1
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Yamaguchi D, Shimizu R, Kubota R. Development of a SARS-CoV-2 viral dynamic model for patients with COVID-19 based on the amount of viral RNA and viral titer. CPT Pharmacometrics Syst Pharmacol 2024; 13:1354-1365. [PMID: 38783551 PMCID: PMC11330184 DOI: 10.1002/psp4.13164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 04/17/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
The target-cell limited model, which is one of the mathematical modeling approaches providing a quantitative understanding of viral dynamics, has been applied to describe viral RNA profiles of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in previous studies. However, these models have been developed mainly using patient data from the early phase of the pandemic. Furthermore, no reports focused on the profiles of the viral titer. In this study, the dynamics of both viral RNA and viral titer were characterized using data reflecting the current clinical situation in which the Omicron variant has become epidemic and vaccines for SARS-CoV-2 have become available. Consecutive data for 5212 viral RNA levels and 5216 viral titers were obtained from 720 patients with coronavirus disease 2019 (COVID-19) in a phase II/III study for ensitrelvir. Our model assumed that productively infected cells would produce only infectious viruses, which could be transformed into non-infectious viruses, and has been used to describe the dynamics of both viral RNA levels and viral titer. The time from infection to symptom onset (tinf) of unvaccinated patients was estimated to be 3.0 days, which was shorter than that of the vaccinated patients. The immune-related parameter as a power function for the vaccinated patients was 1.1 times stronger than that for the unvaccinated patients. Our model allows the prediction of the viral dynamics in patients with COVID-19 from the time of infection to symptom onset. Vaccination status was identified as a factor influencing tinf and the immune function.
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Affiliation(s)
- Daichi Yamaguchi
- Clinical Pharmacology & PharmacokineticsShionogi & Co., Ltd.OsakaJapan
| | - Ryosuke Shimizu
- Clinical Pharmacology & PharmacokineticsShionogi & Co., Ltd.OsakaJapan
| | - Ryuji Kubota
- Clinical Pharmacology & PharmacokineticsShionogi & Co., Ltd.OsakaJapan
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2
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Johnson DM, Juelich T, Zhang L, Smith JK, Kalveram BK, Perez D, Smith J, Grimes MR, Garron T, Torres M, Massey S, Brasel T, Beasley DWC, Freiberg AN, Comer JE. Comparison of Routes of Administration, Frequency, and Duration of Favipiravir Treatment in Mouse and Guinea Pig Models of Ebola Virus Disease. Viruses 2024; 16:1101. [PMID: 39066263 PMCID: PMC11281331 DOI: 10.3390/v16071101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open
Abstract
Favipiravir is a ribonucleoside analogue that has been explored as a therapeutic for the treatment of Ebola Virus Disease (EVD). Promising data from rodent models has informed nonhuman primate trials, as well as evaluation in patients during the 2013-2016 West African EVD outbreak of favipiravir treatment. However, mixed results from these studies hindered regulatory approval of favipiravir for the indication of EVD. This study examined the influence of route of administration, duration of treatment, and treatment schedule of favipiravir in immune competent mouse and guinea pig models using rodent-adapted Zaire ebolavirus (EBOV). A dose of 300 mg/kg/day of favipiravir with an 8-day treatment was found to be fully effective at preventing lethal EVD-like disease in BALB/c mice regardless of route of administration (oral, intraperitoneal, or subcutaneous) or whether it was provided as a once-daily dose or a twice-daily split dose. Preclinical data generated in guinea pigs demonstrates that an 8-day treatment of 300 mg/kg/day of favipiravir reduces mortality following EBOV challenge regardless of route of treatment or duration of treatments for 8, 11, or 15 days. This work supports the future translational development of favipiravir as an EVD therapeutic.
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Affiliation(s)
- Dylan M. Johnson
- Department of Microbiology and Immunology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- Department of Biotechnology & Bioengineering, Sandia National Laboratories, Livermore, CA 945501, USA
| | - Terry Juelich
- Department of Pathology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA; (T.J.)
| | - Lihong Zhang
- Department of Pathology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA; (T.J.)
| | - Jennifer K. Smith
- Department of Pathology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA; (T.J.)
| | - Birte K. Kalveram
- Department of Pathology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA; (T.J.)
| | - David Perez
- Office of Biosafety, Texas A&M University, College Station, TX 77843, USA
| | - Jeanon Smith
- Office of Regulated Nonclinical Studies, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA (S.M.)
| | - Michael R. Grimes
- Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist, Houston, TX 77030, USA;
| | - Tania Garron
- Department of Microbiology and Immunology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
| | - Maricela Torres
- Department of Microbiology and Immunology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
| | - Shane Massey
- Office of Regulated Nonclinical Studies, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA (S.M.)
| | - Trevor Brasel
- Department of Microbiology and Immunology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- Office of Regulated Nonclinical Studies, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA (S.M.)
| | - David W. C. Beasley
- Department of Microbiology and Immunology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- Office of Regulated Nonclinical Studies, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA (S.M.)
| | - Alex N. Freiberg
- Department of Pathology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA; (T.J.)
| | - Jason E. Comer
- Department of Microbiology and Immunology, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA
- Office of Regulated Nonclinical Studies, University of Texas Medical Branch at Galveston, Galveston, TX 77555, USA (S.M.)
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3
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Costa IB, Santana-da-Silva MN, Nogami PY, Santos e Santos CDJ, Pereira LMS, França EDS, Freire ABC, Ramos FLDP, Monteiro TAF, Macedo O, Sousa RCM, Freitas FB, Vallinoto ACR, Brasil-Costa I. Immunogenetic Profile Associated with Patients Living with HIV-1 and Epstein-Barr Virus (EBV) in the Brazilian Amazon Region. Viruses 2024; 16:1012. [PMID: 39066175 PMCID: PMC11281405 DOI: 10.3390/v16071012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/14/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024] Open
Abstract
Viral coinfection among HIV-positive patients, coupled with the development of AIDS, remains a major public health problem. The synergism between the presence of HIV and other viruses has consequences in relation to changes in the severity of the infection, as well as changes in the natural course of both infections. Several polymorphisms present in genes that encode cytokines have a relevant influence on their transcription and consequently on the production of such immunological molecules. The present study evaluated the influence of SNPs located in the promoter regions of genes encoding the cytokines INF-ɣ, TNF, IL-6, IL-4, and IL-2, as well as their respective plasma concentrations, in patients infected with HIV and/or EBV in the state of Pará. Additionally, this study described the epidemiological profile and compared CD4+ and CD8+ T lymphocyte counts among the groups studied. The associative analysis between the SNPs and plasma cytokine concentrations in different groups showed statistical relevance for three polymorphisms: rs2069762 (IL2), where the GG genotype demonstrated higher IL-2 levels in HIV mono-infected individuals; rs2243250 (IL4), where the CT genotype showed higher IL-4 levels in the control group; and rs2069705 (IFNG), where the TT genotype showed higher IFN-γ levels in the coinfected group. Regarding SNP associations with CD4+/CD8+ counts, significant findings were observed in HIV mono-infected individuals: the rs2069705 (IFNG) polymorphism was linked to higher CD4+ counts with the CT genotype, and rs1799964 (TNF) was associated with higher CD8+ counts with the CC genotype. Therefore, this study provides evidence that the rs2069705 (IFNG) SNP is associated with elevated IFN-γ levels, which may have pathogenic consequences, as depletion of this cytokine is concerning for people living with HIV due to its antiviral properties.
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Affiliation(s)
- Iran Barros Costa
- Epstein-Barr Virus Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil; (I.B.C.); (M.N.S.-d.-S.); (P.Y.N.); (C.d.J.S.e.S.); (E.d.S.F.); (T.A.F.M.)
- Immunology Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil
| | - Mayara Natália Santana-da-Silva
- Epstein-Barr Virus Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil; (I.B.C.); (M.N.S.-d.-S.); (P.Y.N.); (C.d.J.S.e.S.); (E.d.S.F.); (T.A.F.M.)
- Immunology Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil
| | - Patrícia Yuri Nogami
- Epstein-Barr Virus Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil; (I.B.C.); (M.N.S.-d.-S.); (P.Y.N.); (C.d.J.S.e.S.); (E.d.S.F.); (T.A.F.M.)
- Immunology Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil
| | - Carolinne de Jesus Santos e Santos
- Epstein-Barr Virus Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil; (I.B.C.); (M.N.S.-d.-S.); (P.Y.N.); (C.d.J.S.e.S.); (E.d.S.F.); (T.A.F.M.)
- Immunology Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil
| | - Leonn Mendes Soares Pereira
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (L.M.S.P.); (A.C.R.V.)
| | - Eliane dos Santos França
- Epstein-Barr Virus Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil; (I.B.C.); (M.N.S.-d.-S.); (P.Y.N.); (C.d.J.S.e.S.); (E.d.S.F.); (T.A.F.M.)
| | - Amaury Bentes Cunha Freire
- Epidemiology and Surveillance Service, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil; (A.B.C.F.); (F.L.d.P.R.)
| | - Francisco Lúzio de Paula Ramos
- Epidemiology and Surveillance Service, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil; (A.B.C.F.); (F.L.d.P.R.)
| | - Talita Antonia Furtado Monteiro
- Epstein-Barr Virus Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil; (I.B.C.); (M.N.S.-d.-S.); (P.Y.N.); (C.d.J.S.e.S.); (E.d.S.F.); (T.A.F.M.)
- Immunology Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil
| | - Olinda Macedo
- Retrovirus Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil; (O.M.); (F.B.F.)
| | | | - Felipe Bonfim Freitas
- Retrovirus Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil; (O.M.); (F.B.F.)
| | - Antonio Carlos Rosário Vallinoto
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (L.M.S.P.); (A.C.R.V.)
| | - Igor Brasil-Costa
- Epstein-Barr Virus Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil; (I.B.C.); (M.N.S.-d.-S.); (P.Y.N.); (C.d.J.S.e.S.); (E.d.S.F.); (T.A.F.M.)
- Immunology Laboratory, Virology Department, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil
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4
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Zhang S, Agyeman AA, Hadjichrysanthou C, Standing JF. SARS-CoV-2 viral dynamic modeling to inform model selection and timing and efficacy of antiviral therapy. CPT Pharmacometrics Syst Pharmacol 2023; 12:1450-1460. [PMID: 37534815 PMCID: PMC10583246 DOI: 10.1002/psp4.13022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/15/2023] [Accepted: 07/19/2023] [Indexed: 08/04/2023] Open
Abstract
Mathematical models of viral dynamics have been reported to describe adequately the dynamic changes of severe acute respiratory syndrome-coronavirus 2 viral load within an individual host. In this study, eight published viral dynamic models were assessed, and model selection was performed. Viral load data were collected from a community surveillance study, including 2155 measurements from 162 patients (124 household and 38 non-household contacts). An extended version of the target-cell limited model that includes an eclipse phase and an immune response component that enhances viral clearance described best the data. In general, the parameter estimates showed good precision (relative standard error <10), apart from the death rate of infected cells. The parameter estimates were used to simulate the outcomes of a clinical trial of the antiviral tixagevimab-cilgavimab, a monoclonal antibody combination which blocks infection of the target cells by neutralizing the virus. The simulated outcome of the effectiveness of the antiviral therapy in controlling viral replication was in a good agreement with the clinical trial data. Early treatment with high antiviral efficacy is important for desired therapeutic outcome.
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Affiliation(s)
- Shengyuan Zhang
- Department of Pharmaceutics, School of PharmacyUniversity College LondonLondonUK
| | - Akosua A. Agyeman
- Infection, Immunity and Inflammation Research and Teaching Department, Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Christoforos Hadjichrysanthou
- Department of MathematicsUniversity of SussexBrightonUK
- Department of Infectious Disease Epidemiology, School of Public HealthImperial College LondonLondonUK
| | - Joseph F. Standing
- Infection, Immunity and Inflammation Research and Teaching Department, Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
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5
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Gonçalves J, Santos CD, Fresco P, Fernandez-Llimos F. Potential use of renin-angiotensin-aldosterone system inhibitors to reduce COVID-19 severity. Rev Port Cardiol 2023; 42:373-383. [PMID: 36893838 PMCID: PMC9999244 DOI: 10.1016/j.repc.2022.02.014] [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: 03/11/2021] [Revised: 01/21/2022] [Accepted: 02/03/2022] [Indexed: 03/09/2023] Open
Abstract
SARS-CoV-2 infection and its clinical manifestations (COVID-19) quickly evolved to a pandemic and a global public health emergency. The limited effectivity of available treatments aimed at reducing virus replication and the lessons learned from other coronavirus infections (SARS-CoV-1 or NL63) that share the internalization process of SARS-CoV-2, led us to revisit the COVID-19 pathogenesis and potential treatments. Virus protein S binds to the angiotensin-converting enzyme 2 (ACE2) initiating the internalization process. Endosome formation removes ACE2 from the cellular membrane preventing its counter-regulative effect mediated by the metabolism of angiotensin II to angiotensin (1-7). Internalized virus-ACE2 complexes have been identified for these coronaviruses. SARS-CoV-2 presents the highest affinity for ACE2 and produces the most severe symptoms. Assuming ACE2 internalization is the trigger for COVID-19 pathogenesis, accumulation of angiotensin II can be viewed as the potential cause of symptoms. Angiotensin II is a strong vasoconstrictor, but has also important roles in hypertrophy, inflammation, remodeling, and apoptosis. Higher levels of ACE2 in the lungs explain the acute respiratory distress syndrome as primary symptoms. Most of the described findings and clinical manifestations of COVID-19, including increased interleukin levels, endothelial inflammation, hypercoagulability, myocarditis, dysgeusia, inflammatory neuropathies, epileptic seizures and memory disorders can be explained by excessive angiotensin II levels. Several meta-analyses have demonstrated that previous use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were associated with better prognosis for COVID-19. Therefore, pragmatic trials to assess the potential therapeutic benefits of renin-angiotensin-aldosterone system inhibitors should be urgently promoted by health authorities to widen the therapeutic options for COVID-19.
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Affiliation(s)
- Jorge Gonçalves
- Laboratório de Farmacologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal; I(3)S: Instituto de Investigação e Inovação em Saúde da Universidade do Porto, Porto, Portugal.
| | - Catarina D Santos
- Laboratório de Farmacologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Paula Fresco
- Laboratório de Farmacologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal; I(3)S: Instituto de Investigação e Inovação em Saúde da Universidade do Porto, Porto, Portugal
| | - Fernando Fernandez-Llimos
- Laboratório de Farmacologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal; CINTESIS - Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal
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6
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Xu J, Carruthers J, Finnie T, Hall I. Simplified within-host and Dose-response Models of SARS-CoV-2. J Theor Biol 2023; 565:111447. [PMID: 36898624 PMCID: PMC9993737 DOI: 10.1016/j.jtbi.2023.111447] [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: 10/24/2022] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 03/12/2023]
Abstract
Understanding the mechanistic dynamics of transmission is key to designing more targeted and effective interventions to limit the spread of infectious diseases. A well-described within-host model allows explicit simulation of how infectiousness changes over time at an individual level. This can then be coupled with dose-response models to investigate the impact of timing on transmission. We collected and compared a range of within-host models used in previous studies and identified a minimally-complex model that provides suitable within-host dynamics while keeping a reduced number of parameters to allow inference and limit unidentifiability issues. Furthermore, non-dimensionalised models were developed to further overcome the uncertainty in estimates of the size of the susceptible cell population, a common problem in many of these approaches. We will discuss these models, and their fit to data from the human challenge study (see Killingley et al. (2022)) for SARS-CoV-2 and the model selection results, which has been performed using ABC-SMC. The parameter posteriors have then used to simulate viral-load based infectiousness profiles via a range of dose-response models, which illustrate the large variability of the periods of infection window observed for COVID-19.
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Affiliation(s)
- Jingsi Xu
- Department of Mathematics, University of Manchester, United Kingdom.
| | | | - Thomas Finnie
- PHAGE Joint Modelling Team, UK Health Security Agency, United Kingdom
| | - Ian Hall
- Department of Mathematics, University of Manchester, United Kingdom; PHAGE Joint Modelling Team, UK Health Security Agency, United Kingdom.
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Boytz R, Seitz S, Gaudiano E, Patten JJ, Keiser PT, Connor JH, Sharpe AH, Davey RA. Inactivation of Ebola Virus and SARS-CoV-2 in Cell Culture Supernatants and Cell Pellets by Gamma Irradiation. Viruses 2022; 15:43. [PMID: 36680083 PMCID: PMC9866162 DOI: 10.3390/v15010043] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022] Open
Abstract
Viral pathogens with the potential to cause widespread disruption to human health and society continue to emerge or re-emerge around the world. Research on such viruses often involves high biocontainment laboratories (BSL3 or BSL4), but the development of diagnostics, vaccines and therapeutics often uses assays that are best performed at lower biocontainment. Reliable inactivation is necessary to allow removal of materials to these spaces and to ensure personnel safety. Here, we validate the use of gamma irradiation to inactivate culture supernatants and pellets of cells infected with a representative member of the Filovirus and Coronavirus families. We show that supernatants and cell pellets containing SARS-CoV-2 are readily inactivated with 1.9 MRad, while Ebola virus requires higher doses of 2.6 MRad for supernatants and 3.8 MRad for pellets. While these doses of radiation inactivate viruses, proinflammatory cytokines that are common markers of virus infection are still detected with low losses. The doses required for virus inactivation of supernatants are in line with previously reported values, but the inactivation of cell pellets has not been previously reported and enables new approaches for analysis of protein-based host responses to infection.
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Affiliation(s)
- RuthMabel Boytz
- Department of Microbiology, National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA 02115, USA
| | - Scott Seitz
- Department of Microbiology, National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA 02115, USA
| | - Emily Gaudiano
- Department of Immunology, Harvard Medical School, Boston, MA 02115, USA
| | - J. J. Patten
- Department of Microbiology, National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA 02115, USA
| | - Patrick T. Keiser
- Department of Microbiology, National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA 02115, USA
| | - John H. Connor
- Department of Microbiology, National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA 02115, USA
| | - Arlene H. Sharpe
- Department of Immunology, Harvard Medical School, Boston, MA 02115, USA
| | - Robert A. Davey
- Department of Microbiology, National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA 02115, USA
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8
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Mursel S, Alter N, Slavit L, Smith A, Bocchini P, Buceta J. Estimation of Ebola’s spillover infection exposure in Sierra Leone based on sociodemographic and economic factors. PLoS One 2022; 17:e0271886. [PMID: 36048780 PMCID: PMC9436100 DOI: 10.1371/journal.pone.0271886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
Zoonotic diseases spread through pathogens-infected animal carriers. In the case of Ebola Virus Disease (EVD), evidence supports that the main carriers are fruit bats and non-human primates. Further, EVD spread is a multi-factorial problem that depends on sociodemographic and economic (SDE) factors. Here we inquire into this phenomenon and aim at determining, quantitatively, the Ebola spillover infection exposure map and try to link it to SDE factors. To that end, we designed and conducted a survey in Sierra Leone and implement a pipeline to analyze data using regression and machine learning techniques. Our methodology is able (1) to identify the features that are best predictors of an individual’s tendency to partake in behaviors that can expose them to Ebola infection, (2) to develop a predictive model about the spillover risk statistics that can be calibrated for different regions and future times, and (3) to compute a spillover exposure map for Sierra Leone. Our results and conclusions are relevant to identify the regions in Sierra Leone at risk of EVD spillover and, consequently, to design and implement policies for an effective deployment of resources (e.g., drug supplies) and other preventative measures (e.g., educational campaigns).
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Affiliation(s)
- Sena Mursel
- Department of Civil and Environmental Engineering, Lehigh University, Bethlehem, PA, United States of America
| | - Nathaniel Alter
- Department of Industrial and System Engineering, Lehigh University, Bethlehem, PA, United States of America
| | - Lindsay Slavit
- Department of Chemical and Biomolecular Engineering, Lehigh University, Bethlehem, PA, United States of America
| | - Anna Smith
- Department of Materials Science and Engineering, Lehigh University, Bethlehem, PA, United States of America
| | - Paolo Bocchini
- Department of Civil and Environmental Engineering, Lehigh University, Bethlehem, PA, United States of America
- * E-mail: (PB); (JB)
| | - Javier Buceta
- Institute for Integrative Systems Biology (I2SysBio), CSIC-UV, Paterna, VA, Spain
- * E-mail: (PB); (JB)
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García-Crespo C, Vázquez-Sirvent L, Somovilla P, Soria ME, Gallego I, de Ávila AI, Martínez-González B, Durán-Pastor A, Domingo E, Perales C. Efficacy decrease of antiviral agents when administered to ongoing hepatitis C virus infections in cell culture. Front Microbiol 2022; 13:960676. [PMID: 35992670 PMCID: PMC9382109 DOI: 10.3389/fmicb.2022.960676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
We report a quantification of the decrease of effectiveness of antiviral agents directed to hepatitis C virus, when the agents are added during an ongoing infection in cell culture vs. when they are added at the beginning of the infection. Major determinants of the decrease of inhibitory activity are the time post-infection of inhibitor administration and viral replicative fitness. The efficacy decrease has been documented with antiviral assays involving the combination of the direct-acting antiviral agents, daclatasvir and sofosbuvir, and with the combination of the lethal mutagens, favipiravir and ribavirin. The results suggest that strict antiviral effectiveness assays in preclinical trials may involve the use of high fitness viral populations and the delayed administration of the agents, relative to infection onset.
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Affiliation(s)
- Carlos García-Crespo
- Centro de Biología Molecular “Severo Ochoa” (CSIC-UAM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) del Instituto de Salud Carlos III, Madrid, Spain
| | - Lucía Vázquez-Sirvent
- Centro de Biología Molecular “Severo Ochoa” (CSIC-UAM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, UAM. Av. Reyes Católicos, Madrid, Spain
| | - Pilar Somovilla
- Centro de Biología Molecular “Severo Ochoa” (CSIC-UAM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Eugenia Soria
- Centro de Biología Molecular “Severo Ochoa” (CSIC-UAM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) del Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, UAM. Av. Reyes Católicos, Madrid, Spain
| | - Isabel Gallego
- Centro de Biología Molecular “Severo Ochoa” (CSIC-UAM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) del Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Isabel de Ávila
- Centro de Biología Molecular “Severo Ochoa” (CSIC-UAM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) del Instituto de Salud Carlos III, Madrid, Spain
| | - Brenda Martínez-González
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, UAM. Av. Reyes Católicos, Madrid, Spain
- Department of Molecular and Cell Biology, Centro Nacional de Biotecnología (CNB-CSIC), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Antoni Durán-Pastor
- Centro de Biología Molecular “Severo Ochoa” (CSIC-UAM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Esteban Domingo
- Centro de Biología Molecular “Severo Ochoa” (CSIC-UAM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) del Instituto de Salud Carlos III, Madrid, Spain
| | - Celia Perales
- Centro de Biología Molecular “Severo Ochoa” (CSIC-UAM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) del Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Microbiology, IIS-Fundación Jiménez Díaz, UAM. Av. Reyes Católicos, Madrid, Spain
- Department of Molecular and Cell Biology, Centro Nacional de Biotecnología (CNB-CSIC), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
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10
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Chen C, Lavezzi SM, Iavarone L. The area under the effect curve as an efficacy determinant for anti‐infectives. CPT Pharmacometrics Syst Pharmacol 2022; 11:1029-1044. [PMID: 35638366 PMCID: PMC9381909 DOI: 10.1002/psp4.12811] [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: 12/01/2021] [Revised: 04/11/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022] Open
Abstract
Pharmacokinetic/pharmacodynamic (PK/PD) indices making use of area under the curve, maximum concentration, and the duration that in vivo drug concentration is maintained above a critical level are commonly applied to clinical dose prediction from animal efficacy experiments in the infectious disease arena. These indices make suboptimal use of the nonclinical data, and the prediction depends on the shape of the PK profiles in the animals, determined by the species‐specific absorption, distribution, metabolism, and elimination properties, and the dosing regimen used in the efficacy experiments. Motivated by the principle that efficacy is driven by pharmacology, we conducted simulations using a generalized pathogen dynamic model, to assess the properties of an alternative efficacy predictor: the area under the effect curve (AUEC), computed using in vitro PD and in vivo PK. Across a wide range of hypothetical scenarios, the AUEC consistently showed regimen‐independent strong correlation (R2 0.76–0.98) with in vivo efficacy, superior to all other indices. These findings serve as proof of concept that AUEC should be considered in practice as a translation tool for cross‐species dose prediction. Using AUEC for clinical dose prediction could also potentially cut down animal use by reducing or avoiding dose fractionation experiments.
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Affiliation(s)
- Chao Chen
- Clinical Pharmacology Modelling and Simulation GlaxoSmithKline London UK
| | - Silvia Maria Lavezzi
- Clinical Pharmacology, Modelling, and Simulation, Parexel International Dublin Ireland
| | - Laura Iavarone
- Clinical Pharmacology, Modelling, and Simulation Parexel International London UK
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11
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Duneau D, Ferdy JB. Pathogen within-host dynamics and disease outcome: what can we learn from insect studies? CURRENT OPINION IN INSECT SCIENCE 2022; 52:100925. [PMID: 35489681 DOI: 10.1016/j.cois.2022.100925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
Parasite proliferations within/on the host form the basis of the outcome of all infectious diseases. However, within-host dynamics are difficult to study in vertebrates, as it requires regularly following pathogen proliferation from the start of the infection and at the organismal level. Invertebrate models allow for this monitoring under controlled conditions using population approaches. These approaches offer the possibility to describe many parameters of the within-host dynamics, such as rate of proliferation, probability to control the infection, and average time at which the pathogen is controlled. New parameters such as the Pathogen Load Upon Death and the Set-Point Pathogen Load have emerged to characterize within-host dynamics and better understand disease outcome. While contextualizing the potential of studying within-host dynamics in insects to build fundamental knowledge, we review what we know about within-host dynamics using insect models, and what it can offer to our knowledge of infectious diseases.
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Affiliation(s)
- David Duneau
- Université Toulouse 3 Paul Sabatier, CNRS, IRD, UMR5174 EDB (Laboratoire Évolution & Diversité Biologique), Toulouse, France; Instituto Gulbenkian de Ciência, Rua da Quinta Grande 6, P-2780 Oeiras, Portugal.
| | - Jean-Baptiste Ferdy
- Université Toulouse 3 Paul Sabatier, CNRS, IRD, UMR5174 EDB (Laboratoire Évolution & Diversité Biologique), Toulouse, France.
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12
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Liu X, Pappas EJ, Husby ML, Motsa BB, Stahelin RV, Pienaar E. Mechanisms of phosphatidylserine influence on viral production: A computational model of Ebola virus matrix protein assembly. J Biol Chem 2022; 298:102025. [PMID: 35568195 PMCID: PMC9218153 DOI: 10.1016/j.jbc.2022.102025] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022] Open
Abstract
Ebola virus (EBOV) infections continue to pose a global public health threat, with high mortality rates and sporadic outbreaks in Central and Western Africa. A quantitative understanding of the key processes driving EBOV assembly and budding could provide valuable insights to inform drug development. Here, we use a computational model to evaluate EBOV matrix assembly. Our model focuses on the assembly kinetics of VP40, the matrix protein in EBOV, and its interaction with phosphatidylserine (PS) in the host cell membrane. It has been shown that mammalian cells transfected with VP40-expressing plasmids are capable of producing virus-like particles (VLPs) that closely resemble EBOV virions. Previous studies have also shown that PS levels in the host cell membrane affects VP40 association with the plasma membrane inner leaflet and that lower membrane PS levels result in lower VLP production. Our computational findings indicate that PS may also have a direct influence on VP40 VLP assembly and budding, where a higher PS level will result in a higher VLP budding rate and filament dissociation rate. Our results further suggest that the assembly of VP40 filaments follow the nucleation-elongation theory, where initialization and oligomerization of VP40 are two distinct steps in the assembly process. Our findings advance the current understanding of VP40 VLP formation by identifying new possible mechanisms of PS influence on VP40 assembly. We propose that these mechanisms could inform treatment strategies targeting PS alone or in combination with other VP40 assembly steps.
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Affiliation(s)
- Xiao Liu
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Ethan J Pappas
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Monica L Husby
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana, USA
| | - Balindile B Motsa
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana, USA
| | - Robert V Stahelin
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana, USA
| | - Elsje Pienaar
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA.
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13
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Kenny SE, Antaw F, Locke WJ, Howard CB, Korbie D, Trau M. Next-Generation Molecular Discovery: From Bottom-Up In Vivo and In Vitro Approaches to In Silico Top-Down Approaches for Therapeutics Neogenesis. Life (Basel) 2022; 12:363. [PMID: 35330114 PMCID: PMC8950575 DOI: 10.3390/life12030363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/23/2022] [Indexed: 12/02/2022] Open
Abstract
Protein and drug engineering comprises a major part of the medical and research industries, and yet approaches to discovering and understanding therapeutic molecular interactions in biological systems rely on trial and error. The general approach to molecular discovery involves screening large libraries of compounds, proteins, or antibodies, or in vivo antibody generation, which could be considered "bottom-up" approaches to therapeutic discovery. In these bottom-up approaches, a minimal amount is known about the therapeutics at the start of the process, but through meticulous and exhaustive laboratory work, the molecule is characterised in detail. In contrast, the advent of "big data" and access to extensive online databases and machine learning technologies offers promising new avenues to understanding molecular interactions. Artificial intelligence (AI) now has the potential to predict protein structure at an unprecedented accuracy using only the genetic sequence. This predictive approach to characterising molecular structure-when accompanied by high-quality experimental data for model training-has the capacity to invert the process of molecular discovery and characterisation. The process has potential to be transformed into a top-down approach, where new molecules can be designed directly based on the structure of a target and the desired function, rather than performing screening of large libraries of molecular variants. This paper will provide a brief evaluation of bottom-up approaches to discovering and characterising biological molecules and will discuss recent advances towards developing top-down approaches and the prospects of this.
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Affiliation(s)
- Sophie E. Kenny
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Corner of College and Cooper Roads (Bldg 75), Brisbane, QLD 4072, Australia; (S.E.K.); (F.A.); (C.B.H.)
| | - Fiach Antaw
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Corner of College and Cooper Roads (Bldg 75), Brisbane, QLD 4072, Australia; (S.E.K.); (F.A.); (C.B.H.)
| | - Warwick J. Locke
- Molecular Diagnostic Solutions, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Building 101, Clunies Ross Street, Canberra, ACT 2601, Australia;
| | - Christopher B. Howard
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Corner of College and Cooper Roads (Bldg 75), Brisbane, QLD 4072, Australia; (S.E.K.); (F.A.); (C.B.H.)
| | - Darren Korbie
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Corner of College and Cooper Roads (Bldg 75), Brisbane, QLD 4072, Australia; (S.E.K.); (F.A.); (C.B.H.)
| | - Matt Trau
- Centre for Personalised Nanomedicine, Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Corner of College and Cooper Roads (Bldg 75), Brisbane, QLD 4072, Australia; (S.E.K.); (F.A.); (C.B.H.)
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia
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14
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Hickman MR, Saunders DL, Bigger CA, Kane CD, Iversen PL. The development of broad-spectrum antiviral medical countermeasures to treat viral hemorrhagic fevers caused by natural or weaponized virus infections. PLoS Negl Trop Dis 2022; 16:e0010220. [PMID: 35259154 PMCID: PMC8903284 DOI: 10.1371/journal.pntd.0010220] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The Joint Program Executive Office for Chemical, Biological, Radiological, and Nuclear Defense (JPEO-CBRND) began development of a broad-spectrum antiviral countermeasure against deliberate use of high-consequence viral hemorrhagic fevers (VHFs) in 2016. The effort featured comprehensive preclinical research, including laboratory testing and rapid advancement of lead molecules into nonhuman primate (NHP) models of Ebola virus disease (EVD). Remdesivir (GS-5734, Veklury, Gilead Sciences) was the first small molecule therapeutic to successfully emerge from this effort. Remdesivir is an inhibitor of RNA-dependent RNA polymerase, a viral enzyme that is essential for viral replication. Its robust potency and broad-spectrum antiviral activity against certain RNA viruses including Ebola virus and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) led to its clinical evaluation in randomized, controlled trials (RCTs) in human patients during the 2018 EVD outbreak in the Democratic Republic of the Congo (DRC) and the ongoing Coronavirus Disease 2019 (COVID-19) pandemic today. Remdesivir was recently approved by the US Food and Drug Administration (FDA) for the treatment of COVID-19 requiring hospitalization. Substantial gaps remain in improving the outcomes of acute viral infections for patients afflicted with both EVD and COVID-19, including how to increase therapeutic breadth and strategies for the prevention and treatment of severe disease. Combination therapy that joins therapeutics with complimentary mechanisms of action appear promising, both preclinically and in RCTs. Importantly, significant programmatic challenges endure pertaining to a clear drug and biological product development pathway for therapeutics targeting biodefense and emerging pathogens when human efficacy studies are not ethical or feasible. For example, remdesivir's clinical development was facilitated by outbreaks of Ebola and SARS-CoV-2; as such, the development pathway employed for remdesivir is likely to be the exception rather than the rule. The current regulatory licensure pathway for therapeutics targeting rare, weaponizable VHF agents is likely to require use of FDA's established Animal Rule (21 CFR 314.600-650 for drugs; 21 CFR 601.90-95 for biologics). The FDA may grant marketing approval based on adequate and well-controlled animal efficacy studies when the results of those studies establish that the drug is safe and likely to produce clinical benefit in humans. In practical terms, this is anticipated to include a series of rigorous, well-documented, animal challenge studies, to include aerosol challenge, combined with human safety data. While small clinical studies against naturally occurring, high-consequence pathogens are typically performed where possible, approval for the therapeutics currently under development against biodefense pathogens will likely require the Animal Rule pathway utilizing studies in NHPs. We review the development of remdesivir as illustrative of the effort that will be needed to field future therapeutics against highly lethal, infectious agents.
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Affiliation(s)
- Mark R. Hickman
- Joint Project Manager for Chemical, Biological, Radiological, and Nuclear Medical (JPM CBRN Medical), Fort Detrick, Maryland, United States of America
| | - David L. Saunders
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Maryland, United States of America
| | - Catherine A. Bigger
- Logistics Management International Inc, Tysons Corner, Virginia, United States of America
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15
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Alexander P, Dobrovolny HM. Treatment of Respiratory Viral Coinfections. EPIDEMIOLOGIA 2022; 3:81-96. [PMID: 36417269 PMCID: PMC9620919 DOI: 10.3390/epidemiologia3010008] [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: 11/29/2021] [Revised: 01/18/2022] [Accepted: 02/01/2022] [Indexed: 12/14/2022] Open
Abstract
With the advent of rapid multiplex PCR, physicians have been able to test for multiple viral pathogens when a patient presents with influenza-like illness. This has led to the discovery that many respiratory infections are caused by more than one virus. Antiviral treatment of viral coinfections can be complex because treatment of one virus will affect the time course of the other virus. Since effective antivirals are only available for some respiratory viruses, careful consideration needs to be given on the effect treating one virus will have on the dynamics of the other virus, which might not have available antiviral treatment. In this study, we use mathematical models of viral coinfections to assess the effect of antiviral treatment on coinfections. We examine the effect of the mechanism of action, relative growth rates of the viruses, and the assumptions underlying the interaction of the viruses. We find that high antiviral efficacy is needed to suppress both infections. If high doses of both antivirals are not achieved, then we run the risk of lengthening the duration of coinfection or even of allowing a suppressed virus to replicate to higher viral titers.
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Affiliation(s)
| | - Hana M. Dobrovolny
- Department of Physics & Astronomy, Texas Christian University, Fort Worth, TX 76129, USA;
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16
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Fujita Y. [Remdesivir for COVID-19]. Nihon Yakurigaku Zasshi 2022; 157:31-37. [PMID: 34980809 DOI: 10.1254/fpj.21058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Remdesivir is a direct-acting antiviral agent that inhibits viral RNA synthesis developed by Gilead Sciences, Inc. in the United States. It has been shown to have antiviral activity against single-stranded RNA viruses, including coronaviruses, in cell culture systems and animal models, and has been developed as a therapeutic agent for Ebola virus infection since 2015. however, to date, it has not been approved in any country. A novel coronavirus infection (COVID-19) was identified in Wuhan, Hubei Province, China in Dec, 2019, and is a respiratory disease characterized by fever, cough, and dyspnea. In severe cases, it may cause serious pneumonia, multi-organ failure and death. Gilead Sciences, Inc. U.S. embarked on the development of COVID-19 as a therapeutic drug, using remdesivir, which has shown in vitro and in vivo antiviral activities against MERS-CoV and SARS-CoV, which are single-stranded RNA coronaviruses that cause Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). The in vitro antiviral activity of remdesivir against SARS-CoV-2, which causes COVID-19, was confirmed and clinical studies were initiated in February 2020. Based on the results of clinical studies conducted by the National Institute of Allergy and Infectious Diseases (NIAID) and Gilead Sciences, Inc. and experience of administration from a compassionate use, an exceptional approval system based on the "Pharmaceuticals and Medical Devices Act" was also approved in Japan as of May 7, 2020 for the indication of "infections caused by SARS-CoV-2." In this article, the background of the development and clinical results of remdesivir are described.
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17
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Nian F, Shi Y, Cao J. COVID-19 Propagation Model Based on Economic Development and Interventions. WIRELESS PERSONAL COMMUNICATIONS 2022; 122:2355-2365. [PMID: 34421225 PMCID: PMC8371428 DOI: 10.1007/s11277-021-08998-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 05/03/2023]
Abstract
In order to understand the influencing factors affecting the COVID-19 propagation, and analyze the development trend of the epidemic situation in the world, COVID-19 propagation model to simulate the COVID-19 propagation in the population is proposed in this paper. First of all, this paper analyzes the economic factors and interventions affecting the COVID-19 propagation in various different countries. Then, the touch number for COVID-19 High-risk Population Dynamic Network in this paper was redefined, and it predicts and analyzes the development trend of the epidemic situation in different countries. The simulation data and the published confirmed data by the world health organization could fit well, which also verified the reliability of the model. Finally, this paper also analyzes the impact of public awareness of prevention on the control of the epidemic. The analysis shows that increasing the awareness of prevention, timely and early adoption of protective measures such as wearing masks, and reducing travel can greatly reduce the risk of infection and the outbreak scale.
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Affiliation(s)
- Fuzhong Nian
- School of Computer and Communication, Lanzhou University of Technology, Lanzhou, 730050 China
| | - Yayong Shi
- School of Computer and Communication, Lanzhou University of Technology, Lanzhou, 730050 China
| | - Jun Cao
- School of Computer and Communication, Lanzhou University of Technology, Lanzhou, 730050 China
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18
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Jung SY, Kim MS, Li H, Lee KH, Koyanagi A, Solmi M, Kronbichler A, Dragioti E, Tizaoui K, Cargnin S, Terrazzino S, Hong SH, Abou Ghayda R, Kim NK, Chung SK, Jacob L, Salem JE, Yon DK, Lee SW, Kostev K, Kim AY, Jung JW, Choi JY, Shin JS, Park SJ, Choi SW, Ban K, Moon SH, Go YY, Shin JI, Smith L. Cardiovascular events and safety outcomes associated with remdesivir using a World Health Organization international pharmacovigilance database. Clin Transl Sci 2021; 15:501-513. [PMID: 34719115 PMCID: PMC8841455 DOI: 10.1111/cts.13168] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/24/2021] [Accepted: 09/10/2021] [Indexed: 12/15/2022] Open
Abstract
On October 2020, the US Food and Drug Administration (FDA) approved remdesivir as the first drug for the treatment of coronavirus disease 2019 (COVID-19), increasing remdesivir prescriptions worldwide. However, potential cardiovascular (CV) toxicities associated with remdesivir remain unknown. We aimed to characterize the CV adverse drug reactions (ADRs) associated with remdesivir using VigiBase, an individual case safety report database of the World Health Organization (WHO). Disproportionality analyses of CV-ADRs associated with remdesivir were performed using reported odds ratios and information components. We conducted in vitro experiments using cardiomyocytes derived from human pluripotent stem cell cardiomyocytes (hPSC-CMs) to confirm cardiotoxicity of remdesivir. To distinguish drug-induced CV-ADRs from COVID-19 effects, we restricted analyses to patients with COVID-19 and found that, after adjusting for multiple confounders, cardiac arrest (adjusted odds ratio [aOR]: 1.88, 95% confidence interval [CI]: 1.08-3.29), bradycardia (aOR: 2.09, 95% CI: 1.24-3.53), and hypotension (aOR: 1.67, 95% CI: 1.03-2.73) were associated with remdesivir. In vitro data demonstrated that remdesivir reduced the cell viability of hPSC-CMs in time- and dose-dependent manners. Physicians should be aware of potential CV consequences following remdesivir use and implement adequate CV monitoring to maintain a tolerable safety margin.
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Affiliation(s)
- Se Yong Jung
- Division of Pediatric Cardiology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Min Seo Kim
- College of Medicine, Korea University, Seoul, Korea.,Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Han Li
- University of Florida College of Medicine, Gainesville, Florida, USA
| | - Keum Hwa Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM, Barcelona, Spain.,ICREA, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada.,Department of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ottawa, Ontario, Canada
| | - Andreas Kronbichler
- Department of Internal Medicine IV, Medical University Innsbruck, Innsbruck, Austria
| | - Elena Dragioti
- Department of Health, Medicine and Caring Sciences, Pain and Rehabilitation Centre, Linköping University, Linköping, Sweden
| | - Kalthoum Tizaoui
- Laboratory Microorganismes and Active Biomolecules, Sciences Faculty of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Sarah Cargnin
- Department of Pharmaceutical Sciences, Interdepartmental Research Center of Pharmacogenetics and Pharmacogenomics (CRIFF), University of Piemonte Orientale, Novara, Italy
| | - Salvatore Terrazzino
- Department of Pharmaceutical Sciences, Interdepartmental Research Center of Pharmacogenetics and Pharmacogenomics (CRIFF), University of Piemonte Orientale, Novara, Italy
| | | | - Ramy Abou Ghayda
- Urology Institute, University Hospitals and Case Western Reserve University, Cleveland, Ohio, USA
| | - Nam Kyun Kim
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA.,Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea
| | | | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Joe-Elie Salem
- Department of Pharmacology, INSERM, CIC-1901 Paris-Est, CLIP Galilée, UNICO-GRECO Cardio-oncology Program, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Dong Keon Yon
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Won Lee
- Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
| | | | - Ah Young Kim
- Division of Pediatric Cardiology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jo Won Jung
- Division of Pediatric Cardiology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Young Choi
- Division of Pediatric Cardiology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Soo Shin
- Infectious Disease Research Center, Korea Research Institute of Chemical Technology, Daejeon, Korea
| | - Soon-Jung Park
- Stem Cell Research Institute, T&R Biofab Co. Ltd, Siheung, Korea
| | - Seong Woo Choi
- Department of Physiology, Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Kiwon Ban
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Sung-Hwan Moon
- Stem Cell Research Institute, T&R Biofab Co. Ltd, Siheung, Korea
| | - Yun Young Go
- Department of Infectious Diseases and Public Health, City University of Hong Kong, Hong Kong SAR, China
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
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19
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Laddada W, Soualmia LF, Zanni-Merk C, Ayadi A, Frydman C, L'Hote I, Imbert I. OntoRepliCov: an Ontology-Based Approach for Modeling the SARS-CoV-2 Replication Process. ACTA ACUST UNITED AC 2021; 192:487-496. [PMID: 34630741 PMCID: PMC8486259 DOI: 10.1016/j.procs.2021.08.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Understanding the replication machinery of viruses contributes to suggest and try effective antiviral strategies. Exhaustive knowledge about the proteins structure, their function, or their interaction is one of the preconditions for successfully modeling it. In this context, modeling methods based on a formal representation with a high semantic expressiveness would be relevant to extract proteins and their nucleotide or amino acid sequences as an element from the replication process. Consequently, our approach relies on the use of semantic technologies to design the SARS-CoV-2 replication machinery. This provides the ability to infer new knowledge related to each step of the virus replication. More specifically, we developed an ontology-based approach enriched with reasoning process of a complete replication machinery process for SARS-CoV-2. We present in this paper a partial overview of our ontology OntoRepliCov to describe one step of this process, namely, the continuous translation or protein synthesis, through classes, properties, axioms, and SWRL (Semantic Web Rule Language) rules.
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Affiliation(s)
- Wissame Laddada
- Normandie Universit, LITIS, 7600 Rouen, France.,Aix-Marseille Universit, LIS, 13009 Marseille, France
| | | | | | - Ali Ayadi
- Aix-Marseille Universit, LIS, 13009 Marseille, France
| | | | - India L'Hote
- Aix-Marseille Universit, AFMB, 13009 Marseille, France
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20
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Marc A, Kerioui M, Blanquart F, Bertrand J, Mitjà O, Corbacho-Monné M, Marks M, Guedj J. Quantifying the relationship between SARS-CoV-2 viral load and infectiousness. eLife 2021; 10:e69302. [PMID: 34569939 PMCID: PMC8476126 DOI: 10.7554/elife.69302] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/01/2021] [Indexed: 12/16/2022] Open
Abstract
The relationship between SARS-CoV-2 viral load and infectiousness is poorly known. Using data from a cohort of cases and high-risk contacts, we reconstructed viral load at the time of contact and inferred the probability of infection. The effect of viral load was larger in household contacts than in non-household contacts, with a transmission probability as large as 48% when the viral load was greater than 1010 copies per mL. The transmission probability peaked at symptom onset, with a mean probability of transmission of 29%, with large individual variations. The model also projects the effects of variants on disease transmission. Based on the current knowledge that viral load is increased by two- to eightfold with variants of concern and assuming no changes in the pattern of contacts across variants, the model predicts that larger viral load levels could lead to a relative increase in the probability of transmission of 24% to 58% in household contacts, and of 15% to 39% in non-household contacts.
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Affiliation(s)
| | | | - François Blanquart
- Université de Paris, IAME, INSERMParisFrance
- Centre for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, PSL Research UniversityParisFrance
| | | | - Oriol Mitjà
- Fight AIDS and Infectious Diseases Foundation, Hospital Universitari Germans Trias i PujolBadalonaSpain
- Lihir Medical Centre, International SOSLondolovitPapua New Guinea
| | - Marc Corbacho-Monné
- Fight AIDS and Infectious Diseases Foundation, Hospital Universitari Germans Trias i PujolBadalonaSpain
- Hospital Universitari Parc TaulíSabadellSpain
- Facultat de Medicina–Universitat de BarcelonaBarcelonaSpain
| | - Michael Marks
- London School of Hygiene and Tropical MedicineLondonUnited Kingdom
- Hospital for Tropical DiseasesLondonUnited Kingdom
- Division of infection and Immunity, University College LondonLondonUnited Kingdom
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21
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Maroney KJ, Pinski AN, Marzi A, Messaoudi I. Transcriptional Analysis of Infection With Early or Late Isolates From the 2013-2016 West Africa Ebola Virus Epidemic Does Not Suggest Attenuated Pathogenicity as a Result of Genetic Variation. Front Microbiol 2021; 12:714817. [PMID: 34484156 PMCID: PMC8415004 DOI: 10.3389/fmicb.2021.714817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/06/2021] [Indexed: 11/13/2022] Open
Abstract
The 2013-2016 West Africa Ebola virus (EBOV) epidemic caused by the EBOV-Makona isolate is the largest and longest recorded to date. It incurred over 28,000 infections and ∼11,000 deaths. Early in this epidemic, several mutations in viral glycoprotein (A82V), nucleoprotein (R111C), and polymerase L (D759G) emerged and stabilized. In vitro studies of these new EBOV-Makona isolates showed enhanced fitness and viral replication capacity. However, in vivo studies in mice and rhesus macaques did not provide any evidence of enhanced viral fitness or shedding. Infection with late isolates carrying or early isolates lacking (early) these mutations resulted in uniformly lethal disease in nonhuman primates (NHPs), albeit with slightly delayed kinetics with late isolates. The recent report of a possible reemergence of EBOV from a persistent infection in a survivor of the epidemic highlights the urgency for understanding the impact of genetic variation on EBOV pathogenesis. However, potential molecular differences in host responses remain unknown. To address this gap in knowledge, we conducted the first comparative analysis of the host responses to lethal infection with EBOV-Mayinga and EBOV-Makona isolates using bivariate, longitudinal, regression, and discrimination transcriptomic analyses. Our analysis shows a conserved core of differentially expressed genes (DEGs) involved in antiviral defense, immune cell activation, and inflammatory processes in response to EBOV-Makona and EBOV-Mayinga infections. Additionally, EBOV-Makona and EBOV-Mayinga infections could be discriminated based on the expression pattern of a small subset of genes. Transcriptional responses to EBOV-Makona isolates that emerged later during the epidemic, specifically those from Mali and Liberia, lacked signatures of profound lymphopenia and excessive inflammation seen following infection with EBOV-Mayinga and early EBOV-Makona isolate C07. Overall, these findings provide novel insight into the mechanisms underlying the lower case fatality rate (CFR) observed with EBOV-Makona compared to EBOV-Mayinga.
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Affiliation(s)
- Kevin J Maroney
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA, United States
| | - Amanda N Pinski
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA, United States
| | - Andrea Marzi
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH, Rocky Mountain Laboratories, Hamilton, MT, United States
| | - Ilhem Messaoudi
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA, United States.,Center for Virus Research, University of California, Irvine, Irvine, CA, United States.,Institute for Immunology, University of California, Irvine, Irvine, CA, United States
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22
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Evans N, Martinez E, Petrosillo N, Nichols J, Islam E, Pruitt K, Almodovar S. SARS-CoV-2 and Human Immunodeficiency Virus: Pathogen Pincer Attack. HIV AIDS (Auckl) 2021; 13:361-375. [PMID: 33833585 PMCID: PMC8020331 DOI: 10.2147/hiv.s300055] [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: 01/01/2021] [Accepted: 02/22/2021] [Indexed: 12/16/2022] Open
Abstract
Paramount efforts worldwide are seeking to increase understanding of the basic virology of SARS-CoV-2, characterize the spectrum of complications associated with COVID-19, and develop vaccines that can protect from new and recurrent infections with SARS-CoV-2. While we continue learning about this new virus, it is clear that 1) the virus is spread via the respiratory route, primarily by droplets and contact with contaminated surfaces and fomites, as well as by aerosol formation during invasive respiratory procedures; 2) the airborne route is still controversial; and 3) that those infected can spread the virus without necessarily developing COVID-19 (ie, asymptomatic). With the number of SARS-CoV-2 infections increasing globally, the possibility of co-infections and/or co-morbidities is becoming more concerning. Co-infection with Human Immunodeficiency Virus (HIV) is one such example of polyparasitism of interest. This military-themed comparative review of SARS-CoV-2 and HIV details their virology and describes them figuratively as separate enemy armies. HIV, an old enemy dug into trenches in individuals already infected, and SARS-CoV-2 the new army, attempting to attack and capture territories, tissues and organs, in order to provide resources for their expansion. This analogy serves to aid in discussion of three main areas of focus and draw attention to how these viruses may cooperate to gain the upper hand in securing a host. Here we compare their target, the key receptors found on those tissues, viral lifecycles and tactics for immune response surveillance. The last focus is on the immune response to infection, addressing similarities in cytokines released. While the majority of HIV cases can be successfully managed with antiretroviral therapy nowadays, treatments for SARS-CoV-2 are still undergoing research given the novelty of this army.
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Affiliation(s)
- Nicholas Evans
- Texas Tech University Health Sciences Center, Department of Immunology & Molecular Microbiology, Lubbock, TX, USA
| | - Edgar Martinez
- Texas Tech University Health Sciences Center, Department of Immunology & Molecular Microbiology, Lubbock, TX, USA
| | - Nicola Petrosillo
- National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy
| | - Jacob Nichols
- Texas Tech University Health Sciences Center, Department of Internal Medicine, Lubbock, TX, USA
| | - Ebtesam Islam
- Texas Tech University Health Sciences Center, Department of Internal Medicine, Lubbock, TX, USA
| | - Kevin Pruitt
- Texas Tech University Health Sciences Center, Department of Immunology & Molecular Microbiology, Lubbock, TX, USA
| | - Sharilyn Almodovar
- Texas Tech University Health Sciences Center, Department of Immunology & Molecular Microbiology, Lubbock, TX, USA
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23
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Reynard S, Gloaguen E, Baillet N, Madelain V, Guedj J, Raoul H, de Lamballerie X, Mullaert J, Baize S. Early control of viral load by favipiravir promotes survival to Ebola virus challenge and prevents cytokine storm in non-human primates. PLoS Negl Trop Dis 2021; 15:e0009300. [PMID: 33780452 PMCID: PMC8031739 DOI: 10.1371/journal.pntd.0009300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 04/08/2021] [Accepted: 03/09/2021] [Indexed: 12/02/2022] Open
Abstract
Ebola virus has been responsible for two major epidemics over the last several years and there has been a strong effort to find potential treatments that can improve the disease outcome. Antiviral favipiravir was thus tested on non-human primates infected with Ebola virus. Half of the treated animals survived the Ebola virus challenge, whereas the infection was fully lethal for the untreated ones. Moreover, the treated animals that did not survive died later than the controls. We evaluated the hematological, virological, biochemical, and immunological parameters of the animals and performed proteomic analysis at various timepoints of the disease. The viral load strongly correlated with dysregulation of the biological functions involved in pathogenesis, notably the inflammatory response, hemostatic functions, and response to stress. Thus, the management of viral replication in Ebola virus disease is of crucial importance in preventing the immunopathogenic disorders and septic-like shock syndrome generally observed in Ebola virus-infected patients. Ebola virus was responsible for several epidemics in the recent years and is now considered as a major public health concern in Central and West African countries. We and others demonstrated that pathogenic events observed during Ebola virus disease are linked to a deleterious immune response. However, the mechanisms implicated are not fully understood. Here, we studied immune responses depending on the viral loads observed in infected cynomolgus monkeys. An antiviral treatment allowed the reduction of viral load in some animals and we observed that these animals did not experience deleterious immune response and the loss of hemostasis. The release of pathogen-associated molecular patterns may thus be limited by the inhibition of viral replication, avoiding the overstimulation of the immune system and consequently the pathogenic events observed in Ebola virus disease.
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Affiliation(s)
- Stéphanie Reynard
- Unité de Biologie des Infections Virales Emergentes, Institut Pasteur, Lyon, France
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | | | - Nicolas Baillet
- Unité de Biologie des Infections Virales Emergentes, Institut Pasteur, Lyon, France
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | | | | | - Hervé Raoul
- Laboratoire P4 Jean Mérieux–INSERM, INSERM US003, Lyon, France
| | - Xavier de Lamballerie
- Unité des Virus Émergents (UVE Aix-Marseille Université-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France
| | | | - Sylvain Baize
- Unité de Biologie des Infections Virales Emergentes, Institut Pasteur, Lyon, France
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
- * E-mail:
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24
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Jogalekar MP, Veerabathini A, Patel AB. COVID-19: Antiviral agents and enzyme inhibitors/receptor blockers in development. Exp Biol Med (Maywood) 2021; 246:1533-1540. [PMID: 33757336 DOI: 10.1177/1535370221999989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Novel 2019 coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) and coronavirus disease 2019 (COVID-19), the respiratory syndrome it causes, have shaken the world to its core by infecting and claiming the lives of many people since originating in December 2019 in Wuhan, China. World Health Organization and several states have declared a pandemic situation and state of emergency, respectively. As there is no treatment for COVID-19, several research institutes and pharmaceutical companies are racing to find a cure. Advances in computational approaches have allowed the screening of massive antiviral compound libraries to identify those that may potentially work against SARS-CoV-2. Antiviral agents developed in the past to combat other viruses are being repurposed. At the same time, new vaccine candidates are being developed and tested in preclinical/clinical settings. This review provides a detailed overview of select repurposed drugs, their mechanism of action, associated toxicities, and major clinical trials involving these agents.
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25
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Formulation, Stability, Pharmacokinetic, and Modeling Studies for Tests of Synergistic Combinations of Orally Available Approved Drugs against Ebola Virus In Vivo. Microorganisms 2021; 9:microorganisms9030566. [PMID: 33801811 PMCID: PMC7998926 DOI: 10.3390/microorganisms9030566] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 12/28/2022] Open
Abstract
Outbreaks of Ebola ebolavirus (EBOV) have been associated with high morbidity and mortality. Milestones have been reached recently in the management of EBOV disease (EVD) with licensure of an EBOV vaccine and two monoclonal antibody therapies. However, neither vaccines nor therapies are available for other disease-causing filoviruses. In preparation for such outbreaks, and for more facile and cost-effective management of EVD, we seek a cocktail containing orally available and room temperature stable drugs with strong activity against multiple filoviruses. We previously showed that (bepridil + sertraline) and (sertraline + toremifene) synergistically suppress EBOV in cell cultures. Here, we describe steps towards testing these combinations in a mouse model of EVD. We identified a vehicle suitable for oral delivery of the component drugs and determined that, thus formulated the drugs are equally active against EBOV as preparations in DMSO, and they maintain activity upon storage in solution for up to seven days. Pharmacokinetic (PK) studies indicated that the drugs in the oral delivery vehicle are well tolerated in mice at the highest doses tested. Collectively the data support advancement of these combinations to tests for synergy in a mouse model of EVD. Moreover, mathematical modeling based on human oral PK projects that the combinations would be more active in humans than their component single drugs.
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26
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Friberg LE. Pivotal Role of Translation in Anti‐Infective Development. Clin Pharmacol Ther 2021; 109:856-866. [DOI: 10.1002/cpt.2182] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/08/2021] [Indexed: 12/12/2022]
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27
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Leowattana W. COVID-19: Potential Repurposing Drugs. Infect Disord Drug Targets 2021; 22:e110122191924. [PMID: 33645490 DOI: 10.2174/1871526521666210301143441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/12/2020] [Accepted: 01/18/2021] [Indexed: 02/05/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is one of the most infectious diseases and caused coronavirus disease in 2019 (COVID-19). It has been widely spread worldwide and infected more than 28 million peoples in 215 countries, and more than 920,000 have now died from COVID-19. To date, no effective antiviral drugs or specific vaccines have been discovered yet. In this bewilderment, the potential therapeutic antiviral drug targets for the COVID-19 are repurposing to speed up the discovery of effective treatment. The most potential drug targets are continuously published, especially Favipiravir, Chloroquine, Hydroxychloroquine, and Remdesivir. Moreover, the antiviral target proteins and anti-host target proteins were reported continuously. This review summarized the current research studies of potential therapeutic drug targets being tested against the SARS-CoV-2. It will provide information relative to potential repurposing drugs to overcome the COVID-19.
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Affiliation(s)
- Wattana Leowattana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi road, Rachatawee, Bangkok 10400. Thailand
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28
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Gonçalves A, Maisonnasse P, Donati F, Albert M, Behillil S, Contreras V, Naninck T, Marlin R, Solas C, Pizzorno A, Lemaitre J, Kahlaoui N, Terrier O, Ho Tsong Fang R, Enouf V, Dereuddre-Bosquet N, Brisebarre A, Touret F, Chapon C, Hoen B, Lina B, Rosa Calatrava M, de Lamballerie X, Mentré F, Le Grand R, van der Werf S, Guedj J. SARS-CoV-2 viral dynamics in non-human primates. PLoS Comput Biol 2021; 17:e1008785. [PMID: 33730053 PMCID: PMC8007039 DOI: 10.1371/journal.pcbi.1008785] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/29/2021] [Accepted: 02/11/2021] [Indexed: 01/08/2023] Open
Abstract
Non-human primates infected with SARS-CoV-2 exhibit mild clinical signs. Here we used a mathematical model to characterize in detail the viral dynamics in 31 cynomolgus macaques for which nasopharyngeal and tracheal viral load were frequently assessed. We identified that infected cells had a large burst size (>104 virus) and a within-host reproductive basic number of approximately 6 and 4 in nasopharyngeal and tracheal compartment, respectively. After peak viral load, infected cells were rapidly lost with a half-life of 9 hours, with no significant association between cytokine elevation and clearance, leading to a median time to viral clearance of 10 days, consistent with observations in mild human infections. Given these parameter estimates, we predict that a prophylactic treatment blocking 90% of viral production or viral infection could prevent viral growth. In conclusion, our results provide estimates of SARS-CoV-2 viral kinetic parameters in an experimental model of mild infection and they provide means to assess the efficacy of future antiviral treatments.
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Affiliation(s)
| | - Pauline Maisonnasse
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Flora Donati
- Unité de Génétique Moléculaire des Virus à ARN, GMVR: Institut Pasteur, UMR CNRS 3569, Université de Paris, Paris, France
- Centre National de Référence des Virus des infections respiratoires (dont la grippe), Institut Pasteur, Paris, France
| | - Mélanie Albert
- Unité de Génétique Moléculaire des Virus à ARN, GMVR: Institut Pasteur, UMR CNRS 3569, Université de Paris, Paris, France
- Centre National de Référence des Virus des infections respiratoires (dont la grippe), Institut Pasteur, Paris, France
| | - Sylvie Behillil
- Unité de Génétique Moléculaire des Virus à ARN, GMVR: Institut Pasteur, UMR CNRS 3569, Université de Paris, Paris, France
- Centre National de Référence des Virus des infections respiratoires (dont la grippe), Institut Pasteur, Paris, France
| | - Vanessa Contreras
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Thibaut Naninck
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Romain Marlin
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Caroline Solas
- Aix-Marseille Univ, APHM, Unité des Virus Emergents (UVE) IRD 190, INSERM 1207, Laboratoire de Pharmacocinétique et Toxicologie, Hôpital La Timone, Marseille, France
| | - Andres Pizzorno
- CIRI, Centre International de Recherche en Infectiologie, (Team VirPath), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Julien Lemaitre
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Nidhal Kahlaoui
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, 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, Lyon, France
| | - Raphael Ho Tsong Fang
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Vincent Enouf
- Unité de Génétique Moléculaire des Virus à ARN, GMVR: Institut Pasteur, UMR CNRS 3569, Université de Paris, Paris, France
- Centre National de Référence des Virus des infections respiratoires (dont la grippe), Institut Pasteur, Paris, France
- Plate-forme de microbiologie mutualisée (P2M), Pasteur International Bioresources Network (PIBnet), Institut Pasteur, Paris, France
| | - Nathalie Dereuddre-Bosquet
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Angela Brisebarre
- Unité de Génétique Moléculaire des Virus à ARN, GMVR: Institut Pasteur, UMR CNRS 3569, Université de Paris, Paris, France
- Centre National de Référence des Virus des infections respiratoires (dont la grippe), Institut Pasteur, Paris, France
| | - Franck Touret
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, IHU Méditerranée Infection, Marseille, France
| | - Catherine Chapon
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Bruno Hoen
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France
| | - Bruno Lina
- CIRI, Centre International de Recherche en Infectiologie, (Team VirPath), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
- Laboratoire de Virologie, Centre National de Référence des Virus des infections respiratoires (dont la grippe), Institut des Agents Infectieux, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Manuel Rosa Calatrava
- CIRI, Centre International de Recherche en Infectiologie, (Team VirPath), Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, IHU Méditerranée Infection, Marseille, France
| | | | - Roger Le Grand
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IMVA-HB/IDMIT), Fontenay-aux-Roses & Le Kremlin-Bicêtre, France
| | - Sylvie van der Werf
- Unité de Génétique Moléculaire des Virus à ARN, GMVR: Institut Pasteur, UMR CNRS 3569, Université de Paris, Paris, France
- Centre National de Référence des Virus des infections respiratoires (dont la grippe), Institut Pasteur, Paris, France
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29
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Michael Lavigne G, Russell H, Sherry B, Ke R. Autocrine and paracrine interferon signalling as 'ring vaccination' and 'contact tracing' strategies to suppress virus infection in a host. Proc Biol Sci 2021; 288:20203002. [PMID: 33622135 PMCID: PMC7935137 DOI: 10.1098/rspb.2020.3002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
The innate immune response, particularly the interferon response, represents a first line of defence against viral infections. The interferon molecules produced from infected cells act through autocrine and paracrine signalling to turn host cells into an antiviral state. Although the molecular mechanisms of IFN signalling have been well characterized, how the interferon response collectively contribute to the regulation of host cells to stop or suppress viral infection during early infection remain unclear. Here, we use mathematical models to delineate the roles of the autocrine and the paracrine signalling, and show that their impacts on viral spread are dependent on how infection proceeds. In particular, we found that when infection is well-mixed, the paracrine signalling is not as effective; by contrast, when infection spreads in a spatial manner, a likely scenario during initial infection in tissue, the paracrine signalling can impede the spread of infection by decreasing the number of susceptible cells close to the site of infection. Furthermore, we argue that the interferon response can be seen as a parallel to population-level epidemic prevention strategies such as ‘contact tracing’ or ‘ring vaccination’. Thus, our results here may have implications for the outbreak control at the population scale more broadly.
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Affiliation(s)
- G Michael Lavigne
- Department of Mathematics, North Carolina State University, Raleigh, NC 27606, USA
| | - Hayley Russell
- Department of Mathematics, North Carolina State University, Raleigh, NC 27606, USA
| | - Barbara Sherry
- School of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
| | - Ruian Ke
- Department of Mathematics, North Carolina State University, Raleigh, NC 27606, USA.,T-6, Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM 87545, USA
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30
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Néant N, Lingas G, Le Hingrat Q, Ghosn J, Engelmann I, Lepiller Q, Gaymard A, Ferré V, Hartard C, Plantier JC, Thibault V, Marlet J, Montes B, Bouiller K, Lescure FX, Timsit JF, Faure E, Poissy J, Chidiac C, Raffi F, Kimmoun A, Etienne M, Richard JC, Tattevin P, Garot D, Le Moing V, Bachelet D, Tardivon C, Duval X, Yazdanpanah Y, Mentré F, Laouénan C, Visseaux B, Guedj J. Modeling SARS-CoV-2 viral kinetics and association with mortality in hospitalized patients from the French COVID cohort. Proc Natl Acad Sci U S A 2021; 118:e2017962118. [PMID: 33536313 PMCID: PMC7929555 DOI: 10.1073/pnas.2017962118] [Citation(s) in RCA: 142] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The characterization of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral kinetics in hospitalized patients and its association with mortality is unknown. We analyzed death and nasopharyngeal viral kinetics in 655 hospitalized patients from the prospective French COVID cohort. The model predicted a median peak viral load that coincided with symptom onset. Patients with age ≥65 y had a smaller loss rate of infected cells, leading to a delayed median time to viral clearance occurring 16 d after symptom onset as compared to 13 d in younger patients (P < 10-4). In multivariate analysis, the risk factors associated with mortality were age ≥65 y, male gender, and presence of chronic pulmonary disease (hazard ratio [HR] > 2.0). Using a joint model, viral dynamics after hospital admission was an independent predictor of mortality (HR = 1.31, P < 10-3). Finally, we used our model to simulate the effects of effective pharmacological interventions on time to viral clearance and mortality. A treatment able to reduce viral production by 90% upon hospital admission would shorten the time to viral clearance by 2.0 and 2.9 d in patients of age <65 y and ≥65 y, respectively. Assuming that the association between viral dynamics and mortality would remain similar to that observed in our population, this could translate into a reduction of mortality from 19 to 14% in patients of age ≥65 y with risk factors. Our results show that viral dynamics is associated with mortality in hospitalized patients. Strategies aiming to reduce viral load could have an effect on mortality rate in this population.
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Affiliation(s)
- Nadège Néant
- Université de Paris, INSERM, IAME, F-75018 Paris, France;
| | | | - Quentin Le Hingrat
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hôpital Bichat, Laboratoire de Virologie, F-75018 Paris, France
| | - Jade Ghosn
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hopital Bichat, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France
| | - Ilka Engelmann
- Univ. Lille, Virology Laboratory, EA3610, Institute of Microbiology, Centre Hospitalier-Universitaire de Lille, F-59037 Lille Cedex, France
| | - Quentin Lepiller
- Laboratoire de Virologie, Centre Hospitalier-Universitaire de Besançon, F-25000 Besançon, France
| | - Alexandre Gaymard
- Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, F-69004 Lyon, France
- Centre National de Référence des Virus Respiratoires, Hospices Civils de Lyon, Groupement Hospitalier Nord, F-69004 Lyon, France
| | - Virginie Ferré
- Service de Virologie, Centre Hospitalier-Universitaire de Nantes, F-44093 Nantes, France
| | - Cédric Hartard
- Laboratoire de Microbiologie, Centre Hospitalier-Universitaire de Nancy, F-54000 Nancy, France
- Université de Lorraine, CNRS, Laboratoire de Chimie Physique et Microbiologie pour les Matériaux et l'Environnement, F-54000 Nancy, France
| | - Jean-Christophe Plantier
- Normandie University, UNIROUEN Rouen, EA2656, Virology, Rouen University Hospital, F-76000 Rouen, France
| | - Vincent Thibault
- Virology, Pontchaillou University Hospital, F-35033 Rennes cedex, France
| | - Julien Marlet
- Laboratoire de Virologie, Centre Hospitalier-Universitaire de Bretonneau, F-37044 Tours, France
- INSERM UMR 1259, Université de Tours, F-37044 Tours, France
| | - Brigitte Montes
- Laboratoire de Virologie, Centre Hospitalier-Universitaire de Montpellier, F-34295 Montpellier, France
| | - Kevin Bouiller
- Infectious and Tropical Disease Department, Besancon University Hospital, F-25000 Besancon, France
- UMR CNRS 6249, Chrono Environnement, University of Bourgogne Franche-Comté, F-25000 Besancon, France
| | - François-Xavier Lescure
- AP-HP, Hopital Bichat, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France
| | - Jean-François Timsit
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hôpital Bichat, Service de Réanimation Médicale et Infectieuse, F-75018 Paris, France
| | - Emmanuel Faure
- Centre Hospitalier-Universitaire de Lille, Univ. Lille, Infectious Disease Department, CNRS, Inserm, U1019-UMR9017-CIIL, F-59000 Lille, France
| | - Julien Poissy
- Université de Lille, INSERM U1285, Centre Hospitalier-Universitaire de Lille, Pôle de réanimation, CNRS, UMR 8576-UGSF-Unité de Glycobiologie Structurale et Fonctionnelle, F-59000 Lille, France
| | - Christian Chidiac
- Infectious and Tropical Disease Department, Croix-Rousse Hospital, University Hospital of Lyon, F-69004 Lyon, France
| | - François Raffi
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier-Universitaire de Nantes, F-44093 Nantes, France
- Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, Centre Hospitalier-Universitaire de Nantes, F-44093 Nantes, France
| | - Antoine Kimmoun
- Université de Lorraine, Centre Hospitalier Régional Universitaire de Nancy, INSERM U1116, F-CRIN INICRCT, Service de Médecine Intensive et Réanimation Brabois, F-54000 Nancy, France
| | - Manuel Etienne
- Infectious Diseases Department, Rouen University Hospital, F-76000 Rouen, France
| | - Jean-Christophe Richard
- Lyon University, CREATIS, CNRS UMR5220, INSERM U1044, INSA, F-69000 Lyon, France
- Intensive Care Unit, Hospices Civils de Lyon, F-69002 Lyon, France
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, F-35000 Rennes, France
| | - Denis Garot
- Centre Hospitalier Régional Universitaire de Tours, Service de Médecine Intensive Réanimation, F-37044 Tours Cedex 9, France
| | - Vincent Le Moing
- Tropical and Infectious Diseases, Saint Eloi Hospital, Université de Montpellier, Medical School, Montpellier University Hospital, F-34295 Montpellier Cedex 5, France
| | - Delphine Bachelet
- AP-HP, Hôpital Bichat, Department of Epidemiology Biostatistics and Clinical Research, F-75018 Paris, France
| | - Coralie Tardivon
- AP-HP, Hôpital Bichat, Department of Epidemiology Biostatistics and Clinical Research, F-75018 Paris, France
| | - Xavier Duval
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hôpital Bichat, Centre d'Investigation Clinique, INSERM CIC-1425, F-75018 Paris, France
| | - Yazdan Yazdanpanah
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hopital Bichat, Service de Maladies Infectieuses et Tropicales, F-75018 Paris, France
| | - France Mentré
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hôpital Bichat, Department of Epidemiology Biostatistics and Clinical Research, F-75018 Paris, France
| | - Cédric Laouénan
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hôpital Bichat, Department of Epidemiology Biostatistics and Clinical Research, F-75018 Paris, France
| | - Benoit Visseaux
- Université de Paris, INSERM, IAME, F-75018 Paris, France
- AP-HP, Hôpital Bichat, Laboratoire de Virologie, F-75018 Paris, France
| | - Jérémie Guedj
- Université de Paris, INSERM, IAME, F-75018 Paris, France
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31
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Qaseem A, Yost J, Etxeandia-Ikobaltzeta I, Abraham GM, Jokela JA, Forciea MA, Miller MC, Humphrey LL, Centor RM, Andrews R, Haeme R, Kansagara DL, Marcucci M. Should Remdesivir Be Used for the Treatment of Patients With COVID-19? Rapid, Living Practice Points From the American College of Physicians (Version 1). Ann Intern Med 2021; 174:229-236. [PMID: 33017175 PMCID: PMC7556654 DOI: 10.7326/m20-5831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
These rapid and living practice points from the American College of Physicians address the effectiveness and harms of remdesivir treatment in patients with COVID-19.
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Affiliation(s)
- Amir Qaseem
- American College of Physicians, Philadelphia, Pennsylvania (A.Q., I.E.)
| | - Jennifer Yost
- American College of Physicians, Philadelphia, and Villanova University, Villanova, Pennsylvania (J.Y.)
| | | | - George M Abraham
- University of Massachusetts Medical School and Saint Vincent Hospital, Worcester, Massachusetts (G.M.A.)
| | - Janet A Jokela
- University of Illinois College of Medicine at Urbana-Champaign, Champaign, Illinois (J.A.J.)
| | | | | | - Linda L Humphrey
- Portland Veterans Affairs Medical Center and Oregon Health & Science University, Portland, Oregon (L.L.H.)
| | | | | | | | | | | |
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32
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Lingas G, Rosenke K, Safronetz D, Guedj J. Lassa viral dynamics in non-human primates treated with favipiravir or ribavirin. PLoS Comput Biol 2021; 17:e1008535. [PMID: 33411731 PMCID: PMC7817048 DOI: 10.1371/journal.pcbi.1008535] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 01/20/2021] [Accepted: 11/13/2020] [Indexed: 02/07/2023] Open
Abstract
Lassa fever is an haemorrhagic fever caused by Lassa virus (LASV). There is no vaccine approved against LASV and the only recommended antiviral treatment relies on ribavirin, despite limited evidence of efficacy. Recently, the nucleotide analogue favipiravir showed a high antiviral efficacy, with 100% survival obtained in an otherwise fully lethal non-human primate (NHP) model of Lassa fever. However the mechanism of action of the drug is not known and the absence of pharmacokinetic data limits the translation of these results to the human setting. Here we aimed to better understand the antiviral effect of favipiravir by developping the first mathematical model recapitulating Lassa viral dynamics and treatment. We analyzed the viral dynamics in 24 NHPs left untreated or treated with ribavirin or favipiravir, and we put the results in perspective with those obtained with the same drugs in the context of Ebola infection. Our model estimates favipiravir EC50 in vivo to 2.89 μg.mL-1, which is much lower than what was found against Ebola virus. The main mechanism of action of favipiravir was to decrease virus infectivity, with an efficacy of 91% at the highest dose. Based on our knowledge acquired on the drug pharmacokinetics in humans, our model predicts that favipiravir doses larger than 1200 mg twice a day should have the capability to strongly reduce the production infectious virus and provide a milestone towards a future use in humans.
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Affiliation(s)
| | - Kyle Rosenke
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana, USA
| | - David Safronetz
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada.,Zoonotic Diseases and Special Pathogens, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
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33
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Liao LE, Carruthers J, Smither SJ, Weller SA, Williamson D, Laws TR, García-Dorival I, Hiscox J, Holder BP, Beauchemin CAA, Perelson AS, López-García M, Lythe G, Barr JN, Molina-París C. Quantification of Ebola virus replication kinetics in vitro. PLoS Comput Biol 2020; 16:e1008375. [PMID: 33137116 PMCID: PMC7660928 DOI: 10.1371/journal.pcbi.1008375] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 11/12/2020] [Accepted: 09/23/2020] [Indexed: 12/17/2022] Open
Abstract
Mathematical modelling has successfully been used to provide quantitative descriptions of many viral infections, but for the Ebola virus, which requires biosafety level 4 facilities for experimentation, modelling can play a crucial role. Ebola virus modelling efforts have primarily focused on in vivo virus kinetics, e.g., in animal models, to aid the development of antivirals and vaccines. But, thus far, these studies have not yielded a detailed specification of the infection cycle, which could provide a foundational description of the virus kinetics and thus a deeper understanding of their clinical manifestation. Here, we obtain a diverse experimental data set of the Ebola virus infection in vitro, and then make use of Bayesian inference methods to fully identify parameters in a mathematical model of the infection. Our results provide insights into the distribution of time an infected cell spends in the eclipse phase (the period between infection and the start of virus production), as well as the rate at which infectious virions lose infectivity. We suggest how these results can be used in future models to describe co-infection with defective interfering particles, which are an emerging alternative therapeutic.
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Affiliation(s)
- Laura E. Liao
- Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM, USA 87545
| | - Jonathan Carruthers
- Department of Applied Mathematics, School of Mathematics, University of Leeds, Leeds LS2 9JT, UK
| | | | | | - Simon A. Weller
- Defence Science and Technology Laboratory, Salisbury SP4 0JQ, UK
| | - Diane Williamson
- Defence Science and Technology Laboratory, Salisbury SP4 0JQ, UK
| | - Thomas R. Laws
- Defence Science and Technology Laboratory, Salisbury SP4 0JQ, UK
| | - Isabel García-Dorival
- Institute of Infection and Global Health, University of Liverpool, Liverpool, L69 7BE, UK
| | - Julian Hiscox
- Institute of Infection and Global Health, University of Liverpool, Liverpool, L69 7BE, UK
| | - Benjamin P. Holder
- Department of Physics, Grand Valley State University, Allendale, MI, USA 49401
| | - Catherine A. A. Beauchemin
- Department of Physics, Ryerson University, Toronto, ON, Canada M5B 2K3
- Interdisciplinary Theoretical and Mathematical Sciences (iTHEMS) Research Program at RIKEN, Wako, Saitama, Japan, 351-0198
| | - Alan S. Perelson
- Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM, USA 87545
| | - Martín López-García
- Department of Applied Mathematics, School of Mathematics, University of Leeds, Leeds LS2 9JT, UK
| | - Grant Lythe
- Department of Applied Mathematics, School of Mathematics, University of Leeds, Leeds LS2 9JT, UK
| | - John N. Barr
- School of Molecular and Cellular Biology, University of Leeds, Leeds LS2 9JT, UK
| | - Carmen Molina-París
- Department of Applied Mathematics, School of Mathematics, University of Leeds, Leeds LS2 9JT, UK
- * E-mail:
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34
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Dobrovolny HM. Quantifying the effect of remdesivir in rhesus macaques infected with SARS-CoV-2. Virology 2020; 550:61-69. [PMID: 32882638 PMCID: PMC7443325 DOI: 10.1016/j.virol.2020.07.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/28/2020] [Accepted: 07/21/2020] [Indexed: 02/08/2023]
Abstract
The world is in the midst of a pandemic caused by a novel coronavirus and is desperately searching for possible treatments. The antiviral remdesivir has shown some effectiveness against SARS-CoV-2 in vitro and in a recent animal study. We use data from a study of remdesivir in rhesus macaques to fit a viral kinetics model in an effort to determine the most appropriate mathematical descripton of the effect of remdesivir. We find statistically significant differences in the viral decay rate and use this to inform a possible mathematical formulation of the effect of remdesivir. Unfortunately, this model formulation suggests that the application of remdesivir will lengthen SARS-CoV-2 infections, putting into question its potential clinical benefit.
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Affiliation(s)
- Hana M Dobrovolny
- Department of Physics and Astronomy, Texas Christian University, Fort Worth, TX, USA.
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35
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Schmid H, Dobrovolny HM. An approximate solution of the interferon-dependent viral kinetics model of influenza. J Theor Biol 2020; 498:110266. [PMID: 32339545 DOI: 10.1016/j.jtbi.2020.110266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/10/2020] [Accepted: 04/01/2020] [Indexed: 11/25/2022]
Abstract
The analysis of viral kinetics models is mostly achieved by numerical methods. We present an approach via a Magnus expansion that allows us to give an approximate solution to the interferon-dependent viral infection model of influenza which is compared with numerical results. The time of peak viral load is calculated from the approximation and stays within 10% in the studied range of interferon (IFN) efficacy ϵ ∈ [0, 1000]. We utilize our solution to interpret the effect of varying IFN efficacy, suggesting a competition between virions and interferon that can cause an additional peak in the usually exponential increase in the viral load.
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Affiliation(s)
- Harald Schmid
- Department of Physics & Astronomy, Texas Christian University, Fort Worth, TX, USA
| | - Hana M Dobrovolny
- Department of Physics & Astronomy, Texas Christian University, Fort Worth, TX, USA.
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36
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Nili A, Farbod A, Neishabouri A, Mozafarihashjin M, Tavakolpour S, Mahmoudi H. Remdesivir: A beacon of hope from Ebola virus disease to COVID-19. Rev Med Virol 2020; 30:1-13. [PMID: 33210457 DOI: 10.1002/rmv.2133] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 12/18/2022]
Abstract
Since the emergence of coronavirus disease 2019 (Covid-19), many studies have been performed to characterize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and find the optimum way to combat this virus. After suggestions and assessments of several therapeutic options, remdesivir (GS-5734), a direct-acting antiviral drug previously tested against Ebola virus disease, was found to be moderately effective and probably safe for inhibiting SARS-CoV-2 replication. Finally, on 1 May 2020, remdesivir (GS-5734) was granted emergency use authorization as an investigational drug for the treatment of Covid-19 by the Food and Drug Administration. However, without a doubt, there are challenging days ahead. Here, we provide a review of the latest findings (based on preprints, post-prints, and news releases in scientific websites) related to remdesivir efficacy and safety for the treatment of Covid-19, along with covering remdesivir history from bench-to-bedside, as well as an overview of its mechanism of action. In addition, active clinical trials, as well as challenging issues related to the future of remdesivir in Covid-19, are covered. Up to the date of writing this review (19 May 2020), there is one finished randomized clinical trial and two completed non-randomized studies, in addition to some ongoing studies, including three observational studies, two expanded access studies, and seven active clinical trials registered on the clinicaltrials.gov and isrctn.com websites. Based on these studies, it seems that remdesivir could be an effective and probably safe treatment option for Covid-19. However, more randomized controlled studies are required.
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Affiliation(s)
- Ali Nili
- Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abolfazl Farbod
- Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Afarin Neishabouri
- Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mozafarihashjin
- Department of Microbiology, Sinai Health System, Toronto, Ontario, Canada.,Sinai Health System, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
| | - Soheil Tavakolpour
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Hamidreza Mahmoudi
- Department of Dermatology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
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37
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Titova YA, Fedorova OV. Favipiravir - a Modern Antiviral Drug: Synthesis and Modifications. Chem Heterocycl Compd (N Y) 2020; 56:659-662. [PMID: 32836314 PMCID: PMC7364135 DOI: 10.1007/s10593-020-02715-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/07/2020] [Indexed: 11/29/2022]
Abstract
The routes of synthesis are considered, as well as the modifications of the promising modern antiviral drug favipiravir. Literature data from the last 10 years are reported.
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Affiliation(s)
- Yulia A. Titova
- Postovsky Institute of Organic Synthesis, Ural Branch of the Russian Academy of Sciences, 22 S. Kovalevskoi / 20 Akademicheskaya St, Yekaterinburg, 620108 Russia
| | - Olga V. Fedorova
- Postovsky Institute of Organic Synthesis, Ural Branch of the Russian Academy of Sciences, 22 S. Kovalevskoi / 20 Akademicheskaya St, Yekaterinburg, 620108 Russia
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38
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Cicco S, Cicco G, Racanelli V, Vacca A. Neutrophil Extracellular Traps (NETs) and Damage-Associated Molecular Patterns (DAMPs): Two Potential Targets for COVID-19 Treatment. Mediators Inflamm 2020; 2020:7527953. [PMID: 32724296 PMCID: PMC7366221 DOI: 10.1155/2020/7527953] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/11/2020] [Accepted: 06/30/2020] [Indexed: 12/17/2022] Open
Abstract
COVID-19 is a pandemic disease caused by the new coronavirus SARS-CoV-2 that mostly affects the respiratory system. The consequent inflammation is not able to clear viruses. The persistent excessive inflammatory response can build up a clinical picture that is very difficult to manage and potentially fatal. Modulating the immune response plays a key role in fighting the disease. One of the main defence systems is the activation of neutrophils that release neutrophil extracellular traps (NETs) under the stimulus of autophagy. Various molecules can induce NETosis and autophagy; some potent activators are damage-associated molecular patterns (DAMPs) and, in particular, the high-mobility group box 1 (HMGB1). This molecule is released by damaged lung cells and can induce a robust innate immunity response. The increase in HMGB1 and NETosis could lead to sustained inflammation due to SARS-CoV-2 infection. Therefore, blocking these molecules might be useful in COVID-19 treatment and should be further studied in the context of targeted therapy.
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Affiliation(s)
- Sebastiano Cicco
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro Medical School, Piazza G. Cesare 11, I-70124 Bari, Italy
| | - Gerolamo Cicco
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro Medical School, Piazza G. Cesare 11, I-70124 Bari, Italy
| | - Vito Racanelli
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro Medical School, Piazza G. Cesare 11, I-70124 Bari, Italy
| | - Angelo Vacca
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro Medical School, Piazza G. Cesare 11, I-70124 Bari, Italy
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39
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Eastman RT, Roth JS, Brimacombe KR, Simeonov A, Shen M, Patnaik S, Hall MD. Correction to Remdesivir: A Review of Its Discovery and Development Leading to Human Clinical Trials for Treatment of COVID-19. ACS CENTRAL SCIENCE 2020; 6:1009. [PMID: 32607448 PMCID: PMC7318059 DOI: 10.1021/acscentsci.0c00747] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Indexed: 05/04/2023]
Abstract
[This corrects the article DOI: 10.1021/acscentsci.0c00489.].
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40
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Eastman R, Roth JS, Brimacombe KR, Simeonov A, Shen M, Patnaik S, Hall MD. Remdesivir: A Review of Its Discovery and Development Leading to Emergency Use Authorization for Treatment of COVID-19. ACS CENTRAL SCIENCE 2020; 6:672-683. [PMID: 32483554 PMCID: PMC7202249 DOI: 10.1021/acscentsci.0c00489] [Citation(s) in RCA: 548] [Impact Index Per Article: 137.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Indexed: 05/09/2023]
Abstract
The global pandemic of SARS-CoV-2, the causative viral pathogen of COVID-19, has driven the biomedical community to action-to uncover and develop antiviral interventions. One potential therapeutic approach currently being evaluated in numerous clinical trials is the agent remdesivir, which has endured a long and winding developmental path. Remdesivir is a nucleotide analogue prodrug that perturbs viral replication, originally evaluated in clinical trials to thwart the Ebola outbreak in 2014. Subsequent evaluation by numerous virology laboratories demonstrated the ability of remdesivir to inhibit coronavirus replication, including SARS-CoV-2. Here, we provide an overview of remdesivir's discovery, mechanism of action, and the current studies exploring its clinical effectiveness.
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Affiliation(s)
- Richard
T. Eastman
- National
Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland 20850, United States
| | - Jacob S. Roth
- National
Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland 20850, United States
- Albert
Einstein College of Medicine, New
York, New York 10461, United States
| | - Kyle R. Brimacombe
- National
Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland 20850, United States
| | - Anton Simeonov
- National
Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland 20850, United States
| | - Min Shen
- National
Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland 20850, United States
| | - Samarjit Patnaik
- National
Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland 20850, United States
| | - Matthew D. Hall
- National
Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland 20850, United States
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41
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Saber-Ayad M, Saleh MA, Abu-Gharbieh E. The Rationale for Potential Pharmacotherapy of COVID-19. Pharmaceuticals (Basel) 2020; 13:E96. [PMID: 32423024 PMCID: PMC7281404 DOI: 10.3390/ph13050096] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/09/2020] [Accepted: 05/11/2020] [Indexed: 12/11/2022] Open
Abstract
On 11 March 2020, the coronavirus disease (COVID-19) was defined by the World Health Organization as a pandemic. Severe acute respiratory syndrome-2 (SARS-CoV-2) is the newly evolving human coronavirus infection that causes COVID-19, and it first appeared in Wuhan, China in December 2019 and spread rapidly all over the world. COVID-19 is being increasingly investigated through virology, epidemiology, and clinical management strategies. There is currently no established consensus on the standard of care in the pharmacological treatment of COVID-19 patients. However, certain medications suggested for other diseases have been shown to be potentially effective for treating this infection, though there has yet to be clear evidence. Therapies include new agents that are currently tested in several clinical trials, in addition to other medications that have been repurposed as antiviral and immune-modulating therapies. Previous high-morbidity human coronavirus epidemics such as the 2003 SARS-CoV and the 2012 Middle East respiratory syndrome coronavirus (MERS-CoV) prompted the identification of compounds that could theoretically be active against the emerging coronavirus SARS-CoV-2. Moreover, advances in molecular biology techniques and computational analysis have allowed for the better recognition of the virus structure and the quicker screening of chemical libraries to suggest potential therapies. This review aims to summarize rationalized pharmacotherapy considerations in COVID-19 patients in order to serve as a tool for health care professionals at the forefront of clinical care during this pandemic. All the reviewed therapies require either additional drug development or randomized large-scale clinical trials to be justified for clinical use.
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Affiliation(s)
- Maha Saber-Ayad
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, UAE; (M.A.S.); (E.A.-G.)
- College of Medicine, Cairo University, Cairo 12613, Egypt
| | - Mohamed A. Saleh
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, UAE; (M.A.S.); (E.A.-G.)
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Eman Abu-Gharbieh
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, UAE; (M.A.S.); (E.A.-G.)
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42
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Madelain V, Mentré F, Baize S, Anglaret X, Laouénan C, Oestereich L, Nguyen THT, Malvy D, Piorkowski G, Graw F, Günther S, Raoul H, de Lamballerie X, Guedj J. Modeling Favipiravir Antiviral Efficacy Against Emerging Viruses: From Animal Studies to Clinical Trials. CPT Pharmacometrics Syst Pharmacol 2020; 9:258-271. [PMID: 32198838 PMCID: PMC7239338 DOI: 10.1002/psp4.12510] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/30/2019] [Indexed: 12/14/2022] Open
Abstract
In 2014, our research network was involved in the evaluation of favipiravir, an anti-influenza polymerase inhibitor, against Ebola virus. In this review, we discuss how mathematical modeling was used, first to propose a relevant dosing regimen in humans, and then to optimize its antiviral efficacy in a nonhuman primate (NHP) model. The data collected in NHPs were finally used to develop a model of Ebola pathogenesis integrating the interactions among the virus, the innate and adaptive immune response, and the action of favipiravir. We conclude the review of this work by discussing how these results are of relevance for future human studies in the context of Ebola virus, but also for other emerging viral diseases for which no therapeutics are available.
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Affiliation(s)
| | | | - Sylvain Baize
- UBIVEInstitut PasteurCentre International de Recherche en InfectiologieLyonFrance
| | - Xavier Anglaret
- INSERMUMR 1219Université de BordeauxBordeauxFrance
- Programme PACCI/site ANRS de Côte d’IvoireAbidjanCôte d’Ivoire
| | | | - Lisa Oestereich
- Bernhard‐Nocht‐Institute for Tropical MedicineHamburgGermany
- German Center for Infection Research (DZIF)Partner Site HamburgGermany
| | | | - Denis Malvy
- INSERMUMR 1219Université de BordeauxBordeauxFrance
- Centre Hospitalier Universitaire de BordeauxBordeauxFrance
| | - Géraldine Piorkowski
- UMR "Emergence des Pathologies Virales" (EPV: Aix‐Marseille University – IRD 190 – Inserm 1207 – EHESP) – Institut Hospitalo‐Universitaire Méditerranée InfectionMarseilleFrance
| | - Frederik Graw
- Center for Modeling and Simulation in the Biosciences (BIOMS)BioQuant‐CenterHeidelberg UniversityHeidelbergGermany
| | - Stephan Günther
- Bernhard‐Nocht‐Institute for Tropical MedicineHamburgGermany
- German Center for Infection Research (DZIF)Partner Site HamburgGermany
| | - Hervé Raoul
- Laboratoire P4 Inserm‐Jean MérieuxUS003 InsermLyonFrance
| | - Xavier de Lamballerie
- UMR "Emergence des Pathologies Virales" (EPV: Aix‐Marseille University – IRD 190 – Inserm 1207 – EHESP) – Institut Hospitalo‐Universitaire Méditerranée InfectionMarseilleFrance
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43
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Madelain V, Duthey A, Mentré F, Jacquot F, Solas C, Lacarelle B, Vallvé A, Barron S, Barrot L, Mundweiler S, Thomas D, Carbonnelle C, Raoul H, de Lamballerie X, Guedj J. Ribavirin does not potentiate favipiravir antiviral activity against Ebola virus in non-human primates. Antiviral Res 2020; 177:104758. [PMID: 32135218 DOI: 10.1016/j.antiviral.2020.104758] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND In spite of recurrent and dramatic outbreaks, there are no therapeutics approved against Ebola virus disease. Favipiravir, a RNA polymerase inhibitor active against several RNA viruses, recently demonstrated significant but not complete protection in a non-human primate model of Ebola virus disease. In this study, we assessed the benefit of the combination of favipiravir and ribavirin, another broad spectrum antiviral agent, in the same model. METHODS 15 female cynomolgus macaques were challenged intramuscularly with 1,000 FFU of Ebola virus Gabon 2001 strain and followed for 21 days. All animals received favipiravir 180 mg/kg twice a day (BID), either as monotherapy (n = 5) or in combination with ribavirin (n = 10). Ribavirin was given either at the dose 10 mg/kg BID (n = 5) or 5 mg/kg BID (n = 5). Favipiravir and ribavirin were initiated two and one days before viral challenge respectively and treatment were continued for 14 days. Treatment effects on viral and hematological markers were assessed using a mathematical model. Survival rate of 0% and 20% were obtained in macaques receiving favipiravir plus ribavirin 10 and 5 mg/kg BID, respectively, compared to 40% in the favipiravir monotherapy group (P = 0.061 when comparing monotherapy and bitherapy, log rank). Viral dynamic modeling analysis did not identify an association between plasma concentrations of ribavirin and viral load levels. Using a model of erythropoiesis, plasma concentrations of ribavirin were strongly associated with a hemoglobin drop (p = 0.0015). CONCLUSION Ribavirin plus favipiravir did not extend survival rates and did not lower viral replication rate compared to favipiravir monotherapy in this animal model. Patients receiving this combination in other indications, such as Lassa fever, should be closely monitored to prevent potential toxicity associated with anemia.
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Affiliation(s)
| | - Aurélie Duthey
- Laboratoire P4 Inserm-Jean Mérieux, US003 Inserm, 69365, Lyon, France
| | - France Mentré
- Université de Paris, IAME, INSERM, F-75018, Paris, France
| | - Frédéric Jacquot
- Laboratoire P4 Inserm-Jean Mérieux, US003 Inserm, 69365, Lyon, France
| | - Caroline Solas
- Aix-Marseille Univ, APHM, UMR "Emergence des Pathologies Virales" IRD190-Inserm1207-EHESP, Laboratoire Pharmacocinétique-Toxicologie, Hôpital La Timone, 13005, Marseille, France
| | - Bruno Lacarelle
- Aix-Marseille Univ, APHM, UMR "Emergence des Pathologies Virales" IRD190-Inserm1207-EHESP, Laboratoire Pharmacocinétique-Toxicologie, Hôpital La Timone, 13005, Marseille, France
| | - Audrey Vallvé
- Laboratoire P4 Inserm-Jean Mérieux, US003 Inserm, 69365, Lyon, France
| | - Stéphane Barron
- Laboratoire P4 Inserm-Jean Mérieux, US003 Inserm, 69365, Lyon, France
| | - Laura Barrot
- Laboratoire P4 Inserm-Jean Mérieux, US003 Inserm, 69365, Lyon, France
| | | | - Damien Thomas
- Laboratoire P4 Inserm-Jean Mérieux, US003 Inserm, 69365, Lyon, France
| | | | - Hervé Raoul
- Laboratoire P4 Inserm-Jean Mérieux, US003 Inserm, 69365, Lyon, France
| | - Xavier de Lamballerie
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille University - IRD 190 - Inserm 1207 - EHESP), Institut Hospitalo-Universitaire Méditerranée Infection, F-13385, Marseille, France
| | - Jérémie Guedj
- Université de Paris, IAME, INSERM, F-75018, Paris, France.
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44
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Gonçalves A, Mentré F, Lemenuel-Diot A, Guedj J. Model Averaging in Viral Dynamic Models. AAPS JOURNAL 2020; 22:48. [PMID: 32060662 DOI: 10.1208/s12248-020-0426-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/16/2020] [Indexed: 12/24/2022]
Abstract
The paucity of experimental data makes both inference and prediction particularly challenging in viral dynamic models. In the presence of several candidate models, a common strategy is model selection (MS), in which models are fitted to the data but only results obtained with the "best model" are presented. However, this approach ignores model uncertainty, which may lead to inaccurate predictions. When several models provide a good fit to the data, another approach is model averaging (MA) that weights the predictions of each model according to its consistency to the data. Here, we evaluated by simulations in a nonlinear mixed-effect model framework the performances of MS and MA in two realistic cases of acute viral infection, i.e., (1) inference in the presence of poorly identifiable parameters, namely, initial viral inoculum and eclipse phase duration, (2) uncertainty on the mechanisms of action of the immune response. MS was associated in some scenarios with a large rate of false selection. This led to a coverage rate lower than the nominal coverage rate of 0.95 in the majority of cases and below 0.50 in some scenarios. In contrast, MA provided better estimation of parameter uncertainty, with coverage rates ranging from 0.72 to 0.98 and mostly comprised within the nominal coverage rate. Finally, MA provided similar predictions than those obtained with MS. In conclusion, parameter estimates obtained with MS should be taken with caution, especially when several models well describe the data. In this situation, MA has better performances and could be performed to account for model uncertainty.
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Affiliation(s)
- Antonio Gonçalves
- Université de Paris, IAME, INSERM, Henri Huchard, F-75018, Paris, France.
| | - France Mentré
- Université de Paris, IAME, INSERM, Henri Huchard, F-75018, Paris, France
| | - Annabelle Lemenuel-Diot
- Roche Pharmaceutical Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center, Basel, Switzerland
| | - Jérémie Guedj
- Université de Paris, IAME, INSERM, Henri Huchard, F-75018, Paris, France
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45
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Hendricks K, Parrado MG, Bradley J. Opinion: An Existing Drug to Assess In Vivo for Potential Adjunctive Therapy of Ebola Virus Disease and Post-Ebola Syndrome. Front Pharmacol 2020; 10:1691. [PMID: 32082173 PMCID: PMC7002323 DOI: 10.3389/fphar.2019.01691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 12/24/2019] [Indexed: 01/02/2023] Open
Affiliation(s)
| | | | - John Bradley
- Division of Infectious Diseases, Department of Pediatrics, UCSD School of Medicine, San Diego, CA, United States
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46
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Chertow DS, Shekhtman L, Lurie Y, Davey RT, Heller T, Dahari H. Modeling Challenges of Ebola Virus-Host Dynamics during Infection and Treatment. Viruses 2020; 12:v12010106. [PMID: 31963118 PMCID: PMC7019702 DOI: 10.3390/v12010106] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/10/2019] [Accepted: 01/14/2020] [Indexed: 02/06/2023] Open
Abstract
Mathematical modeling of Ebola virus (EBOV)-host dynamics during infection and treatment in vivo is in its infancy due to few studies with frequent viral kinetic data, lack of approved antiviral therapies, and limited insight into the timing of EBOV infection of cells and tissues throughout the body. Current in-host mathematical models simplify EBOV infection by assuming a single homogeneous compartment of infection. In particular, a recent modeling study assumed the liver as the largest solid organ targeted by EBOV infection and predicted that nearly all cells become refractory to infection within seven days of initial infection without antiviral treatment. We compared our observations of EBOV kinetics in multiple anatomic compartments and hepatocellular injury in a critically ill patient with Ebola virus disease (EVD) with this model's predictions. We also explored the model's predictions, with and without antiviral therapy, by recapitulating the model using published inputs and assumptions. Our findings highlight the challenges of modeling EBOV-host dynamics and therapeutic efficacy and emphasize the need for iterative interdisciplinary efforts to refine mathematical models that might advance understanding of EVD pathogenesis and treatment.
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Affiliation(s)
- Daniel S. Chertow
- Critical Care Medicine Department, National Institutes of Health Clinical Center, Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, USA
- Correspondence: ; Tel.: +1-(301)-451-7731
| | - Louis Shekhtman
- The Program for Experimental and Theoretical Modeling, Division of Hepatology, Department of Medicine, Loyola University Medical Center, Maywood, IL 60153, USA; (L.S.); (H.D.)
- Network Science Institute, Northeastern University, Boston, MA 02115, USA
| | - Yoav Lurie
- Liver Unit, Shaare Zedek Medical Center and the Hebrew University of Jerusalem, Jerusalem 9103102, Israel
| | - Richard T. Davey
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Theo Heller
- Translational Hepatology Unit, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Harel Dahari
- The Program for Experimental and Theoretical Modeling, Division of Hepatology, Department of Medicine, Loyola University Medical Center, Maywood, IL 60153, USA; (L.S.); (H.D.)
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47
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Friberg LE, Guedj J. Acute bacterial or viral infection-What's the difference? A perspective from PKPD modellers. Clin Microbiol Infect 2019; 26:1133-1136. [PMID: 31899337 DOI: 10.1016/j.cmi.2019.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/28/2019] [Accepted: 12/14/2019] [Indexed: 01/14/2023]
Affiliation(s)
- L E Friberg
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.
| | - J Guedj
- Université de Paris, IAME, INSERM, F-75018, Paris, France.
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48
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Thangaraju P, Varthya S, Venkatesan S. Ebola virüsüne yönelik ilaç çalışmaları: bir umut ışığı. CUKUROVA MEDICAL JOURNAL 2019. [DOI: 10.17826/cumj.517406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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49
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Erb-Alvarez J, Wendelboe AM, Chertow DS. Ebola Virus in the Democratic Republic of the Congo: Advances and Remaining Obstacles in Epidemic Control, Clinical Care, and Biomedical Research. Chest 2019; 157:42-46. [PMID: 31518557 DOI: 10.1016/j.chest.2019.08.2183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/01/2019] [Accepted: 08/19/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
- Julie Erb-Alvarez
- Division of Intramural Research, Office of the Clinical Director, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Aaron M Wendelboe
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Daniel S Chertow
- Critical Care Medicine Department, Clinical Center and Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.
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50
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Banadyga L, Siragam V, Zhu W, He S, Cheng K, Qiu X. The Cytokine Response Profile of Ebola Virus Disease in a Large Cohort of Rhesus Macaques Treated With Monoclonal Antibodies. Open Forum Infect Dis 2019; 6:ofz046. [PMID: 30949520 PMCID: PMC6440691 DOI: 10.1093/ofid/ofz046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 01/30/2019] [Indexed: 12/16/2022] Open
Abstract
Ebola virus (EBOV) is a highly pathogenic filovirus that causes outbreaks of a severe hemorrhagic fever known as EBOV disease (EVD). Ebola virus disease is characterized in part by a dysregulated immune response and massive production of both pro- and anti-inflammatory cytokines. To better understand the immune response elicited by EVD in the context of treatment with experimental anti-EBOV antibody cocktails, we analyzed 29 cytokines in 42 EBOV-infected rhesus macaques. In comparison to the surviving treated animals, which exhibited minimal aberrations in only a few cytokine levels, nonsurviving animals exhibited a dramatically upregulated inflammatory response that was delayed by antibody treatment.
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Affiliation(s)
- Logan Banadyga
- Zoonotic Diseases and Special Pathogens Program, Public Health Agency of Canada, Winnipeg
| | - Vinayakumar Siragam
- Zoonotic Diseases and Special Pathogens Program, Public Health Agency of Canada, Winnipeg
| | - Wenjun Zhu
- Zoonotic Diseases and Special Pathogens Program, Public Health Agency of Canada, Winnipeg
| | - Shihua He
- Zoonotic Diseases and Special Pathogens Program, Public Health Agency of Canada, Winnipeg
| | - Keding Cheng
- Science and Technology Core, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg.,Department of Human Anatomy and Cell Sciences, University of Manitoba, Winnipeg, Canada
| | - Xiangguo Qiu
- Zoonotic Diseases and Special Pathogens Program, Public Health Agency of Canada, Winnipeg.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
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