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153. Molnupiravir Exhibits a High Barrier to the Development of SARS-CoV-2 Resistance in vitro
BACKGROUND: Molnupiravir is an orally available prodrug of the antiviral nucleoside analog N-Hydroxycytidine (NHC). In preclinical studies NHC has shown broad-spectrum antiviral activity against multiple RNA viruses including SARS-CoV-2. Incorporation of NHC by viral polymerases impairs replication...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9752128/ http://dx.doi.org/10.1093/ofid/ofac492.231 |
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author | Strizki, Julie Murgolo, Nicholas Gaspar, John Howe, John Hutchins, Beth Mohri, Hiroshi Ho, David D Hazuda, Daria Grobler, Jay |
author_facet | Strizki, Julie Murgolo, Nicholas Gaspar, John Howe, John Hutchins, Beth Mohri, Hiroshi Ho, David D Hazuda, Daria Grobler, Jay |
author_sort | Strizki, Julie |
collection | PubMed |
description | BACKGROUND: Molnupiravir is an orally available prodrug of the antiviral nucleoside analog N-Hydroxycytidine (NHC). In preclinical studies NHC has shown broad-spectrum antiviral activity against multiple RNA viruses including SARS-CoV-2. Incorporation of NHC by viral polymerases impairs replication by introducing errors into the viral genome. NHC has been shown to have a high barrier to the development of resistance in vitro with RSV, Influenza and Venezualen Equine Encephalitis viruses. In these studies, we have explored the potential for SARS-CoV-2 to develop resistance to NHC in cell culture. METHODS: Vero E6 cells were infected with SARS-CoV-2 (WA-1) in triplicate in the presence of NHC or a C3L-protease inhibitor (MRK-A). Culture supernatants from wells with the highest drug concentration exhibiting a cytopathic effect (CPE) score of ≥ 2+ were repassaged and at each passage, IC50 values were estimated based on CPE scoring. At each passage, full genome next generation sequencing (NGS) was performed on the viral RNA RESULTS: No change in susceptibility to NHC (EC50 fold change ≤ 1.1) was noted in 2 of 3 cultures and a 2-fold change was observed in one culture after 30 passages. In contrast, a 3- to 4-fold decreases in susceptibility to the 3CL protease inhibitor were seen by passage by 12, with increasing resistance of 4.6- to 15.7-fold observed by passage 30. NHC passaged viruses exhibited 53 to 99 amino acid changes, including substitutions and deletions (both in-frame and frameshift), across 25 different viral proteins as compared with 10 to 13 changes in 13 proteins in the MRK-A cultures. With NHC, 3 to 4 changes were observed in the viral polymerase; however, these were randomly distributed, and none were observed more than once. In contrast, the 3CL protease passaged virus had a nsp5 T21I substitution detected in all 3 cultures. CONCLUSION: No evidence of SARS-CoV-2 phenotypic or genotypic resistance was observed following 30 passages with NHC. A random pattern of amino acid changes were observed across multiple proteins consistent with the mechanism of action of NHC. In the same study, resistance was readily selected to a control 3CL protease inhibitor. Together these data support previous reports demonstrating the high barrier to resistance of NHC. DISCLOSURES: Julie Strizki, PhD, Merck and Co.: Stocks/Bonds Nicholas Murgolo, PhD, MERCK: Employee|MERCK: Stocks/Bonds John Howe, PhD, Merck & Co Inc: Employee|Merck & Co Inc: Stocks/Bonds Beth Hutchins, PhD, Merck & Co.: Employee|Merck & Co.: Stocks/Bonds Hiroshi Mohri, PhD/MD, Merck: Grant/Research Support Daria Hazuda, PhD, Merck: Employee|Merck: Stocks/Bonds Jay Grobler, PhD, Merck & Co., Inc.: Employee|Merck & Co., Inc.: Stocks/Bonds. |
format | Online Article Text |
id | pubmed-9752128 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-97521282022-12-16 153. Molnupiravir Exhibits a High Barrier to the Development of SARS-CoV-2 Resistance in vitro Strizki, Julie Murgolo, Nicholas Gaspar, John Howe, John Hutchins, Beth Mohri, Hiroshi Ho, David D Hazuda, Daria Grobler, Jay Open Forum Infect Dis Abstracts BACKGROUND: Molnupiravir is an orally available prodrug of the antiviral nucleoside analog N-Hydroxycytidine (NHC). In preclinical studies NHC has shown broad-spectrum antiviral activity against multiple RNA viruses including SARS-CoV-2. Incorporation of NHC by viral polymerases impairs replication by introducing errors into the viral genome. NHC has been shown to have a high barrier to the development of resistance in vitro with RSV, Influenza and Venezualen Equine Encephalitis viruses. In these studies, we have explored the potential for SARS-CoV-2 to develop resistance to NHC in cell culture. METHODS: Vero E6 cells were infected with SARS-CoV-2 (WA-1) in triplicate in the presence of NHC or a C3L-protease inhibitor (MRK-A). Culture supernatants from wells with the highest drug concentration exhibiting a cytopathic effect (CPE) score of ≥ 2+ were repassaged and at each passage, IC50 values were estimated based on CPE scoring. At each passage, full genome next generation sequencing (NGS) was performed on the viral RNA RESULTS: No change in susceptibility to NHC (EC50 fold change ≤ 1.1) was noted in 2 of 3 cultures and a 2-fold change was observed in one culture after 30 passages. In contrast, a 3- to 4-fold decreases in susceptibility to the 3CL protease inhibitor were seen by passage by 12, with increasing resistance of 4.6- to 15.7-fold observed by passage 30. NHC passaged viruses exhibited 53 to 99 amino acid changes, including substitutions and deletions (both in-frame and frameshift), across 25 different viral proteins as compared with 10 to 13 changes in 13 proteins in the MRK-A cultures. With NHC, 3 to 4 changes were observed in the viral polymerase; however, these were randomly distributed, and none were observed more than once. In contrast, the 3CL protease passaged virus had a nsp5 T21I substitution detected in all 3 cultures. CONCLUSION: No evidence of SARS-CoV-2 phenotypic or genotypic resistance was observed following 30 passages with NHC. A random pattern of amino acid changes were observed across multiple proteins consistent with the mechanism of action of NHC. In the same study, resistance was readily selected to a control 3CL protease inhibitor. Together these data support previous reports demonstrating the high barrier to resistance of NHC. DISCLOSURES: Julie Strizki, PhD, Merck and Co.: Stocks/Bonds Nicholas Murgolo, PhD, MERCK: Employee|MERCK: Stocks/Bonds John Howe, PhD, Merck & Co Inc: Employee|Merck & Co Inc: Stocks/Bonds Beth Hutchins, PhD, Merck & Co.: Employee|Merck & Co.: Stocks/Bonds Hiroshi Mohri, PhD/MD, Merck: Grant/Research Support Daria Hazuda, PhD, Merck: Employee|Merck: Stocks/Bonds Jay Grobler, PhD, Merck & Co., Inc.: Employee|Merck & Co., Inc.: Stocks/Bonds. Oxford University Press 2022-12-15 /pmc/articles/PMC9752128/ http://dx.doi.org/10.1093/ofid/ofac492.231 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Abstracts Strizki, Julie Murgolo, Nicholas Gaspar, John Howe, John Hutchins, Beth Mohri, Hiroshi Ho, David D Hazuda, Daria Grobler, Jay 153. Molnupiravir Exhibits a High Barrier to the Development of SARS-CoV-2 Resistance in vitro |
title | 153. Molnupiravir Exhibits a High Barrier to the Development of SARS-CoV-2 Resistance in vitro |
title_full | 153. Molnupiravir Exhibits a High Barrier to the Development of SARS-CoV-2 Resistance in vitro |
title_fullStr | 153. Molnupiravir Exhibits a High Barrier to the Development of SARS-CoV-2 Resistance in vitro |
title_full_unstemmed | 153. Molnupiravir Exhibits a High Barrier to the Development of SARS-CoV-2 Resistance in vitro |
title_short | 153. Molnupiravir Exhibits a High Barrier to the Development of SARS-CoV-2 Resistance in vitro |
title_sort | 153. molnupiravir exhibits a high barrier to the development of sars-cov-2 resistance in vitro |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9752128/ http://dx.doi.org/10.1093/ofid/ofac492.231 |
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