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CMX001 is a lipophilic nucleotide analog formed by covalently linking 3-(hexdecyloxy)propan-1-ol to cidofovir (CDV) used for treatment of smallpox.[1]
In vitro experiment it shown that 0.079 μM CMX001 inhibited JCV replication in COS-7 cells. And treatment with 0.038 μM or 0.6 μM CMX001 in PDA cells resulted in a obviously decreased the number of infectious JCV progeny in a concentration-dependent manner. Treatment with 0.079 to 10 μM CMX001 in COS-7 cells reduced the metabolic activity to 52% and BrdU incorporation to 10% at the highest concentration.[2] CMX001 was active with EC90 of 0.31 μM at about 400-times-lower concentrations than the EC90 for CDV in the same test system.[3] In vitro efficacy test it exhibited that treatment with 0.01 μM to 0.1 μM resulted in minimal cytotoxic effects in human fetal brain SVG cells.[4] In vitro, CMX001 has against five variola virus strains with EC50 of averaged 0.11 μM.[5]
In vivo clinical study it shown that treatment with oral CMX001 at a dose of 100 mg twice weekly obviously reduced the incidence of CMV events in recipients of hematopoietic-cell transplants.[6] In ECTV-infected A/NCR mice, a 2.5 mg/kg dose of CMX001 given once daily for five days starting 4 h post-infection provides complete protection against a lethal intranasal challenge. Mice were treated with 10 mg/kg CMX001 when the fifth day, then followed by a 2.5 mg/kg dose every other day for 14 days can be completely protected from mortality. However, treatment with 20 mg/kg CMX001 orally as late as four days post-infection provided 100% protection against lethal ECTV infection.[7]
参考文献:
[1].Rice AD, et al. Efficacy of CMX001 as a post exposure antiviral in New Zealand White rabbits infected with rabbitpox virus, a model for orthopoxvirus infections of humans. Viruses. 2011 Jan;3(1):47-62.
[2].Gosert R, et al. CMX001 (1-O-hexadecyloxypropyl-cidofovir) inhibits polyomavirus JC replication in human brain progenitor-derived astrocytes. Antimicrob Agents Chemother. 2011 May;55(5):2129-36.
[3].Rinaldo CH, et al. 1-O-hexadecyloxypropyl cidofovir (CMX001) effectively inhibits polyomavirus BK replication in primary human renal tubular epithelial cells. Antimicrob Agents Chemother. 2010 Nov;54(11):4714-22.
[4].Jiang ZG, et al. Hexadecyloxypropyl-cidofovir (CMX001) suppresses JC virus replication in human fetal brain SVG cell cultures. Antimicrob Agents Chemother. 2010 Nov;54(11):4723-32.
[5].Olson VA, et al. In vitro efficacy of brincidofovir against variola virus. Antimicrob Agents Chemother. 2014 Sep;58(9):5570-1.
[6].Marty FM, et al. CMX001 to prevent cytomegalovirus disease in hematopoietic-cell transplantation. N Engl J Med. 2013 Sep 26;369(13):1227-36.
[7].Lanier R, et al. Development of CMX001 for the Treatment of Poxvirus Infections. Viruses. 2010 Dec;2(12):2740-2762.
CMX001 是一种亲脂性核苷酸类似物,由 3-(hexdecyloxy)propan-1-ol 与西多福韦 (CDV) 共价连接而成,用于治疗天花。[1]
体外实验表明,0.079 μM CMX001 可抑制 COS-7 细胞中的 JCV 复制。在 PDA 细胞中用 0.038 μM 或 0.6 μM CMX001 处理导致感染性 JCV 后代数量明显减少,且呈浓度依赖性。在 COS-7 细胞中用 0.079 至 10 μM CMX001 处理,在最高浓度下,代谢活性降低至 52%,BrdU 掺入降低至 10%。[2] CMX001 在大约 0.31 μM 时具有活性,EC90 为 0.31 μM在同一测试系统中,浓度比 CDV 的 EC90 低 400 倍。[3] 体外药效测试表明,0.01 μM 至 0.1 μM 的处理对人胎儿大脑的细胞毒性作用最小SVG 细胞。[4] 在体外,CMX001 对五种天花病毒株具有平均 EC50 0.11 μM。[5]
体内临床研究表明,每周两次口服 CMX001 100 mg 可显着降低造血细胞移植受者的 CMV 事件发生率。[6] 在 ECTV-对于感染的 A/NCR 小鼠,从感染后 4 小时开始每天一次给予 2.5 mg/kg 剂量的 CMX001,持续五天,可提供针对致命鼻内攻击的完全保护。小鼠在第五天时用 10 mg/kg CMX001 处理,然后每隔一天用 2.5 mg/kg 剂量处理,持续 14 天可以完全保护免于死亡。然而,最晚在感染后 4 天口服 20 mg/kg CMX001 可提供 100% 的保护,防止致命的 ECTV 感染。[7]
Cell experiment [1]: | |
Cell lines |
Primary human renal proximal tubule epithelial cells |
Preparation Method |
About 24 h after seeding 150 μl of the medium was replaced with fresh medium with or without purified BKV-Dunlop in the presence or absence of CMX001 (final concentration of 0.31 μM). The cells were grown for 96 h, and impedance was measured every 15 min for the first 6 h and then every 30 min. |
Reaction Conditions |
0.31 μM; 24h |
Applications |
CMX001 reduced the extracellular BKV load in a concentration-dependent manner.The CMX001 concentration of 0.31 μM consistently provided this level of inhibition. |
Animal experiment [2]: | |
Animal models |
8 week (3-4 lb) old New Zealand White rabbits |
Dosage form |
20 mg/kg per dose; i.v. |
Preparation Method |
Animals were given a total of one, two or three doses of CMX001 (20 mg/kg per dose) spaced every other day beginning on the day secondary lesions were detected in the ears of the animals. |
Applications |
As with the intradermal infection model, one, two, or three doses of CMX001 appeared to significantly reduce disease symptoms and have a survival benefit. |
参考文献: [1] Rinaldo CH, et al. 1-O-hexadecyloxypropyl cidofovir (CMX001) effectively inhibits polyomavirus BK replication in primary human renal tubular epithelial cells. Antimicrob Agents Chemother. 2010 Nov;54(11):4714-22. |
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