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Bauermeister JA, Tingler RC, Ho K, Scheckter R, McClure T, Davis J, Piper J, Friedland BA, Edick S, Song M, Jiao Y, Hendrix CW, Hoesley C. Acceptability of PC-1005 Gel Administered Rectally to HIV-1 Seronegative Adults at Three Different Volume Levels (MTN-037). AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:257-271. [PMID: 35994578 PMCID: PMC9924357 DOI: 10.1521/aeap.2022.34.4.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Multipurpose prevention technologies (MPT) have been increasingly researched for their dual-purpose preventative properties against HIV and other STIs. The acceptability of PC-1005, a topical MPT candidate, was explored among men and women participating in the MTN-037 Phase I trial at two U.S. sites (Pittsburgh, PA, and Birmingham, AL). We triangulated quantitative and qualitative assessments of the acceptability of three volumes (4 mL, 16 mL, 32 mL) of PC-1005 administered rectally (N = 12; 6 males, 6 females). Participants rated overall gel acceptability on a scale of 1-10, with a median of 7.17 (SD = 2.04) and had positive feelings about all three dose volumes, citing them to be very comfortable or comfortable (dose 1 = 91.7%; dose 2 = 91.7%; dose 3 = 83.3%). High acceptability of and comfort with all three dose volumes shows promise for PC-1005 as an MPT to prevent HIV and STIs, warranting future clinical development.
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Affiliation(s)
| | | | - Ken Ho
- University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | | | | | | | - Stacey Edick
- University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mei Song
- Microbicide Trials Network, Pittsburgh, Pennsylvania
| | - Yuqing Jiao
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Craig W Hendrix
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Craig Hoesley
- University of Alabama at Birmingham, Birmingham, Alabama
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2
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Verma N, Mukhopadhyay S, Barnable P, Plagianos MG, Teleshova N. Estradiol inhibits HIV-1 BaL infection and induces CFL1 expression in peripheral blood mononuclear cells and endocervical mucosa. Sci Rep 2022; 12:6165. [PMID: 35418661 PMCID: PMC9008051 DOI: 10.1038/s41598-022-10163-6] [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: 09/27/2021] [Accepted: 03/30/2022] [Indexed: 11/15/2022] Open
Abstract
An inhibitory effect of estradiol (E2) on HIV-1 infection was suggested by several reports. We previously identified increased gene expression of actin-binding protein cofilin 1 (CFL1) in endocervix in the E2-dominated proliferative phase of the menstrual cycle. Actin cytoskeleton has an integral role in establishing and spreading HIV-1 infection. Herein, we studied in vitro effects of E2 on HIV-1 infection and on CFL1 expression to gain insight into the mechanism of HIV-1 inhibition by E2. E2 dose-dependently inhibited HIV-1BaL infection in peripheral blood mononuclear cells (PBMCs) and endocervix. In PBMCs and endocervix, E2 increased protein expression of total CFL1 and phosphorylated CFL1 (pCFL1) and pCFL1/CFL1 ratios. LIMKi3, a LIM kinase 1 and 2 inhibitor, abrogated the phenotype and restored infection in both PBMCs and endocervix; inhibited E2-induced expression of total CFL1, pCFL1; and decreased pCFL1/CFL1 ratios. Knockdown of CFL1 in PBMCs also abrogated the phenotype and partially restored infection. Additional analysis of soluble mediators revealed decreased concentrations of pro-inflammatory chemokines CXCL10 and CCL5 in infected tissues incubated with E2. Our results suggest a link between E2-mediated anti-HIV-1 activity and expression of CFL1 in PBMCs and endocervical mucosa. The data support exploration of cytoskeletal signaling pathway targets for the development of prevention strategies against HIV-1.
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Affiliation(s)
- N Verma
- Center for Biomedical Research, Population Council, 1230 York Ave., New York, NY, 10065, USA
| | - S Mukhopadhyay
- Center for Biomedical Research, Population Council, 1230 York Ave., New York, NY, 10065, USA
| | - P Barnable
- Center for Biomedical Research, Population Council, 1230 York Ave., New York, NY, 10065, USA
| | - M G Plagianos
- Center for Biomedical Research, Population Council, 1230 York Ave., New York, NY, 10065, USA
| | - N Teleshova
- Center for Biomedical Research, Population Council, 1230 York Ave., New York, NY, 10065, USA.
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3
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Teleshova N, Keller MJ, Fernández Romero JA, Friedland BA, Creasy GW, Plagianos MG, Ray L, Barnable P, Kizima L, Rodriguez A, Cornejal N, Melo C, Cruz Rodriguez G, Mukhopadhyay S, Calenda G, Sinkar SU, Bonnaire T, Wesenberg A, Zhang S, Kleinbeck K, Palmer K, Alami M, O’Keefe BR, Gillevet P, Hur H, Liang Y, Santone G, Fichorova RN, Kalir T, Zydowsky TM. Results of a phase 1, randomized, placebo-controlled first-in-human trial of griffithsin formulated in a carrageenan vaginal gel. PLoS One 2022; 17:e0261775. [PMID: 35051209 PMCID: PMC8775213 DOI: 10.1371/journal.pone.0261775] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/01/2021] [Indexed: 12/13/2022] Open
Abstract
HIV pre-exposure prophylaxis (PrEP) is dominated by clinical therapeutic antiretroviral (ARV) drugs. Griffithsin (GRFT) is a non-ARV lectin with potent anti-HIV activity. GRFT’s preclinical safety, lack of systemic absorption after vaginal administration in animal studies, and lack of cross-resistance with existing ARV drugs prompted its development for topical HIV PrEP. We investigated safety, pharmacokinetics (PK), pharmacodynamics (PD), and immunogenicity of PC-6500 (0.1% GRFT in a carrageenan (CG) gel) in healthy women after vaginal administration. This randomized, placebo-controlled, parallel group, double-blind first-in-human phase 1 study enrolled healthy, HIV-negative, non-pregnant women aged 24–45 years. In the open label period, all participants (n = 7) received single dose of PC-6500. In the randomized period, participants (n = 13) were instructed to self-administer 14 doses of PC-6500 or its matching CG placebo (PC-535) once daily for 14 days. The primary outcomes were safety and PK after single dose, and then after 14 days of dosing. Exploratory outcomes were GRFT concentrations in cervicovaginal fluids, PD, inflammatory mediators and gene expression in ectocervical biopsies. This trial is registered with ClinicalTrials.gov, number NCT02875119. No significant adverse events were recorded in clinical or laboratory results or histopathological evaluations in cervicovaginal mucosa, and no anti-drug (GRFT) antibodies were detected in serum. No cervicovaginal proinflammatory responses and no changes in the ectocervical transcriptome were evident. Decreased levels of proinflammatory chemokines (CXCL8, CCL5 and CCL20) were observed. GRFT was not detected in plasma. GRFT and GRFT/CG in cervicovaginal lavage samples inhibited HIV and HPV, respectively, in vitro in a dose-dependent fashion. These data suggest GRFT formulated in a CG gel is a safe and promising on-demand multipurpose prevention technology product that warrants further investigation.
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Affiliation(s)
- Natalia Teleshova
- Center for Biomedical Research, Population Council, New York, New York, United States of America
- * E-mail:
| | - Marla J. Keller
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - José A. Fernández Romero
- Center for Biomedical Research, Population Council, New York, New York, United States of America
- Science Department, Borough of Manhattan Community College, New York, New York, United States of America
| | - Barbara A. Friedland
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - George W. Creasy
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Marlena G. Plagianos
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Laurie Ray
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Patrick Barnable
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Larisa Kizima
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Aixa Rodriguez
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Nadjet Cornejal
- Science Department, Borough of Manhattan Community College, New York, New York, United States of America
| | - Claudia Melo
- Science Department, Borough of Manhattan Community College, New York, New York, United States of America
| | - Gearoff Cruz Rodriguez
- Science Department, Borough of Manhattan Community College, New York, New York, United States of America
| | - Sampurna Mukhopadhyay
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Giulia Calenda
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Shweta U. Sinkar
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Thierry Bonnaire
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Asa Wesenberg
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Shimin Zhang
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Kyle Kleinbeck
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Kenneth Palmer
- University of Louisville, Louisville, Kentucky, United States of America
| | - Mohcine Alami
- Center for Biomedical Research, Population Council, New York, New York, United States of America
| | - Barry R. O’Keefe
- Division of Cancer Treatment and Diagnosis, Molecular Targets Program, Center for Cancer Research and Natural Products Branch, Developmental Therapeutics Program, National Cancer Institute, Frederick, Maryland, United States of America
| | - Patrick Gillevet
- George Mason University, Manassas, Virginia, United States of America
| | - Hong Hur
- Rockefeller University, New York, New York, United States of America
| | - Yupu Liang
- Rockefeller University, New York, New York, United States of America
| | - Gabriela Santone
- Harvard Medical School, Boston, Massachusetts, United States of America
| | | | - Tamara Kalir
- Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Thomas M. Zydowsky
- Center for Biomedical Research, Population Council, New York, New York, United States of America
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Lee C. Carrageenans as Broad-Spectrum Microbicides: Current Status and Challenges. Mar Drugs 2020; 18:md18090435. [PMID: 32825645 PMCID: PMC7551811 DOI: 10.3390/md18090435] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/09/2020] [Accepted: 08/18/2020] [Indexed: 01/08/2023] Open
Abstract
Different kinds of red algae are enriched with chemically diverse carbohydrates. In particular, a group of sulfated polysaccharides, which were isolated from the cell walls of red algae, gained a large amount of attention due to their broad-spectrum antimicrobial activities. Within that group, carrageenans (CGs) were expected to be the first clinically applicable microbicides that could prevent various viral infections due to their superior antiviral potency and desirable safety profiles in subclinical studies. However, their anticipated beneficial effects could not be validated in human studies. To assess the value of a second attempt at pharmacologically developing CGs as a new class of preventive microbicides, all preclinical and clinical development processes of CG-based microbicides need to be thoroughly re-evaluated. In this review, the in vitro toxicities; in vivo safety profiles; and in vitro, ex vivo, and in vivo antiviral activities of CGs are summarized according to the study volume of their target viruses, which include human immunodeficiency virus, herpesviruses, respiratory viruses, human papillomavirus, dengue virus, and other viruses along with a description of their antiviral modes of action and development of antiviral resistance. This evaluation of the strengths and weaknesses of CGs will help provide future research directions that may lead to the successful development of CG-based antimicrobial prophylactics.
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Affiliation(s)
- Choongho Lee
- College of Pharmacy, Dongguk University, Goyang 10326, Korea
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5
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Szöllősi A, Raffai T, Bogdanov A, Endrész V, Párducz L, Somogyvári F, Janovák L, Burián K, Virok DP. Correlation between detergent activity and anti-herpes simplex virus-2 activity of commercially available vaginal gels. BMC Res Notes 2020; 13:52. [PMID: 32005126 PMCID: PMC6995179 DOI: 10.1186/s13104-020-4918-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/23/2020] [Indexed: 09/03/2023] Open
Abstract
OBJECTIVE Herpes simplex virus-2 (HSV-2) infections are almost exclusively sexually transmitted. The presence of vaginal gels during sexual activity may have a significant positive or negative impact on viral transmission. Therefore we investigated three off-the-shelf vaginal lubricants and one pH restoring gel to evaluate their impact on HSV-2 replication. RESULTS HeLa cells were infected with untreated virions and virions incubated with the particular gels. The accumulation of viral genomes was monitored by quantitative PCR (qPCR) method at 24 h post infection. Two of the tested gels had no significant effect on HSV-2 replication at the maximum applied concentration, while two had a strong inhibitory effect (~ 98% reduction of replication). The replication inhibitory effect was observed at various multiplicity of infection (MOI 0.4-6.4) and the two inhibitory gels were also capable of inhibiting the HSV-2 induced cytopathic effect on HeLa cells. The surface tension decreasing activity-an indication of detergent activity-was strongly correlated with the anti-HSV-2 activity of the gels (R2: 0.88). Our results indicate that off-the-shelf vaginal gels have a markedly different anti-HSV-2 activity that may influence HSV-2 transmission.
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Affiliation(s)
- Andrea Szöllősi
- Department of Health and Social Sciences, Gál Ferenc College, Szent István st. 17-19, Gyula, 5700, Hungary
| | - Tímea Raffai
- Department of Medical Microbiology and Immunobiology, University of Szeged, Dóm sqr. 10, Szeged, 6720, Hungary
| | - Anita Bogdanov
- Department of Medical Microbiology and Immunobiology, University of Szeged, Dóm sqr. 10, Szeged, 6720, Hungary
| | - Valéria Endrész
- Department of Medical Microbiology and Immunobiology, University of Szeged, Dóm sqr. 10, Szeged, 6720, Hungary
| | - László Párducz
- Department of Health and Social Sciences, Gál Ferenc College, Szent István st. 17-19, Gyula, 5700, Hungary.,Pándy Kálmán County Hospital, Semmelweis st. 1, Gyula, 5700, Hungary
| | - Ferenc Somogyvári
- Department of Medical Microbiology and Immunobiology, University of Szeged, Dóm sqr. 10, Szeged, 6720, Hungary
| | - László Janovák
- Interdisciplinary Excellence Centre, Department of Physical Chemistry and Materials Science, University of Szeged, Rerrich Béla sqr. 1, Szeged, 6720, Hungary
| | - Katalin Burián
- Department of Medical Microbiology and Immunobiology, University of Szeged, Dóm sqr. 10, Szeged, 6720, Hungary
| | - Dezső P Virok
- Department of Medical Microbiology and Immunobiology, University of Szeged, Dóm sqr. 10, Szeged, 6720, Hungary.
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6
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Sarmah BK, Konwar M, Bhattacharyya D, Adhikari P, Das A. Regioselective Cyanation of Six‐MemberedN‐Heteroaromatic Compounds Under Metal‐, Activator‐, Base‐ and Solvent‐Free Conditions. Adv Synth Catal 2019. [DOI: 10.1002/adsc.201901103] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Bikash Kumar Sarmah
- Department of ChemistryIndian Institute of Technology Guwahati 781039, Assam India
| | - Monuranjan Konwar
- Department of ChemistryIndian Institute of Technology Guwahati 781039, Assam India
| | | | - Priyanka Adhikari
- Department of ChemistryIndian Institute of Technology Guwahati 781039, Assam India
| | - Animesh Das
- Department of ChemistryIndian Institute of Technology Guwahati 781039, Assam India
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7
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Calenda G, Villegas G, Reis A, Millen L, Barnable P, Mamkina L, Kumar N, Roberts K, Kalir T, Martinelli E, Sperling R, Teleshova N. Mucosal Susceptibility to Human Immunodeficiency Virus Infection in the Proliferative and Secretory Phases of the Menstrual Cycle. AIDS Res Hum Retroviruses 2019; 35:335-347. [PMID: 30600686 DOI: 10.1089/aid.2018.0154] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Factors underlying HIV acquisition in women remain incompletely understood. This study evaluated ex vivo mucosal HIV-1BaL infection (ectocervix, endocervix), T cell frequencies and phenotype (ectocervix, endocervix, peripheral blood), and HIV-1BaL-induced tissue immune responses (ectocervix) in the proliferative and secretory phases of the menstrual cycle using samples obtained from women undergoing hysterectomies. Tissue infectivity (number of productively infected explants) and infection level following 500 and/or fifty 50% tissue culture infectious dose (TCID50) HIV-1BaL challenge were similar in the proliferative and secretory phases. Although not associated with infection outcomes, higher frequencies of HIV target CD4+α4β7+ T cells, and stronger HIV-1BaL-induced proinflammatory responses were detected in ectocervix in the secretory versus proliferative phase. Independently of the cycle phase, serum E2 concentrations were inversely associated with ectocervical and endocervical tissue infection levels following high-dose 500 TCID50 HIV-1BaL challenge, with frequencies of CD4+α4β7+ T cells in endocervix, and with HIV-induced interleukin (IL)2R and IL4 in ectocervix. Although serum P4 concentrations and P4/E2 ratios were neither associated with tissue infection level nor infectivity, high P4 concentrations and/or P4/E2 ratios correlated with high frequencies of CD4+α4β7+ T cells in ectocervix, low frequencies of CD4+CD103+ blood T cells, low CD4+LFA-1+ T cells in endocervix, and high proinflammatory (IL1β, IL17, tumor necrosis factor α) ectocervical tissue responses to HIV-1BaL. The data suggest an inhibitory effect of E2 on mucosal HIV infection, provide insights into potential mechanisms of E2-mediated anti-HIV activity, and highlight P4-associated immune changes in the mucosa.
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Affiliation(s)
- Giulia Calenda
- Center for Biomedical Research, Population Council, New York, New York
| | | | - Alexandra Reis
- Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Lily Millen
- Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Patrick Barnable
- Center for Biomedical Research, Population Council, New York, New York
| | - Lisa Mamkina
- Center for Biomedical Research, Population Council, New York, New York
| | - Narender Kumar
- Center for Biomedical Research, Population Council, New York, New York
| | - Kevin Roberts
- Center for Biomedical Research, Population Council, New York, New York
| | - Tamara Kalir
- Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Elena Martinelli
- Center for Biomedical Research, Population Council, New York, New York
| | - Rhoda Sperling
- Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Natalia Teleshova
- Center for Biomedical Research, Population Council, New York, New York
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8
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Abstract
Sexual intercourse (vaginal and anal) is the predominant mode of human immunodeficiency virus (HIV) transmission. Topical microbicides used in an on-demand format (i.e., immediately before or after sex) can be part of an effective tool kit utilized to prevent sexual transmission of HIV. The effectiveness of prevention products is positively correlated with adherence, which is likely to depend on user acceptability of the product. The development of an efficacious and acceptable product is therefore paramount for the success of an on-demand product. Acceptability of on-demand products (e.g., gels, films, and tablets) and their attributes is influenced by a multitude of user-specific factors that span behavioral, lifestyle, socio-economic, and cultural aspects. In addition, physicochemical properties of the drug, anatomical and physiological aspects of anorectal and vaginal compartments, issues relating to large-scale production, and cost can impact product development. These factors together with user preferences determine the design space of an effective, acceptable, and feasible on-demand product. In this review, we summarize the interacting factors that together determine product choice and its target product profile.
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Affiliation(s)
- Sravan Kumar Patel
- School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA
| | - Lisa Cencia Rohan
- School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, 15213, USA. .,Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA.
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MZC Gel Inhibits SHIV-RT and HSV-2 in Macaque Vaginal Mucosa and SHIV-RT in Rectal Mucosa. J Acquir Immune Defic Syndr 2017; 74:e67-e74. [PMID: 27552154 DOI: 10.1097/qai.0000000000001167] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The Population Council's microbicide gel MZC (also known as PC-1005) containing MIV-150 and zinc acetate dihydrate (ZA) in carrageenan (CG) has shown promise as a broad-spectrum microbicide against HIV, herpes simplex virus (HSV), and human papillomavirus. Previous data show antiviral activity against these viruses in cell-based assays, prevention of vaginal and rectal simian-human immunodeficiency virus reverse transcriptase (SHIV-RT) infection, and reduction of vaginal HSV shedding in rhesus macaques and also excellent antiviral activity against HSV and human papillomavirus in murine models. Recently, we demonstrated that MZC is safe and effective against SHIV-RT in macaque vaginal explants. Here we established models of ex vivo SHIV-RT/HSV-2 coinfection of vaginal mucosa and SHIV-RT infection of rectal mucosa in macaques (challenge of rectal mucosa with HSV-2 did not result in reproducible tissue infection), evaluated antiviral activity of MZC, and compared quantitative polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay readouts for monitoring SHIV-RT infection. MZC (at nontoxic dilutions) significantly inhibited SHIV-RT in vaginal and rectal mucosas and HSV-2 in vaginal mucosa when present during viral challenge. Analysis of SHIV-RT infection and MZC activity by 1-step simian immunodeficiency virus gag quantitative RT-PCR and p27 enzyme-linked immunosorbent assay demonstrated similar virus growth dynamics and MZC activity by both methods and higher sensitivity of quantitative RT-PCR. Our data provide more evidence that MZC is a promising dual compartment multipurpose prevention technology candidate.
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10
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First-in-Human Trial of MIV-150 and Zinc Acetate Coformulated in a Carrageenan Gel: Safety, Pharmacokinetics, Acceptability, Adherence, and Pharmacodynamics. J Acquir Immune Defic Syndr 2017; 73:489-496. [PMID: 27437826 PMCID: PMC5172848 DOI: 10.1097/qai.0000000000001136] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate the safety and pharmacokinetics of MIV-150 and zinc acetate in a carrageenan gel (PC-1005). Acceptability, adherence, and pharmacodynamics were also explored. DESIGN A 3-day open-label safety run-in (n = 5) preceded a placebo-controlled, double-blind trial in healthy, HIV-negative, abstinent women randomized (4:1) to vaginally apply 4 mL of PC-1005 or placebo once daily for 14 days. METHODS Assessments included physical examinations, safety labs, colposcopy, biopsies, cervicovaginal lavages (CVLs), and behavioral questionnaires. MIV-150 (plasma, CVL, tissue), zinc (plasma, CVL), and carrageenan (CVL) concentrations were determined with LC-MS/MS, ICP-MS, and ELISA, respectively. CVL antiviral activity was measured using cell-based assays. Safety, acceptability, and adherence were analyzed descriptively. Pharmacokinetic parameters were calculated using noncompartmental techniques and actual sampling times. CVL antiviral EC50 values were calculated using a dose-response inhibition analysis. RESULTS Participants (n = 20) ranged from 19-44 years old; 52% were black or African American. Among those completing the trial (13/17, PC-1005; 3/3, placebo), 11/17 reported liking the gel overall; 7 recommended reducing the volume. Adverse events, which were primarily mild and/or unrelated, were comparable between groups. Low systemic MIV-150 levels were observed, without accumulation. Plasma zinc levels were unchanged from baseline. Seven of seven CVLs collected 4-hour postdose demonstrated antiviral (HIV, human papillomavirus) activity. High baseline CVL anti-herpes-simplex virus type-2 (HSV-2) activity precluded assessment of postdose activity. CONCLUSIONS PC-1005 used vaginally for 14 days was well tolerated. Low systemic levels of MIV-150 were observed. Plasma zinc levels were unchanged. Postdose CVLs had anti-HIV and anti-human papillomavirus activity. These data warrant further development of PC-1005 for HIV and sexually transmitted infection prevention.
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