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1.
J Innate Immun ; 2024 Jun 08.
Artículo en Inglés | MEDLINE | ID: mdl-38852581

RESUMEN

INTRODUCTION: Inactivated parapoxvirus ovis (iPPVO) exerts strong immunomodulatory effects on innate immune cells, making it an attractive therapeutic candidate. However, little is known about the signaling pathways involvIing in iPPVO-induced immune responses. METHODS: In this study, we systematically analyzed how different types of dendritic cells (DCs) react to iPPVO (Zylexis, strain D1710) in both BALB/c and C57BL/c mice by Flow cytometry and ELISAs, and investigated which signaling pathway is related to DC activation by Western blotting and Protein profiling. RESULTS: We demonstrated that bone marrow-derived conventional DCs (BM-cDCs) and bone marrow-derived plasmacytoid DCs (BM-pDCs) matured and secreted IFN-α/ß in response to Zylexis stimulation in both mouse strains. Similarly, Zylexis promoted the secretion of IL-12/23p40 and TNF by pDCs. However, IL-12/23p40 and TNF secretion by cDCs was induced in BALB/c mice but not in C57BL/6 mice. Analyzing the underlying signaling pathways revealed that iPPVO-induced maturation of cDCs was TLR9 independent, while the maturation of pDCs partially depended on the TLR9 pathway. Moreover, the production of proinflammatory cytokines by cDCs and the secretion IFN-α/ß by pDCs partially depended on the TLR9 pathway in both mouse strains. Therefore, other signaling pathways seem to participate in the response of DCs to iPPVO, supported by protein profiling. CONCLUSION: Our data provide useful insights into the diversity of iPPVO sensors and their varying effects across different strains and species.

2.
Artículo en Inglés | MEDLINE | ID: mdl-38752475

RESUMEN

Pritelivir is a novel viral helicase-primase inhibitor active against herpes simplex virus. In vitro drug-drug interaction studies indicated that pritelivir has the potential for clinically relevant interactions on the cytochrome P450 (CYP) enzymes 2C8, 2C9, 3A4, and 2B6, and intestinal uptake transporter organic anion transporting polypeptide (OATP) 2B1 and efflux transporter breast cancer resistance protein (BCRP). This was evaluated in 2 clinical trials. In 1 trial the substrates flurbiprofen (CYP2C9), bupropion (CYP2B6), and midazolam (CYP3A4) were administered simultaneously as part of the Geneva cocktail, while the substrate celiprolol (OAPT2B1) was administered separately. In another trial, the substrates repaglinide (CYP2C8) and rosuvastatin (BCRP) were administered separately. Exposure parameters of the substrates and their metabolites (flurbiprofen and bupropion only) were compared after administration with or without pritelivir under therapeutic concentrations. The results of these trials indicated that pritelivir has no clinically relevant effect on the exposure of substrates for the intestinal uptake transporter OATP2B1 and the CYP enzymes 3A4, 2B6, 2C9, and 2C8, and has a weak inhibitory effect on the intestinal efflux transporter BCRP. In summary, the results suggest that pritelivir has a low drug-drug interaction potential.

3.
Clin Pharmacol Drug Dev ; 13(4): 389-403, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38189209

RESUMEN

Pritelivir is a helicase-primase inhibitor active against HSV. Two human mass balance trials (a multiple-dose trial and a single-dose trial) were performed to characterize the absorption, distribution, metabolism, and excretion of 100 mg oral pritelivir combined with a single microdose of 14C-pritelivir. Blood, urine, and feces samples were collected up to 26 days postdose. The plasma half-life of pritelivir was 63-67 hours. Overall, 92% and 66% of the administered dose was recovered in the multiple and single dose trials, respectively. The low recovery after the single dose (66%) was most likely related to the formulation used. The major metabolic pathway was amide hydrolysis leading to amino thiazole sulfonamide (ATS) and pyridinyl phenyl acetic acid (PPA). In plasma, pritelivir, ATS, PPA, and PPA-acyl glucuronide accounted for 40.6%, 9.4%, 5.1%, and 0.2% of total radioactivity. More than 90% of drug-related material was eliminated 624 hours postdose. The majority was excreted in urine (75% and 77%), followed by feces (16% and 23%). The main components in urine were PPA-acyl glucuronide (and its isomers), ATS, and its N-demethylated isomers. Only minor metabolites were observed in feces. In conclusion, the major metabolic pathways of pritelivir have been identified with the primary excretion route being renal.


Asunto(s)
Glucurónidos , Sulfonamidas , Humanos , Voluntarios Sanos , Tiazoles
4.
Clin Pharmacol Drug Dev ; 12(7): 749-760, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-36860173

RESUMEN

The pharmacokinetics and safety of the novel herpes simplex virus helicase-primase inhibitor pritelivir were evaluated in 5 phase 1 trials: a single-ascending-dose trial, 2 multiple-ascending-dose trials, a food-effect trial, and an absolute bioavailability trial in healthy male subjects. One cohort of healthy female subjects was included in the single-ascending-dose trial. Pritelivir pharmacokinetics were linear up to 480 mg following single and up to 400 mg following multiple once-daily doses. The half-life ranged from 52 to 83 hours, and steady state was reached between 8 and 13 days. Maximum plasma concentration and area under the plasma concentration-time curve from time 0 to the last quantifiable concentration were 1.5- and 1.1-fold higher in female compared to male subjects. Absolute bioavailability was 72% under fasted conditions. Following a fatty diet, pritelivir time to maximum concentration was 1.5 hour delayed and maximum plasma concentration and area under the plasma concentration-time curve from time 0 to the last quantifiable concentration were 33% and 16% higher, respectively. Pritelivir was safe and well tolerated up to 600 mg following single and up to 200 mg following multiple once-daily doses. Considering a therapeutic dose of 100 mg once-daily, pritelivir demonstrated a favorable safety and tolerability and pharmacokinetic profile in healthy subjects to support further development.


Asunto(s)
ADN Primasa , Simplexvirus , Femenino , Humanos , Masculino , Disponibilidad Biológica , Voluntarios Sanos
5.
J Med Chem ; 65(20): 13614-13628, 2022 10 27.
Artículo en Inglés | MEDLINE | ID: mdl-36202389

RESUMEN

When the nucleoside analogue acyclovir was introduced in the early 1980s, it presented a game-changing treatment modality for herpes simplex virus infections. Since then, work has been ongoing to improve the weaknesses that have now been identified: a narrow time window for therapeutic success, resistance in immunocompromised patients, little influence on frequency of recurrences, relatively fast elimination, and poor bioavailability. The present Drug Annotation focuses on the helicase-primase inhibitor pritelivir currently in development for the treatment of acyclovir-resistant HSV infections and describes how a change of the molecular target (from viral DNA polymerase to the HSV helicase-primase complex) afforded improvement of the shortcomings of nucleoside analogs. Details are presented for the discovery process leading to the final drug candidate, the pivotal preclinical studies on mechanism of action and efficacy, and on how ongoing clinical research has been able to translate preclinical promises into clinical use.


Asunto(s)
Aciclovir , Herpes Simple , Humanos , Aciclovir/farmacología , Aciclovir/uso terapéutico , Nucleósidos/uso terapéutico , ADN Primasa , Antivirales/farmacología , Antivirales/uso terapéutico , Piridinas/farmacología , Herpes Simple/tratamiento farmacológico , Farmacorresistencia Viral
6.
Antiviral Res ; 158: 135-142, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30031759

RESUMEN

One of the most promising viral targets in current hepatitis B virus (HBV) drug development is the core protein due to its multiple roles in the viral life cycle. Here we investigated the differences in the mode of action and antiviral activity of representatives of six different capsid assembly modifier (CAM) scaffolds: three from the well-characterized scaffolds heteroarylpyrimidine (HAP), sulfamoylbenzamide (SBA), and phenylpropenamide (PPA), and three from novel scaffolds glyoxamide-pyrrolamide (GPA), pyrazolyl-thiazole (PT), and dibenzo-thiazepin-2-one (DBT). The target activity and antiviral efficacy of the different CAMs were tested in biochemical and cellular assays. Analytical size exclusion chromatography and transmission electron microscopy showed that only the HAP compound induced formation of aberrant non-capsid structures (class II mode of action), while the remaining CAMs did not affect capsid gross morphology (class I mode of action). Intracellular lysates from the HepAD38 cell line, inducibly replicating HBV, showed no reduction in the quantities of intracellular core protein or capsid after treatment with SBA, PPA, GPA, PT, or DBT compounds; however HAP-treatment led to a profound decrease in both. Additionally, immunofluorescence staining of compound-treated HepAD38 cells showed that all non-HAP CAMs led to a shift in the equilibrium of HBV core antigen (HBcAg) towards complete cytoplasmic staining, while the HAP induced accumulation of HBcAg aggregates in the nucleus. Our study demonstrates that the novel scaffolds GPA, PT, and DBT exhibit class I modes of action, alike SBA and PPA, whereas HAP remains the only scaffold belonging to class II inhibitors.


Asunto(s)
Antivirales/farmacología , Proteínas de la Cápside/efectos de los fármacos , Proteínas de la Cápside/metabolismo , Cápside/efectos de los fármacos , Virus de la Hepatitis B/efectos de los fármacos , Antivirales/química , Benzamidas/química , Benzamidas/farmacología , Benzoatos , Línea Celular , Desarrollo de Medicamentos , Antígenos del Núcleo de la Hepatitis B , Virus de la Hepatitis B/metabolismo , Humanos , Pirimidinas/química , Pirimidinas/farmacología , Proteínas del Núcleo Viral , Ensamble de Virus/efectos de los fármacos , Replicación Viral/efectos de los fármacos
7.
Antiviral Res ; 149: 1-6, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29113740

RESUMEN

Pritelivir, a helicase-primase inhibitor, has excellent in vitro and in vivo activity against human herpes simplex virus (HSV). Mice lethally infected with HSV type 1 or 2, including acyclovir-resistant strains, were treated 72 h after infection for 7 days with pritelivir or acyclovir. Both drugs were administered orally twice daily either alone or in combination. Dosages of pritelivir from 0.3 to 30 mg/kg reduced mortality (P < 0.001) against HSV-1, E-377. With an acyclovir resistant HSV-1, 11360, pritelivir at 1 and 3 mg/kg increased survival (P < 0.005). With HSV-2, MS infected mice, all dosages higher than the 0.3 mg/kg dose of pritelivir were effective (P < 0.005). For acyclovir resistant HSV-2, strain 12247, pritelivir dosages of 1-3 mg/kg significantly improved survival (P < 0.0001). Combination therapies of pritelivir at 0.1 or 0.3 mg/kg/dose with acyclovir (10 mg/kg/dose) were protective (P < 0.0001) when compared to the vehicle treated group against HSV-2, strain MS (in line with previous data using HSV-1). An increased mean days to death (P < 0.05) was also observed and was indicative of a potential synergy. Pharmacokinetic studies were performed to determine pritelivir concentrations and a dose dependent relationship was found in both plasma and brain samples regardless of infection status or time of initiation of dosing. In summary, pritelivir was shown to be active when treatment was delayed to 72 h post viral inoculation and appeared to synergistically inhibit mortality in this model in combination with acyclovir. We conclude pritelivir has potent and resistance-breaking antiviral efficacy with potential for the treatment of potentially life-threatening HSV type 1 and 2 infections, including herpes simplex encephalitis.


Asunto(s)
Aciclovir/farmacología , Antivirales/farmacología , Encefalitis por Herpes Simple/virología , Piridinas/farmacología , Tiazoles/farmacología , Aciclovir/administración & dosificación , Aciclovir/farmacocinética , Animales , Antivirales/administración & dosificación , Antivirales/farmacocinética , Modelos Animales de Enfermedad , Quimioterapia Combinada , Encefalitis por Herpes Simple/tratamiento farmacológico , Encefalitis por Herpes Simple/mortalidad , Encefalitis por Herpes Simple/patología , Femenino , Humanos , Ratones , Piridinas/administración & dosificación , Piridinas/farmacocinética , Sulfonamidas , Tiazoles/administración & dosificación , Tiazoles/farmacocinética , Distribución Tisular , Resultado del Tratamiento
8.
J Med Chem ; 60(7): 3154-3164, 2017 04 13.
Artículo en Inglés | MEDLINE | ID: mdl-28272885

RESUMEN

A series of congeners structurally related to pritelivir, N-[5-(aminosulfonyl)-4-methyl-1,3-thiazol-2-yl]-N-methyl-2-[4-(2-pyridinyl)phenyl]acetamide, a helicase-primase inhibitor for the treatment of herpes simplex virus infections, was prepared. The synthesized primary and secondary sulfonamides were investigated as inhibitors of six physiologically and pharmacologically relevant human (h) carbonic anhydrase (hCA, EC 4.2.1.1) isoforms, the cytosolic enzymes hCA I and II, the mitochondrial ones hCA VA and VB, and the transmembrane, tumor associated hCA IX and XII. Low nanomolar inhibition KI values were detected for all of them, with a very interesting and well-defined structure-activity relationship. As many CAs are involved in serious pathologies, among which are cancer, obesity, epilepsy, glaucoma, etc., sulfonamide inhibitors as those reported here may be of interest as drug candidates. Furthermore, pritelivir itself is an effective inhibitor of some CAs, also inhibiting whole blood enzymes from several mammalian species, which may be a favorable pharmacokinetic feature of the drug which can be transported throughout the body bound to blood CA I and II.


Asunto(s)
Inhibidores de Anhidrasa Carbónica/química , Inhibidores de Anhidrasa Carbónica/farmacología , Sulfonamidas/química , Sulfonamidas/farmacología , Tiazoles/química , Tiazoles/farmacología , Anhidrasas Carbónicas/química , Anhidrasas Carbónicas/metabolismo , Diseño de Fármacos , Humanos , Simulación del Acoplamiento Molecular , Isoformas de Proteínas/antagonistas & inhibidores , Isoformas de Proteínas/química , Isoformas de Proteínas/metabolismo
9.
JAMA ; 316(23): 2495-2503, 2016 12 20.
Artículo en Inglés | MEDLINE | ID: mdl-27997653

RESUMEN

Importance: Current therapy of herpes infections relies on nucleoside analogues. Pritelivir is a well-tolerated novel herpes simplex virus (HSV) helicase-primase inhibitor that reduced genital shedding and lesions. Objective: To compare the efficacy of pritelivir with valacyclovir for suppression of genital HSV-2 infection. Design, Setting, and Participants: A phase 2, randomized, double-blind, crossover clinical trial at clinical research centers in 4 US cities (October 2012-July 2013) compared daily oral doses of 100 mg of pritelivir with 500 mg of valacyclovir. The planned sample size was 98 adults, allowing for detection of a 50% reduction in viral shedding between the study treatments. Healthy adults with 4 to 9 annual genital HSV-2 recurrences were eligible. 45 participants were randomized to receive pritelivir [corrected] and 46 to receive valacyclovir first when the US Food and Drug Administration placed the trial on clinical hold based on findings in a concurrent nonclinical toxicity study, and the sponsor terminated the study. Interventions: Participants took the first drug for 28 days followed by 28 days of washout before taking the second drug for 28 days. Throughout treatment, the participants collected genital swabs 4 times daily for testing by HSV polymerase chain reaction assays. Main Outcomes and Measures: The primary end point was within-participant genital HSV shedding while receiving pritelivir compared with valacyclovir. Secondary end points included the quantity of HSV in positive swabs and the frequency of genital lesions and shedding episodes. Results: Of the 91 randomized participants (median age, 48 years; 57 women [63%]), 56 had completed both treatment periods at the time of the study's termination. In intent-to-treat analyses, HSV shedding was detected in 2.4% (173 of 7276 ) of swabs during pritelivir treatment compared with 5.3% (392 of 7453) during valacyclovir treatment (relative risk [RR], 0.42 [corrected]; 95% CI, 0.21 to 0.82; P = .01). In swabs with HSV, the mean quantity of HSV was 3.2 log10 copies/mL during pritelivir treatment vs 3.7 log10 copies/mL during valacyclovir treatment (difference, -0.1; 95% CI, -0.6 to 0.5; P = .83). Genital lesions were present on 1.9% of days in the pritelivir group vs 3.9% in the valacyclovir group (RR, 0.40; 95% CI, 0.17-0.96; P = .04). The frequency of shedding episodes did not differ by group, with 1.3 per person-month for pritelivir and 1.6 per person-month for valacyclovir (RR, 0.80; 95% CI, 0.52 to 1.22; P = .29). Treatment-emergent adverse events occurred in 62.3% of participants in the pritelivir group and 69.2% of participants in the valacyclovir group. Conclusions and Relevance: Among adults with frequently recurring genital HSV-2, the use of pritelivir compared with valacyclovir resulted in a lower percentage of swabs with HSV detection over 28 days. Further research is needed to assess longer-term efficacy and safety. Trial Registration: clinicaltrials.gov Identifier: NCT01658826.


Asunto(s)
Aciclovir/análogos & derivados , Antivirales/uso terapéutico , Herpes Genital/tratamiento farmacológico , Piridinas/uso terapéutico , Tiazoles/uso terapéutico , Valina/análogos & derivados , Esparcimiento de Virus/efectos de los fármacos , Aciclovir/efectos adversos , Aciclovir/uso terapéutico , Adulto , Anciano , Antivirales/efectos adversos , Estudios Cruzados , Método Doble Ciego , Femenino , Herpes Genital/virología , Herpesvirus Humano 2 , Humanos , Masculino , Persona de Mediana Edad , Piridinas/efectos adversos , Recurrencia , Sulfonamidas , Tiazoles/efectos adversos , Valaciclovir , Valina/efectos adversos , Valina/uso terapéutico , Adulto Joven
10.
J Infect Dis ; 214(2): 258-64, 2016 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-27056950

RESUMEN

BACKGROUND: Pritelivir is a novel helicase-primase inhibitor in clinical development for treatment of herpes simplex virus type 2 (HSV-2) infections. In preclinical work, resistance-mediating mutations were identified in the HSV-2 genome at 3 loci in the UL5 gene and 1 locus in UL52. METHODS: To evaluate whether daily pritelivir treatment results in emergence of resistance-mediating mutations, we analyzed HSV-2 strains detected in genital swab specimens from trial participants who were randomly assigned to receive different dosages of pritelivir. We sequenced resistance regions from 87 participants' samples, the UL5 gene in 73 samples from 44 participants, and the UL52 gene in 71 samples from 43 participants. RESULTS: We found no evidence that pritelivir induced known resistance-mediating mutations or for amino acid variation at other loci. In one participant's HSV-2 isolate, we found a previously unidentified mutation close to the putative resistance-mediating region in UL5 and subsequently determined in vitro susceptibility to pritelivir. We characterized mutations from 32 cultivated HSV-2 isolates previously found to be susceptible to pritelivir in vitro and identified several novel mutations that most likely reflect preexisting variation in circulating HSV-2. CONCLUSIONS: This study demonstrates evidence of retained susceptibility of HSV-2 to pritelivir in immunocompetent persons following daily therapy for up to 28 days.


Asunto(s)
Antivirales/administración & dosificación , Farmacorresistencia Viral , Herpes Genital/tratamiento farmacológico , Herpesvirus Humano 2/efectos de los fármacos , Piridinas/administración & dosificación , Tiazoles/administración & dosificación , Antivirales/farmacología , Femenino , Herpesvirus Humano 2/aislamiento & purificación , Humanos , Masculino , Mutación , Piridinas/farmacología , Análisis de Secuencia de ADN , Sulfonamidas , Tiazoles/farmacología , Proteínas Virales/genética
11.
Sci Transl Med ; 8(324): 324ra15, 2016 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-26843190

RESUMEN

Pharmacokinetic and pharmacodynamic models estimate the potency of antiviral agents but do not capture viral and immunologic factors that drive the natural dynamics of infection. We designed a mathematical model that synthesizes pharmacokinetics, pharmacodynamics, and viral pathogenesis concepts to simulate the activity of pritelivir, a DNA helicase-primase inhibitor that targets herpes simplex virus. Our simulations recapitulate detailed viral kinetic shedding features in five dosage arms of a phase 2 clinical trial. We identify that in vitro estimates of median effective concentration (EC50) are lower than in vivo values for the drug. Nevertheless, pritelivir potently decreases shedding at appropriate doses based on its mode of action and long half-life. Although pritelivir directly inhibits replication in epithelial cells, our model indicates that pritelivir also indirectly limits downstream viral spread from neurons to genital keratinocytes, within genital ulcers, and from ulcer to new mucosal sites of infection. We validate our model based on its ability to predict outcomes in a subsequent trial with a higher dose. The model can therefore be used to optimize dose selection in clinical practice.


Asunto(s)
Antivirales/farmacología , Herpesvirus Humano 2/efectos de los fármacos , Herpesvirus Humano 2/fisiología , Modelos Biológicos , Piridinas/farmacología , Tiazoles/farmacología , Ensayos Clínicos como Asunto , Simulación por Computador , Relación Dosis-Respuesta a Droga , Humanos , Cinética , Sulfonamidas , Resultado del Tratamiento , Esparcimiento de Virus/efectos de los fármacos
12.
Curr Opin Virol ; 18: 9-13, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26897058

RESUMEN

Herpes simplex virus (HSV) types 1 and 2 can cause infections with clinical manifestations ranging from benign and generally self-limiting blisters or sores as seen in labial and genital herpes through to severe and in rare cases even life-threatening infections. At present, approved treatments for herpes simplex virus are almost all nucleoside analogs. Novel antiviral approaches include therapeutic vaccines, with the most advanced having successfully completed Phase 2 clinical development. Moreover, several small molecules approaches are being developed for the treatment of genital or labial HSV infections. Of particular interest are two novel compounds (amenamevir and pritelivir) belonging to the new class of helicase-primase inhibitors with promising Phase 2 data.


Asunto(s)
Antivirales/uso terapéutico , Herpes Genital/tratamiento farmacológico , Herpes Simple/tratamiento farmacológico , Herpes Simple/virología , Aciclovir/efectos adversos , Aciclovir/farmacología , Aciclovir/uso terapéutico , Antivirales/administración & dosificación , Ensayos Clínicos Fase II como Asunto , ADN Helicasas/antagonistas & inhibidores , ADN Primasa/antagonistas & inhibidores , Farmacorresistencia Viral , Herpes Genital/virología , Herpes Simple/prevención & control , Vacunas contra el Virus del Herpes Simple/administración & dosificación , Vacunas contra el Virus del Herpes Simple/efectos adversos , Vacunas contra el Virus del Herpes Simple/uso terapéutico , Herpesvirus Humano 1/efectos de los fármacos , Herpesvirus Humano 2/efectos de los fármacos , Humanos , Oxadiazoles/efectos adversos , Oxadiazoles/uso terapéutico , Piridinas/efectos adversos , Piridinas/uso terapéutico , Sulfonamidas , Tiazoles/efectos adversos , Tiazoles/uso terapéutico , Proteínas Virales/efectos de los fármacos
13.
Antimicrob Agents Chemother ; 58(7): 3843-52, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24752278

RESUMEN

Herpes simplex virus (HSV) infections can cause considerable morbidity. Transmission of HSV-2 has become a major health concern, since it has been shown to promote transmission of other sexually transmitted diseases. Pritelivir (AIC316, BAY 57-1293) belongs to a new class of HSV antiviral compounds, the helicase-primase inhibitors, which have a mode of action that is distinct from that of antiviral nucleoside analogues currently in clinical use. Analysis of pharmacokinetic-pharmacodynamic parameters is a useful tool for the selection of appropriate doses in clinical trials, especially for compounds belonging to new classes for which no or only limited data on therapeutic profiles are available. For this purpose, the effective dose of pritelivir was determined in a comprehensive mouse model of HSV infection. Corresponding plasma concentrations were measured, and exposures were compared with efficacious concentrations derived from cell cultures. The administration of pritelivir at 10 mg/kg of body weight once daily for 4 days completely suppressed any signs of HSV infection in the animals. Associated plasma concentrations adjusted for protein binding stayed above the cell culture 90% effective concentration (EC90) for HSV-1 for almost the entire dosing interval. Interestingly, by increasing the dose 6-fold and prolonging the treatment duration to 8 days, it was possible to treat mice infected with an approximately 30-fold pritelivir-resistant but fully pathogenic HSV-1 virus. Corresponding plasma concentrations exceeded the EC90 of this mutant for <8 h, indicating that even suboptimal exposure to pritelivir is sufficient to achieve antiviral efficacy, possibly augmented by other factors such as the immune system.


Asunto(s)
Antivirales/farmacología , Antivirales/farmacocinética , ADN Primasa/antagonistas & inhibidores , AdnB Helicasas/antagonistas & inhibidores , Herpes Simple/tratamiento farmacológico , Herpesvirus Humano 1 , Piridinas/farmacología , Piridinas/farmacocinética , Tiazoles/farmacología , Tiazoles/farmacocinética , Animales , Relación Dosis-Respuesta a Droga , Farmacorresistencia Viral , Femenino , Herpes Simple/virología , Masculino , Ratones , Ratones Endogámicos BALB C , Enfermedades Cutáneas Virales/tratamiento farmacológico , Enfermedades Cutáneas Virales/patología , Sulfonamidas , Ensayo de Placa Viral , Replicación Viral/efectos de los fármacos
14.
N Engl J Med ; 370(3): 201-10, 2014 Jan 16.
Artículo en Inglés | MEDLINE | ID: mdl-24428466

RESUMEN

BACKGROUND: Pritelivir, an inhibitor of the viral helicase-primase complex, exhibits antiviral activity in vitro and in animal models of herpes simplex virus (HSV) infection. We tested the efficacy and safety of pritelivir in otherwise healthy persons with genital HSV-2 infection. METHODS: We randomly assigned 156 HSV-2-positive persons with a history of genital herpes to receive one of four doses of oral pritelivir (5, 25, or 75 mg daily, or 400 mg weekly) or placebo for 28 days. Participants obtained daily swabs from the genital area for HSV-2 testing, which was performed with a polymerase-chain-reaction assay. Participants also maintained a diary of genital signs and symptoms. The primary end point was the rate of genital HSV shedding. RESULTS: HSV shedding among placebo recipients was detected on 16.6% of days; shedding among pritelivir recipients was detected on 18.2% of days among those receiving 5 mg daily, 9.3% of days among those receiving 25 mg daily, 2.1% of days among those receiving 75 mg daily, and 5.3% of days among those receiving 400 mg weekly. The relative risk of viral shedding with pritelivir, as compared with placebo, was 1.11 (95% confidence interval [CI], 0.65 to 1.87) with the 5-mg daily dose, 0.57 (95% CI, 0.31 to 1.03) with the 25-mg daily dose, 0.13 (95% CI, 0.04 to 0.38) with the 75-mg daily dose, and 0.32 (95% CI, 0.17 to 0.59) with the 400-mg weekly dose. The percentage of days with genital lesions was also significantly reduced, from 9.0% in the placebo group to 1.2% in both the group receiving 75 mg of pritelivir daily (relative risk, 0.13; 95% CI, 0.02 to 0.70) and the group receiving 400 mg weekly (relative risk, 0.13; 95% CI, 0.03 to 0.52). The rate of adverse events was similar in all groups. CONCLUSIONS: Pritelivir reduced the rates of genital HSV shedding and days with lesions in a dose-dependent manner in otherwise healthy men and women with genital herpes. (Funded by AiCuris; ClinicalTrials.gov number, NCT01047540.).


Asunto(s)
Antivirales/administración & dosificación , Herpes Genital/tratamiento farmacológico , Herpesvirus Humano 2 , Piridinas/administración & dosificación , Tiazoles/administración & dosificación , Esparcimiento de Virus/efectos de los fármacos , Administración Oral , Adulto , Anciano , Antivirales/efectos adversos , Antivirales/farmacología , ADN Viral/análisis , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Farmacorresistencia Viral , Femenino , Herpes Genital/virología , Herpesvirus Humano 2/genética , Herpesvirus Humano 2/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Piridinas/efectos adversos , Piridinas/farmacología , Sulfonamidas , Tiazoles/efectos adversos , Tiazoles/farmacología , Carga Viral/efectos de los fármacos
15.
Antiviral Res ; 100(2): 297-9, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24021190

RESUMEN

Fifty-nine US isolates of HSV-1 and HSV-2 obtained between 1998 and 2004 were tested for sensitivity to the helicase-primase inhibitor, pritelivir (AIC316, BAY 57-1293) by plaque-reduction assay. All isolates, which were collected prior to any clinical use of primase-helicase inhibitors, were sensitive and showed mean EC50 values of 0.026 and 0.029µM for HSV-1 and HSV-2, respectively. Furthermore, several laboratory-selected acyclovir-resistant HSV mutants were also sensitive to pritelivir. These data provide a baseline for HSV sensitivity to pritelivir in general population before it is introduced and broadly used to treat HSV infection. The data also validate pritelivir as an appropriate therapy for nucleoside-resistant HSV infections.


Asunto(s)
Antivirales/farmacología , ADN Helicasas/antagonistas & inhibidores , Herpesvirus Humano 1/efectos de los fármacos , Herpesvirus Humano 2/efectos de los fármacos , Piridinas/farmacología , Tiazoles/farmacología , Aciclovir/farmacología , Herpesvirus Humano 1/aislamiento & purificación , Herpesvirus Humano 2/aislamiento & purificación , Humanos , Pruebas de Sensibilidad Microbiana , Sulfonamidas , Estados Unidos , Ensayo de Placa Viral
16.
J Antimicrob Chemother ; 65(7): 1347-52, 2010 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-20453068

RESUMEN

OBJECTIVES: Previous studies suggested that helicase-primase inhibitor (HPI) resistance mutations can be selected at relatively high frequency from some isolates of herpes simplex virus type 1 (HSV-1). An intentional mismatch primer (IMP) PCR was developed to detect three known HPI resistance mutations well above the expected background frequency. The objective of this study was to provide proof that HPI resistance mutations pre-exist at relatively high frequency in some clinical isolates obtained from individuals naive to HPIs. METHODS: Three different IMP PCRs were standardized to detect critical HPI resistance mutations (K356N or K356T in UL5, or A899T in UL52) at 10-100 times the expected background frequency (<10(-6)). Thirty HSV-1 clinical isolates were then screened for the resistance mutations in the absence of the inhibitor using IMP PCR. RESULTS: Among 30 clinical isolates that were all susceptible to the HPI, BAY 57-1293, 5 were shown to contain UL5 mutations at 10-100 times higher than the expected frequency. No UL52 resistance mutations were encountered in this study. CONCLUSIONS: The detection of HPI-resistant mutations in some clinical isolates by means of IMP PCR proved that the mutations pre-exist and showed that they are not induced during incubation with the inhibitor.


Asunto(s)
Antivirales/farmacología , ADN Primasa/genética , Farmacorresistencia Viral , Herpes Simple/virología , Herpesvirus Humano 1/efectos de los fármacos , Herpesvirus Humano 1/genética , Mutación Missense , Animales , Línea Celular , Chlorocebus aethiops , ADN Primasa/antagonistas & inhibidores , Cartilla de ADN/genética , ADN Viral/genética , Inhibidores Enzimáticos/farmacología , Herpesvirus Humano 1/aislamiento & purificación , Humanos , Reacción en Cadena de la Polimerasa/métodos , Porcinos , Proteínas Virales/antagonistas & inhibidores , Proteínas Virales/genética
17.
Antiviral Res ; 87(1): 67-73, 2010 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-20420855

RESUMEN

Point mutations in the HSV-1 UL5 (helicase) gene confer resistance to helicase-primase inhibitors (HPIs), e.g. BAY 57-1293. Such mutations normally occur at a frequency of < or =10(-6)PFU. However, individual HSV-1 laboratory strains and some clinical isolates contained resistance mutations (e.g. UL5: Lys356Asn) at 10(-4)PFU. To address the possibility that pre-existing mutants at high frequency might have an impact on therapy using HPIs, deliberate mixtures were prepared to contain the SC16 UL5: Lys356Asn mutant in SC16 wild-type in the proportion of 1/500 or 1/50PFU. Mice were infected in the neck-skin with 5x10(4)PFU/mouse of wt alone, mutant alone, or the respective mixture. The mutant could not be detected in infectious virus yields from mice inoculated with the 1/500 mixture. However, resistant mutant was recovered from some treated mice inoculated with the 1/50 mixture. All mice inoculated with mixtures remained responsive to BAY 57-1293-therapy with no increase in clinical signs compared to treatment of wt-infected mice.


Asunto(s)
Antivirales/uso terapéutico , ADN Helicasas/antagonistas & inhibidores , ADN Primasa/antagonistas & inhibidores , Farmacorresistencia Viral , Inhibidores Enzimáticos/uso terapéutico , Herpes Simple/tratamiento farmacológico , Herpesvirus Humano 1/efectos de los fármacos , Proteínas Virales/antagonistas & inhibidores , Sustitución de Aminoácidos/genética , Animales , ADN Helicasas/genética , ADN Primasa/genética , Femenino , Herpes Simple/virología , Herpesvirus Humano 1/enzimología , Herpesvirus Humano 1/genética , Ratones , Ratones Endogámicos BALB C , Mutación Missense , Resultado del Tratamiento , Proteínas Virales/genética
18.
J Virol ; 83(1): 396-407, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18945775

RESUMEN

The attachment, entry, and fusion of Kaposi's sarcoma-associated herpesvirus (KSHV) with target cells are mediated by complex machinery containing, among others, viral glycoprotein H (gH) and its alleged chaperone, gL. We observed that KSHV gH, in contrast to its homologues in several other herpesviruses, is transported to the cytoplasm membrane independently from gL, but not vice versa. Mutational analysis revealed that the N terminus of gH is sufficient for gL interaction. However, the entire extracellular part of gH is required for efficient gL secretion. The soluble ectodomain of gH was sufficient to interact with the surfaces of potential target cells in a heparin-dependent manner, and binding was further enhanced by coexpression of gL. Surface plasmon resonance revealed a remarkably high affinity of gH for glycosaminoglycans. Heparan sulfate (HS) proteoglycans of the syndecan family act as cellular receptors for the gH/gL complex. They promoted KSHV infection, and expression of gH/gL on target cells inhibited subsequent KSHV infection. Whereas gH alone was able to bind to HS, we observed that only the gH/gL complex adhered to heparan sulfate-negative cells at lamellipodium-like structures.


Asunto(s)
Herpesvirus Humano 8/fisiología , Receptores Virales/metabolismo , Proteínas del Envoltorio Viral/metabolismo , Proteínas Virales/metabolismo , Internalización del Virus , Línea Celular , Membrana Celular/química , Análisis Mutacional de ADN , Glicosaminoglicanos/metabolismo , Proteoglicanos de Heparán Sulfato/metabolismo , Humanos , Unión Proteica , Dominios y Motivos de Interacción de Proteínas , Mapeo de Interacción de Proteínas , Transporte de Proteínas , Resonancia por Plasmón de Superficie , Proteínas del Envoltorio Viral/genética
19.
Antiviral Res ; 80(1): 81-5, 2008 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-18539344

RESUMEN

Herpes simplex virus (HSV) helicase-primase (HP) is the target for a novel class of antiviral compounds, the helicase-primase inhibitors (HPIs), e.g. BAY 57-1293. Although mutations in herpesviruses conferring resistance to nucleoside analogues are commonly associated with attenuation in vivo, to date, this is not necessarily true for HPIs. HPI-resistant HSV mutants selected in tissue culture are reported to be equally pathogenic compared to parental virus in animal models. Here we demonstrate that a slow-growing HSV-1 mutant, with the BAY 57-1293-resistance mutation Gly352Arg in UL5 helicase, is clearly less virulent than its wild-type parent in a murine zosteriform infection model. This contrasts with published results obtained for a mutant containing a different HPI-resistance substitution (Gly352Val) at the same location, since this mutant was reported to be fully pathogenic. We believe our report to be the first to describe an HPI-resistant HSV-1 mutant, that is markedly less virulent in vivo and slowly growing in tissue culture compared to the parental strain. Another BAY 57-1293-resistant UL5 mutant (Lys356Gln), which showed faster growth characteristics in cell culture, however, was at least equally virulent compared to the parent strain.


Asunto(s)
ADN Helicasas/genética , ADN Primasa/genética , Farmacorresistencia Viral/genética , Inhibidores Enzimáticos/farmacología , Herpesvirus Humano 1 , Mutación , Proteínas Virales/genética , Animales , Antivirales/farmacología , Chlorocebus aethiops , ADN Helicasas/antagonistas & inhibidores , ADN Helicasas/química , ADN Primasa/antagonistas & inhibidores , ADN Primasa/química , Herpes Simple/patología , Herpes Simple/virología , Herpesvirus Humano 1/efectos de los fármacos , Herpesvirus Humano 1/genética , Herpesvirus Humano 1/crecimiento & desarrollo , Herpesvirus Humano 1/patogenicidad , Humanos , Ratones , Ratones Endogámicos BALB C , Piridinas/farmacología , Sulfonamidas , Tiazoles/farmacología , Células Vero , Proteínas Virales/antagonistas & inhibidores , Proteínas Virales/química , Virulencia
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