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Antimicrobial Agents and Chemotherapy, December 1998, p. 3285-3289, Vol. 42, No. 12
Rega Institute for Medical Research,
Katholieke Universiteit Leuven, Leuven, Belgium
Received 17 March 1998/Returned for modification 6 May
1998/Accepted 5 October 1998
Mycophenolate mofetil (MMF) has been approved as an
immunosuppressive agent in kidney transplant recipients and may thus be used concomitantly with antiherpetic agents, which are used for the
treatment of intercurrent herpesvirus infections. We have recently
demonstrated that MMF and its parent compound mycophenolic acid (MPA),
which is a potent inhibitor of IMP dehydrogenase, potentiate the
antiherpesvirus activity of acyclovir, ganciclovir, and penciclovir. We
have now evaluated the antiviral efficacy of the combination of MPA and
the novel antiherpesvirus agent H2G
[(R)-9-[4-hydroxy-2-(hydroxymethyl)butyl]guanine]. When
combined with H2G, MPA (at concentrations ranging from 0.25 to 10 µg/ml, which are readily attainable in human plasma) markedly
potentiated the antiviral efficacy of H2G against herpes simplex virus
type 1 (HSV-1) and type 2 (HSV-2), as reflected by a 10- to 150-fold decrease in the 50% effective concentration. Moreover, the
activity of H2G against a thymidine kinase-deficient strain of HSV-1
(TK
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
The Antiherpesvirus Activity of H2G
[(R)-9-[4-Hydroxy-2-(Hydroxymethyl)Butyl]Guanine] Is
Markedly Enhanced by the Novel Immunosuppressive Agent
Mycophenolate Mofetil
HSV-1) was increased more than 2,500-fold when
combined with MPA. MPA by itself had little or no effect on the
replication of these viruses. Similar observations were made for
varicella-zoster virus. Also, ribavirin (another inhibitor of IMP
dehydrogenase) caused a marked enhancement of the activity of H2G
against HSV-1 (10-fold), HSV-2 (10-fold), and TK
HSV-1
(>185-fold). Exogenously added guanosine reversed the potentiating effects of MPA on the antiviral activity of H2G, indicating that this
potentiating effect resulted from a depletion of the endogenous dGTP
pools, thus favoring the inhibitory action of the H2G triphosphate on
the viral DNA polymerase.
*
Corresponding author. Mailing address: Rega Institute
for Medical Research, Minderbroedersstraat 10, B-3000 Leuven, Belgium. Phone: 32-16-33.73.41. Fax: 32-16-33.73.40. E-mail:
johan.neyts{at}rega.kuleuven.ac.be.
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