Enisamium Reduces Influenza Virus Shedding and Improves Patient Recovery by Inhibiting Viral RNA Polymerase Activity

Infections with respiratory viruses constitute a huge burden on our health and economy. Antivirals against some respiratory viruses are available, but further options are urgently needed. Enisamium iodide (laboratory code FAV00A, trade name Amizon) is an antiviral, marketed in countries of the Commo...

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Autores principales: te Velthuis, Aartjan J. W., Zubkova, Tatiana G., Shaw, Megan, Mehle, Andrew, Boltz, David, Gmeinwieser, Norbert, Stammer, Holger, Milde, Jens, Müller, Lutz, Margitich, Victor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society for Microbiology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097484/
https://www.ncbi.nlm.nih.gov/pubmed/33558285
http://dx.doi.org/10.1128/AAC.02605-20
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author te Velthuis, Aartjan J. W.
Zubkova, Tatiana G.
Shaw, Megan
Mehle, Andrew
Boltz, David
Gmeinwieser, Norbert
Stammer, Holger
Milde, Jens
Müller, Lutz
Margitich, Victor
author_facet te Velthuis, Aartjan J. W.
Zubkova, Tatiana G.
Shaw, Megan
Mehle, Andrew
Boltz, David
Gmeinwieser, Norbert
Stammer, Holger
Milde, Jens
Müller, Lutz
Margitich, Victor
author_sort te Velthuis, Aartjan J. W.
collection PubMed
description Infections with respiratory viruses constitute a huge burden on our health and economy. Antivirals against some respiratory viruses are available, but further options are urgently needed. Enisamium iodide (laboratory code FAV00A, trade name Amizon) is an antiviral, marketed in countries of the Commonwealth of Independent States for the treatment of viral respiratory infections, but its clinical efficacy and mode of action are not well understood. In this study, we investigated the efficacy of enisamium in patients aged between 18 and 60 years with confirmed influenza virus and other viral respiratory infections. Enisamium treatment resulted in reduced influenza virus shedding (at day 3, 71.2% in the enisamium group tested negative versus 25.0% in placebo group [P < 0.0001]), faster patient recovery (at day 14, 93.9% in the enisamium group had recovered versus 32.5% in placebo group [P < 0.0001]), and reduced disease symptoms (from 9.6 ± 0.7 to 4.6 ± 0.9 score points in enisamium group versus 9.7 ± 1.1 to 5.6 ± 1.1 score points in placebo group [P < 0.0001]) compared to those in the placebo group. Using mass spectrometry, and cell-based and cell-free viral RNA synthesis assays, we identified a hydroxylated metabolite of enisamium, VR17-04. VR17-04 is capable of inhibiting influenza virus RNA synthesis and is present in plasma of patients treated with enisamium. VR17-04 inhibits the activity of the influenza virus RNA polymerase more potently than its parent compound. Overall, these results suggest that enisamium is metabolized in humans to an inhibitor of the influenza virus RNA polymerase that reduces viral shedding and improves patient recovery in influenza patients. (This study has been registered at ClinicalTrials.gov under identifier NCT04682444.)
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spelling pubmed-80974842021-05-10 Enisamium Reduces Influenza Virus Shedding and Improves Patient Recovery by Inhibiting Viral RNA Polymerase Activity te Velthuis, Aartjan J. W. Zubkova, Tatiana G. Shaw, Megan Mehle, Andrew Boltz, David Gmeinwieser, Norbert Stammer, Holger Milde, Jens Müller, Lutz Margitich, Victor Antimicrob Agents Chemother Antiviral Agents Infections with respiratory viruses constitute a huge burden on our health and economy. Antivirals against some respiratory viruses are available, but further options are urgently needed. Enisamium iodide (laboratory code FAV00A, trade name Amizon) is an antiviral, marketed in countries of the Commonwealth of Independent States for the treatment of viral respiratory infections, but its clinical efficacy and mode of action are not well understood. In this study, we investigated the efficacy of enisamium in patients aged between 18 and 60 years with confirmed influenza virus and other viral respiratory infections. Enisamium treatment resulted in reduced influenza virus shedding (at day 3, 71.2% in the enisamium group tested negative versus 25.0% in placebo group [P < 0.0001]), faster patient recovery (at day 14, 93.9% in the enisamium group had recovered versus 32.5% in placebo group [P < 0.0001]), and reduced disease symptoms (from 9.6 ± 0.7 to 4.6 ± 0.9 score points in enisamium group versus 9.7 ± 1.1 to 5.6 ± 1.1 score points in placebo group [P < 0.0001]) compared to those in the placebo group. Using mass spectrometry, and cell-based and cell-free viral RNA synthesis assays, we identified a hydroxylated metabolite of enisamium, VR17-04. VR17-04 is capable of inhibiting influenza virus RNA synthesis and is present in plasma of patients treated with enisamium. VR17-04 inhibits the activity of the influenza virus RNA polymerase more potently than its parent compound. Overall, these results suggest that enisamium is metabolized in humans to an inhibitor of the influenza virus RNA polymerase that reduces viral shedding and improves patient recovery in influenza patients. (This study has been registered at ClinicalTrials.gov under identifier NCT04682444.) American Society for Microbiology 2021-03-18 /pmc/articles/PMC8097484/ /pubmed/33558285 http://dx.doi.org/10.1128/AAC.02605-20 Text en Copyright © 2021 te Velthuis et al. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Antiviral Agents
te Velthuis, Aartjan J. W.
Zubkova, Tatiana G.
Shaw, Megan
Mehle, Andrew
Boltz, David
Gmeinwieser, Norbert
Stammer, Holger
Milde, Jens
Müller, Lutz
Margitich, Victor
Enisamium Reduces Influenza Virus Shedding and Improves Patient Recovery by Inhibiting Viral RNA Polymerase Activity
title Enisamium Reduces Influenza Virus Shedding and Improves Patient Recovery by Inhibiting Viral RNA Polymerase Activity
title_full Enisamium Reduces Influenza Virus Shedding and Improves Patient Recovery by Inhibiting Viral RNA Polymerase Activity
title_fullStr Enisamium Reduces Influenza Virus Shedding and Improves Patient Recovery by Inhibiting Viral RNA Polymerase Activity
title_full_unstemmed Enisamium Reduces Influenza Virus Shedding and Improves Patient Recovery by Inhibiting Viral RNA Polymerase Activity
title_short Enisamium Reduces Influenza Virus Shedding and Improves Patient Recovery by Inhibiting Viral RNA Polymerase Activity
title_sort enisamium reduces influenza virus shedding and improves patient recovery by inhibiting viral rna polymerase activity
topic Antiviral Agents
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097484/
https://www.ncbi.nlm.nih.gov/pubmed/33558285
http://dx.doi.org/10.1128/AAC.02605-20
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