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Combined aerosolized Toll-like receptor ligands are an effective therapeutic agent against influenza pneumonia when co-administered with oseltamivir

tetano

Editor, Senior Moderator
Eur J Pharmacol. 2017 Oct 21. pii: S0014-2999(17)30684-2. doi: 10.1016/j.ejphar.2017.10.035. [Epub ahead of print]
[h=1]Combined aerosolized Toll-like receptor ligands are an effective therapeutic agent against influenza pneumonia when co-administered with oseltamivir.[/h] Leiva-Juarez MM[SUP]1[/SUP], Kirkpatrick CT[SUP]1[/SUP], Gilbert BE[SUP]2[/SUP], Scott B[SUP]3[/SUP], Tuvim MJ[SUP]1[/SUP], Dickey BF[SUP]4[/SUP], Evans SE[SUP]5[/SUP], Markesich D[SUP]3[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] Influenza pneumonia remains a common and debilitating viral infection despite vaccination programs and antiviral agents developed for prophylaxis and treatment. The neuraminidase inhibitor oseltamivir is frequently prescribed for established influenza A virus infections, but the emergence of neuraminidase inhibitor resistant viruses, a brief therapeutic window and competing diagnoses complicate its use. PUL-042 is a clinical stage, aerosol drug comprised of synthetic ligands for Toll-like receptor (TLR) 2/6 and TLR 9. This host-targeted, innate immune stimulant broadly protects against bacterial, fungal and viral pneumonias, including those caused by influenza, when given prophylactically to animals. This study evaluated the therapeutic antiviral effects of PUL-042 against established influenza A pneumonia, when given alone or in combination with oseltamivir. Mice were treated with PUL-042 aerosol, oseltamivir or both at varying time points before or after challenge with influenza pneumonia. Treating established, otherwise lethal influenza A pneumonia (>1 LD[SUB]100[/SUB]) with multiple inhaled doses of PUL-042 aerosol plus oral oseltamivir resulted in greater mouse survival than treatment with either drug alone. Single agent PUL-042 also protected mice against established infections following challenges with lower viral inocula (approximately 1 LD[SUB]20[/SUB]). Aerosolized oseltamivir further enhanced survival when co-delivered with PUL-042 aerosol. The prophylactic and therapeutic benefits of PUL-042 were similar against multiple strains of influenza virus. In vitro influenza challenge of human HBEC3kt lung epithelial cells revealed PUL-042-induced protection against infection that was comparable to that observed in vivo. These studies offer new insights into means to protect susceptible populations against influenza A pneumonia.
Copyright ? 2017. Published by Elsevier B.V.


[h=4]KEYWORDS:[/h] Influenza; Innate immunity; Oseltamivir; Toll-like receptor; Viral pneumonia

PMID: 29066417 DOI: 10.1016/j.ejphar.2017.10.035
 
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