[Attempt at treatment with methisazone of an infant with vaccinia and herpes simplex viruses].
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In vitro antiviral activity of 11 different drugs against the viruses of infectious bovine rhionotracheitis (IBR) and bovine viral diarrhea (BVD) was studied. The ID50 of the drugs were determined in monolayers of cell cultures MDBK and KCT: 20 mcg/ml for anandin, 25 mcg/ml for polyprenole, 50 mcg/ml for bromuridin, methisazone, aciclovir, gossypole, ribavirin and liposomal ribavirin, 100 mcg/ml for eracond, and 200 mcg/ml for phosprenil and argovit. Phosprenil was the only drug that showed virucidal activity against the IBR virus. All the drugs inhibited reproduction of the IBR virus in sensitive cell culture MDBK: 100,000-fold inhibition by bromuridin, aciclovir, ribavirin and methisazone, 1000-10000-fold inhibition by liposomal ribavirin, gossypole, anandin, polyprenole and phosprenil, 100-fold inhibition by eracond and argovit. As for the BVD virus, bromuridin, phosprenil, polyprenole, methisazone, aciclovir, gossypole, argovit, ribavirin and liposomal ribavirin also showed their activity in cell culture KCT (100-10,000-fold inhibition). The other drugs were ineffective.
In this paper ectodermal lesions on the tails of mice inoculated intravenously with vaccinia virus were used to study the influence of N,N'-bis[methylisatin-beta-thiosemicarbazone]-2-methylpiperazine (TSKI VI) on the number and dynamics of lesion formations. The activity of this compound was compared to that of the antiviral drug, methisazone. The reduction in lesions after treatment with TSKI VI was similar to the reduction induced by methisazone, which, on the basis of earlier theroretical and experimental data as well as on the lower toxicity of TSKI VI for the tissues and a more favorable therapeutic index, makes this compound worth considering in the treatment of postvaccinal complications. This method proved very useful in examination of the substances having potential prophylactic properties in preventing generalized infections.
The era of antiviral chemotherapy started more than 50 years with the findings by Domagk and his colleagues that thiosemicarbazones showed activity against vaccinia virus. One of the derivatives, methisazone, was even investigated in the prophylaxis of smallpox. With the successful implementation of the smallpox vaccine, the use of methisazone was not further pursued. Should there be a threat of smallpox or other poxvirus infections, that could not be immediately controlled by vaccination, a therapeutic intervention could be envisaged based on several therapeutic strategies targeted at such cellular enzymes as IMP dehydrogenase, SAH hydrolase, OMP decarboxylase and CTP synthetase, as well as viral enzymes such as the DNA polymerase. Most advanced as a therapeutic or early prophylactic modality to tackle poxvirus infection is cidofovir, which was found active (i) in vitro against all poxviruses studied so far; (ii) in vivo, against vaccinia and cowpox virus infections in experimental animal models; as well as (iii) some human poxvirus infections, such as molluscum contagiosum. In case of an inadvertent poxvirus epidemic, antiviral therapy (i.e. with cidofovir) will offer the possibility to provide short-term prophylaxis, or therapy. Cidofovir should also allow to treat severe complications of vaccination as may happen in for example immunosuppressed patients.
The inhibitory effect of N,N'-bis(methylisatin-beta-thiosemicarbazone)-2-methylpiperazine (compound TSKI-VI) and methisazone (Marboran) on the growth of vaccinia virus (IHD strain) was studied in vitro and in vivo. The therapeutic indices of both compounds determined in vivo were similar, but TSKI-VI was found more efficient in vitro.
The development of antiviral agents has been hindered by a variety of problems. There are fundamental biological differences between viruses and other infectious agents. Viruses are strictly dependent on cellular metabolic processes and possess very limited intrinsic enzyme systems and building blocks which may serve as targets for drugs. Antiviral drugs must also possess the ability to enter the host cell. Viral replication consists of a series of events, each of which can be interfered with, leading to interruption of the viral replication cycle. Currently, the major antiviral agents in therapeutic use are amantadine, idoxuridine and vidarabine. Methisazone and isoprinosine are also used in some areas. Immunoglobulins have some antiviral activity. Immune serum globulin and high titred hepatitis B immune globulin have both been used in prophylaxis of viral hepatitis. However, studies in this area have not been well controlled and results in some areas are conflicting. Interferon appears to be the most exciting antiviral agent yet discovered. However, its potential is limited by its availability, which remains dependent on biological method. Significant progress has been made recently, though, which may lead to the chemical synthesis of interferon and thus to an antiviral agent active against many viruses.
N,N'-bis(methylisatin-beta-thiosemicarbazone)-2-methylpiperazine (TSKI-VI) proved to be significantly effective against lethal vaccinia, pseudorabies and Mengo virus-induced encephalitis in different strains of mice when administered subcutaneously (s.c.) in doses of 20 mg/kg body weight, twice daily, for a period of five days. The strongest effects occurred in vaccinia virus-infected mice, and the degree of protection was both dose- and virus-dependent. Titres of vaccinia virus in brains of infected mice were slightly lower in TSKI-VI or methisazone-treated mice as compared to virus controls.
Only a few agents with antiviral activity are available for routine clinical use. Amantadine hydrochloride is effective in the prophylaxis of influenza A. In addition, accumulated evidence shows that amantadine has some therapeutic effect when used early in the course of an influenza A infection. Idoxuridine and adenine arabinoside have found application as topical agents in the treatment of herpes simplex keratitis. Adenine arabinoside has also been approved for the treatment of disseminated infections due to herpes zoster and herpes simplex. Acyclovir sodium has been approved as a topical agent in the treatment of limited mucocutaneous herpes simplex viral infections in immunosuppressed patients and of initial episodes of genital herpes simplex infections in patients with normal immunity. Ribavirin, an experimental agent with a wide spectrum of activity in vitro, has not fulfilled expectations in clinical trials. Because of the eradication of smallpox, methisazone has become obsolete as a prophylactic agent in smallpox.
Only a few agents with antiviral activity are available for regular clinical use. Amantadine hydrochloride is effective in the prophylaxis of influenza A2. Idoxuridine and adenine arabinoside have found application as topical agents in the treatment of herpes simplex keratitis. Adenine arabinoside is also under investigation in the treatment of disseminated infections due to herpes zoster and herpes simplex. Ribavirin, an agent with a wide spectrum of activity in vitro, has not fulfilled expectations in clinical trials. Because of the near eradication of smallpox, methisazone has become less important as a prophylactic agent in smallpox.