Study the new method which helps to understand failures of
hepatitis C antiviral drug (in clinical trials) and also help in identifying the
medication that eliminates all adverse effects, thanks to a research team led
by Craig Cameron, the Paul Berg Professor of Biochemistry and Molecular Biology
at Penn State University.
The team's findings, published in the current issue of the journal PLOS
Pathogens, may help pave the way toward the development of safer and
more-effective treatments for hepatitis C, as well as other pathogens such as
SARS and West Nile virus.
First author Jamie Arnold, a research associate in Cameron's lab
at Penn State, explained that the hepatitis C virus (HCV), which affects over
170,000,000 people worldwide, is the leading cause of liver disease and,
although antiviral treatments are effective in many patients, they cause
serious side effects in others. "Many antiviral medications for treating
HCV are chemical analogs for the building blocks of RNA that are used to
assemble new copies of the virus's genome, enabling it to replicate," he
said. "These medications are close enough to the virus's natural building
blocks that they get incorporated into the virus's genome. But they also are
different in ways that lead to the virus's incomplete replication. The problem,
however, is that the medication not only mimics the virus's genetic material,
but also the genetic material of the patient. So, while the drug causes damage
to the virus, it also may affect the patient's own healthy tissues."
A method to reveal these adverse side effects in the safety of a
laboratory setting, rather than in clinical trials where patients may be placed
at risk, has been developed by the research team, which includes Cameron;
Arnold; Suresh Sharma, a research associate in Cameron's lab; other scientists
at Penn State; and researchers from other academic, government, and corporate
labs. "We have taken anti-HCV medications and, in Petri dishes and test
tubes, we have shown that these drugs affect functions within a cell's
mitochondria," Cameron explained. "The cellular mitochondria -- a
tiny structure known as 'the powerhouse of the cell' that is responsible for
making energy known as ATP -- is affected by these compounds and is likely a
major reason why we see adverse effects." Cameron noted that scientists
have known for some time that certain individuals have "sick"
mitochondria. Such individuals are likely more sensitive to the mitochondrial
side effects of antiviral drugs.
"We know that antiviral drugs, including the ones used to
treat HCV, affect even normal, healthy mitochondria by slowing ATP
output," Arnold added. "While a person with normal mitochondria will
experience some ATP and mitochondrial effects, a person who is already
predisposed to mitochondrial dysfunction will be pushed over the 'not enough
cellular energy' threshold by the antiviral drug. The person's mitochondria
simply won't be able to keep up."
One of the problems with clinical trials, Arnold explained, is
that a drug may be shown to be quite effective but, if even a miniscule
percentage of patients have side effects, the U.S. Food and Drug Administration
is obligated to put the trial on hold or stop the trial altogether. This
possibility makes drug companies reluctant to invest money in drug trials after
an adverse event has been observed, even when the drugs could still help
millions of people. The researchers hope that their methods eventually will
become a part of the pre-clinical development process for this class of
antiviral drugs. "If we can show, in the lab, that a drug will cause side
effects, then these compounds will not enter lengthy, expensive clinical trials
and cause harm to patients " he said. "What's more, a drug company
can invest its money more wisely and carefully in drug research that will
produce safe and effective products. Better and more-willing investments by
drug companies ultimately will help patients, because resources will be spent
developing drugs that not only work, but that are safe for all patients."
Cameron added that the next step for his team is to identify the
genes that make some individuals respond poorly to these particular antiviral
treatments. "By taking blood samples from various patients and using the
new method to test for toxicity in the different samples, we hope to discover
which individuals will respond well and which will experience mitochondrial
reactions, based on their genetic profiles," he said. "That is, we
hope to use this method as a step toward truly personalized medicine, opening
the door to pre-screening of patients so that those with mitochondrial diseases
can be treated with different regimens from the start."
The team members also hope their method will be a means to study
toxicity and side effects in other diseases. "Specifically, our technology
will illuminate toxicity of a particular class of compounds that interrupts
viral RNA synthesis," Cameron said. "While this class of compounds
currently is being developed for treatment of HCV, a wide range of other RNA
viruses, including West Nile virus, Dengue virus, SARS coronavirus, and perhaps
even the Ebola virus, could be treated using this class of compounds as well."
In addition to Cameron, Arnold, and Sharma, other researchers who
contributed to this study include Eric D. Smidansky from Penn State; Joy Y.
Feng, Adrian S. Ray, Aesop Cho, Jason Perry, Jennifer E. Vela, Yeojin Park,
Yili Xu, Yang Tian, Darius Babusis, Ona Barauskus, and Weidong Zhong from
Gilead Sciences, Inc.; Maria L. Kireeva and Mikhail Kashlev from the Frederick
National Laboratory for Cancer Research; Blake R. Peterson from the University
of Kansas; and Averell Gnatt from the University of Maryland School of
Medicine.
The research was funded by the National Institutes of Health and a
Penn State Paul Berg Endowment.
Journal Reference:
1. Jamie J. Arnold, Suresh D. Sharma, Joy Y. Feng,
Adrian S. Ray, Eric D. Smidansky, Maria L. Kireeva, Aesop Cho, Jason Perry,
Jennifer E. Vela, Yeojin Park, Yili Xu, Yang Tian, Darius Babusis, Ona
Barauskus, Blake R. Peterson, Averell Gnatt, Mikhail Kashlev, Weidong Zhong,
Craig E. Cameron. Sensitivity of Mitochondrial Transcription and
Resistance of RNA Polymerase II Dependent Nuclear Transcription to Antiviral
Ribonucleosides. PLoS Pathogens, 2012; 8 (11): e1003030 DOI:10.1371/journal.ppat.1003030
Source:
The above story is reprinted from materials provided
by Penn
State. The original article was written by Katrina Voss.
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