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用于具有流行潜力的虫媒病毒感染的新型及重新利用的抗病毒分子:一项系统综述。

Novel and repurposed antiviral molecules for arbovirus infections with epidemic Potential: A systematic review.

作者信息

Logiudice Jacopo, Tiecco Giorgio, Pavesi Alessandro, Bertoni Francesca, Gerami Roberta, Zanella Isabella, Artese Anna, Quiros-Roldan Eugenia

机构信息

ASST Spedali Civili di Brescia. SC Malattie Infettive, 25123 Brescia, Italy.

Department of Clinical and Experimental Sciences, University of Brescia 25123 Brescia, Italy.

出版信息

New Microbes New Infect. 2025 Jul 10;66:101614. doi: 10.1016/j.nmni.2025.101614. eCollection 2025 Aug.

Abstract

This systematic review investigates experimental and repurposed antiviral molecules for epidemic-potential arboviruses, including dengue (DENV), Zika (ZIKV), chikungunya (CHIKV), West Nile (WNV), and Usutu (USUV) viruses. Arboviral diseases pose a growing public health concern, exacerbated by climate change and increased global travel. Despite the absence of approved antiviral therapies for most arboviruses, numerous , and in human studies have evaluated candidate molecules targeting the different stages of viral replication. : Our methods adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Pubmed, Embase, and Cochrane Library trials were searched. Studies published until March 2024 were included. After abstract review and duplication removal, full-text articles were obtained for further review, reviewed by two independent reviewers, and disagreements were resolved by a third reviewer. : Our analysis, based on 185 studies, highlights the antiviral role of molecules such as nucleoside analogs, protease inhibitors, and immune-modulators. No studies conducted in humans have been reported to demonstrate the antiviral efficacy of any molecule. Favipiravir, ribavirin, and sofosbuvir demonstrated viremia reduction and symptoms improvement and experiments. Cholesterol-lowering agents, such as atorvastatin and ezetimibe, showed promise in disrupting viral assembly. Montelukast and doxycycline exhibited anti-inflammatory effects, contributing to improved clinical outcomes. The cytokine modulation profiles varied, with notable reductions in pro-inflammatory markers in certain studies. : Currently, there are no studies in humans demonstrating effective treatments against arboviral infections. Although some molecules have shown efficacy in reducing viral titters, further clinical evaluation of promising candidates and the exploration of combination therapies targeting viral replication and host immune-response are needed.

摘要

本系统综述研究了针对具有流行潜力的虫媒病毒的实验性和重新利用的抗病毒分子,这些病毒包括登革热病毒(DENV)、寨卡病毒(ZIKV)、基孔肯雅病毒(CHIKV)、西尼罗河病毒(WNV)和乌苏图病毒(USUV)。虫媒病毒病对公共卫生的威胁日益增加,气候变化和全球旅行增加使这一情况更加恶化。尽管大多数虫媒病毒尚无获批的抗病毒疗法,但大量临床前和人体研究已对针对病毒复制不同阶段的候选分子进行了评估。方法:我们的方法遵循系统综述和Meta分析的首选报告项目(PRISMA)2020指南。检索了PubMed、Embase和Cochrane图书馆试验库。纳入截至2024年3月发表的研究。经过摘要审查和去除重复项后,获取全文文章进行进一步审查,由两名独立审稿人进行评审,分歧由第三名审稿人解决。结果:我们基于185项研究的分析突出了核苷类似物、蛋白酶抑制剂和免疫调节剂等分子的抗病毒作用。尚无在人体中进行的研究报告证明任何分子具有抗病毒疗效。法匹拉韦、利巴韦林和索磷布韦在体外和体内实验中均显示出病毒血症降低和症状改善。降胆固醇药物,如阿托伐他汀和依折麦布,在破坏病毒组装方面显示出前景。孟鲁司特和多西环素表现出抗炎作用,有助于改善临床结果。细胞因子调节谱各不相同,在某些研究中促炎标志物显著降低。结论:目前,尚无在人体中证明有效治疗虫媒病毒感染的研究。尽管一些分子在降低病毒滴度方面显示出疗效,但仍需要对有前景的候选药物进行进一步的临床评估,并探索针对病毒复制和宿主免疫反应的联合疗法。

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