Development of Therapeutic Monoclonal Antibodies for Emerging Arbovirus Infections

Antibody-based passive immunotherapy has been used effectively in the treatment and prophylaxis of infectious diseases. Outbreaks of emerging viral infections from arthropod-borne viruses (arboviruses) represent a global public health problem due to their rapid spread, urging measures and the treatment of infected individuals to combat them. Preparedness in advances in developing antivirals and relevant epidemiological studies protect us from damage and losses. Immunotherapy based on monoclonal antibodies (mAbs) has been shown to be very specific in combating infectious diseases and various other illnesses. Recent advances in mAb discovery techniques have allowed the development and approval of a wide number of therapeutic mAbs. This review focuses on the technological approaches available to select neutralizing mAbs for emerging arbovirus infections and the next-generation strategies to obtain highly effective and potent mAbs. The characteristics of mAbs developed as prophylactic and therapeutic antiviral agents for dengue, Zika, chikungunya, West Nile and tick-borne encephalitis virus are presented, as well as the protective effect demonstrated in animal model studies.

Machine learning and deep learning techniques to support clinical diagnosis of arboviral diseases: A systematic review

BACKGROUND

Neglected tropical diseases (NTDs) primarily affect the poorest populations, often living in remote, rural areas, urban slums or conflict zones. Arboviruses are a significant NTD category spread by mosquitoes. Dengue, Chikungunya, and Zika are three arboviruses that affect a large proportion of the population in Latin and South America. The clinical diagnosis of these arboviral diseases is a difficult task due to the concurrent circulation of several arboviruses which present similar symptoms, inaccurate serologic tests resulting from cross-reaction and co-infection with other arboviruses.

OBJECTIVE

The goal of this paper is to present evidence on the state of the art of studies investigating the automatic classification of arboviral diseases to support clinical diagnosis based on Machine Learning (ML) and Deep Learning (DL) models.

METHOD

We carried out a Systematic Literature Review (SLR) in which Google Scholar was searched to identify key papers on the topic. From an initial 963 records (956 from string-based search and seven from a single backward snowballing procedure), only 15 relevant papers were identified.

RESULTS

Results show that current research is focused on the binary classification of Dengue, primarily using tree-based ML algorithms. Only one paper was identified using DL. Five papers presented solutions for multi-class problems, covering Dengue (and its variants) and Chikungunya. No papers were identified that investigated models to differentiate between Dengue, Chikungunya, and Zika.

CONCLUSIONS

The use of an efficient clinical decision support system for arboviral diseases can improve the quality of the entire clinical process, thus increasing the accuracy of the diagnosis and the associated treatment. It should help physicians in their decision-making process and, consequently, improve the use of resources and the patient's quality of life.

Antiviral Compounds for Blocking Arboviral Transmission in Mosquitoes

Mosquito-borne arthropod-borne viruses (arboviruses) such as the dengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV) are important human pathogens that are responsible for significant global morbidity and mortality. The recent emergence and re-emergence of mosquito-borne viral diseases (MBVDs) highlight the urgent need for safe and effective vaccines, therapeutics, and vector-control approaches to prevent MBVD outbreaks. In nature, arboviruses circulate between vertebrate hosts and arthropod vectors; therefore, disrupting the virus lifecycle in mosquitoes is a major approach for combating MBVDs. Several strategies were proposed to render mosquitoes that are refractory to arboviral infection, for example, those involving the generation of genetically modified mosquitoes or infection with the symbiotic bacterium Wolbachia. Due to the recent development of high-throughput screening methods, an increasing number of drugs with inhibitory effects on mosquito-borne arboviruses in mammalian cells were identified. These antivirals are useful resources that can impede the circulation of arboviruses between arthropods and humans by either rendering viruses more vulnerable in humans or suppressing viral infection by reducing the expression of host factors in mosquitoes. In this review, we summarize recent advances in small-molecule antiarboviral drugs in mammalian and mosquito cells, and discuss how to use these antivirals to block the transmission of MBVDs.

Antiviral Natural Products for Arbovirus Infections

Over the course of the last 50 years, the emergence of several arboviruses have resulted in countless outbreaks globally. With a high proportion of infections occurring in tropical and subtropical regions where arthropods tend to be abundant, Asia in particular is a region that is heavily affected by arboviral diseases caused by dengue, Japanese encephalitis, West Nile, Zika, and chikungunya viruses. Major gaps in protection against the most significant emerging arboviruses remains as there are currently no antivirals available, and vaccines are only available for some. A potential source of antiviral compounds could be discovered in natural products—such as vegetables, fruits, flowers, herbal plants, marine organisms and microorganisms—from which various compounds have been documented to exhibit antiviral activities and are expected to have good tolerability and minimal side effects. Polyphenols and plant extracts have been extensively studied for their antiviral properties against arboviruses and have demonstrated promising results. With an abundance of natural products to screen for new antiviral compounds, it is highly optimistic that natural products will continue to play an important role in contributing to antiviral drug development and in reducing the global infection burden of arboviruses.

[Virus infections and interferon inducers in the complex therapy]

Interferon inductors of various chemical groups, belonging to antivirals, and induction of several types of endogenous interferon in blood serum are described. Cycloferon was shown efficient in the complex treatment of chronic hepatitis C, tuberculosis in HIV-infected subjects, arbovirus diseases, influenza and acute respiratory virus infections.

[Anti-arboviral properties of different substances of chemical and plant origin]

The paper deals with the results of search for inhibitors of two arboviral infections, including Alfavirus of Venezuelan equine encephalomyelitis (family Togaviridae) and Bunyavirus Tahyna (family Bunyaviridae), interferon inducers among 99 substances of organic synthesis and 92 compounds of plant origin. Antiarboviral activity of some of these chemicals were investigated as well. Reproduction of the studied viruses in cell culture was inhibited by 8 derivatives of triazole, triazine and uracile (UPI-264 and UPI-273, PV-166, PV-169, PV-171, PV-184, PV-188 and PV-214) and 21 plant remedies (lyophilizates ASHCH-1, BL-1, VN, GAL-1, GAPr-1, GACH-1, GVPr-1, GVCH-1, GM-1, GCA-2, GCV-2, LGSHCHA, LSHCH-6, KIS-1, KJL-1, KKL-1, RDO-1, SX-2, SHCHKS-1, YA and YAN).

Postinfection therapy of arbovirus infections in mice

Most antiviral agents are efficacious prophylactically in vivo, and a few are efficacious for postinfection (p.i.) therapy. To explore possibilities for p.i. therapy of encephalogenic Banzi virus (BZV) and Semliki Forest virus infections in mice, we evaluated candidate antiviral therapies after development of the first clinical signs of infection. The earliest clinical indication of BZV viremia in mice is a rise in core body temperature beginning on day 3 p.i. BZV-infected mice showing elevated core body temperatures (greater than or equal to 37.3 degrees C) on days 3 and 4 p.i. were treated intraperitoneally with the interferon inducer poly(ICLC) (80 micrograms per mouse) and/or specific antiserum. Combined therapy on day 3 of a BZV infection protected over 75% of mice showing clinical evidence of viral disease before treatment. Protection against early brain infection must occur on day 4 p.i., since by that day BZV has started multiplying in the brains of the mice. Significant protection occurred with antiserum alone and increased with poly(ICLC). Similar protection was obtained during Semliki Forest virus viremia, but this infection is so rapid that the first clinical signs are reliably detectable only after viremia.

[Accelerated method of determining the antiviral activity of interferon inducers in experimental infection]

By the example of trials of two typical interferon inducers: a double-stranded complex of synthetic polyribonucleotides poly (I).poly (C) and polyacrylic acid the use of the proposed rapid method for the determination of the antiviral activity of interferon inducers in an experimental infection of mice with an alphavirus is described. The method permits to perform a statistically treated evaluation of the antiviral effect of a group of preparations within 96 hours. The mean standard error of the method is +/- 0,333 1g PFU per 1 ml of 10% brain suspension.

Effects of tilorone hydrochloride on experimental flavivirus infections in mice

The effect of tilorone hydrochloride on experimental infections of mice with West Nile, Langat and Dengue type 2 viruses were studied. The drug significantly reduced the mortality after intraperitoneal inoculation of West Nile virus, but failed to affect intracerebral infection with Langat or Dengue viruses. Tilorone partially reversed cyclophosphan-enhanced mortality after extraneural inoculation of West Nile and Langat viruses. The possible modes of action of tilorone, interferon-inducing ability and stimulation of humoral immunity, are discussed.

The damaging action of cellular immunity in flavivirus infections of mice

The development of acute infections caused by different flaviviruses was studied in immunosuppressed inbred and non-inbred mice. Cyclophosphamide treatment of challenged animals resulted in an increase of the mean survival time by 24--144 hours in some but not all virus-mouse strain combinations. The transient protective action of cyclophosphamide was not due to suppression of the reproduction of tick-borne encephalitis (TBE) or dengue 2 (D2) virus in the brains of mice. In TBE or D2 infections of immunosuppressed mice the clinical signs of central nervous system lesions seemed to be associated with the development of cellular immunity measured by the splenobyte migration inhibition test. The transfer of sensitized splenocytes in immunosuppressed animals, challenged with TBE or D2 virus, shortened the incubation period. These results suggest that cellular immunity may have a damaging effect in acute flavivirus infections in mice, and also that the immunopathological response varies considerably in different strains of inbred mice.

An antiviral substance from Penicillium funiculosum. IV. Inquiry into the mechanism by which helenine exerts its antiviral effect

1. Helenine injected intraperitoneally 24 hr prior to a regularly fatal dose of Semliki Forest virus saves most of the mice to which it is administered. 2. Mice saved by helenine develop no viral immunity and regularly succumb when rechallenged 2 wk later with the same dose of virus from which they were originally saved. 3. The time during which helenine is optimally effective in protecting mice from death by Semliki Forest virus covers a period of approximately 36 hr beginning after about 12 hr and extending to 48 hr before virus infection. When periods of less than 12 hr, or more than 48 hr, elapse between the time of helenine administration and virus inoculation, its protective effectiveness diminishes progressively. 4. Repeated injections of helenine at 2- or 3-day intervals, if continued long enough, exhaust the capacity of a host to respond favorably to helenine administered 24 hr before virus inoculation. 5. Helenine injections at intervals of 4, 3, and 2 wk before its administration 24 hr prior to infection do not decrease the effectiveness of this final dose in protecting mice from fatal infection by the virus. The experimental results here reported indicate that, as suggested by the findings of earlier work, helenine does not act directly as an antiviral substance, but instead exerts its effect through some substance that it induces the host to elaborate. The nature of this induced antiviral substance is as yet unknown though, to judge from the failure of spared mice to acquire viral immunity, it appears to act at a stage in viral replication prior to that at which antigenic viral protein is produced. The findings with helenine and those thus far reported for interferon afford no factual basis for judging the relationship of the two, if any.