Pokeweed antiviral protein: ribosome inactivation and therapeutic applications.

Pokeweed antiviral protein (PAP) is a ribosome-inactivating protein (RIP) that inactivates ribosomes by the removal of a single adenine from ribosomal RNA. The studies summarized in our review concern the nature and application of this novel therapeutic agent. We describe how researchers continue to elucidate the structure and biologic activity of RIPs. Pokeweed antiviral protein is among the RIPs that have been conjugated to selective monoclonal antibodies for the treatment of several human cancers and viral diseases. Clinical trials using PAP immunotoxins for the treatment of leukemia have been particularly encouraging.     

Poliovirus-mediated entry of pokeweed antiviral protein.

Infection of HeLa cells with poliovirus results in cell permeabilization to pokeweed antiviral protein. Cell permeabilization was dependent on the integrity of virus capsid proteins and directly proportional to the multiplicity of infection. This study demonstrates that virus adsorption is sufficient for the entry of pokeweed antiviral protein into poliovirus-infected cells.     

Inhibition of herpes simplex virus multiplication by the pokeweed antiviral protein.

The pokeweed antiviral protein inhibited the multiplication of herpes simplex virus type 1 in cell culture. The extent of antiviral activity was proportional to the length of time that the antiviral protein was present postinfection. The results demonstrate that the continued presence of the pokeweed antiviral protein is necessary for the maximum inhibition of virus yields.     

Inhibition of herpes simplex virus DNA synthesis by pokeweed antiviral protein.

Pokeweed antiviral protein at a concentration of 3 microM inhibited both the synthesis and release of infectious herpes simplex virus type 1 in cell culture by 90 and 99%, respectively. Addition of pokeweed antiviral protein to Vero cell monolayers before virus infection was 10 to 15% more effective in reducing virus yields than was the simultaneous addition of the antiviral protein with virus inoculum. Viral DNA synthesis was inhibited by 90% in cells which had been exposed to the antiviral protein, whereas cellular DNA synthesis was unaffected. No significant inhibition in the synthesis of the majority of viral infected-cell polypeptides was observed early postinfection (7 h), with the exception of infected cell polypeptides 4 and 41, whose syntheses were reduced by 38 and 25%, respectively. At 9 to 21 h postinfection, however, the synthesis of individual infected cell polypeptides was reduced by 48 to greater than 99%.     

Dysfunctions of Pokeweed Mitogen-stimulated T and B Lymphocyte Responses Induced by Gammaglobulin Therapy

Lymphocytes obtained from nonimmuno deficient children treated with commercially available preparations of gammaglobulin failed to proliferate and to mature into plasma cells in vitro after stimulation with pokeweed mitogen. The influence of the treatment on lymphocyte functions varied according to the cell population considered. A T helper cell activity was detected in these patients but only in the cell subset bearing receptors for IgG after irradiation. T lymphocytes exerted a suppressive effect that disappeared after irradiation or incubation at 37°C. The suppressive cells were found among E rosette-forming cells depleted of leukocytes bearing receptors for IgG. Their suppressive effect was expressed only in the presence of normal radioresistant T lymphocytes that did not bear Fc receptors for IgG. Similar dysfunctions could be induced in vitro by incubation of normal T and B lymphocytes with gammaglobulin preparations. Because F(ab)′2 fragments or deaggregated preparations of gammaglobulin failed to activate T suppressor lymphocytes, this activation was likely triggered by attachment of Fc portion of denatured IgG to the corresponding membrane receptor. This activation step was prostaglandin E₂-dependent, suggesting that activated monocytes were involved in the activation process. B lymphocyte responses appeared directly inhibited by attachment of denatured gammaglobulin on membrane Fc receptor. Our observations suggest that immunological effects of gammaglobulin therapy are not limited to antibody transfer, since it also induces subtle modifications of in vitro pokeweed mitogen-stimulated T and B cell responses. These modifications must be considered in interpreting results obtained in immunodeficient patients investigated under gamma-globulin therapy.     

First demonstration of the effectiveness of inhibitors of cellular protein kinases in antiviral therapy

Viral replication and pathogenesis involves many cellular protein kinases, and many specific inhibitors of such kinase have been developed for the treatment of noninfectious diseases. As expected, such drugs have been repeatedly demonstrated to inhibit viral replication in cultured cells. Cellular protein kinases have thus been considered for several years as potentially valid targets for antiviral therapy. However, until recently there was no proof of such activity in vivo. The three papers discussed herein demonstrate that inhibitors of cellular protein kinases are indeed effective for the treatment of virus-induced disease in animal models and human clinical trials.     

First demonstration of the effectiveness of inhibitors of cellular protein kinases in antiviral therapy

Viral replication and pathogenesis involves many cellular protein kinases, and many specific inhibitors of such kinase have been developed for the treatment of noninfectious diseases. As expected, such drugs have been repeatedly demonstrated to inhibit viral replication in cultured cells. Cellular protein kinases have thus been considered for several years as potentially valid targets for antiviral therapy. However, until recently there was no proof of such activity in vivo. The three papers discussed herein demonstrate that inhibitors of cellular protein kinases are indeed effective for the treatment of virus-induced disease in animal models and human clinical trials.     

Polysaccharides as antiviral agents: antiviral activity of carrageenan.

A number of polysaccharides showed good antiviral activity against several animal viruses. At 5 micrograms/ml, carrageenan prevented the cell monolayer from destruction by herpes simplex virus type 1 (HSV-1) growth. At 10 micrograms/ml, carrageenan reduced the formation of new infectious HSV-1 by almost five logs. No cytotoxic effects were detected with concentrations of carrageenan up to 200 micrograms/ml. When 10 micrograms of carrageenan per ml was added at the beginning of HSV-1 infection of HeLa cells, there was potent inhibition of viral protein synthesis, and the cells continued synthesizing cellular proteins. This did not occur if carrageenan was added 1 h after HSV-1 infection. The use of [35S]methionine-labeled virions to analyze the entry of HSV-1 or Semliki Forest virions into cells indicated that carrageenan had no effect on virus attachment or virus entry. Moreover, carrageenan did not block the early permeabilization of cells to the toxic protein alpha-sarcin. These results suggest that this sulfated polysaccharide inhibits a step in virus replication subsequent to viral internalization but prior to the onset of late viral protein synthesis.     

Anti-human immunodeficiency virus type 1 activity of an anti-CD4 immunoconjugate containing pokeweed antiviral protein.

The ability of an alpha CD4-pokeweed antiviral protein (PAP) immunoconjugate to inhibit replication of human immunodeficiency virus type 1 (HIV-1) was evaluated in vitro with 22 clinical HIV-1 strains obtained from four seropositive asymptomatic individuals, three patients with AIDS-related complex, and four patients with AIDS. Fifteen isolates were from zidovudine-untreated individuals, whereas seven isolates were obtained after 24 to 104 weeks of therapy with zidovudine, alone or alternating with zalcitabine. Mean zidovudine 50% inhibitory concentrations (IC50s) were 126 nM (range, 1 to 607 nM) for isolates from zidovudine-untreated individuals and 2,498 nM (range, 14 to 6,497 nM) for strains from patients treated with antiretroviral agents. Mean alpha CD4-PAP IC50s were 48 x 10(-3) nM (range, 0.02 x 10(-3) to 212 x 10(-3) nM) for isolates from zidovudine-untreated individuals, and 16 x 10(-3) nM (range, 2 x 10(-3) to 28 x 10(-3) nM) for isolates from treated patients. Overall, higher concentrations of alpha CD4-PAP were necessary to inhibit HIV-1 strains from untreated individuals at more advanced stages of disease. Seventeen isolates were susceptible to zidovudine (mean IC50, 117 nM), and five were resistant to zidovudine (mean IC50, 3,724 nM). Mean alpha CD4-PAP IC50s were 43 x 10(-3) nM for zidovudine-susceptible isolates and 19 x 10(-3) nM for isolates resistant to zidovudine. All HIV-1 strains had IC50s greater than 0.5 nM for unconjugated PAP, the alpha CD19-PAP immunoconjugate, and monoclonal antibody alpha CD4. At concentrations as high as 5,000 nM, alphaCD4-PAP did not inhibit colony formation by normal bone marrow progenitor cells(BFU-E, CFU-GM , and CFU-GEMM) or myeloid cell lines (KG-1 and HL-60) and did not decrease cell viabilities of T-cell (Jurkat) or B-cell (FL-112 and Raji) precursor lines. Overall, alphaCD4-PAP demonstrated more potent anti-HIV-1 activity than zidovudine and inhibited replication of zidovudine-susceptible and zidovudine-resistant viruses at concentrations that were not toxic to lymphohematopoietic cell populations.     

Current non-AIDS antiviral chemotherapy

The evolution of antiviral therapy began with developments in the management of influenza and herpes simplex keratitis in the 1960s and early 1970s. However, the field exploded with the successful treatment of herpes simplex encephalitis, herpes zoster and genital herpes simplex virus infections, all occurring in the late 1970s and early 1980s. These advances have contributed to the development of therapies for HIV that have transformed the lives of infected patients in recent years. The clinical fruit of all of these research advances has been an armamentarium of drugs that can be used to successfully treat a variety of viral illnesses. In addition to HIV/AIDS, current antiviral therapy focuses primarily on herpesviruses, hepatitis viruses and influenza. Notably, considerable progress remains to be made in these areas. Moreover, a variety of additional viral diseases currently require the development of specific therapies.     

ARHAI: antiviral resistance

Development of antiviral resistance is a particular concern for the Advisory Committee on Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI). Over the last 4 years, considerable time has been devoted to examining the ability of the UK to monitor the presence and transmission of antiviral resistance. Resistances to antiviral agents in influenza virus, HIV and hepatitis B and C viruses were identified as the main targets. The emphasis is on a network of laboratories that are able to perform diagnostic tests for resistance and to participate in surveillance programmes with co-ordination either through a central reference facility in the HPA or a collaborative study group.     

Perspectives in antiviral chemotherapy

The current progress in antiviral therapy is related to our better understanding of the viral multiplication, with potential targets for specific antiviral action at each step of the multiplication cycle inside the infected cell. Amantadine and Rimantadine are anti-influenza A drugs interfering with the penetration and the release of the virus. Most of the other antiviral drugs which are clinically available have the same target in common, namely the viral DNA polymerase. This holds true for modified nucleosides such as Acycloguanosine (Acyclovir), DHPG, Adenine-Arabinoside, Azidothymidine as well as pyrophosphate derivatives such as phosphonoformic acid. Unfortunately the antiviral chemotherapy must confront 3 obstacles: 1) a possible interference with the normal cellular metabolism, leading to residual cytotoxic side effects; 2) the genetic variability of the viruses, producing drug-resistant mutants and 3) the inability of any antiviral chemotherapeutic agent known to date to eradicate latent viral infection. A new approach of the control of latent infection is suggested with anti sense oligonucleotides of hybridons.     

Oligonucleotide analogs as antiviral agents

The recent availability of a wider range of oligonucleotide analogs has stimulated renewed interest in their application as potential antiviral agents through a variety of mechanisms. These mechanisms include RNase H-mediated antisense, steric block antisense and small interfering RNA targeting viral RNAs, but also other mechanisms, including blockage of virus uptake by cells and the stimulation of a Toll-like receptor-9-dependent immune response by CpG oligonucleotides.