School of Pharmacy, Pharmaceutical Sciences Division, University of Wisconsin-Madison, Madison, WI 53705, USA.
Regional Biocontainment Laboratory, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
Sci Transl Med. 2023 Apr 12;15(691):eabl9344. doi: 10.1126/scitranslmed.abl9344.
Venezuelan and eastern equine encephalitis viruses (VEEV and EEEV, respectively) are mosquito-borne, neuroinvasive human pathogens for which no FDA-approved therapeutic exists. Besides the biothreat posed by these viruses when aerosolized, arthropod transmission presents serious health risks to humans, as demonstrated by the 2019 outbreak of EEE disease in the United States that resulted in 38 confirmed cases, 19 deaths, and neurological effects in survivors. Here, we describe the discovery of a 2-pyrrolidinoquinazolinone scaffold, efficiently synthesized in two to five steps, whose structural optimization resulted in profound antiviral activity. The lead quinazolinone, BDGR-49, potently reduced cellular VEEV and EEEV titers by >7 log at 1 μM and exhibited suitable intravenous and oral pharmacokinetic profiles in BALB/c mice to achieve excellent brain exposure. Outstanding in vivo efficacy was observed in several lethal, subcutaneous infection mouse models using an 8-day dosing regimen. Prophylactically administered BDGR-49 at 25 mg kg per day fully protected against a 10× LD VEEV Trinidad donkey (TrD) challenge in BALB/c mice. Similarly, we observed 70% protection when 10× LD EEEV FL93-939-infected C57BL/6 mice were treated prophylactically with BDGR-49 at 50 mg kg per day. Last, we observed 100% therapeutic efficacy when mice, challenged with 10× LD VEEV TrD, were dosed at 48 hours after infection with BDGR-49 at 25 mg kg per day. Mouse brain viral titers at 96 hours after infection were reduced to values near the limit of detection. Collectively, these results underscore the substantial development potential of a well-tolerated, brain-penetrant lead compound that shows promise in preventing and treating encephalitic alphavirus disease.
委内瑞拉和东部马脑炎病毒(分别为 VEEV 和 EEEV)是通过蚊子传播的、具有神经侵袭性的人类病原体,目前还没有获得 FDA 批准的治疗方法。除了这些病毒气溶胶化带来的生物威胁外,节肢动物传播也给人类健康带来了严重的风险,这一点在美国 2019 年东部马脑炎疫情中得到了证明,该疫情导致 38 例确诊病例、19 人死亡,幸存者还出现了神经系统影响。在这里,我们描述了一种 2-吡咯烷并喹唑啉酮支架的发现,该支架可在两到五步内高效合成,其结构优化导致了显著的抗病毒活性。先导喹唑啉酮 BDGR-49 在 1μM 时可强力降低细胞内 VEEV 和 EEEV 滴度 >7 对数级,并且在 BALB/c 小鼠中具有合适的静脉内和口服药代动力学特征,可实现优异的大脑暴露。在使用 8 天给药方案的几种致死性皮下感染小鼠模型中观察到出色的体内疗效。预防性给予 25mg/kg/天的 BDGR-49 可完全预防 BALB/c 小鼠 10×LD VEEV Trinidad 驴(TrD)挑战。同样,当 10×LD EEEV FL93-939 感染的 C57BL/6 小鼠用 50mg/kg/天的 BDGR-49 预防性治疗时,我们观察到 70%的保护作用。最后,当用 10×LD VEEV TrD 感染的小鼠在感染后 48 小时给予 25mg/kg/天的 BDGR-49 治疗时,我们观察到 100%的治疗效果。感染后 96 小时,小鼠大脑中的病毒滴度降低到接近检测极限的值。总的来说,这些结果突显了一种具有良好耐受性、可穿透大脑的先导化合物的巨大开发潜力,该化合物在预防和治疗脑炎性甲型病毒病方面具有广阔的前景。