ABSTRACT
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-[2-(Phosphonomethoxy)propyl]-adenine (tenofovir) is an acyclic nucleoside phosphonate with antiviral activity against human immunodeficiency virus type 1 (HIV-1) and hepatitis B virus (HBV). Tenofovir is not orally bioavailable but becomes orally active against HIV-1 infection as the disoproxil ester (tenofovir disoproxil fumarate [Viread]). We have developed an alternative strategy for promoting the oral availability of nucleoside phosphonate analogs which involves esterification with a lipid to form a lysolecithin mimic. This mimic can utilize natural lysolecithin uptake pathways in the gut, resulting in high oral availability. Since the mimic is not subject to cleavage in the plasma by nonspecific esterases, it remains intact in the circulation and facilitates uptake by target cells. Significant drops in apparent antiviral 50% effective concentrations (EC
50
s) of up to 3 logs have been observed in comparison with non-lipid-conjugated parent compounds in target cells. We have applied this technology to tenofovir with the goal of increasing oral availability, decreasing the apparent EC
50
, and decreasing the potential for nephrotoxicity by reducing the exposure of the kidney to the free dianionic tenofovir. Here we report that, in vitro, the hexadecyloxypropyl ester of tenofovir, CMX157, is 267-fold more active than tenofovir against HIV-1 and 4.5-fold more active against HBV. CMX157 is orally available and has no apparent toxicity when given orally to rats for 7 days at doses of 10, 30, or 100 mg/kg/day. Consequently, CMX157 represents a second-generation tenofovir analog which may have an improved clinical profile.
摘要
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-[2-(膦酰甲氧基)丙基]-腺嘌呤(替诺福韦)是一种无环核苷膦酸盐,对 1 型人类免疫缺陷病毒(HIV-1)和乙型肝炎病毒(HBV)具有抗病毒活性。替诺福韦不能口服,但其二丙羟酯(富马酸替诺福韦二丙酯 [Viread])具有口服抗 HIV-1 感染的活性。我们开发了一种促进核苷膦酸盐类似物口服可用性的替代策略,包括与脂质发生酯化反应,形成一种溶脂卵磷脂模拟物。这种模拟物可以利用肠道中天然的溶脂卵磷脂摄取途径,从而提高口服可用性。由于这种模拟物在血浆中不会被非特异性酯酶裂解,因此它在血液循环中保持完好无损,有利于靶细胞吸收。表观抗病毒 50%有效浓度(EC
50
s)显著下降,与非脂质结合的母体化合物相比,在靶细胞中的降幅可达 3 个对数。我们已将这项技术应用于替诺福韦,目的是提高口服的可用性,降低表观 EC
50
,并通过减少肾脏与游离二离子替诺福韦的接触来降低肾毒性的可能性。我们在此报告,在体外,替诺福韦的十六烷氧基丙酯 CMX157 对 HIV-1 的活性是替诺福韦的 267 倍,对 HBV 的活性是替诺福韦的 4.5 倍。CMX157 可口服,按 10、30 或 100 毫克/千克/天的剂量给大鼠口服 7 天后,无明显毒性。因此,CMX157代表了第二代替诺福韦类似物,可能具有更好的临床表现。