivity fixed-dose assays in parallel. Results revealed that (i) both affirmative approaches provided valuable information on anti-CMV drug efficacies and interactions, (ii) the analyzed combinations comprised additive, synergistic or antagonistic drug interactions consistent with the drugs’ antiviral mode-of-action, (iii) the selected PKIs, especially LDC4297, showed promising inhibitory profiles, not only against HCMV but also other α-, β- and γ-herpesviruses, and specifically, (iv) the combination treatment with LDC4297 and maribavir revealed a strong synergism against HCMV, which might open doors towards novel clinical options in the near future. Taken together, this study highlights the potential of therapeutic drug combinations of current developmental/preclinical PKIs.
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Affiliation(s)
- Markus Wild
- Institute for Clinical and Molecular Virology, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Schlossgarten 4, 91054 Erlangen, Germany; (M.W.); (J.K.); (C.W.); (S.W.); (F.H.)
| | - Jintawee Kicuntod
- Institute for Clinical and Molecular Virology, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Schlossgarten 4, 91054 Erlangen, Germany; (M.W.); (J.K.); (C.W.); (S.W.); (F.H.)
| | - Lisa Seyler
- Institute of Radiology, University Medical Center Erlangen, FAU, Palmsanlage 5, 91054 Erlangen, Germany; (L.S.); (T.B.)
| | - Christina Wangen
- Institute for Clinical and Molecular Virology, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Schlossgarten 4, 91054 Erlangen, Germany; (M.W.); (J.K.); (C.W.); (S.W.); (F.H.)
| | - Luca D. Bertzbach
- Institute of Virology, Freie Universität Berlin, Robert-von-Ostertag-Straße 7-13, 14163 Berlin, Germany; (L.D.B.); (A.M.C.); (B.B.K.)
| | - Andelé M. Conradie
- Institute of Virology, Freie Universität Berlin, Robert-von-Ostertag-Straße 7-13, 14163 Berlin, Germany; (L.D.B.); (A.M.C.); (B.B.K.)
| | - Benedikt B. Kaufer
- Institute of Virology, Freie Universität Berlin, Robert-von-Ostertag-Straße 7-13, 14163 Berlin, Germany; (L.D.B.); (A.M.C.); (B.B.K.)
| | - Sabrina Wagner
- Institute for Clinical and Molecular Virology, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Schlossgarten 4, 91054 Erlangen, Germany; (M.W.); (J.K.); (C.W.); (S.W.); (F.H.)
| | - Detlef Michel
- Institute for Virology, Ulm University Medical Center, Albert-Einstein-Allee 11, 89081 Ulm, Germany;
| | - Jan Eickhoff
- Lead Discovery Center GmbH, Otto-Hahn-Str. 15, 44227 Dortmund, Germany;
| | - Svetlana B. Tsogoeva
- Institute of Organic Chemistry I, FAU, Nikolaus-Fiebiger-Straße 10, 91058 Erlangen, Germany;
| | - Tobias Bäuerle
- Institute of Radiology, University Medical Center Erlangen, FAU, Palmsanlage 5, 91054 Erlangen, Germany; (L.S.); (T.B.)
| | - Friedrich Hahn
- Institute for Clinical and Molecular Virology, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Schlossgarten 4, 91054 Erlangen, Germany; (M.W.); (J.K.); (C.W.); (S.W.); (F.H.)
| | - Manfred Marschall
- Institute for Clinical and Molecular Virology, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), Schlossgarten 4, 91054 Erlangen, Germany; (M.W.); (J.K.); (C.W.); (S.W.); (F.H.)
- Correspondence: ; Tel.: +49-9131-8526-089
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IMU-838, a Developmental DHODH Inhibitor in Phase II for Autoimmune Disease, Shows Anti-SARS-CoV-2 and Broad-Spectrum Antiviral Efficacy In Vitro. Viruses 2020; 12:v12121394. [PMID: 33291455 PMCID: PMC7762174 DOI: 10.3390/v12121394] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/17/2022] Open
Abstract
The ongoing pandemic spread of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) demands skillful strategies for novel drug development, drug repurposing and cotreatments, in particular focusing on existing candidates of host-directed antivirals (HDAs). The developmental drug IMU-838, currently being investigated in a phase 2b trial in patients suffering from autoimmune diseases, represents an inhibitor of human dihydroorotate dehydrogenase (DHODH) with a recently proven antiviral activity in vitro and in vivo. Here, we established an analysis system for assessing the antiviral potency of IMU-838 and DHODH-directed back-up drugs in cultured cell-based infection models. By the use of SARS-CoV-2-specific immunofluorescence, Western blot, in-cell ELISA, viral yield reduction and RT-qPCR methods, we demonstrated the following: (i) IMU-838 and back-ups show anti-SARS-CoV-2 activity at several levels of viral replication, i.e., protein production, double-strand RNA synthesis, and release of infectious virus; (ii) antiviral efficacy in Vero cells was demonstrated in a micromolar range (IMU-838 half-maximal effective concentration, EC50, of 7.6 ± 5.8 µM); (iii) anti-SARS-CoV-2 activity was distinct from cytotoxic effects (half-cytotoxic concentration, CC50, >100 µM); (iv) the drug in vitro potency was confirmed using several Vero lineages and human cells; (v) combination with remdesivir showed enhanced anti-SARS-CoV-2 activity; (vi) vidofludimus, the active determinant of IMU-838, exerted a broad-spectrum activity against a selection of major human pathogenic viruses. These findings strongly suggest that developmental DHODH inhibitors represent promising candidates for use as anti-SARS-CoV-2 therapeutics.
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Yaremenko IA, Radulov PS, Medvedev MG, Krivoshchapov NV, Belyakova YY, Korlyukov AA, Ilovaisky AI, Terent Ev AO, Alabugin IV. How to Build Rigid Oxygen-Rich Tricyclic Heterocycles from Triketones and Hydrogen Peroxide: Control of Dynamic Covalent Chemistry with Inverse α-Effect. J Am Chem Soc 2020; 142:14588-14607. [PMID: 32787239 DOI: 10.1021/jacs.0c06294] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We describe an efficient one-pot procedure that "folds" acyclic triketones into structurally complex, pharmaceutically relevant tricyclic systems that combine high oxygen content with unusual stability. In particular, β,γ'-triketones are converted into three-dimensional polycyclic peroxides in the presence of H2O2 under acid catalysis. These transformations are fueled by stereoelectronic frustration of H2O2, the parent peroxide, where the lone pairs of oxygen are not involved in strongly stabilizing orbital interactions. Computational analysis reveals how this frustration is relieved in the tricyclic peroxide products, where strongly stabilizing anomeric nO→σC-O* interactions are activated. The calculated potential energy surfaces for these transformations combine labile, dynamically formed cationic species with deeply stabilized intermediate structures that correspond to the introduction of one, two, or three peroxide moieties. Paradoxically, as the thermodynamic stability of the peroxide products increases along this reaction cascade, the kinetic barriers for their formation increase as well. This feature of the reaction potential energy surface, which allows separation of mono- and bis-peroxide tricyclic products, also explains why formation of the most stable tris-peroxide is the least kinetically viable and is not observed experimentally. Such unique behavior can be explained through the "inverse α-effect", a new stereoelectronic phenomenon with many conceptual implications for the development of organic functional group chemistry.
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Affiliation(s)
- Ivan A Yaremenko
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, 47 Leninsky prosp., Moscow 119991, Russian Federation
| | - Peter S Radulov
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, 47 Leninsky prosp., Moscow 119991, Russian Federation
| | - Michael G Medvedev
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, 47 Leninsky prosp., Moscow 119991, Russian Federation
| | - Nikolai V Krivoshchapov
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, 47 Leninsky prosp., Moscow 119991, Russian Federation.,Lomonosov Moscow State University, Leninskie Gory 1 (3), Moscow 119991, Russia
| | - Yulia Yu Belyakova
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, 47 Leninsky prosp., Moscow 119991, Russian Federation
| | - Alexander A Korlyukov
- A. N. Nesmeyanov Institute of Organoelement Compounds, Russian Academy of Sciences, 28 Vavilova st, Moscow 119991, Russian Federation
| | - Alexey I Ilovaisky
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, 47 Leninsky prosp., Moscow 119991, Russian Federation
| | - Alexander O Terent Ev
- N. D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, 47 Leninsky prosp., Moscow 119991, Russian Federation
| | - Igor V Alabugin
- Department of Chemistry and Biochemistry, Florida State University, Tallahassee, Florida 32306, United States
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The Artemisinin-Derived Autofluorescent Compound BG95 Exerts Strong Anticytomegaloviral Activity Based on a Mitochondrial Targeting Mechanism. Int J Mol Sci 2020; 21:ijms21155578. [PMID: 32759737 PMCID: PMC7432203 DOI: 10.3390/ijms21155578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 01/05/2023] Open
Abstract
Human cytomegalovirus (HCMV) is a major human pathogen associated with severe pathology. Current options of antiviral therapy only partly satisfy the needs of a well-tolerated long-term treatment/prophylaxis free from drug-induced viral resistance. Recently, we reported the strong antiviral properties in vitro and in vivo of the broad-spectrum anti-infective drug artesunate and its optimized derivatives. NF-κB signaling was described as a targeting mechanism and additional target proteins have recently been identified. Here, we analyzed the autofluorescent hybrid compound BG95, which could be utilized for intracellular visualization by confocal imaging and a tracking analysis in virus-infected primary human fibroblasts. As an important finding, BG95 accumulated in mitochondria visualized by anti-prohibitin and MitoTracker staining, and induced statistically significant changes of mitochondrial morphology, distinct from those induced by HCMV infection. Notably, mitochondrial membrane potential was found substantially reduced by BG95, an effect apparently counteracting efficient HCMV replication, which requires active mitochondria and upregulated energy levels. This finding was consistent with binding properties of artesunate-like compounds to mitochondrial proteins and thereby suggested a new mechanistic aspect. Combined, the present study underlines an important role of mitochondria in the multifaceted, host-directed antiviral mechanism of this drug class, postulating a new mitochondria-specific mode of protein targeting.
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