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Probenecid reveals exercise in opposition to respiratory syncytial virus

Among the many commonest viruses inflicting viral respiratory illness is the respiratory syncytial virus (RSV), with the best burden of illness in infants and younger kids.

Many researchers have tried to cut back this burden by way of RSV vaccines and antivirals. Now, a brand new examine, revealed on-line within the journal Viruses, describes the antiviral exercise of the accredited drug probenecid in opposition to this virus.

Research: Probenecid Inhibits Respiratory Syncytial Virus (RSV) Replication. Picture Credit score: Iren_Geo/Shutterstock


RSV causes over 150,000 hospitalizations amongst kids every year, and tons of of thousands and thousands of {dollars} are spent on healthcare expenditures because of this pathogen.

At current, solely ribavirin and palivizumab are recognized to have any exercise in opposition to RSV, that too with combined outcomes. The truth is, the emergence of resistance mutations to the latter, which must be given month-to-month by injection to high-risk infants all through the RSV season, will scale back its efficacy significantly from the present 50% lower in RSV-related toddler hospitalizations.

Repurposing is an accepted method whereby already accredited medication are efficiently proven to be efficient for one more indication, slicing down on drug growth prices and the timeline for approval and advertising and marketing. A method is to look at the pathways whereby viruses work together with their hosts, in order to determine druggable targets.

For example, discovering a bunch cell protein that’s required for viral replication might assist determine a drug that targets that protein.

This might assist discover an antiviral that acts in opposition to a number of viruses by way of a standard pathway. Within the present paper, the researchers carried out high-throughput screening (HTS) together with RNA interference (RNAi), to be able to silence particular host genes and thus discover out which of the host genes and mobile pathways are necessary as druggable antiviral targets.

The present examine builds on earlier work by the identical group to seek out genes of potential significance within the inhibition of influenza A virus (IAV) replication. Right here, that they had discovered that natural anion transporter-3 (OAT3) gene is important on this course of, and that the OAT3 or SLC22A8 gene is inhibited by the accredited uricosuric drug probenecid.

On this means, probenecid was in a position to drastically scale back the replication of IAV in cell cultures and in mice. The SLC gene household is widespread to people and mice. When cells in tradition had been induced to specific siRNA that focused the OAT3 gene, IAV replication stopped. The specificity of this motion was indicated by the shortcoming of OAT1, OAT2, OAT4 and OAT7 inhibitors to attain the identical outcome.

Probenecid is each concerned in uric acid excretion in urine and in OAT3 inhibition, and is used broadly for the therapy of gout. It’s nicely tolerated and has few adversarial results, however could produce other results on the inflammatory system by way of its motion on different ion channels. The truth that it doesn’t goal RNA-dependent RNA polymerase attracted the eye of the present group of scientists.


The usage of probenecid in three totally different cell traces and in mice confirmed a marked drop in RSV replication, as anticipated from earlier research involving influenza virus and the at the moment circulating extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2). No toxicity was evident.

The drug had equal efficacy in opposition to RSV A and RSV B. The identical outcomes had been noticed with RSV-infected mice, with a major discount in virus load. This was mediated by way of a discount in OAT3 expression. When pretreated with probenecid, cells turned proof against RSV replication, with the half-maximal inhibitory focus (IC50) in opposition to RSV A2 being <0.1 uM, and in opposition to RSV B1 0.85 uM.

In different phrases, this drug affected RSV replication at nanomolar concentrations, which may be very a lot decrease than the focus required to inhibit IAV replication. Each pre-treatment and post-exposure administration of probenecid confirmed the flexibility to cut back lung viral titers, comparable to the prophylactic and therapeutic utility of this drug in RSV an infection.


Based on the researchers,

The research confirmed that nanomolar concentrations of all probenecid regimens forestall RSV pressure A and B replication in vitro and RSV pressure A in vivo, representing a possible prophylactic and chemotherapeutic for RSV.”

Such information factors to the necessity to discover using probenecid to stop RSV an infection in kids aged 2-14 years, who’ve been examined for security when administered this drug together with antibiotics. Additional research will likely be required to ascertain its efficacy in vivo, and utilizing different RSV strains.

The required dosing protocols and period of therapy and the additional results of the drug on communication between cells and on the inflammatory cascade, attributable to the function of probenecid on pannexin 1 channels, must be elucidated.

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