Alkoxyalkyl prodrugs of acyclic nucleoside phosphonates enhance oral antiviral activity and reduce toxicity: Current state of the art

作者：Hostetler Karl Y

来源：Antiviral Research, 2009, 82(2): A84-A98.

DOI：10.1016/j.antiviral.2009.01.005

• Lysophospholipids
• Ether lipids
• Prodrugs
• Alkoxyalkyl esters
• Hexadecyloxypropyl-cidofovir
• Hexadecyloxypropyl-tenfovir
• Hexadecyloxypropyl-(S)-HPMPA
• Vaccinia virus
• Cowpoxvirus
• Ectromelia virus
• Cytomegalovirus
• Adenovirus
• HIV-1
• Hepatitis B virus

Although the acyclic nucleoside phosphonates cidofovir, adefovir and tenofovir are approved for treating human cytomegalovirus, hepatitis B and HIV infections, respectively, their utility is limited by low oral bioavailability, renal toxicity and poor cell penetration. Research over the past decade has shown that these undesirable features can be eliminated by esterifying the compounds with all alkoxyalkyl group, in effect disguising them as lysophospholipids. In this modified form, the drugs are readily taken up in the gastrointestinal tract and have a prolonged circulation time in plasma. The active metabolite also has a long half life within cells, permitting infrequent closing. Because these modified drugs are not recognized by the transport mechanisms that cause the accumulation of acyclic nucleoside phosphonates in renal tubular cells, they lack nephrotoxicity. Alkoxyalkyl esterification also markedly increases the in vitro antiviral activity of acyclic nucleoside phosphonates by improving their delivery into cells. For example, all alkoxyalkyl ester of cyclic-cidofovir, a less soluble Compound. retains anti-CMV activity for 3 months following a single intravitreal injection. Two of these novel compounds, hexadecyloxypropyl-cidofovir (CMX001) and hexadecyloxypropyl-tenofovir (CMX157) are now in clinical development. This article focuses oil the hexadecyloxypropyl and octaclecyloxyethyl esters of cidofovir and (S)-HIMPA, describing their synthesis and the evaluation of their in vitro and in vivo activity against a range of orthopoxvit-uses, herpesviruses, adenoviruses and other double-stranded DNA Viruses. The extension to other nucleoside phosphonate antivirals is highlighted, demonstrating that this novel approach call markedly improve the medicinal properties of these drugs. Published by Elsevier B.V.

• 出版日期2009-5