Development of therapeutic fusion inhibitor peptides for Measles encephalitis

尽管努力通过疫苗根除麻疹(MV)，但它在全球范围内仍会导致疾病，主要是因为 它很容易在人与人之间传播。目前，MV的地方性特性阻碍了根除MV 发展中国家的疫苗接种率和发达国家的疫苗接种率下降。MV病是 由于暂时性免疫，一般有几种危及生命的并发症 抑制和对中枢神经系统(CNS)的侵袭。 MV感染后的中枢神经系统表现可能发生在感染后的早期，如急性 脑脊髓炎。 MV引起的中枢神经系统疾病的第二种形式，即众所周知的进行性传染性脑炎 麻疹包涵体脑炎(MIBE)，发生在免疫抑制患者1-6个月后 麻疹感染。这是一种致命的后遗症，在不断增长的中国人口中很常见 免疫功能低下的患者，不能接受MV疫苗接种或对MV疫苗有反应。 MV引起的第三种神经系统疾病-亚急性硬化性全脑炎(SSPE)- 即使在存在中和抗体的情况下，也会在感染数年后导致致命后果。数据来自 美国最近的疫情表明，SSPE的发病率可以高达每600名受感染的婴儿中就有一名， 突出了这种疾病对免疫能力强的人群的重要性。 对于麻疹的急性或持续性中枢神经系统症状，尚无特效治疗方法。我们有 应用基础研究成果开发针对MV CNS感染的新的抗病毒策略， 基于在MV进入过程中抑制膜融合。这一应用的一个主要推动力是我们的发现 将脂质部分附着到多肽(称为C-肽)融合抑制物上会产生三种主要的 优点：(1)增强了效力；(2)能够跟随病毒到达融合激活的位置；以及(3) 中枢神经系统的穿透。我们已经证明，我们的原型C-肽可以预防致命的脑炎 转基因小鼠模型。我们建议评估新改进的融合术的疗效。 抑制性C-肽。该策略将在体外、体外和体内使用野生型毒株MV进行评估。 以及免疫受损小鼠的中枢神经系统适应株。拟议的工作将涉及两个具体的 目标： 1.评价C肽融合抑制剂的抗病毒作用：体外和体外研究。 2.评价C肽融合抑制剂对MV体内感染的治疗效果 为临床前期开发提供概念验证。

Measles (MV) causes disease worldwide despite efforts towards eradication by vaccine, largely because it is spread so readily between people. MV eradication is currently hindered by the endemic nature of MV in developing countries and the decreasing rate of vaccination in developed countries. MV disease is generally self-limited with several life-threatening complications due to the temporary immune suppression and to the central nervous system (CNS) invasion. CNS manifestations following MV infection may occur early after infection, in the case of acute encephalomyelitis. A second form of MV-induced CNS disease, progressive infectious encephalitis, known as measles inclusion body encephalitis (MIBE), occurs in immunosuppressed patients 1 to 6 months after measles infection. This is a lethal sequela that is common in the growing population of immunocompromised patients, who cannot receive or respond to MV vaccination. A third form of MV-induced neurological disease – subacute sclerosing panencephalitis (SSPE) – leads to fatal outcomes years after infection even in the presence of neutralizing antibodies. Data from recent US outbreaks show that the incidence of SSPE can be as high as 1 every 600 infected infants, highlighting the significance of this disease also for the immune competent population. There is no specific therapy for acute or persistent CNS manifestations of measles. We have applied the results of fundamental research to develop a new antiviral strategy for MV CNS infection, based on inhibiting membrane fusion during MV entry. A major impetus for this application is our finding that attachment of lipid moieties to a peptide (termed C-peptide) fusion inhibitor yields three major advantages: (1) increased potency; (2) ability to follow the virus to the site of fusion activation; and (3) CNS penetration. We have shown that our prototypical C-peptide prevents lethal encephalitis in a transgenic mouse model. We propose to assess the therapeutic efficacy of newly improved fusion inhibitory C-peptides. The strategy will be assessed in vitro, ex vivo, and in vivo using wild-type strain MV and CNS adapted strains in immune-compromised mice. The proposed work will address two Specific Aims: 1. To assess the antiviral efficacy of C-peptide fusion inhibitors: in vitro and ex vivo studies. 2. To evaluate therapeutic efficacy of C-peptide fusion inhibitors against MV infection in vivo and to provide the proof of concept for pre-clinical development.