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2019 ; 176
(19
): 3834-3844
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Repurposing drugs targeting the P2X7 receptor to limit hyperinflammation and
disease during influenza virus infection
#MMPMID31271646
Rosli S
; Kirby FJ
; Lawlor KE
; Rainczuk K
; Drummond GR
; Mansell A
; Tate MD
Br J Pharmacol
2019[Oct]; 176
(19
): 3834-3844
PMID31271646
show ga
BACKGROUND AND PURPOSE: Severe influenza A virus (IAV) infections are associated
with damaging hyperinflammation that can be fatal. There is an urgent need to
identify new therapeutic agents to treat severe and pathogenic IAV infections.
Repurposing of drugs with an existing and studied pharmacokinetic and safety
profile is a highly attractive potential strategy. We have previously
demonstrated that the NLRP3 inflammasome plays time-dependent roles during severe
IAV infection with early protective responses and later dysregulation leading to
excessive inflammation, contributing to disease severity. EXPERIMENTAL APPROACH:
We tested two existing drugs, probenecid and AZ11645373, to target P2X7 receptor
signalling and dampen NLRP3 inflammasome responses during severe IAV infection.
In vitro, the drugs were assessed for their ability to limit NLRP3
inflammasome-dependent IL-1? secretion in macrophage cultures. In vivo, their
effects were assessed on hyperinflammation and disease during severe IAV
infection in C57BL/6 mice. KEY RESULTS: Treatment of macrophages with probenecid
or AZ11645373 in vitro diminished NLRP3 inflammasome-dependent IL-1? secretion.
Intranasal therapeutic treatment of mice displaying severe influenza disease with
probenecid or AZ11645373 reduced pro-inflammatory cytokine production, cellular
infiltrates in the lung, and provided protection against disease. Importantly,
these drugs could be administered at either early or late stage of disease and
provide therapeutic efficacy. CONCLUSIONS AND IMPLICATIONS: Our study
demonstrates that the anti-inflammatory drugs probenecid and AZ11645373, which
have documented pharmacokinetics and safety profiles in humans, are effective at
dampening hyperinflammation and severe influenza disease providing potentially
new therapeutic strategies for treating severe or pathogenic IAV infections.