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The Role of Brincidofovir in Preparation for a Potential Smallpox Outbreak

Smallpox (variola) virus is considered a Category A bioterrorism agent due to its ability to spread rapidly and the high morbidity and mortality rates associated with infection. Current recommendations recognize the importance of oral antivirals and call for having at least two smallpox antivirals w...

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Autores principales: Foster, Scott A., Parker, Scott, Lanier, Randall
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707527/
https://www.ncbi.nlm.nih.gov/pubmed/29773767
http://dx.doi.org/10.3390/v9110320
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author Foster, Scott A.
Parker, Scott
Lanier, Randall
author_facet Foster, Scott A.
Parker, Scott
Lanier, Randall
author_sort Foster, Scott A.
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description Smallpox (variola) virus is considered a Category A bioterrorism agent due to its ability to spread rapidly and the high morbidity and mortality rates associated with infection. Current recommendations recognize the importance of oral antivirals and call for having at least two smallpox antivirals with different mechanisms of action available in the event of a smallpox outbreak. Multiple antivirals are recommended due in large part to the propensity of viruses to become resistant to antiviral therapy, especially monotherapy. Advances in synthetic biology heighten concerns that a bioterror attack with variola would utilize engineered resistance to antivirals and potentially vaccines. Brincidofovir, an oral antiviral in late stage development, has proven effective against orthopoxviruses in vitro and in vivo, has a different mechanism of action from tecovirimat (the only oral smallpox antiviral currently in the US Strategic National Stockpile), and has a resistance profile that reduces concerns in the scenario of a bioterror attack using genetically engineered smallpox. Given the devastating potential of smallpox as a bioweapon, preparation of a multi-pronged defense that accounts for the most obvious bioengineering possibilities is strategically imperative.
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spelling pubmed-57075272017-12-05 The Role of Brincidofovir in Preparation for a Potential Smallpox Outbreak Foster, Scott A. Parker, Scott Lanier, Randall Viruses Perspective Smallpox (variola) virus is considered a Category A bioterrorism agent due to its ability to spread rapidly and the high morbidity and mortality rates associated with infection. Current recommendations recognize the importance of oral antivirals and call for having at least two smallpox antivirals with different mechanisms of action available in the event of a smallpox outbreak. Multiple antivirals are recommended due in large part to the propensity of viruses to become resistant to antiviral therapy, especially monotherapy. Advances in synthetic biology heighten concerns that a bioterror attack with variola would utilize engineered resistance to antivirals and potentially vaccines. Brincidofovir, an oral antiviral in late stage development, has proven effective against orthopoxviruses in vitro and in vivo, has a different mechanism of action from tecovirimat (the only oral smallpox antiviral currently in the US Strategic National Stockpile), and has a resistance profile that reduces concerns in the scenario of a bioterror attack using genetically engineered smallpox. Given the devastating potential of smallpox as a bioweapon, preparation of a multi-pronged defense that accounts for the most obvious bioengineering possibilities is strategically imperative. MDPI 2017-10-30 /pmc/articles/PMC5707527/ /pubmed/29773767 http://dx.doi.org/10.3390/v9110320 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Perspective
Foster, Scott A.
Parker, Scott
Lanier, Randall
The Role of Brincidofovir in Preparation for a Potential Smallpox Outbreak
title The Role of Brincidofovir in Preparation for a Potential Smallpox Outbreak
title_full The Role of Brincidofovir in Preparation for a Potential Smallpox Outbreak
title_fullStr The Role of Brincidofovir in Preparation for a Potential Smallpox Outbreak
title_full_unstemmed The Role of Brincidofovir in Preparation for a Potential Smallpox Outbreak
title_short The Role of Brincidofovir in Preparation for a Potential Smallpox Outbreak
title_sort role of brincidofovir in preparation for a potential smallpox outbreak
topic Perspective
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707527/
https://www.ncbi.nlm.nih.gov/pubmed/29773767
http://dx.doi.org/10.3390/v9110320
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