Broad-Spectrum Antiviral Strategies and Nucleoside Analogues

The emergence or re-emergence of viruses with epidemic and/or pandemic potential, such as Ebola, Zika, Middle East Respiratory Syndrome (MERS-CoV), Severe Acute Respiratory Syndrome Coronavirus 1 and 2 (SARS and SARS-CoV-2) viruses, or new strains of influenza represents significant human health threats due to the absence of available treatments. Vaccines represent a key answer to control these viruses. However, in the case of a public health emergency, vaccine development, safety, and partial efficacy concerns may hinder their prompt deployment. Thus, developing broad-spectrum antiviral molecules for a fast response is essential to face an outbreak crisis as well as for bioweapon countermeasures. So far, broad-spectrum antivirals include two main categories: the family of drugs targeting the host-cell machinery essential for virus infection and replication, and the family of drugs directly targeting viruses. Among the molecules directly targeting viruses, nucleoside analogues form an essential class of broad-spectrum antiviral drugs. In this review, we will discuss the interest for broad-spectrum antiviral strategies and their limitations, with an emphasis on virus-targeted, broad-spectrum, antiviral nucleoside analogues and their mechanisms of action.

Abstract 288: Use of hiPSC-Derived Cardiomyocytes to Explore Functional Cardiotoxicities of Direct Acting Antiviral Nucleoside Based Structures

Nucleoside-derived structures constitute important Direct-Acting Antivirals (DAAs) for Hepatitis C Virus (HCV) treatment. BMS-986094 (BMS-094: a 2’-C-modified guanosine (G) derivative prodrug) was discontinued in phase II due to heart/kidney failure and cardiomyopathy, whereas sofosbuvir (a 2’-C-modified uridine prodrug) is an effective HCV DAA. Given the importance of purine nucleosides in cardiac signaling, we investigated BMS-094 in the human induced pluripotent stem cell derived cardiomyocyte (hiPSC-CM) model (iCells, CDI Fujifilm). Beating myocyte monolayer impedance signals were monituored for up to 7 days in the RTCA Cardio platform (ACEA-Biosystems). BMS-094 was acutely myotoxic at high concentrations (≥ 17 μM), as evidenced by cessation of myocyte beating and loss of baseline impedance or ‘Cell Index’ (C.I.), a measure of cell adherence, within hours. On prolonged exposure to BMS-094 at concentrations not associated with loss of C.I. (< 1 μM), we observed progressive, dose-dependent decreases in impedance amplitude (myocyte contractility) which were accompanied by increases in the spontaneous myocyte beating rate. The same beating phenotype could be elicited over a multi-day exposure duration by extracellular application of the BMS-094 core nucleoside (2’-C-methyl-guanosine) alone, but not by unmodified G. Loss of contractility with the G derivatives was accompanied by a decrease of the Ca 2+ transient amplitude in a Ca 2+ influx fluorescence assay (FDSS μCell, Hamamatsu). We investigated the impact of purine or pyrimidine base substitutions in the 2’-CMe-modified nucleoside: 2’-CMe-adenosine, -cytidine, -G, and -uridine. The uridine analog had the most limited effects on hiPSC-CMs beating parameters. The effect of 2’-CMe-cytidine on beating rate and impedance amplitude was similar to that of the G derivative, including a progressive multi-day onset. In contrast, 2’-CMe-adenosine slowed beating acutely, and led to loss of C.I. at higher concentrations. These results demonstrate the varied effects on CM function of base substitutions in antiviral nucleoside chemistry and support the utility of hiPSC-CMs as a model for screening in-vitro the potential cardiotoxicities of nucleoside derivative drugs.