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A Cyclic Phosphoramidate Prodrug of 2'-deoxy-2'-fluoro-2'-C-methylguanosine for the Treatment of Dengue Infection

Karuna, Ratna and Yokokawa, Fumiaki and Wang, Keshi and Zhang, Jin and Xu, Haoying and Wang, Gang and Ding, Mei and Chan, Wai Ling and Abdul Ghafar, Nahdiyah and Leonardi, Andrea and Seh, Cheah Chen and Seah, Peck Gee and Liu, Wei and Rao, Srinivasa and Lim, Siew Pheng and Lakshminarayana, Suresh and Growcott, Ellena and Babu, Sreehari and Fenaux, Martijn and Zhong, Weidong and Gu, Feng and Shi, Pei-Yong and Blasco, Francesca and Chen, Yen-Liang (2020) A Cyclic Phosphoramidate Prodrug of 2'-deoxy-2'-fluoro-2'-C-methylguanosine for the Treatment of Dengue Infection. Antimicrobial agents and chemotherapy, 64 (12). pp. 1-17. ISSN 1098-6596

Abstract

Monophosphate prodrug analogs of 2'-deoxy-2'-fluoro-2'-C-methylguanosine have been reported as potent inhibitors of hepatitis C virus (HCV) RNA-dependent RNA polymerase. These prodrugs also display potent anti-dengue activities in cellular assays although their prodrug moieties were designed to produce high levels of triphosphate in the liver. Since peripheral blood mononuclear cells (PBMCs) are one of the major targets of dengue virus, different prodrug moieties were designed to effectively deliver 2'-deoxy-2'-fluoro-2'-C-methylguanosine monophosphate prodrugs and their corresponding triphosphates into PBMCs after oral administration. We identified a cyclic phosphoramidate prodrug 17 demonstrating a well-balanced anti-dengue cellular activity and in vitro stability profiles. We further determined the PBMCs concentration of active triphosphate needed to inhibit 50% virus replication (TP50). Compound 17 was assessed in AG129 mouse model and demonstrated 1.6- and 2.2-log viremia reduction at 100 and 300 mg/kg BID, respectively. At 100 mg/kg BID, the terminal triphosphate concentration in PBMCs reached above TP50, demonstrating TP50 as the target exposure for efficacy. In dogs, oral administration of 17 resulted in high PBMCs triphosphate level, exceeding TP50 at 10 mg/kg. Unfortunately, two-week dog toxicity studies at 30, 100, and 300 mg/kg/day showed that No Observed Adverse Effect Level (NOAEL) could not be achieved due to pulmonary inflammation and hemorrhage. The preclinical safety results suspended further development of 17 Nevertheless, present work has proven the concept that an efficacious monophosphate nucleoside prodrug could be developed for the potential treatment of dengue infection.

Item Type: Article
Keywords: dengue, nucleotide analog, monophosphate prodrug, cyclic phosphoramidate, nucleoside triphosphate, polymerase inhibitor
Date Deposited: 02 Dec 2020 00:45
Last Modified: 02 Dec 2020 00:45
URI: https://oak.novartis.com/id/eprint/41852

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