INNOVATIONS IN ANTIVIRAL DEVELOPMENT AND THE DETECTION OF VIRUS INFECTIONS ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY Editorial Board: NATHAN BACK, State University of New York at Buffalo IRUN R. COHEN, The Weizmann Institute of Science DAVID KRITCHEVSKY, Wistar Institute ABEL LAJTHA, N.S. Kline Institute for Psychiatric Research RODOLFO PAOLETTI, University of Milan Recent Volumes in this Series Volume 309A PURINE AND PYRIMIDINE METABOLISM IN MAN VII, Part A: Chemotherapy, ATP Depletion, and Gout Edited by R. Angus Harkness, Gertrude B. Elion, and Nepomuk Zöllner Volume 309B PURINE AND PYRIMIDINE METABOLISM IN MAN VII, Part B: Structural Biochemistry, Pathogenesis, and Metabolism Edited by R. Angus Harkness, Gertrude B. Elion, and Nepomuk Zöllner Volume 310 IMMUNOLOGY OF MILK AND THE NEONATE Edited by Jiri Mestecky, Claudia Blair, and Pearay L. Ogra Volume 311 EXCITATION-CONTRACTION COUPLING IN SKELETAL, CARDIAC, AND SMOOTH MUSCLE Edited by George B. Frank, C. Paul Bianchi, and Henk E. D. J. ter Keurs Volume 312 INNOVATIONS IN ANTIVIRAL DEVELOPMENT AND THE DETECTION OF VIRUS INFECTIONS Edited by Timothy M. Block, Donald Jungkind, Richard Crowell, Mark Denison, and Lori R. Walsh Volume 313 HEPARIN AND RELATED POLYSACCHARIDES Edited by David A. Lane, Ingemar Björk, and Ulf Lindahl Volume 314 CELL-CELL INTERACTIONS IN THE RELEASE OF INFLAMMATORY MEDIATORS: Eicosanoids, Cytokines, and Adhesion Edited by Patrick Y-K Wong and Charles N. Serhan Volume 315 TAURINE: Nutritional Value and Mechanisms of Action Edited by John B. Lombardini, Stephen W. Schaffer, and Junichi Azuma A Continuation Order Plan is available for this series. A continuation order will bring delivery of each new volume immediately upon publication. Volumes are billed only upon actual shipment. For further information please contact the publisher. INNOVATIONS IN ANTIVIRAL DEVELOPMENT AND THE DETECTION OF VIRUS INFECTIONS Edited by Timothy M. Block and Donald Jimgkind Thomas Jefferson University Hospital Philadelphia, Pennsylvania Richard L. Crowell Hahnemann University School of Medicine Philadelphia, Pennsylvania Mark Denison Vanderbilt University Nashville, Tennessee and Lori R. Walsh Mercy Catholic Medical Center Darby, Pennsylvania SPRINGER SCIENCE+BUSINESS MEDIA, LLC Library of Congress Catalog1ng-1n-PublIcatIon Data Innovations 1n antiviral development and the detection of virus Infections / edited by Timothy M. Block ... [et al.]. p. cm. — (Advances in experimental medicine and biology ; v. 312) "Proceedings of the Eastern Pennsylvania Branch of the American Society for Microbiology Symposium of Innovations 1n Antiviral Development and the Detection of Virus Infections, held November 15-16, 1990, 1n Philadelphia, Pennsylvania"—T.p. verso. Includes bibliographical references and Index. ISBN 978-1-4613-6533-4 ISBN 978-1-4615-3462-4 (eBook) DOI 10.1007/978-1-4615-3462-4 1. Virus diseases—Molecular aspects—Congresses. 2. Virus d 1 seases-.-TreatBjent—Congresses. 3. Virus diseases—Dlagnosls- -Congresses. I. Block, Timothy M. II. American Society for Microbiology. Eastern Pennsylvania Branch. III. Eastern Pennsylvania Branch of the American Society for Microbiology Symposium of Innovations 1n Antiviral Development and the Detection of Virus Infections (1990 : Philadelphia, Pa.) IV. Series. [DNLM: 1. Antiviral Agents—congresses. 2. HIV Infectlons- -prevention & control—congresses. 3. Virus Inhibitors—congresses. W1 AD559 v. 312 / QV 268.5 158 1990] RC114.5.152 1992 616.9'25—dc20 DNLM/DLC for Library of Congress 92-14364 CIP Proceedings of the Eastern Pennsylvania Branch of the American Society for Microbiology Symposium of Innovations in Antiviral Development and the Detection of Virus Infections, held November 15-16, 1990, in Philadelphia, Pennsylvania ISBN 978-1-4613-6533-4 © 1992 Springer Science+Business Media New York Originally published by Plenum Press, New York in 1992 All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher Timothy Block dedicates his contributions to his wife, Joan, his parents, Joyce and Carl, as well as to Russell Schaedler, M.D. and Baruch Blumberg, M.D., Ph.D. for their inspiration. Donald Jungkind dedicates his contributions to his patient and understanding wife, Kim, and to Earle H. Spaulding, Ph.D., who was influential in his decision to study diagnostic microbiology and virology. SYMPOSIUM SPONSORS AMERICAN CYANAMID COMPANY BECTON DICKINSON MICROBIOLOGY SYSTEMS BOEHRINGER INGELHEIM PHARMACEUTICALS, INC. BOEHRINGER MANHEIM BURROUGHS WELLCOME CETUS CORPORATION DAIICHI PHARMACEUTICAL CORPORATION ORTHO DIAGNOSITIC SYSTEMS E. R. SQUIBB PHARMACEUTICAL COMPANY STERLING DRUG COMPANY UPJOHN COMPANY WHITAKER BIOPRODUCTS, INC. WYETH LABORATORIES, INC. vii ACKNOWLEDGEMENTS The editors wish to thank Margie Pike for her patience and tireless efforts in the administrative preparation of these manuscripts. Her influence is evident throughout the book. We also wish to thank Mary Cohen and Elham Bshouti for their typing contributions. viii FOREWORD THE ERA OF ANTIVIRALS Introduction Although there are more than one hundred medically useful antibiotics and fungicides, there are only seven compounds licensed for use as antiviral agents, in the USA. Some of these (acyclovir and ganciclovir) are actually derivatives of each other, making the number of new discoveries even smaller. Moreover, most of these agents are of only limited therapeutic value and have substantial toxicity. It has been more than 100 years ago since Pasteur studied rabies virus (2) and Rous (4) showed that a small filterable agent (not bacteria) caused disease (sarcoma) in chickens. It was nearly 100 years ago that yellow fever virus, the first recognized human pathogenic virus, was unambiguously associated with disease (3). Enteroviruses were cultured for the first time nearly 50 years ago (1). Why then has effective chemotherapy against viruses lagged behind that of other microorganisms? Viruses are often difficult to grow and image. However, with the dynamic advances in molecular biology and increased sophistication in tissue culture, the field of virology has blossomed and resulted in improved methods for detection of virus infection. The use of viruses as models of gene regulation and replication has also resulted in a massive accumulation of information. The rapid advances in molecular biology, including the discovery of specific virus functions that differ greatly from the host and of systems in which virus gene products are expressed, has liberated the study of some viruses, such as human immunodeficiency virus (HIV) and herpes simplex, from a dependency upon tissue culture growth. The discovery of virus functions and replication strategies that differ from their host has made it possible to begin to specifically target antiviral agents and overcome the main obstacle that designers of antiviral chemotherapy have faced: to create antiviral agents that block virus replication but do not substantially interfere with host cell synthetic pathways. These recent developments give researchers confidence that in the near future many antiviral agents will be made available for clinical use. Indeed, from a chemotherapeutic perspective, it is likely that the 1990s may be called the "decade of antivirals." The meeting that this book is based upon, as well as the proceedings themselves, are testimony to the prediction that we are reaching a "critical mass" where the possibility of rapid diagnosis of viral infection plus effective therapy will result in more widespread demand for these clinical services. i)( This publication differs from more conventional reports of virus chemotherapy in that the authors have been encouraged to be speculative. In addition to the presentation of data, authors were welcome to make conjecture about experiments that had not necessarily been conducted and to hypothesize about approaches that have not yet been taken. We have emphasized innovations because with only a handful of antiviral agents out there, some new approaches might be helpful. Highlights of the Book Some of the highlights of the proceedings are outlined here, although it is noted that not all of the contributions to this book are considered in this forward. Antiviral strategists graphically divide the virus life cycle into discreet steps as outlined below: Step 0 Processing of the virion in host biological fluids and access to target tissue Step I Attachment Step II Entry and uncoating Step III Relocation of the viral genome to appropriate cell compartments for synthetic activity Step IV Transcription of the viral genome and translocation of viral mRNA, inhibition of host macromolecular synthesis or transformation events Step V Replication Step VI Assembly and egress Step VII Immunological effects x Although these steps are somewhat artificial, in the sense that the virus life cycle is actually more of a continuum than a sequence of separately occurring events, they do help organize our thinking. Indeed, the findings described in this book can, in some regards, be categorized by the steps that are interfered with. For example, categorizing certain chapters by the step in the virus life cycle they discuss allows us to offer the following outline: Step 0: Processing of the Virus and Access to Host Tissue The book starts with an important lesson and reminder from Bernard Fields. Dr Fields emphasizes the limitations of studying viruses in tissue culture and provides several examples of steps in a virus' life cycle that could only have been revealed by in vivo analysis of pathogenesis. For example, the proteolytic processing of reovirus in the mouse gut, a potentially useful target for antiviral action, would not have been appreciated if analysis of the virus life cycle had been limited to tissue culture. Dr. Bernard Fields reports that reovirus is proteolytically cleaved in the mouse gut. This cleavage results in the "activation" of virus attachment proteins, allowing for efficient binding to the host cell. Inhibition of this processing event results in effective interference with virus replication in vivo. The dynamics of virus spread throughout its host are also reviewed. Remarkably, antibody against reovirus administered to mice that already harbor the virus in their central nervous system can still drastically reduce the spread of virus throughout specific neurotracts. Other full-length contributions that deal with an aspect of virus pathogenesis are by Wu et al., and Coen et al. Step 1: Attachment Receptors for virus attachment provide very attractive antiviral targets. In particular, Richard Colonno reviews the use of anti-rhinovirus receptor agents in the context of the knowledge that the functional receptor is immune cell adhesion molecule #1. The cellular receptor for HIV has also been targeted. An approach that targets the virion, rather than the host, is outlined by Berger et al. Briefly, for example, soluble CD4, the cellular receptor for HIV, has been derivatized and used to "neutralize" in vitro preparations of the virus. The potential of this agent, in the context of combination therapy, is presented. Another full-length contribution that focuses upon virus receptors is by Dutko et al., in which the possibility of using antiviral agents of known mechanisms of action to probe virus function is discussed. Step II: EntO' and Uncoating This step offers opportunities for antiviral action, but is not considered in this report. Steps III and IV: Transcription and Replication of the Virus Genome Included in Steps III and IV are the specific components of the viral biosynthetic machinery, such as specific enzymes. There are many examples of novel antivirals in this area. For example, new approaches to the inhibition of the HIV protease are likely to reach clinical trials shortly. In this book, Merluzzi et aI., report an exciting novel small organic compound characterized by a cyclic propyl group. This xi
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