Inhibition of avian-origin influenza A(H7N9) virus by the novel cap-dependent endonuclease inhibitor baloxavir marboxil

Sci Rep. 2019 Mar 5;9(1):3466. doi: 10.1038/s41598-019-39683-4.

Abstract

Human infections with avian-origin influenza A(H7N9) virus represent a serious threat to global health; however, treatment options are limited. Here, we show the inhibitory effects of baloxavir acid (BXA) and its prodrug baloxavir marboxil (BXM), a first-in-class cap-dependent endonuclease inhibitor, against A(H7N9), in vitro and in vivo. In cell culture, BXA at four nanomolar concentration achieved a 1.5-2.8 log reduction in virus titers of A(H7N9), including the NA-R292K mutant virus and highly pathogenic avian influenza viruses, whereas NA inhibitors or favipiravir required approximately 20-fold or higher concentrations to achieve the same levels of reduction. A(H7N9)-specific amino acid polymorphism at position 37, implicated in BXA binding to the PA endonuclease domain, did not impact on BXA susceptibility. In mice, oral administration of BXM at 5 and 50 mg/kg twice a day for 5 days completely protected from a lethal A/Anhui/1/2013 (H7N9) challenge, and reduced virus titers more than 2-3 log in the lungs. Furthermore, the potent therapeutic effects of BXM in mice were still observed when a higher virus dose was administered or treatment was delayed up to 48 hours post infection. These findings support further investigation of BXM for A(H7N9) treatment in humans.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antiviral Agents / pharmacology*
  • Cytokines / biosynthesis
  • Dibenzothiepins
  • Disease Models, Animal
  • Ducks
  • Endonucleases / antagonists & inhibitors*
  • Enzyme Inhibitors / pharmacology*
  • Humans
  • Inflammation Mediators / metabolism
  • Influenza A Virus, H7N9 Subtype / drug effects*
  • Influenza A Virus, H7N9 Subtype / enzymology*
  • Influenza in Birds / drug therapy
  • Influenza in Birds / virology
  • Influenza, Human / drug therapy
  • Influenza, Human / metabolism
  • Influenza, Human / virology
  • Mice
  • Morpholines
  • Orthomyxoviridae Infections / drug therapy
  • Orthomyxoviridae Infections / metabolism
  • Orthomyxoviridae Infections / virology
  • Oxazines / pharmacology*
  • Pyridines / pharmacology*
  • Pyridones
  • Thiepins / pharmacology*
  • Triazines / pharmacology*
  • Viral Load
  • Virus Replication / drug effects*

Substances

  • Antiviral Agents
  • Cytokines
  • Dibenzothiepins
  • Enzyme Inhibitors
  • Inflammation Mediators
  • Morpholines
  • Oxazines
  • Pyridines
  • Pyridones
  • Thiepins
  • Triazines
  • baloxavir
  • Endonucleases