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Antimicrobial Agents and Chemotherapy, April 2004, p. 1422-1425, Vol. 48, No. 4
0066-4804/04/$08.00+0 DOI: 10.1128/AAC.48.4.1422-1425.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
2'-Fluoro-2'-Deoxycytidine Inhibits Borna Disease Virus Replication and Spread
Jeffrey J. Bajramovic,1,
Romain Volmer,1,
Sylvie Syan,1 Sylvie Pochet,2 and Daniel Gonzalez-Dunia1,3*
Unité des Virus Lents, CNRS URA 1930,1
Unité de Chimie Organique, CNRS URA 2128, Institut Pasteur, Paris,2
INSERM U563, CPTP, Toulouse, France3
Received 1 July 2003/
Returned for modification 23 October 2003/
Accepted 16 December 2003

ABSTRACT
Borna disease virus (BDV) causes neurological diseases in a
variety of warm-blooded animal species, possibly including humans.
To date, there is no effective treatment against BDV infection.
Recently, we reported on the antiviral activity of 1-ß-
D-arabinofuranosylcytosine
(Ara-C). However, Ara-C's cytotoxic side effects are a major
obstacle for its therapeutic use. Herein, we demonstrate that
the nucleoside analog 2'-fluoro-2'-deoxycytidine (2'-FdC) exhibits
potent antiviral activity against BDV. Importantly, 2'-FdC-associated
cytotoxicity is negligible, indicating 2'-FdC as an excellent
candidate for the development of antiviral therapy against BDV.

TEXT
Borna disease virus (BDV) is a nonsegmented, negative-stranded
neurotropic RNA virus (
16). BDV is the causative agent of Borna
disease, a neurological disorder of horses, sheep, and other
farm animals (
17). Recent evidence suggests that BDV is distributed
worldwide, with a principal focus in Central Europe (
25). Natural
infections with BDV have been reported in a large variety of
warm-blooded animal species, among which are dogs (
27) and cats
(
19). There is considerable evidence that BDV also infects humans
(
20), making it a possible zoonotic agent. Human BDV infection
has been claimed to be associated with certain neuropsychiatric
disorders (
3,
20), although the epidemiology and the clinical
consequences of human infection remain controversial (
5,
20).
The importance of BDV infection in veterinary medicine, along with its possible association with human neuropsychiatric disorders, has inspired many groups to search for antiviral drugs against BDV. To date, there is no effective treatment against BDV. Amantadine was initially reported to have some antiviral activity against BDV (2) and has been used in clinical trials of BDV-positive patients with neuropsychiatric disorders (7-9). However, the antiviral activity could not be confirmed in other studies (6, 12, 26). It was suggested that the positive effect of amantadine on clinical parameters in these trials might be attributable instead to the described pharmacological activity of amantadine as a noncompetitive N-methyl-D-aspartate receptor antagonist (13). Several previous studies reported on the inhibitory effect of ribavirin on BDV replication (14, 18), but the effects were modest in vitro and in vivo (24). Recently, we have reported that the nucleoside analog 1-ß-D-arabinofuranosylcytosine (Ara-C) possesses potent antiviral activity against BDV (1). However, the cytotoxic side effects of Ara-C impede its therapeutic use against BDV infection. This obstacle inspired us to search for other compounds with anti-BDV activity but with less associated cytotoxicity. We selected two Ara-C-related cytosine nucleosides, 2'-fluoro-2'-deoxycytidine (2'-FdC) and 2',2'-difluoro-2'-deoxycytidine (gemcitabine), which have one or two fluorine atoms at the 2' position of the ribose ring (where Ara-C has a hydroxyl group) (Fig. 1). 2'-FdC is a fluoronucleoside for which a moderate antiviral activity toward human immunodeficiency virus and herpesviruses has been demonstrated previously (23, 28). Antiviral activity of 2'-FdC has never been demonstrated toward negative-stranded RNA viruses. It is interesting that previous studies have highlighted the minimal toxicity of 2'-FdC, in particular when compared to that of Ara-C. More detailed studies demonstrated that long-term treatment (90 days) of rats and woodchucks with dosages of up to 500 mg of 2'-FdC/kg of body weight/day was relatively nontoxic (21) in spite of the incorporation of 2'-FdC in liver DNA (22).
The antiviral activity of 2'-FdC was assessed by using different
in vitro tests. Previously, we showed that inhibition of BDV
replication by Ara-C was associated with a nuclear retention
of BDV antigens in infected cells (
1). We took advantage of
this characteristic to rapidly screen 2'-FdC and gemcitabine
for their potential to inhibit BDV replication in Vero cells
that were persistently infected with BDV (i.e., Vero-BV). Using
immunofluorescence analysis of BDV nucleoprotein expression,
we observed that of these two compounds, only 2'-FdC caused
nuclear retention of BDV antigens as Ara-C does (Fig.
2). In
addition, we tested Ara-C and 2'-FdC on two other cell lines
persistently infected with BDV, equine dermis cells (NBL6-BV)
and human astrocytoma cells (U373-BV). To our surprise, treatment
of those cell lines with Ara-C did not result in a nuclear retention
of viral proteins as robust as that seen in Vero-BV cells, whereas
the cytotoxic side effects of Ara-C treatment (reduced cell
density and altered shape of the cells) were clearly visible
(Fig.
2). In contrast, the characteristic nuclear accumulation
of BDV antigen was readily detectable upon 2'-FdC treatment
(Fig.
2), suggesting enhanced sensitivity of these cell lines
to 2'-FdC treatment compared to treatment with Ara-C. Thus,
the ability of 2'-FdC to inhibit BDV dissemination was confirmed
in a cell line of equine origin (NBL6), the natural BDV host
for which antiviral therapy is most sought. In addition, we
also showed that 2'-FdC was a potent inhibitor of BDV infection
and spread in primary hippocampal rat neurons (>98% inhibition,
data not shown). This finding is especially relevant since in
vivo, BDV replicates and persists predominantly in neurons of
the limbic system (
11).
Since BDV infectivity is tightly cell associated (
10) and efficient
transmission of BDV is likely to require cell-to-cell contact,
we next used a sensitive assay to analyze cell-to-cell spread
of BDV (
1). Confluent layers of Vero or NBL6 cells were labeled
with 5 (and 6)-carboxyfluorescein diacetate (CFDA) and subsequently
cocultivated for 5 days with unlabeled Vero-BV or NBL6-BV cells.
Cocultivation took place under daily treatment with different
doses of Ara-C, 2'-FdC, or gemcitabine. Both Ara-C and 2'-FdC
exerted potent anti-BDV activity on Vero-BV cells (Fig.
3),
whereas gemcitabine did not show anti-BDV activity (data not
shown). In order to correct for the antimitotic effects of Ara-C
on the different cell populations in the dissemination assay,
we calculated viral spread indices between Vero-BV and Vero
cells treated with Ara-C or 2'-FdC (Table
1). As shown in Table
1, treatment with 2'-FdC resulted in similar inhibition of BDV
spread compared to that of Ara-C. For NBL6-BV cells, gemcitabine
had no effect on BDV dissemination, and activity of Ara-C was
limited. In contrast, 2'-FdC was as active as it was on Vero-BV
cells (Fig.
3).
View this table:
[in this window]
[in a new window]
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TABLE 1. Normalized viral spread indices (SI) and percent inhibition of viral spread of 2'-FdC and Ara-C treatments measured in dissemination assays between Vero-BV and Vero cellsa
|
We next assessed the effects of 2'-FdC treatment on viral RNA
levels in Vero-BV cells by analyzing total cellular RNA by Northern
blotting. We used strand-specific oligonucleotide probes for
BDV mRNA and BDV genomic RNA, and we used random-primed probes
for BDV total RNA and glyceraldehyde-3-phosphate dehydrogenase
(GAPDH; a host cell housekeeping gene) mRNA (Fig.
4). We observed
a dose-dependent inhibition of both BDV genomic RNA (up to 84%)
and BDV mRNA (up to 99% inhibition of the 1.2-kb transcript
coding for BDV-N) upon treatment with 2'-FdC. In addition, Western
blotting showed that the expression levels of BDV-N and phosphoprotein
(P) were decreased upon 2'-FdC treatment (Fig.
4). Quantification
of the signal showed up to 95% inhibition of BDV-N levels compared
to expression levels in untreated cells and showed up to 90%
inhibition for BDV-P (Fig.
4). At a comparable dose (4 µM),
2'-FdC was as effective as Ara-C in inhibiting BDV RNA and protein
levels.
Treatment with nucleoside analogs is typically accompanied by
cytotoxic side effects. To assess the potential cytotoxic effects
of treatment with 2'-FdC, Vero cells were treated with different
concentrations of 2'-FdC or Ara-C, and cell viability was measured
by using the Uptiblue viable cell counting assay (Interchim),
which is based on the detection of metabolic activity of the
cells. Ara-C treatment produced a sharp, concentration-dependent
reduction in cell viability (74%). In contrast, treatment with
up to 100 µM 2'-FdC did not result in a concentration-dependent
loss of cell viability. Reduction of cell viability was limited
to a maximum of 21% at a concentration of 20 µM (Fig.
5, left). Treatment with concentrations of 2'-FdC that inhibit
BDV replication (5 to 10 µM) did not result in a loss
of cell viability. In order to test for potential cytostatic
effects, we compared the number of cells after 5 days of daily
treatment with Ara-C, 2'-FdC, gemcitabine, or no treatment.
Treatment with 5 µM Ara-C resulted in a 20-fold reduction
of cell numbers (Fig.
5, right). This reduction was comparable
to the reduction of cell numbers after treatment with 20 µM
gemcitabine, which is well known for its cytostatic potential
(
4). In contrast, treatment with 10 µM 2'-FdC resulted
in an only twofold reduction of total cell numbers compared
to that of untreated cells (Fig.
5, right).
In this study, we describe for the first time that the nucleoside
analog 2'-FdC exhibits antiviral activity against BDV. Its activity
is comparable to that of Ara-C. In addition, some cell lines
exhibit enhanced susceptibility to the antiviral action of 2'-FdC
when compared to that of Ara-C. This difference in sensitivity
of the tested cell lines to 2'-FdC might be accounted for by
variations in intracellular content of the cellular enzyme deoxycytidine
kinase (dCK). Once in the cell, dCK converts cytidine/deoxycytidine
(its natural substrates), 2'-FdC, and Ara-C into their monophosphorylated
metabolites. These are in turn converted into triphosphorylated
metabolites by nucleoside monophosphate kinase and nucleoside
diphosphate kinase, respectively. During this process, the phosphorylation
by dCK is the rate-limiting step. As a consequence, the antiviral
activities of 2'-FdC and Ara-C are directly dependent on the
availability of dCK in the cell. Since the affinity of dCK for
2'-FdC is much stronger than its affinity for Ara-C (
15), 2'-FdC
might be more effective than Ara-C in cells with a relatively
low dCK content. Finally, since 2'-FdC is not cytotoxic, even
at concentrations that exceed the effective dose by 5- to 10-fold,
it represents the most attractive candidate to date for the
development of effective antiviral therapy against BDV.

ACKNOWLEDGMENTS
This work was supported by grants from the Institut Pasteur,
the Pasteur-Weizmann council, the CNRS, and INSERM Avenir. J.J.B.
is a recipient of a Marie Curie fellowship of the European Community
program "Improving Human Research Potential and the Socio-Economic
Knowledge Base" under contract number HPMF-CT-2000-01088. R.V.
is sponsored by a grant from the French Ministry of Research.
We thank M. Brahic, S. B. Geutskens, A. Hans, and L. Sartorius for critically reading the manuscript.

FOOTNOTES
* Corresponding author. Mailing address: INSERM U563, CPTP Batiment B, Place du Dr. Baylac, 31300 Toulouse, Cedex 3, France. Phone: 33-5-6274-4511. Fax: 33-5-6177-9291. E-mail:
Daniel.Dunia{at}toulouse.inserm.fr.

J.J.B. and R.V. contributed equally to this work. 

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Antimicrobial Agents and Chemotherapy, April 2004, p. 1422-1425, Vol. 48, No. 4
0066-4804/04/$08.00+0 DOI: 10.1128/AAC.48.4.1422-1425.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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