Lomonosova Elena, Zlotnick Adam, Tavis John E
Department of Molecular Microbiology and Immunology, Saint Louis University, and Saint Louis University Liver Center, St. Louis, Missouri, USA.
Molecular and Cellular Biology Department, Indiana University, Bloomington, Indiana, USA.
Antimicrob Agents Chemother. 2017 Feb 23;61(3). doi: 10.1128/AAC.02441-16. Print 2017 Mar.
Combination therapies are standard for management of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections; however, no such therapies are established for human hepatitis B virus (HBV). Recently, we identified several promising inhibitors of HBV RNase H (here simply RNase H) activity that have significant activity against viral replication Here, we investigated the antiviral efficacy of combinations of two RNase H inhibitors with the current anti-HBV drug nucleoside analog lamivudine, with HAP12, an experimental core protein allosteric modulator, and with each other. Anti-HBV activities of the compounds were tested in a HepG2-derived cell line by monitoring intracellular core particle DNA levels, and cytotoxicity was assessed by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay. The antiviral efficiencies of the drug combinations were evaluated using the median-effect equation derived from the mass-action law principle and combination index theorem of Chou and Talalay. We found that combinations of two RNase H inhibitors from different chemical classes were synergistic with lamivudine against HBV DNA synthesis. Significant synergism was also observed for the combination of the two RNase H inhibitors. Combinations of RNase H inhibitors with HAP12 had additive antiviral effects. Enhanced cytotoxicity was not observed in the combination experiments. Because of these synergistic and additive effects, the antiviral activity of combinations of RNase H inhibitors with drugs that act by two different mechanisms and with each other can be achieved by administering the compounds in combination at doses below the respective single drug doses.
联合疗法是治疗人类免疫缺陷病毒(HIV)和丙型肝炎病毒(HCV)感染的标准方法;然而,目前尚无治疗人类乙型肝炎病毒(HBV)的此类疗法。最近,我们鉴定出几种有前景的HBV核糖核酸酶H(以下简称为核糖核酸酶H)活性抑制剂,它们对病毒复制具有显著活性。在此,我们研究了两种核糖核酸酶H抑制剂与当前抗HBV药物核苷类似物拉米夫定、与实验性核心蛋白变构调节剂HAP12以及它们彼此之间联合使用的抗病毒效果。通过监测细胞内核衣壳颗粒DNA水平,在源自HepG2的细胞系中测试了这些化合物的抗HBV活性,并通过3-(4,5-二甲基噻唑-2-基)-5-(3-羧甲氧基苯基)-2-(4-磺基苯基)-2H-四唑(MTS)试验评估了细胞毒性。使用源自质量作用定律原理和Chou与Talalay的联合指数定理的中位效应方程评估了药物组合的抗病毒效率。我们发现,来自不同化学类别的两种核糖核酸酶H抑制剂与拉米夫定联合使用对HBV DNA合成具有协同作用。两种核糖核酸酶H抑制剂联合使用也观察到了显著的协同作用。核糖核酸酶H抑制剂与HAP12联合使用具有相加的抗病毒作用。在联合实验中未观察到细胞毒性增强。由于这些协同和相加作用,通过以低于各自单药剂量的剂量联合施用这些化合物,可以实现核糖核酸酶H抑制剂与通过两种不同机制起作用的药物以及它们彼此之间联合使用的抗病毒活性。