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Antiviral Research (v.82, #2)
Alkoxyalkyl prodrugs of acyclic nucleoside phosphonates enhance oral antiviral activity and reduce toxicity: Current state of the art
by Karl Y. Hostetler (pp. a84-a98).
Although the acyclic nucleoside phosphonates cidofovir, adefovir and tenofovir are approved for treating human cytomegalovirus, hepatitis B and HIV infections, respectively, their utility is limited by low oral bioavailability, renal toxicity and poor cell penetration. Research over the past decade has shown that these undesirable features can be eliminated by esterifying the compounds with an alkoxyalkyl group, in effect disguising them as lysophospholipids. In this modified form, the drugs are readily taken up in the gastrointestinal tract and have a prolonged circulation time in plasma. The active metabolite also has a long half life within cells, permitting infrequent dosing. Because these modified drugs are not recognized by the transport mechanisms that cause the accumulation of acyclic nucleoside phosphonates in renal tubular cells, they lack nephrotoxicity. Alkoxyalkyl esterification also markedly increases the in vitro antiviral activity of acyclic nucleoside phosphonates by improving their delivery into cells. For example, an alkoxyalkyl ester of cyclic-cidofovir, a less soluble compound, retains anti-CMV activity for 3 months following a single intravitreal injection. Two of these novel compounds, hexadecyloxypropyl-cidofovir (CMX001) and hexadecyloxypropyl-tenofovir (CMX157) are now in clinical development. This article focuses on the hexadecyloxypropyl and octadecyloxyethyl esters of cidofovir and (S)-HPMPA, describing their synthesis and the evaluation of their in vitro and in vivo activity against a range of orthopoxviruses, herpesviruses, adenoviruses and other double-stranded DNA viruses. The extension to other nucleoside phosphonate antivirals is highlighted, demonstrating that this novel approach can markedly improve the medicinal properties of these drugs.
Keywords: Abbreviations; Ad5; adenovirus type 5; ALT; alanine aminotransferase; AUC; area under curve; CDV; cidofovir; CDVp; cidofovir monophosphate; CDVpp; cidofovir diphosphate; CMV; cytomegalovirus; cPr-DAP; N; 6; -cyclopropyl-2,6-diaminopurine; CPX; cowpox; dATP; deoxyadenosine triphosphate; dCTP; deoxycytosine triphosphate; ECTV; ectromelia virus; GCV; ganciclovir; HBV; hepatitis B virus; HCMV; human cytomegalovirus; HD; hexadecyl; HDP; hexadecyloxypropyl; HDP-CDV; hexadecyloxypropyl-cidofovir; HDP-PMEDAP; hexadecyloxypropyl-9-(2-phosphono-methoxyethyl)-2,6-diaminopurine; HDP-PMPA; hexadecyloxypropyl-(; R; )-9-(2-phosphono-methoxypropyl)adenine; HHV; human herpes virus; HIV; human immunodeficiency virus; HPMP; 3-hydroxy-2-(phosphonomethoxy)propyl; HPMPA; (; S; )-9-(3-hydroxy-2-phosphono-methoxypropyl)adenine; HPMPAp; HPMPA monophosphate; HPMPApp; HPMPA diphosphate; HPPMP; 3-hydroxy-2-(phosphophosphonomethoxy)propyl; HPMPC; (; S; )-1-(3-hydroxy-2-phosphonomethoxypropyl)cytosine (cidofovir); HPMPDAP; (S)-9-(3-hydroxyl-2-phosphono-methoxypropyl)-2,6-diaminopurine; HPV; human papilloma virus; IHD; the IHD strain of vaccinia virus; LPC; lysophosphatidylcholine; NRTI; nucleoside reverse transcriptase inhibitor; ODBG; 1-; O; -octadecyl-2-; O; -benzyl-sn-glycerol; ODE-CDV; octadecyloxyethyl-cidofovir; PBMC; peripheral blood mononuclear cells; PC; phosphatidylcholine; Pfu; plaque forming unit; PME; 2-(phosphonomethoxy)ethyl; PMEA; 9-(2-phosphonylmethoxyethyl)adenine; PMEDAP; 9-(2-phosphonomethoxyethyl)-2,6-diaminopurine; PMP; 3-hydroxy-2-(phosphonomethoxy)propyl; PMPA; (; R; )-9-(2-phosphonomethoxypropyl)adenine; PPen; 5-phosphono-pent-2-en-1-yl; PPM; phosphonopropoxymethyl; PPMDAP; phosphonopropoxymethyl-2,6,-diaminopurine; RPV; rabbitpox virus; SCID; severe combined immunodeficiency; TCID; tissue culture infectious dose; VV; vaccinia virus; VV-LED; vaccinia virus-Lederle; VV-WR; vaccinia virus Western Reserve; VZV; varicella zoster virus; Wt; wild typeLysophospholipids; Ether lipids; Prodrugs; Alkoxyalkyl esters; Hexadecyloxypropyl-cidofovir; Hexadecyloxypropyl-tenfovir; Hexadecyloxypropyl-(; S; )-HPMPA; Vaccinia virus; Cowpoxvirus; Ectromelia virus; Cytomegalovirus; Adenovirus; HIV-1; Hepatitis B virus
HiT QSAR Study of Antivirals’ Bioavailability
by Anatoly Artemenko; Eugene Muratov; Victor Kuz’min; Maxim Kulinskij; Irina Borisuk; Nikolay Golovenko; Alexander Tropsha (pp. a56).
Antiviral compounds; Bioavailability; Virtual screening
Discovery of New Inhibitors of the Influenza H5N1 Virus
by William Severson; Xi Chen; Joseph Maddry; Yong-Kyu Chu; Colleen Jonsson; Alexis McBrayer; Ronald Tapp; Donald Smee; Clinton Maddox; Subramaniam Ananthan; James Noah; Leland Black; Blake Moore; Melinda Sosa; Lucile White; Lynn Rasmussen (pp. a36-a37).
Animal models for the study of influenza pathogenesis and therapy
by Dale L. Barnard (pp. a110-a122).
Influenza A viruses causes a variety of illnesses in humans. The most common infection, seasonal influenza, is usually a mild, self-limited febrile syndrome, but it can be more severe in infants, the elderly, and immunodeficient persons, in whom it can progress to severe viral pneumonitis or be complicated by bacterial superinfection, leading to pneumonia and sepsis. Seasonal influenza also occasionally results in neurologic complications. Rarely, viruses that have spread from wild birds to domestic poultry can infect humans; such “avian influenza” can range in severity from mild conjunctivitis through the rapidly lethal disease seen in persons infected with the H5N1 virus that first emerged in Hong Kong in 1997. To develop effective therapies for this wide range of diseases, it is essential to have laboratory animal models that replicate the major features of illness in humans. This review describes models currently in use for elucidating influenza pathogenesis and evaluating new therapeutic agents.
Keywords: Influenza; Influenza virus; H5N1 avian influenza; Animal models; Mouse models; Ferret models; Antiviral therapy
The transport of anti-HIV drugs across blood–CNS interfaces: Summary of current knowledge and recommendations for further research
by Lavanya Varatharajan; Sarah A. Thomas (pp. a99-a109).
The advent of highly active antiretroviral therapy (HAART), which constitutes HIV protease inhibitors, nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors and nucleotide reverse transcriptase inhibitors, has dramatically reduced the morbidity and mortality associated with human immunodeficiency virus (HIV) infection in resource-rich countries. However, this disease still kills several million people each year. Though the reason for therapeutic failure is multi-factorial, an important concern is the treatment and control of HIV within the central nervous system (CNS). Due to the restricted entry of anti-HIV drugs, the brain is thought to form a viral sanctuary site. This not only results in virological resistance, but also is often associated with the development of complications such as HIV-associated dementia. The CNS delivery of anti-HIV drugs is limited by the blood–brain and blood–CSF interfaces due to a combination of restricted paracellular movement, powerful metabolic enzymes and numerous transporters including members of the ATP binding cassette (ABC) and solute carrier (SLC) superfamilies. A better appreciation of the transporters present at the brain barriers will prove a valuable milestone in understanding the limited brain penetration of anti-HIV drugs in HIV and also aid the development of new anti-HIV drugs and drug combinations, with enhanced efficacy in the CNS. This review aims to summarise current knowledge on the transport of anti-HIV drugs across the blood–brain barrier and the choroid plexus, as well as provide recommendations for future research.
Keywords: Abbreviations; BBB; blood–brain barrier; P-gp; P-glycoprotein; MRP; multi-drug resistance associated protein; HAART; highly active antiretroviral therapy; PIs; protease inhibitors; NRTIs; nucleoside reverse transcriptase inhibitors; NNRTIs; non-nucleoside reverse transcriptase inhibitors; NtRTIs; nucleotide reverse transcriptase inhibitors; HAD; HIV-associated dementia; HIVE; HIV encephalitis; MND; mild neurocognitive disorder; MDR-1; multi-drug resistance gene 1; BCRP; breast cancer resistance protein; OAT; organic anion transporter; OATP; organic anion-transporting polypeptide; CSF; cerebrospinal fluid; CNS; central nervous system; AIDS; acquired immunodeficiency syndrome; HAD; HIV-associated dementia; ABC; ATP binding cassette; SLC; solute carrier superfamily; ddI; 2′,3′-dideoxyinosine; ddC; 2′3′-dideoxycytidine; 3TC; (−)-2′-deoxy-3′-thiacytidine; AZT; zidovudine; ENT; equilibrative nucleoside transporter; CNT; concentrative nucleoside transporter; ET-1; endothelin-1; LPS; lipopolysaccharideBlood–brain barrier; Choroid plexus; HIV; HAART; Transporters; P-Glycoprotein; Antiretroviral drugs
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