Enterovirus 68 future or investigational therapies
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
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Overview
Even though the treatment for enterovirus infection is currently with supportive care, the development of other medical therapies has increased in the past years. Immune globulin has shown clinical and laboratory improvement among some patients with enterovirus infection. Antiviral medications against enterovirus, such as pleconaril, are currently under research, but have shown benefit in patients with severe infections caused by other subtypes of enteroviruses.
Future or Investigational Therapies
Immune globulin
- Studies in neonates with enterovirus infection suggest a possible benefit of the use of immune globulin in the treatment of this viral infection[1][2], however, more studies need to be done do confirm the benefit of this treatment.
- The development of IVIG with high levels of enterovirus antibody has shown benefit in in vitro and mouse models studies for enterovirus subtype 71, however, this has not been studied for subtype 68.[3]
Antiviral Medication
- Pleconaril has shown benefit in patients with severe life-threatening enterovirus infections. This antiviral drug prevents the attachment of the virus to the host cell and integration of its RNA to the host DNA. [4]
- The table shown below describes the possible targets for antiviral treatment against enterovirus infections.[5][6]
| Target | Antiviral Drugs |
|---|---|
| Protease 2A or 3C | Rupintrivir, Br-UTP, AG7088 derivative |
| Capsid binders | Pleconaril, Pirodavirb, pyridazinyl oxime ethersb (BTA-39c), pyridyl imidazolidinonesc; NF-449c, V-073 |
| RNA replication | Enviroxime, TTP-8307, vinylacetylene analogs, GW5074c, Benzimidazoles, N(6)-benzyladenosine, metrifudil |
| RNA polymerase | 2′C–Me-cytidine, 4′-azidocytidine, 2′C-ME-adenosine, ribavirin, DTriP-22c, aurintricarboxylic acid, gliotoxin, amiloride |
| Proteins involved in replication & assembly | Brefeldin A, geldenamycin, 17AAG |
| Adapted from "The enteroviruses: Problems in need of treatments"[7] | |
References
- ↑ Marc Tebruegge & Nigel Curtis (2009). "Enterovirus infections in neonates". Seminars in fetal & neonatal medicine. 14 (4): 222–227. doi:10.1016/j.siny.2009.02.002. PMID 19303380. Unknown parameter
|month=ignored (help) - ↑ M. J. Abzug, H. L. Keyserling, M. L. Lee, M. J. Levin & H. A. Rotbart (1995). "Neonatal enterovirus infection: virology, serology, and effects of intravenous immune globulin". Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 20 (5): 1201–1206. PMID 7620000. Unknown parameter
|month=ignored (help) - ↑ Rui-Yuan Cao, Jian-Feng Han, Tao Jiang, Xue Tian, Man Yu, Yong-Qiang Deng, E.-De Qin & Cheng-Feng Qin (2011). "In vitro and in vivo characterization of a new enterovirus type 71-specific human intravenous immunoglobulin manufactured from selected plasma donors". Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. 51 (4): 246–249. doi:10.1016/j.jcv.2011.05.002. PMID 21641277. Unknown parameter
|month=ignored (help) - ↑ Rotbart, H. A.; Webster, A. D. (2001). "Treatment of Potentially Life-Threatening Enterovirus Infections with Pleconaril". Clinical Infectious Diseases. 32 (2): 228–235. doi:10.1086/318452. ISSN 1058-4838.
- ↑ Thibaut, Hendrik Jan; Leyssen, Pieter; Puerstinger, Gerhard; Muigg, Alexandra; Neyts, Johan; De Palma, Armando Mirko (2011). "Towards the design of combination therapy for the treatment of enterovirus infections". Antiviral Research. 90 (3): 213–217. doi:10.1016/j.antiviral.2011.03.187. ISSN 0166-3542.
- ↑ Hendrik Jan Thibaut, Armando M. De Palma & Johan Neyts (2012). "Combating enterovirus replication: state-of-the-art on antiviral research". Biochemical pharmacology. 83 (2): 185–192. doi:10.1016/j.bcp.2011.08.016. PMID 21889497. Unknown parameter
|month=ignored (help) - ↑ Abzug, Mark J. (2014). "The enteroviruses: Problems in need of treatments". Journal of Infection. 68: S108–S114. doi:10.1016/j.jinf.2013.09.020. ISSN 0163-4453.