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Combination Therapy for the Treatment of Shingles with an Immunostimulatory Vaccine Virus and Acyclovir
Practically the entire global population is infected by herpesviruses that establish lifelong latency and can be reactivated. Alpha-herpesviruses, herpes simplex viruses 1 and 2 (HSV-1/HSV-2) and varicella zoster virus (VZV), establish latency in sensory neurons and then reactivate to infect epithel...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9958712/ https://www.ncbi.nlm.nih.gov/pubmed/37259374 http://dx.doi.org/10.3390/ph16020226 |
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author | Bakacs, Tibor Sandig, Volker Kovesdi, Imre |
author_facet | Bakacs, Tibor Sandig, Volker Kovesdi, Imre |
author_sort | Bakacs, Tibor |
collection | PubMed |
description | Practically the entire global population is infected by herpesviruses that establish lifelong latency and can be reactivated. Alpha-herpesviruses, herpes simplex viruses 1 and 2 (HSV-1/HSV-2) and varicella zoster virus (VZV), establish latency in sensory neurons and then reactivate to infect epithelial cells in the mucosa or skin, resulting in a vesicular rash. Licensed antivirals inhibit virus replication, but do not affect latency. On reactivation, VZV causes herpes zoster, also known as shingles. The 76-year-old first author of this paper published an autobiography of his own severe herpes zoster ophthalmicus (HZO) infection with orbital edema, which is considered an emergency condition. Acyclovir (ACV) treatment was complemented with an immunostimulatory viral therapy, which resolved most symptoms within a few days. The orally administered live-attenuated infectious bursal disease vaccine virus (IBDV) delivers its double-stranded RNA (dsRNA) cargo to host cells and activates the natural antiviral interferon (IFN) gene defense system from within the host cells. IBDV has already been demonstrated to be safe and effective against five different families of viruses, hepatitis A virus (HAV), hepatitis B and C virus (HBV/HCV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and varicella zoster virus (VZV). Here we propose a short phase I/II trial in elderly shingles patients who will be assigned to receive either ACV monotherapy or ACV combined with R903/78, an attenuated immunostimulatory IBDV strain. The primary endpoints will be safety, but the efficacy of the combination therapy against the ACV monotherapy also will be assessed. |
format | Online Article Text |
id | pubmed-9958712 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-99587122023-02-26 Combination Therapy for the Treatment of Shingles with an Immunostimulatory Vaccine Virus and Acyclovir Bakacs, Tibor Sandig, Volker Kovesdi, Imre Pharmaceuticals (Basel) Opinion Practically the entire global population is infected by herpesviruses that establish lifelong latency and can be reactivated. Alpha-herpesviruses, herpes simplex viruses 1 and 2 (HSV-1/HSV-2) and varicella zoster virus (VZV), establish latency in sensory neurons and then reactivate to infect epithelial cells in the mucosa or skin, resulting in a vesicular rash. Licensed antivirals inhibit virus replication, but do not affect latency. On reactivation, VZV causes herpes zoster, also known as shingles. The 76-year-old first author of this paper published an autobiography of his own severe herpes zoster ophthalmicus (HZO) infection with orbital edema, which is considered an emergency condition. Acyclovir (ACV) treatment was complemented with an immunostimulatory viral therapy, which resolved most symptoms within a few days. The orally administered live-attenuated infectious bursal disease vaccine virus (IBDV) delivers its double-stranded RNA (dsRNA) cargo to host cells and activates the natural antiviral interferon (IFN) gene defense system from within the host cells. IBDV has already been demonstrated to be safe and effective against five different families of viruses, hepatitis A virus (HAV), hepatitis B and C virus (HBV/HCV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and varicella zoster virus (VZV). Here we propose a short phase I/II trial in elderly shingles patients who will be assigned to receive either ACV monotherapy or ACV combined with R903/78, an attenuated immunostimulatory IBDV strain. The primary endpoints will be safety, but the efficacy of the combination therapy against the ACV monotherapy also will be assessed. MDPI 2023-02-01 /pmc/articles/PMC9958712/ /pubmed/37259374 http://dx.doi.org/10.3390/ph16020226 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Opinion Bakacs, Tibor Sandig, Volker Kovesdi, Imre Combination Therapy for the Treatment of Shingles with an Immunostimulatory Vaccine Virus and Acyclovir |
title | Combination Therapy for the Treatment of Shingles with an Immunostimulatory Vaccine Virus and Acyclovir |
title_full | Combination Therapy for the Treatment of Shingles with an Immunostimulatory Vaccine Virus and Acyclovir |
title_fullStr | Combination Therapy for the Treatment of Shingles with an Immunostimulatory Vaccine Virus and Acyclovir |
title_full_unstemmed | Combination Therapy for the Treatment of Shingles with an Immunostimulatory Vaccine Virus and Acyclovir |
title_short | Combination Therapy for the Treatment of Shingles with an Immunostimulatory Vaccine Virus and Acyclovir |
title_sort | combination therapy for the treatment of shingles with an immunostimulatory vaccine virus and acyclovir |
topic | Opinion |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9958712/ https://www.ncbi.nlm.nih.gov/pubmed/37259374 http://dx.doi.org/10.3390/ph16020226 |
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