ABSTRACT
The incidence of cytomegalovirus (CMV) retinitis is declining in AIDS patients but remains a significant clinical problem in patients with organ transplants and bone marrow transplants. Prophylaxis with ganciclovir (GCV) or valganciclovir reduces the incidence of CMV disease but may lead to the emergence of drug-resistant virus with mutations in the UL97 or UL54 gene. It would be useful to have other types of oral therapy for CMV disease. We synthesized hexadecyloxypropyl and octadecyloxyethyl derivatives of cyclic cidofovir (cCDV) and cidofovir (CDV) and found that these novel analogs had 2.5- to 4-log increases in antiviral activity against CMV compared to the activities of unmodified CDV and cCDV. Multiple-log increases in activity were noted against laboratory CMV strains and various CMV clinical isolates including GCV-resistant strains with mutations in the UL97 and UL54 genes. Preliminary cell studies suggest that the increase in antiviral activity may be partially explained by a much greater cell penetration of the novel analogs. 1-
O
-Hexadecyloxypropyl-CDV, 1-
O
-octadecyloxyethyl-CDV, and their corresponding cCDV analogs are worthy of further preclinical evaluation for treatment and prevention of CMV and herpes simplex virus infections in humans.
摘要
巨细胞病毒(CMV)视网膜炎在艾滋病患者中的发病率正在下降,但在器官移植和骨髓移植患者中仍是一个严重的临床问题。使用更昔洛韦(GCV)或缬更昔洛韦进行预防可降低 CMV 的发病率,但可能会导致 UL97 或 UL54 基因突变的耐药病毒的出现。如果能有其他类型的口服疗法来治疗 CMV 病,将会非常有用。我们合成了环状西多福韦(cCDV)和西多福韦(CDV)的十六烷氧基丙基和十八烷氧基乙基衍生物,发现与未修饰的 CDV 和 cCDV 相比,这些新型类似物对 CMV 的抗病毒活性提高了 2.5 到 4 个对数值。针对实验室 CMV 株系和各种 CMV 临床分离株(包括 UL97 和 UL54 基因突变的 GCV 耐药株)的活性提高了多个对数值。初步细胞研究表明,新型类似物的细胞穿透力更强,这可能是抗病毒活性提高的部分原因。1-
O
-十六烷氧基丙基-CDV、1- O
O
-十八烷氧基乙基-CDV 及其相应的 cCDV 类似物值得进一步进行临床前评估,以治疗和预防人类 CMV 和单纯疱疹病毒感染。