Can we target antivirals to the host cell?

Two papers published recently explore the idea of targeting antiviral compounds to the host cell using high-throughput organic synthesis and an in vitro screen. Both groups identify a single novel inhibitor of virus replication and both are host specific.  One paper goes further and identifies the target and also the in vivo potential of this compound. These papers highlight the hopes and pitfalls of targeting the host cell against viruses while shedding light on the basic biology of these viruses.

   We can protect ourselves from the harmful effects of viral infection through the use of vaccination, antivirals or indeed behavioral changes. Yet not all viruses have proved to be amenable to these and some, like measles and mumps, are quite easily combated with mass immunization campaigns while the likes of HIV have shown to be quite sensitive to antiviral compounds.

Respiratory infections are a problem! hastings.gov.uk

   For a majority of viruses though, we have neither effective vaccines nor antivirals. We need these now more than ever. And, even those which we do have vaccines and/or antivirals (Influenza A), resistance is quickly built up over time rendering them clinically useless. How then are we able to generate new, more effective antiviral molecules against a whole range of viral pathogens, especially given the cost of taking a single drug to patients?; we want more bang for our buck with antivirals. One way maybe through the targeting not of a viral gene or protein but a cellular one. The virus life cycle is so intimately connected to that of the host cell that removal of cellular pathways may have a dramatic effect on virus functioning and applications like these have the beauty of possibly targeting both established and emerging pathogens.

   Krumm et al, from the Emory University School of Medicine, Atlanta, U.S.A, demonstrate the feasibility of this approach using viruses from the paramyxo- and the orthomyxoviruses (generally called the 'myxoviruses') as their model of choice. Read the paper here. Using this, they discover a novel compound that demonstrates host-cell specificity while greatly inhibiting virus replication. Even at nanomolar concentrations (potent!).

   This work falls on the back of a series of experiments they reported back in 2008 where they screened a 137,500 compound library against in vitro infection with the related measles, canine distemper and human parainfluenza 3 viruses. This was to determine if they could uncover broad range, potent inhibitors of a large number of viruses. Moving away from the 'one-bug, one-drug' paradigm, this work identified a class of 11 compounds that did just that: they significantly inhibited replication and cytopathic effect of all the three viruses. They use the data from this series of experiments to find a host-targeted compound.

They state that their 'ideal' inhibitor would be:

In search of candidates with a host-directed antiviral profile, we anticipated three distinct features of desirable compounds: a) potent inhibition of virus replication at the screening concentration (3.3 µM); b) a primary screening score, representative of the selectivity index (CC₅₀/EC₅₀), close to the cut-off value for hit candidates due to some anticipated host-cell interference ( = 1.9); and c) a broadened viral target spectrum in counter screening assays that extends to other pathogens of the myxovirus families

initial compound A) and B), the synthetically optimised JMN3-003

   A single compound was taken forward and then synthetically optimized (high-throughput synthetic chemistry anybody?) to achieve even better inhibition. No longer do we have to rely on the natural diversity of compounds out there. This new and improved compound (JMN3-003) could inhibit not just myxo-virus replication but also that of clinically relevant RNA (Sindbis virus) and to a lesser extent DNA viruses, such as vaccinia virus. The broad activity of the molecule suggests that it may target a more general aspect of viral replication than others had previously. The activity of this drug was also host-cell specific, suggesting that it did not target a virus structure but rather one found within the host cell, whose activity would change depending on the species assayed.

JMN3-003 antiviral activity

   This molecule had little or no effect on the metabolic activity of the immortalized cell lines used or of other primary cell cultures when administered at >7,000X the active dose, possibly hinting at the safety profile of such a drug. And, under liver cell extract stability tests, the compound showed a desirable extrapolated half-life of around 200 minutes. Host transcription and translation weren't affected by drug administration.To be safe, the authors put forward that this compound may only be preferentially used in acute respiratory infections where the treatment time would be substantially shorter. This group did not carry out any in vivo work so the real safety of this compound cannot really be assessed. See below for how this should be done.

Activity changes depending on the cell used. Human PBMCs or primate Veros

   So, we have demonstrated that the compound inhibits virus replication. But just how exactly does it do this? At what stage of the virus replication cycle does it act? Entry? Transcription? replication? assembly? exit? The group addressed these points through the use of assays that measure virus envelope fusion with the cell membrane (virus entry) and virus gene expression and replication (post entry). This work showed that fusion was not inhibited when the drug was added suggesting a post entry step was being targeted. When compared to a known inhibitor of virus polymerase activity, JMN3-003 looked very similar. Other experiments, assessing levels of mRNA and genomes produced from virus replication showed a significant inhibition in one or both processes during measles or influenza virus infection. Some component associated with virus polymerase reactions is being targeted. What it is, sadly this paper did not address, yet further experiments I am sure will uncover the mechanism of action of this compound and maybe through this identify an important host-virus association that has been previously overlooked. Recently, evidence has suggested that these viruses require the activity of host kinases for proper, regulated replication. Could it be these?

Little risk of resistance?

   Their experiments also suggest that it is extremely difficult for these viruses to adapt to the inhibition from JMN3-003. After 90 days of replication on cells treated with the compound, little resistance had emerged. Again, the reasons for this were not addressed. When compared to previous problems of drug resistance seen in Influenza A and HIV-1, this activity looks very promising.

RSV - the biggest cause of bronchiolotis in young children. http://www.empowher.com/

   Interestingly, this approach has been used for another medically important virus (Respiratory syncitial virus, RSV - also a paramyxovirus) and just published recently in the journal PNAS (Bonavia et al 2011). This group used effectively the same strategy as described above, except using a lot more compounds (1.7 million). They picked up a number of molecules that also targeted a post-entry step in virus replication, possibly virus replication ( RdRp activity); it also shows broad spectrum activity against a range of RNA viruses. And again, no resistant viruses emerged in the experiments. 

   This work went a little further than that I mentioned earlier and Bonavia et al were able to pull down the drug target using a type of affinity purification with immobilized samples of the compound (iTRAQ quantitative chemical proteomics). The protein binding most strongly to this may mostly likely be the target. In this case, the two compounds tested both targeted seperated enzymes in the same pathway, the de novo pyrimidine biosynthesis pathway, that is the nucleotides A, T and U (A and U being used extensively by RNA viruses). To assess the safety of targeting this important cellular pathway, the group looked at both in vitro and in vivo rodent models of disease. Rapidly-dividing cells showed high sensitivity to the compound while significant histopathological changes were observed in lymphoid and gut tissues in the cotton rat. This is not good for a potential clinical drug that may be administered to very young babies. 

Pyramidine biosynthesis - a good antiviral target? http://upload.wikimedia.org/

   Sadly, these compounds exhibited no antiviral activity in vivo and rather one increased RSV virus replication. This is possibly down to the potential immunosupressive nature of the target (inhibits rapidly dividing cells - T and B cells) or the ability of circulating pyramidines in the animal's body to rescue the inhibition of their synthesis inside the cell.

   I wonder how the first compound, JMN3-003 would fare in the many animal models of myxovirus infection. And, what would the target be when the chemical pull-down was applied? would it be the same pathway? Both these papers highlight the ability of this approach to identify readily targeted host cell components to reduce virus replication in vitro and potentially overcome the problems of narrow virus targeting and resistance while the second paper goes further and shows us how the results may not be pleasing. The targeting of host factors has obvious implications for patient health and this cotton rat model displays what can go wrong. We should learn from this and expand any potential drug candidates into in vivo modeling quickly and at the start of any experiments, not like what was done with JMN3-003, although that's not to say the same will happen with that compound.



Bonavia, A., Franti, M., Pusateri Keaney, E., Kuhen, K., Seepersaud, M., Radetich, B., Shao, J., Honda, A., Dewhurst, J., Balabanis, K., Monroe, J., Wolff, K., Osborne, C., Lanieri, L., Hoffmaster, K., Amin, J., Markovits, J., Broome, M., Skuba, E., Cornella-Taracido, I., Joberty, G., Bouwmeester, T., Hamann, L., Tallarico, J., Tommasi, R., Compton, T., & Bushell, S. (2011). Organic Synthesis Toward Small-Molecule Probes and Drugs Special Feature: Identification of broad-spectrum antiviral compounds and assessment of the druggability of their target for efficacy against respiratory syncytial virus (RSV) Proceedings of the National Academy of Sciences, 108 (17), 6739-6744 DOI: 10.1073/pnas.1017142108

Krumm, S., Ndungu, J., Yoon, J., Dochow, M., Sun, A., Natchus, M., Snyder, J., & Plemper, R. (2011). Potent Host-Directed Small-Molecule Inhibitors of Myxovirus RNA-Dependent RNA-Polymerases PLoS ONE, 6 (5) DOI: 10.1371/journal.pone.0020069

Yoon, J., Chawla, D., Paal, T., Ndungu, M., Du, Y., Kurtkaya, S., Sun, A., Snyder, J., & Plemper, R. (2008). High-Throughput Screening--Based Identification of Paramyxovirus Inhibitors Journal of Biomolecular Screening, 13 (7), 591-608 DOI: 10.1177/1087057108321089