Chapter 14 : Antirespiratory Virus Agents

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This chapter reviews antiviral agents that have been, or are being, developed to treat or prevent respiratory viral infections. Detailed information is provided for approved agents and those in more advanced stages of clinical development. Agents in Phase I human studies or promising approaches that are still in preclinical development are described briefly. The reader is referred to the respective pathogen-specific chapters for full discussions of the viral agents and the diseases they cause.

Citation: Pereira M, Miko B, Mehta M, Hammer S. 2017. Antirespiratory Virus Agents, p 271-290. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch14
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Image of FIGURE 1

Molecular structures of M2 protein inhibitors amantadine (A) and rimantadine (B).

Citation: Pereira M, Miko B, Mehta M, Hammer S. 2017. Antirespiratory Virus Agents, p 271-290. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch14
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Image of FIGURE 2

Replicative cycle of influenza virus. The influenza virus is shown binding to the surface of an airway epithelial cell via the interaction of hemagglutinin (HA) with sialic acid residues. HA is subsequently cleaved by a protease, and the virus is endocytosed. The M2 protein allows hydrogen ions to enter the virion, promoting the dissociation of ribonuclear protein and release of viral nucleic acids into the cytoplasm (uncoating). Viral RNA replication occurs in the nucleus by the viral RNA polymerase (RNAp) complex. Following replication of viral RNA and synthesis of structural/nonstructural proteins, virions are assembled and released. Sites of action of antiviral compounds are shown by a solid line.

Citation: Pereira M, Miko B, Mehta M, Hammer S. 2017. Antirespiratory Virus Agents, p 271-290. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch14
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Image of FIGURE 3

Schematic representation of the closed-state structure of the M2 protein channel by solid-state nuclear magnetic resonance (NMR) spectroscopy. Tetrameric assembly is shown from the side (A) and top (B). (Source: Nishimura K et al., 2002;13170–13177.) This image is cited as being in the public domain.

Citation: Pereira M, Miko B, Mehta M, Hammer S. 2017. Antirespiratory Virus Agents, p 271-290. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch14
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Image of FIGURE 4

Molecular structures of the neuraminidase inhibitors oseltamivir (A), zanamivir (B), and peramivir (C).

Citation: Pereira M, Miko B, Mehta M, Hammer S. 2017. Antirespiratory Virus Agents, p 271-290. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch14
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Image of FIGURE 5

Molecular structure of ribavirin.

Citation: Pereira M, Miko B, Mehta M, Hammer S. 2017. Antirespiratory Virus Agents, p 271-290. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch14
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