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Vol. 63, Issue 3, 678-681, March 2003
Department of Medicine, San Diego VA Healthcare System and the
University of California, San Diego, La Jolla, California
Recently, there has been renewed interest in finding orally
active drugs against smallpox. Cidofovir (CDV) given by parenteral injection has been shown to protect against lethal poxvirus infection. We have been interested in the synthesis and evaluation of orally active derivatives of CDV. Previous studies showed that the CDV and
cyclic cidofovir (cCDV) analogs
1-O-hexa-decyloxypropyl-CDV (HDP-CDV) and
1-O-hexadecyloxypropyl-cCDV (HDP-cCDV), show >100-fold increases in antiviral activity versus the unmodified nucleosides against cells infected with orthopoxviruses, cowpox, and vaccinia virus. In contrast to CDV, HDP-CDV is orally bioavailable and has been
reported to be orally active in lethal cowpox virus infection in mice.
To assess the metabolic basis for the increased antiviral activity of
HDP-CDV in vitro, we studied the cellular uptake and anabolic
metabolism of 14C-labeled CDV, cCDV, and their
alkoxyalkanol esters HDP-CDV and HDP-cCDV. HDP-CDV and HDP-cCDV were
taken up rapidly by MRC-5 human lung fibroblasts in vitro, but uptake
of CDV and cCDV was much slower. Analysis of cellular metabolites
showed that levels of cidofovir diphosphate (CDV-DP), the active
antiviral compound, were >100 times greater with HDP-CDV than levels
observed with CDV. When cells were exposed to HDP-CDV, the
intracellular half-life of CDV-DP was 10 days versus 2.7 days reported
when cells are exposed to CDV. HDP-CDV seems to circumvent poor
cellular uptake by rapid association with cellular membrane
phospholipids, whereas CDV uptake proceeds via the slow process of
fluid endocytosis.
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