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Repurposing of Drugs as Novel Influenza Inhibitors From Clinical Gene Expression Infection Signatures.

ABSTRACT: Influenza virus infections remain a major and recurrent public health burden. The intrinsic ever-evolving nature of this virus, the suboptimal efficacy of current influenza inactivated vaccines, as well as the emergence of resistance against a limited antiviral arsenal, highlight the critical need for novel therapeutic approaches. In this context, the aim of this study was to develop and validate an innovative strategy for drug repurposing as host-targeted inhibitors of influenza viruses and the rapid evaluation of the most promising candidates in Phase II clinical trials. We exploited in vivo global transcriptomic signatures of infection directly obtained from a patient cohort to determine a shortlist of already marketed drugs with newly identified, host-targeted inhibitory properties against influenza virus. The antiviral potential of selected repurposing candidates was further evaluated in vitro, in vivo, and ex vivo. Our strategy allowed the selection of a shortlist of 35 high potential candidates out of a rationalized computational screening of 1,309 FDA-approved bioactive molecules, 31 of which were validated for their significant in vitro antiviral activity. Our in vivo and ex vivo results highlight diltiazem, a calcium channel blocker currently used in the treatment of hypertension, as a promising option for the treatment of influenza infections. Additionally, transcriptomic signature analysis further revealed the so far undescribed capacity of diltiazem to modulate the expression of specific genes related to the host antiviral response and cholesterol metabolism. Finally, combination treatment with diltiazem and virus-targeted oseltamivir neuraminidase inhibitor further increased antiviral efficacy, prompting rapid authorization for the initiation of a Phase II clinical trial. This original, host-targeted, drug repurposing strategy constitutes an effective and highly reactive process for the rapid identification of novel anti-infectious drugs, with potential major implications for the management of antimicrobial resistance and the rapid response to future epidemic or pandemic (re)emerging diseases for which we are still disarmed.

SUBMITTER: Pizzorno A

PROVIDER: S-EPMC6361841 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Project description:BackgroundDengue is a major arthropod-borne viral disease spreading rapidly across the globe. The absence of vaccines and inadequate vector control measures leads to further expansion of dengue in many regions globally. Hence, the identification of genes involved in the pathogenesis of dengue will help to understand the molecular basis of the disease and the genes responsible for the disease progression.MethodsIn the present study, a meta-analysis was carried out using dengue gene expression data obtained from Gene Expression Omnibus repository. The differentially expressed genes such as CCNB1 and CCNB2 (G2/mitotic-specific cyclin-B2 and B1) were upregulated in dengue fever to control (DF-CO) and severe dengue (dengue hemorrhagic fever [DHF]) to control (DHF-CO) were identified as key genes for controlling the major pathways (cell cycle, oocyte meiosis, p53 signaling pathway, cellular senescence and progesterone-mediated oocyte maturation). Similarly, interferon alpha-inducible (IFI27) genes, type-I and type-III interferon (IFN) signaling genes (STAT1 and STAT2), B cell activation and survival genes (TNFSF13B, TNFRSF17) and toll like receptor (TLR7) genes were differentially up activated during DF-CO and DHF-CO. Followed by, Cytoscape was used to identify the immune system process and topological analysis.ResultsThe results showed that the top differentially expressed genes under the statistical significance p <0.001, which is majorly involved in Kyoto Encyclopedia of Genes and Genomes orthology K05868 and K21770 with gene names CCNB1 and CCNB2. In addition to this, the immune system profile showed up-regulation of IL12A, CXCR3, TNFSF13B, IFI27, TNFRSF17, STAT, STAT2, and TLR7 genes in DF-CO and DHF-CO act as immunological signatures for inducing the immune response towards dengue infection.ConclusionsThe current study could aid in understanding of molecular pathogenesis, genes and corresponding pathway upon dengue infection, and could facilitate for identification of novel drug targets and prognostic markers.

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Repurposing of Drugs as Novel Influenza Inhibitors From Clinical Gene Expression Infection Signatures.

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