Filociclovir Is a Potent In Vitro and In Vivo Inhibitor of Human Adenoviruses

• Published in: Antimicrobial agents and chemotherapy 2020-10, Vol.64 (11)
• Main Authors: Toth, Karoly, Hussein, Islam T M, Tollefson, Ann E, Ying, Baoling, Spencer, Jacqueline F, Eagar, Jessica, James, Scott H, Prichard, Mark N, Wold, William S M, Bowlin, Terry L
• Format: Article
• Language: English
• Subjects: Adenovirus Infections, Human - drug therapy; Adenoviruses, Human; Animals; Antiviral Agents; Antiviral Agents - pharmacology; Antiviral Agents - therapeutic use; Cricetinae; Cytomegalovirus Infections - drug therapy; Humans; Virus Replication
• ISSN: 0066-4804; 1098-6596
• DOI: 10.1128/AAC.01299-20

Human adenovirus (HAdV) infection is common in the general population and can cause a range of clinical manifestations, among which pneumonia and keratoconjunctivitis are the most common. Although HAdV infections are mostly self-limiting, infections in immunocompromised individuals can be severe. No antiviral drug has been approved for treating adenoviruses. Filociclovir (FCV) is a nucleoside analogue which has successfully completed phase I human clinical safety studies and is now being developed for treatment of human cytomegalovirus (HCMV)-related disease in immunocompromised patients. In this report, we show that FCV is a potent broad-spectrum inhibitor of HAdV types 4 to 8, with 50% effective concentrations (EC s) ranging between 1.24 and 3.6 μM and a 50% cytotoxic concentration (CC ) of 100 to 150 μM in human foreskin fibroblasts (HFFs). We also show that the prophylactic oral administration of FCV (10 mg/kg of body weight) 1 day prior to virus challenge and then daily for 14 days to immunosuppressed Syrian hamsters infected intravenously with HAdV6 was sufficient to prevent morbidity and mortality. FCV also mitigated tissue damage and inhibited virus replication in the liver. The 10-mg/kg dose had similar effects even when the treatment was started on day 4 after virus challenge. Furthermore, FCV administered at the same dose after intranasal challenge with HAdV6 partially mitigated body weight loss but significantly reduced pathology and virus replication in the lung. These findings suggest that FCV could potentially be developed as a pan-adenoviral inhibitor.