A comparison of moxifloxacin and levofloxacin topical prophylaxis in a fluoroquinolone-resistant Staphylococcus aureus rabbit model.

PURPOSE: Moxifloxacin, a fourth-generation fluoroquinolone (FQ), was compared to levofloxacin, a third-generation FQ, for preventing FQ-resistant, methicillin-resistant Staphylococcus aureus (FQrMRSA) endophthalmitis in a rabbit model. METHODS: Three regimens of topical treatments (moxifloxacin 0.5%, levofloxacin 0.5%, and saline) were tested to prevent endophthalmitis. For each regimen, drops were instilled every 15 min for 1 h into the left eyes of 15 rabbits. After anesthesia, 2 x 10(4) cfu of FQrMRSA was injected into the aqueous. One drop of treatment was given immediately, and another four drops were applied over 24 h. At 24 h, the eyes were clinically graded for endophthalmitis. After the rabbits were sacrificed, the aqueous and vitreous were tapped for bacterial colony counts. RESULTS: Topical moxifloxacin (12/15, 80%) significantly (P=0.0001) prevented clinical endophthalmitis in more rabbits than levofloxacin (2/15, 13%) or saline (2/15, 13%). The total median clinical score for moxifloxacin treatment (1.0) was significantly (P=0.0004) lower than that for levofloxacin (20.0) or saline (23.0). Culture-negative eyes were less frequent for levofloxacin (8/15, 53%) and saline (1/15, 7%) treatments than for moxifloxacin treatment (12/15, 80%). CONCLUSION: This in vivo study indicates that moxifloxacin, a fourth-generation FQ, may be more effective than levofloxacin, a third-generation FQ, in preventing experimental FQrMRSA. endophthalmitis.

Comparative tear concentrations over time of ofloxacin and tobramycin in human eyes.

The pharmacokinetic profiles of 0.3% ofloxacin and 0.3% tobramycin ophthalmic solutions after multiple administrations in the eyes of 160 healthy volunteers were evaluated. In human tears, ofloxacin and tobramycin were found to have terminal half-lives of 226 and 154 minutes, respectively. The mean residence time in the ocular tear fluid was 326 minutes for ofloxacin and 106 minutes for tobramycin. The mean duration of time that ofloxacin remained above the MIC90 value for five bacterial species evaluated was 605 minutes, compared with 251 minutes for tobramycin. The mean area under the inhibitory curve for the five bacterial species evaluated was greater for ofloxacin (2224) compared with tobramycin (1549). The duration of time above the MIC90 for ofloxacin was longer compared with tobramycin for gram-positive isolates. Overall, the pharmacokinetic and pharmacodynamic profiles of ofloxacin were superior to those of tobramycin for most parameters studied.

Efficacy of topical cidofovir on multiple adenoviral serotypes in the New Zealand rabbit ocular model.

PURPOSE: The goal of the present study was to determine the efficacy of topical 0.5% cidofovir twice daily for 7 days on the replication of multiple adenovirus (Ad) serotypes of subgroup C (Ad1, Ad5, Ad6) in the New Zealand rabbit ocular model. METHODS: In duplicate experiments for each serotype, a total of 20 rabbits (Ad5) or 16 rabbits each (Ad1 and Ad6) were inoculated topically in both eyes, with 1.5 X 10(6) pfu/eye of the appropriate virus. Twenty-four hours later, the rabbits in each serotype group were randomly divided into two topical treatment groups: I, 0.5% cidofovir; II, control vehicle. Treatment was twice daily for 7 days. All eyes were cultured for virus on days 0, 1, 3, 4, 5, 7, 9, 11, and 14. RESULTS: Compared to the control, treatment with 0.5% cidofovir reduced the following: mean Ad titer (days 1 to 7) for Ad1 (6.3 +/- 20 x 10(1) versus 2.5 +/- 3.9 X 102 pfu/ml; P < 0.0003), Ad5 (3.4 +/-5.8 x 102 versus 1.6 +/- 2.0 x 10(3) pfu/ml; P < 0.000001), and Ad6 (1.2 +/- 5.1 x 10(2) versus 5.5 +/-14 x 10(2) pfu/ml; P = 0.015); reduced Ad-positive eyes/total for Adl [45/128 (35%) versus 84/128 (66%); P = 0.000002], Ad5 [84/160 (53%) versus 131/152 (86%); P < 0.000001], and Ad6 [36/128 (28%) versus 82/128 (64%); P < 0.000001]: and reduced the duration of Ad shedding forAdl (4.9 +/-1.9 versus 9.3 +/- 3.3 days; P < 0.00007), Ad5 (6.4 +/- 2.8 versus 11.5 +/- 2.3 days; P < 0.0001), and Ad6 (4.4 +/- 2.1 versus 8.4 +/- 2.5 days; P < 0.00004). CONCLUSIONS: Topical 0.5% cidofovir twice daily for 7 days demonstrated significant antiviral activity against multiple adenoviral serotypes (Ad1, Ad5, and Ad6) in the New Zealand rabbit ocular model. These in vivo data expand in vitro studies indicating the efficacy of cidofovir against different adenovirus serotypes and support its use in clinical trials.

Effects of diclofenac or ketorolac on the inhibitory activity of cidofovir in the Ad5/NZW rabbit model.

PURPOSE: The goal of this study was to determine the effects of concurrent therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) on the antiviral activity of cidofovir on adenovirus replication and the formation of subepithelial infiltrates in the Ad5/New Zealand White rabbit ocular model. METHODS: According to two protocols, 20 rabbits were inoculated in both eyes with Ad5 topically to study adenovirus replication, and 20 rabbits were inoculated in both eyes topically and intrastromally to study the formation of subepithelial infiltrates. Animals were randomized to four masked treatment groups: group I, 0.5% cidofovir + artificial tears; group II, 0.5% cidofovir + 0.5% ketorolac tromethamine; group III, 0.5% cidofovir + 0.1% diclofenac sodium; and group IV, control + artificial tears. Cidofovir and control were administered to both eyes twice daily for 7 days, and artificial tears, ketorolac, and diclofenac four times daily for 14 days. Eyes were cultured on days 0, 1, 3, 4, 5, 7, 9, 11, and 14. RESULTS: Compared with the control group, all cidofovir-treated groups demonstrated significant antiviral effects on adenovirus replication. There were no differences in adenovirus replication among the cidofovir-treated groups (I, II, and III), nor were there any differences among all groups (I-IV) in the formation of subepithelial infiltrates. CONCLUSIONS: Concurrent treatment of ketorolac or diclofenac with cidofovir did not diminish its antiviral inhibitory activity on adenovirus replication, nor did it prevent the formation of subepithelial infiltrates in the rabbit model.

An ocular model of adenovirus type 5 infection in the NZ rabbit.

Ocular adenoviral infections occur worldwide, and currently, there is no ocular animal model for evaluating new antivirals or studying pathogenesis. With a paired-eye design, an ocular model was developed in 32 New Zealand rabbits following topical and intrastromal inoculation with a clinical isolate of adenovirus type 5 (Ad5 McEwen). Clinical signs of infection--conjunctivitis, corneal edema, subepithelial infiltrates, and iritis--and seroconversion were evaluated. Replicating virus on the ocular surface was determined by serial ocular titers. Reproducible acute ocular infection was demonstrated in 32 of 32 infected eyes (100%), with mean viral replication lasting for 8.3 days. Peak ocular viral titers (10(3) plaque forming units/ml) were achieved on day three after inoculation and represented a 2 log increase (100 times) over day one. Ocular viral replication was associated with acute conjunctivitis (24/34 eyes, 75%), and delayed-onset presumed immune-mediated clinical disease was associated with: blepharoconjunctivitis (21/32 eyes, 66%), iritis (29/32 eyes, 91%), corneal edema (32/32 eyes, 100%), and subepithelial corneal infiltrates (30/32 eyes, 94%). Seroconversion was demonstrated in 26 of 31 rabbits (84%). The study concludes that a potentially useful animal model of adenoviral ocular infection can be attained.

HSV-1 thymidine kinase promotes virulence and latency in the mouse.

The relationship between thymidine kinase (TK) activity and virulence was studied in the mouse using three HSV-1 strains: (1) NIH TK+ (100% activity), (2) NIH TK+/- (25% TK activity), and (3) NIH TK- (0% TK activity). Following corneal inoculation, keratitis, virus titers (eye, trigeminal ganglia brain), survival, and latency were determined for each strain. The most virulent strain, NIH TK+ (30% survival) produced the worst keratitis, highest CNS titers, and established latency in 78% of surviving mice. NIH TK+/- demonstrated dose-dependent intermediate virulence (57-90% survival) and established latency in 80% of mice. NIH TK-, the most avirulent strain (93-100% survival) produced eye virus titers equal to the other strains but did not appear to invade the CNS or establish latency. These results indicate that TK gene activity is essential for HSV-1 murine neurovirulence (ie, efficient CNS invasion, replication and establishment of latency), but not for ocular replication.

A fast, simple reactivation method for the study of HSV-1 latency in the rabbit ocular model.

We developed a simple, fast, economical, and versatile reactivation method for the study of herpes simplex virus type 1 (HSV-1) latency in the rabbit ocular model. Intrastromal injection of sterile, deionized water induced reactivation and ocular shedding of latent HSV-1 in 21 of 27 eyes (78%) in 93% of New Zealand rabbits. Other control groups (eg, anterior chamber injection of sterile, deionized water; topical administration of sterile, deionized water; intrastromal injection of air; and intrastromal needle track), were less efficient in reactivating latent HSV-1. Although the mechanism of reactivation in this model is unknown, the reactivation signal may be related to the relative amount of corneal trauma.

Timolol promotes reactivation of latent HSV-1 in the mouse iontophoresis model.

The present study examined the effect of topical timolol, a nonspecific beta 1 and beta 2 blocker on reactivation and ocular shedding of latent HSV-1 in an improved mouse iontophoresis model. Latent trigeminal ganglionic infection was established in Balb/C mice following inoculation by corneal scarification with HSV-1 W strain, a clinical isolate, and confirmed by co-cultivation. On day 30, postinfection (pi), the mice were divided into two groups, and treatment begun with coded eye drops (timolol 0.5% or placebo) BID OU for 5 days. On day 31 pi, iontophoresis with 1% 6-hydroxydopamine was performed, and daily treatment with topical epinephrine and 1% prednisolone was administered. Reactivation and recovery of latent HSV-1 was determined by daily ocular swabs, and characteristic HSV-1 cytopathic effect in Vero cells. Results demonstrated that the timolol-treated group had a significantly greater number of positive eyes, multiple shedding episodes, and total shedding days compared to the control group. We conclude that beta blockade promotes recurrent ocular shedding induced by epinephrine in the mouse iontophoresis latency model.

Topical corticosteroids reverse the antiviral effect of topical cidofovir in the Ad5-inoculated New Zealand rabbit ocular model.

PURPOSE: To determine how the addition of topical corticosteroids would affect the anti-adenoviral inhibitory effect of topical cidofovir (S-HPMPC) in the Ad5 New Zealand (Ad5/NZ) rabbit ocular model. METHODS: In a series of experiments (two-eye design), Ad5-inoculated/NZ rabbits (10(6) pfu/eye) were treated with 1 of 3 treatment regimens. Group 1 was administered 1% cidofovir (CDV) twice a day for 3 days plus comfort tears four times a day for 14 days. Group 2 was administered 1% CDV twice a day for 3 days plus 1% Pred Forte four times a day for 14 days. Group 3 was administered vehicle twice a day for 3 days plus comfort tears four times a day for 14 days and served as the control. All eyes were evaluated for 21 days for serial eye titers, Ad5 positive eyes, and duration of Ad5 shedding. RESULTS: Compared to control eyes in the Ad5/NZ rabbit ocular model, CDV alone demonstrated a significant antiviral inhibitory effect: reduced mean Ad5 eye titer during the early phase of infection (days 3 to 7), fewer Ad5-positive eyes during the early and late (days 9 to 21) phases of infection, and shortened duration of shedding. However, concomitant treatment with both Pred Forte and CDV significantly reversed the antiviral inhibitory activity of CDV: increased mean Ad5 eye titer, increased Ad5-positive eyes (early and late phases) and prolonged duration of shedding. CONCLUSIONS: These experimental data further support the clinical development of cidofovoir as a topical antiviral agent, but they do not support a treatment regimen that includes a combination of topical corticosteroids and topical cidofovir as a desirable strategy for the treatment of symptomatic adenoviral ocular infection.

Topical HPMPC inhibits adenovirus type 5 in the New Zealand rabbit ocular replication model.

PURPOSE: To evaluate the antiviral inhibitory activity of HPMPC against ocular adenoviral serotypes in vitro and to determine the therapeutic efficacy and ocular toxicity of treatment with topical HPMPC on established adenovirus type 5 (AD5) McEwen infection in the New Zealand (NZ) rabbit ocular replication model. METHODS: The 50% inhibitory dose (ID50) of HPMPC was determined for various clinical isolates of AD5 and AD8 by plaque assay in A549 cells. In vivo inhibitory effects were measured by serial ocular titers and duration of viral shedding in the AD5-NZ rabbit ocular model. Local ocular toxicity was evaluated by external and slit lamp examination for blepharitis, conjunctivitis, keratitis, and iritis. RESULTS: The mean ID50 for seven isolates of AD8 was 0.47 (range, 0.02 microgram/ml to 0.82 microgram/ml), and the mean ID50 for seven isolates of AD5 was 1.03 (range, 0.15 microgram/ml to 2.80 micrograms/ml). In a series of in vivo experiments, topical administration of HPMPC for as long as 10 days (total dose, > 2.8 mg) significantly reduced both AD5 ocular titers and the number of days of viral shedding compared to that for vehicle-treated control eyes. Local ocular toxicity was not clinically significant at a total dose of < 10 mg administered for as long as 10 days. CONCLUSIONS: HPMPC, a broad-spectrum, long-acting nucleoside monophosphate analog, is a promising candidate for the treatment of epidemic keratoconjunctivitis infections. Further studies to ensure safety and efficacy in humans are warranted.

Comparative antiviral efficacies of cidofovir, trifluridine, and acyclovir in the HSV-1 rabbit keratitis model.

PURPOSE: To determine the relative antiviral inhibitory activity of topical 1% and 0.5% cidofovir, topical trifluridine (Viroptic; Burroughs-Wellcome, Research Triangle Park, NC), and topical acyclovir (Zovirax; The Wellcome Foundation, London, UK) during a 7-day period for the treatment of herpes simplex virus type 1 (HSV-1) keratitis and HSV-1 replication in the New Zealand rabbit ocular model. METHODS: In a series of four experiments using a two-eye design, a total of 80 New Zealand rabbits were inoculated in both eyes with HSV-1 McKrae after epithelial scarification. Forty-eight hours after inoculation, the rabbits were randomly assigned to a treatment group. Five treatment groups (16 rabbits/group) were evaluated: I, 1% cidofovir, twice daily for 7 days; II, 0.5% cidofovir, twice daily for 7 days; III, 3% acyclovir ointment, five times daily for 7 days; IV, 1% trifluridine, nine times daily for 3 days, then 4 times daily for 4 days; and V, control vehicle twice daily for 7 days. HSV-1 dendritic keratitis was graded in a masked fashion by slit-lamp examination on days 2, 3, 5, 7, 9, 11, and 14. Ocular viral cultures were obtained after slit-lamp examination on days 1, 3, 5, 7, 9, 11, and 14. RESULTS: Compared with the control group, all four treatment groups demonstrated significantly lower viral titers, fewer HSV-1-positive eyes/total during the treatment period, lower keratitis scores, fewer eyes with keratitis/total, and a shorter time to resolution of keratitis. Within the treatment groups, the 1% and 0.5% cidofovir treatments were significantly more effective than acyclovir and trifluridine as measured by the previous viral and keratitis parameters. CONCLUSIONS: Topical 1% and 0.5% cidofovir both appeared to be significantly more efficacious than topical trifluridine and acyclovir, during a 7-day course, in the treatment of experimental HSV-1 ocular disease in the New Zealand rabbit keratitis model.

Multiple adenoviral serotypes demonstrate host range extension in the New Zealand rabbit ocular model.

PURPOSE: Although several human adenoviral serotypes demonstrated the genetic capability of replicating in New Zealand rabbit corneas in organ culture, only a single adenovirus (Ad) serotype, Ad5, has been reported to replicate in vivo in New Zealand rabbit eyes. The purpose of this study was to determine whether additional adenoviral serotypes could extend their host range to the New Zealand rabbit ocular model. METHODS: Six rabbits per viral isolate were inoculated in each eye after corneal scarification with 1.5 x 10(6) plaque-forming units per eye with one of the following reference or clinical adenovirus isolates: Ad1 ATCC, Ad1 Kmetz, Ad2 ATCC, Ad2 Wolf, Ad5 ATCC, Ad5 McEwen, Ad6 ATCC, Ad 19 ATCC, and Ad8 Cray (five rabbits). Eyes were cultured on days 0, 1, 3, 4, 5, 7, 9, 11, 14, 16, 18, and 21 after inoculation, and their tear film viral titers were determined on A549 cells. RESULTS: Ad19 ATCC and Ad8 Cray demonstrated no apparent viral replication. The mean duration of shedding was 1.5 and 0.3 days, respectively, and the total percentage of Ad-positive eyes was 13% and 3%, respectively. In contrast to Ad19 ATCC and Ad8 Cray, all other isolates demonstrated productive infection. The mean duration of shedding was 8 to 16 days (P < 0.0001), and the total percentage of Ad-positive eyes was 33% to 79% (P < 0.0002). The durations of shedding for Ad1 ATCC, Ad1 Kmetz, Ad2 ATCC, Ad2 Wolf, and Ad6 ATCC did not differ statistically from Ad5 McEwen, whereas Ad5 ATCC demonstrated a duration of shedding longer than all isolates (P < 0.0001). CONCLUSIONS: This was the first demonstration of host range extension by additional clinical and reference isolates of adenovirus types 1, 2, 5, and 6 in the New Zealand rabbit ocular model. These results suggested that host specificity was less stringent than previously thought.

A herpes simplex type 1 ICPO deletion mutant demonstrates diminished pathogenicity during acute ocular infection in different host animals.

We compared a previously characterized herpes simplex type 1 alpha 0 deletion mutant, dlx3.1, which produced no functional ICP0, with its wild-type parental strain, KOS, during acute ocular infection of different host animals. Acute pathogenicity of the viral strains in NZ rabbits, Balb/c and A/J mice was evaluated by keratitis scores, ocular and trigeminal ganglionic viral titers, and host survival. We found that dlx3.1 was significantly less pathogenic than KOS. Host differences proved very important in the evaluation of acute pathogenicity. A species-dependent enhancement of ocular pathogenicity was demonstrated for dlx3.1 following a larger viral inoculum and host immunosuppression. We conclude that alpha 0 gene function appears to play an important role during acute ocular pathogenicity of HSV-1 in animal models. Furthermore, in vivo pathogenicity studies contribute important information in the evaluation of essential viral gene function.

Isolation of human adenovirus type 5 variants resistant to the antiviral cidofovir.

PURPOSE: Cidofovir (S-HPMPC) is a potent broad-spectrum antiviral drug with potential clinical application against infections caused by human cytomegalovirus, herpes simplex virus, and adenovirus (AD). This study sought to determine whether variants of AD5 could be isolated in vitro that demonstrated increased resistance to this new antiviral drug. METHODS: Homogenous stocks of wild-type AD5 (ATCC strain VR-5) were generated from isolated plaques grown in A549 cells. The stocks subsequently were serially passaged in cells containing increasing levels (from 5 to 75 micrograms/ml) of cidofovir. The recovered virus either was passaged, titrated, or assayed for 50% inhibitory concentration (IC50) of cidofovir. RESULTS: Three independently isolated variants were obtained that demonstrated increased resistance to cidofovir. Viral resistance to the drug increased on stepwise passage in higher concentrations. Compared to the ATCC AD5 reference (IC50 = 6.2 micrograms/ml), stable cidofovir-resistant variants showed fivefold to eightfold resistance (AD5 RI IC50 = 36.5 micrograms/ml; AD5 R2 IC50 = 36.7 micrograms/ml; and AD5 R3 IC50 = 32.6 micrograms/ml; analysis of variance, P = 0.000001). However, a variable number of passages (1 to 13) at each concentration of cidofovir was performed to obtain robust infectious virus suitable for testing at the next higher concentration. All resistant virus isolates grew to levels of virus titer comparable to the parental virus and showed no apparent phenotypic changes in growth rates, plaque size, or efficiency of plaque formation. CONCLUSIONS: The successful isolation of AD5 variants in tissue culture resistant to cidofovir has important clinical implications with respect to the anticipated use of this antiviral drug in treating adenoviral ocular infections.

Use of polymerase chain amplification reaction for the detection of adenoviruses in ocular swab specimens.

PURPOSE: To evaluate the application of polymerase chain reaction (PCR) methodology as a potential diagnostic tool for the detection of adenovirus DNA in ocular swab samples. METHODS: Oligonucleotides derived from the adenovirus hexon gene were used to amplify a 306-base pair (bp) product by PCR. Radiolabeled oligonucleotides derived from sequences within the amplified product were used as specific probes. Specificity was determined against DNA of 13 adenovirus serotypes (types 1 to 11, inclusive, and types 19 and 37) and from nonadenoviral DNAs. Limits of detection were determined by PCR amplification of known amounts of purified adenovirus serotype 2 DNA. The assay was tested on 107 ocular swab samples and correlated to results obtained from tissue culture and a commercial immunoassay (Adenoclone). RESULTS: The 306-bp PCR product was amplified from all adenovirus serotypes tested, but not from negative control DNAs. As little as 15 fg of adenovirus type 2 DNA could be detected by PCR and ethidium bromide stain. Using a simplified sample preparation procedure, 46 of 58 adenovirus culture-positive but Adenoclone-negative swabs were positive by PCR (79% sensitivity). All (11 of 11) Adenoclone-positive clinical eye swabs tested were positive by PCR (100% sensitivity). Only 1 of 38 nonadenoviral ocular swab samples was positive by PCR (97% specificity). CONCLUSIONS: PCR appeared to be highly suitable for the diagnosis of adenovirus in ocular swabs, offering important improvements in speed over tissue culture isolation and in sensitivity over immunoassay.

The antiviral resistance and replication of cidofovir-resistant adenovirus variants in the New Zealand White rabbit ocular model.

PURPOSE: To determine the antiviral resistance of three cidofovir (CDV)-resistant variants of adenovirus type 5 (Ad5) and their ability to replicate in the New Zealand White rabbit ocular model. METHODS: Rabbits were inoculated topically in both eyes with the CDV-resistant variants R1, R2, and R3, and the Ad5 parental strain. On day 1, rabbits from each virus inoculation were divided into two topical treatment groups: 0.5% CDV and PBS control. Treatment was administered twice daily in both eyes for 7 days. All eyes were cultured for virus on days 0, 1, 3, 4, 5, 7, 9, 11, and 14. Using viral outcome parameters, CDV resistance was determined for each virus by comparing each CDV-treated virus group to its respective PBS control, and altered pathogenesis was assessed by comparing viral replication in the PBS control groups of the Ad5 parent and the three resistant variants. RESULTS: Topical 0.5% CDV treatment demonstrated significant antiviral inhibitory activity in the Ad5 parental group (e.g., reduced total Ad5-positive cultures, reduced daily Ad5-positive cultures on days 5, 9, 11, and 14, and duration of ocular shedding), but had no effect on the three CDV-resistant variants. There were no significant differences in pathogenicity between the Ad5 parent and the CDV-resistant variants. CONCLUSIONS: The Ad5 variants R1, R2, and R3 were resistant to topical treatment with 0.5% cidofovir in the rabbit ocular model. However, the acquisition of CDV resistance did not alter the replication of the three Ad5 CDV variants on the rabbit eye.

The development of an improved murine iontophoresis reactivation model for the study of HSV-1 latency.

The present study reviews the development of an effective murine iontophoresis reactivation model for the study of HSV-1 latency. In a series of experiments, Balb C mice latently infected with HSV-1 McKrae strain were iontophoresed with epinephrine X 3 days (EPI X 3/ION) or 6-hydroxydopamine X 1 day followed by topical epinephrine (6-HD ION/EPI). Reactivation and recovery of latent HSV-1 was determined by daily ocular swabs, titration, and neutralization. Additional studies determined the effect of topical ocular steroids on viral recovery rate. The results demonstrated no recovery of McKrae strain in Balb C (0%) with EPI X 3/ION, and no enhancement with topical steroids. 6-HD ION/EPI demonstrated a low recovery rate in mice (8%). However, the recovery rate was significantly increased to 50% by the addition of topical steroids to form the 6-HD ION/EPI/STEROID model, a useful experimental tool. The substitution of a clinical isolate, W strain, for McKrae strain further improved the model. The results demonstrated that, following the acute infection in mice, W strain was associated with a significantly higher (P = .001) survival rate than McKrae strain (81% vs. 52%). There was no statistically significant difference between the two strains, W vs McKrae, in Balb C mice comparing keratitis, establishment of latency (by co-cultivation), spontaneous shedding rate, or induced ocular shedding following iontophoresis. The development of an effective murine iontophoresis model offers an economical method which is uniquely suited for immunological and genetic studies of HSV-1 latency.

Antiviral prophylaxis with twice daily topical cidofovir protects against challenge in the adenovirus type 5/New Zealand rabbit ocular model.

Adenoviral ocular infections are the most common external ocular infections world wide and there is no approved treatment. Topical cidofovir has been shown to be effective in vitro, in animal models and in case studies for the treatment of adenoviral ocular infections. Prophylaxis to prevent transmission within households and to reduce community epidemics remains an important public health goal. The current study examined whether antiviral prophylaxis with cidofovir, twice daily dosing, would restrict viral replication following a large challenge inoculum of adenovirus type 5 (Ad5) in the New Zealand white rabbit ocular model. The results showed that antiviral prophylaxis with 1 and 0.5% cidofovir significantly reduced mean daily Ad5 ocular titers (days 0-5), the number of Ad5 positive cultures/total (days 1-14), serial Ad5 positive cultures/total (days 1, 2, 3, 4, 5, 7), and the number of eyes with Ad5 replication beyond day 0 (1% cidofovir only). Antiviral prophylaxis appears to be an effective strategy to reduce and restrict adenovirus replication experimentally.

Inhibitory effect of (S)-HPMPC, (S)-HPMPA, and 2'-nor-cyclic GMP on clinical ocular adenoviral isolates is serotype-dependent in vitro.

Currently, there is no effective treatment for ocular adenoviral infections that occur in epidemics worldwide, produce significant patient morbidity, and cause substantial economic losses. We tested several new antivirals in vitro, and found that (S)-HPMPC, (S)-HPMPA, and 2'-nor-cyclic GMP demonstrated significant serotype-dependent inhibitory activity by plaque reduction assay (ID50 = 0.017-17.0 micrograms/ml) against common clinical ocular isolates and standard adenoviral serotypes (Ad 1, Ad 5, Ad 8, and Ad 19). (S)-HPMPC was the least toxic (CD50 in A549 cells = 306 micrograms/ml), and (S)-HPMPC and (S)-HPMPA had high selectivity indices.