瑞德西韦(GS-441524)、莫努匹韦和利巴韦林三联疗法在抑制人鼻腔气道上皮细胞培养物中的冠状病毒复制和仓鼠感染模型中具有高效性。

The triple combination of Remdesivir (GS-441524), Molnupiravir and Ribavirin is highly efficient in inhibiting coronavirus replication in human nasal airway epithelial cell cultures and in a hamster infection model.

机构信息

KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Virology and Chemotherapy, 3000, Leuven, Belgium.

KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Virology and Chemotherapy, 3000, Leuven, Belgium; The VirusBank Platform, Gaston Geenslaan, B-3000, Leuven, Belgium.

出版信息

Antiviral Res. 2024 Nov;231:105994. doi: 10.1016/j.antiviral.2024.105994. Epub 2024 Sep 3.

Abstract

The use of fixed dose-combinations of antivirals with different mechanisms of action has proven key in the successful treatment of infections with HIV and HCV. For the treatment of infections with SARS-CoV-2 and possible future epi-/pandemic coronaviruses, it will be important to explore the efficacy of combinations of different drugs, in particular to avoid resistance development, such as in patients with immunodeficiencies. This work explores the effect of a combination of 3 broad-spectrum antiviral nucleosides on the replication of coronaviruses. To that end, we made use of primary human airway epithelial cell (HAEC) cultures grown at the air-liquid interface that were infected with the beta coronavirus OC43. We found that the triple combination of GS-441524 (the parent nucleoside of remdesivir), molnupiravir and ribavirin resulted in a more pronounced antiviral efficacy than what could be expected from a purely additive antiviral effect. The potency of this triple combination was next tested in SARS-CoV-2 infected hamsters in a prophylactic setup. To that end, for each of the drugs, intentionally suboptimal or even ineffective doses were selected. Yet, in the lungs of all hamsters that received triple prophylactic therapy (but not in those that received the respective double combinations) no infectious virus was detectable. Our findings indicate that co-administration of approved drugs for the treatment of coronavirus infections should be further explored but also against other families of viruses with epidemic and pandemic potential for which no effective antiviral treatment is available.

摘要

固定剂量组合的抗病毒药物具有不同的作用机制,已被证明是成功治疗 HIV 和 HCV 感染的关键。为了治疗 SARS-CoV-2 感染和可能出现的未来大流行冠状病毒,探索不同药物组合的疗效将非常重要,特别是要避免耐药性的产生,如在免疫缺陷患者中。这项工作探讨了三种广谱抗病毒核苷组合对冠状病毒复制的影响。为此,我们利用在气液界面培养的原代人呼吸道上皮细胞 (HAEC) 进行了实验,这些细胞被β冠状病毒 OC43 感染。我们发现,GS-441524(瑞德西韦的母核)、莫努匹韦和利巴韦林的三联组合比单纯的相加抗病毒效果产生了更显著的抗病毒效果。接下来,我们在预防感染 SARS-CoV-2 的仓鼠中测试了这种三联组合的效果。为此,对于每种药物,都选择了低于最佳剂量甚至无效的剂量。然而,在接受三联预防治疗的所有仓鼠的肺部(但在接受各自双联组合治疗的仓鼠的肺部中没有)都检测不到有传染性的病毒。我们的研究结果表明,应进一步探索联合使用已批准用于治疗冠状病毒感染的药物,但也应针对其他具有流行和大流行潜力且尚无有效抗病毒治疗方法的病毒家族进行探索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4fa/11560660/5de7454e0546/nihms-2023808-f0001.jpg

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