Combating Intracellular Pathogens with Repurposed Host-Targeted Drugs

There is a large, global unmet need for the development of countermeasures to combat intracellular pathogens. The development of novel antimicrobials is expensive and slow and typically focuses on selective inhibition of proteins encoded by a single pathogen, thereby providing a narrow spectrum of coverage. The repurposing of approved drugs targeting host functions required for microbial infections represents a promising alternative. This review summarizes progress and challenges in the repurposing of approved drugs as host-targeted broad-spectrum agents for the treatment of intracellular pathogens. These strategies include targeting both cellular factors required for infection by various viruses, intracellular bacteria, and/or protozoa as well as factors that modulate the host immune response to these microbial infections. The repurposed approach offers complementary means to develop therapeutics against existing and emerging intracellular microbial threats.

[1]  A. Strongin,et al.  Repurposing of the anti-malaria drug chloroquine for Zika Virus treatment and prophylaxis , 2017, Scientific Reports.

[2]  A. Stenzinger,et al.  Chloroquine enhances the antimycobacterial activity of isoniazid and pyrazinamide by reversing inflammation-induced macrophage efflux. , 2017, International journal of antimicrobial agents.

[3]  J. Dye,et al.  Anticancer kinase inhibitors impair intracellular viral trafficking and exert broad-spectrum antiviral effects , 2017, The Journal of clinical investigation.

[4]  N. Gray,et al.  GNF-2 Inhibits Dengue Virus by Targeting Abl Kinases and the Viral E Protein. , 2016, Cell chemical biology.

[5]  S. Ezzat,et al.  Impact of nitazoxanide on sustained virologic response in Egyptian patients with chronic hepatitis C genotype 4: a double-blind placebo-controlled trial , 2016, European journal of gastroenterology & hepatology.

[6]  A. Butt,et al.  Lipid dysregulation in hepatitis C virus, and impact of statin therapy upon clinical outcomes. , 2015, World journal of gastroenterology.

[7]  Steven M. Opal,et al.  Treating the Host Response to Ebola Virus Disease with Generic Statins and Angiotensin Receptor Blockers , 2015, mBio.

[8]  Nicolas Stransky,et al.  Targeting cancer with kinase inhibitors. , 2015, The Journal of clinical investigation.

[9]  B. D. da Fonseca,et al.  Antiviral activity of chloroquine against dengue virus type 2 replication in Aotus monkeys. , 2015, Viral immunology.

[10]  G. Kaplan,et al.  Metformin as adjunct antituberculosis therapy , 2014, Science Translational Medicine.

[11]  J. Rossignol Nitazoxanide: A first-in-class broad-spectrum antiviral agent , 2014, Antiviral Research.

[12]  C. Ginocchio,et al.  Effect of nitazoxanide in adults and adolescents with acute uncomplicated influenza: a double-blind, randomised, placebo-controlled, phase 2b/3 trial , 2014, The Lancet Infectious Diseases.

[13]  Julie Dyall,et al.  Repurposing of Clinically Developed Drugs for Treatment of Middle East Respiratory Syndrome Coronavirus Infection , 2014, Antimicrobial Agents and Chemotherapy.

[14]  Michele Connelly,et al.  Repositioning: the fast track to new anti-malarial medicines? , 2014, Malaria Journal.

[15]  Anne E Carpenter,et al.  Identification of Host-Targeted Small Molecules That Restrict Intracellular Mycobacterium tuberculosis Growth , 2014, PLoS pathogens.

[16]  B. D. da Fonseca,et al.  Chloroquine use improves dengue-related symptoms , 2013, Memorias do Instituto Oswaldo Cruz.

[17]  J. Tilton,et al.  Entry inhibitors and their use in the treatment of HIV-1 infection. , 2013, Antiviral research.

[18]  Priscilla L. Yang,et al.  The Small Molecules AZD0530 and Dasatinib Inhibit Dengue Virus RNA Replication via Fyn Kinase , 2013, Journal of Virology.

[19]  P. Gallay,et al.  Curing a viral infection by targeting the host: The example of cyclophilin inhibitors , 2013, Antiviral Research.

[20]  C. Nathan,et al.  Efficacy of Nitazoxanide against Clinical Isolates of Mycobacterium tuberculosis , 2013, Antimicrobial Agents and Chemotherapy.

[21]  Chengyu Jiang,et al.  Anti-malaria drug chloroquine is highly effective in treating avian influenza A H5N1 virus infection in an animal model , 2012, Cell Research.

[22]  J. Farrar,et al.  Correction: A Randomized Controlled Trial of Chloroquine for the Treatment of Dengue in Vietnamese Adults , 2012, PLoS Neglected Tropical Diseases.

[23]  D. Kalman,et al.  Productive Replication of Ebola Virus Is Regulated by the c-Abl1 Tyrosine Kinase , 2012, Science Translational Medicine.

[24]  R. Striker,et al.  Phosphorylation events during viral infections provide potential therapeutic targets , 2011, Reviews in medical virology.

[25]  D. Kalman,et al.  Imatinib-sensitive tyrosine kinases regulate mycobacterial pathogenesis and represent therapeutic targets against tuberculosis. , 2011, Cell host & microbe.

[26]  Olivier Poch,et al.  EGFR and EphA2 are host factors for hepatitis C virus entry and possible targets for antiviral therapy , 2011, Nature Medicine.

[27]  H. Ellerbrok,et al.  Inhibition of poxvirus spreading by the anti-tumor drug Gefitinib (Iressa). , 2011, Antiviral research.

[28]  D. Kalman,et al.  Variola and Monkeypox Viruses Utilize Conserved Mechanisms of Virion Motility and Release That Depend on Abl and Src Family Tyrosine Kinases , 2010, Journal of Virology.

[29]  J. Farrar,et al.  A Randomized Controlled Trial of Chloroquine for the Treatment of Dengue in Vietnamese Adults , 2010, PLoS neglected tropical diseases.

[30]  M. Labow,et al.  Cholesterol biosynthesis modulation regulates dengue viral replication. , 2009, Virology.

[31]  P. Shi,et al.  Cyclosporine Inhibits Flavivirus Replication through Blocking the Interaction between Host Cyclophilins and Viral NS5 Protein , 2009, Antimicrobial Agents and Chemotherapy.

[32]  B. Klebl,et al.  Protein kinase inhibitors of the quinazoline class exert anti-cytomegaloviral activity in vitro and in vivo. , 2008, Antiviral research.

[33]  J. Millis,et al.  Leflunomide for polyomavirus type BK nephropathy. , 2005, The New England journal of medicine.

[34]  S. Huong,et al.  Epidermal growth factor receptor is a cellular receptor for human cytomegalovirus , 2003, Nature.

[35]  S. McOrist Obligate intracellular bacteria and antibiotic resistance. , 2000, Trends in microbiology.

[36]  D. Knight,et al.  Inhibition of cytomegalovirus in vitro and in vivo by the experimental immunosuppressive agent leflunomide. , 1999, Intervirology.

[37]  B. Rosenwirth,et al.  Mode of action of SDZ NIM 811, a nonimmunosuppressive cyclosporin A analog with activity against human immunodeficiency virus (HIV) type 1: interference with HIV protein-cyclophilin A interactions , 1995, Journal of virology.

[38]  R. Baker,et al.  Stage-selective inhibition of rodent malaria by cyclosporine , 1988, Antimicrobial Agents and Chemotherapy.