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A review of candidate therapies for Middle East respiratory syndrome from a molecular perspective.
J Med Microbiol. 2017 Sep; 66(9):1261-1274.JM

Abstract

There have been 2040 laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) in 27 countries, with a mortality rate of 34.9 %. There is no specific therapy. The current therapies have mainly been adapted from severe acute respiratory syndrome (SARS-CoV) treatments, including broad-spectrum antibiotics, corticosteroids, interferons, ribavirin, lopinavir-ritonavir or mycophenolate mofetil, and have not been subject to well-organized clinical trials. The development of specific therapies and vaccines is therefore urgently required. We examine existing and potential therapies and vaccines from a molecular perspective. These include viral S protein targeting; inhibitors of host proteases, including TMPRSS2, cathepsin L and furin protease, and of viral M(pro) and the PL(pro) proteases; convalescent plasma; and vaccine candidates. The Medline database was searched using combinations and variations of terms, including 'Middle East respiratory syndrome coronavirus', 'MERS-CoV', 'SARS', 'therapy', 'molecular', 'vaccine', 'prophylactic', 'S protein', 'DPP4', 'heptad repeat', 'protease', 'inhibitor', 'anti-viral', 'broad-spectrum', 'interferon', 'convalescent plasma', 'lopinavir ritonavir', 'antibodies', 'antiviral peptides' and 'live attenuated viruses'. There are many options for the development of MERS-CoV-specific therapies. Currently, MERS-CoV is not considered to have pandemic potential. However, the high mortality rate and potential for mutations that could increase transmissibility give urgency to the search for direct, effective therapies. Well-designed and controlled clinical trials are needed, both for existing therapies and for prospective direct therapies.

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Authors+Show Affiliations

Rabaan AA
Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia.
Alahmed SH
Specialty Paediatric Medicine, Qatif Central Hospital, Qatif 32654, Saudi Arabia.
Bazzi AM
Microbiology Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia.
Alhani HM
Maternity and Children Hospital, and Directorate of Infection Control at Eastern Province, Ministry of Health, Dammam, Saudi Arabia.

MeSH

Antiviral AgentsCathepsin LCoronavirus InfectionsHost-Pathogen InteractionsHumansInterferonsMiddle East Respiratory Syndrome CoronavirusProspective StudiesSerine EndopeptidasesSerine Proteinase InhibitorsViral Vaccines

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28855003

Citation

Rabaan, Ali A., et al. "A Review of Candidate Therapies for Middle East Respiratory Syndrome From a Molecular Perspective." Journal of Medical Microbiology, vol. 66, no. 9, 2017, pp. 1261-1274.
Rabaan AA, Alahmed SH, Bazzi AM, et al. A review of candidate therapies for Middle East respiratory syndrome from a molecular perspective. J Med Microbiol. 2017;66(9):1261-1274.
Rabaan, A. A., Alahmed, S. H., Bazzi, A. M., & Alhani, H. M. (2017). A review of candidate therapies for Middle East respiratory syndrome from a molecular perspective. Journal of Medical Microbiology, 66(9), 1261-1274. https://doi.org/10.1099/jmm.0.000565
Rabaan AA, et al. A Review of Candidate Therapies for Middle East Respiratory Syndrome From a Molecular Perspective. J Med Microbiol. 2017;66(9):1261-1274. PubMed PMID: 28855003.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A review of candidate therapies for Middle East respiratory syndrome from a molecular perspective. AU - Rabaan,Ali A, AU - Alahmed,Shamsah H, AU - Bazzi,Ali M, AU - Alhani,Hatem M, Y1 - 2017/08/31/ PY - 2017/9/1/pubmed PY - 2017/11/29/medline PY - 2017/9/1/entrez KW - Antiviral peptide KW - DPP4 KW - GLS-5300 KW - M(pro) KW - MERS-CoV KW - PL(pro) KW - S protein KW - camostat KW - convalescent plasma KW - glycopeptide antibiotic KW - interferon KW - lopinavir KW - monoclonal antibodies KW - protease KW - vaccine SP - 1261 EP - 1274 JF - Journal of medical microbiology JO - J Med Microbiol VL - 66 IS - 9 N2 - There have been 2040 laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) in 27 countries, with a mortality rate of 34.9 %. There is no specific therapy. The current therapies have mainly been adapted from severe acute respiratory syndrome (SARS-CoV) treatments, including broad-spectrum antibiotics, corticosteroids, interferons, ribavirin, lopinavir-ritonavir or mycophenolate mofetil, and have not been subject to well-organized clinical trials. The development of specific therapies and vaccines is therefore urgently required. We examine existing and potential therapies and vaccines from a molecular perspective. These include viral S protein targeting; inhibitors of host proteases, including TMPRSS2, cathepsin L and furin protease, and of viral M(pro) and the PL(pro) proteases; convalescent plasma; and vaccine candidates. The Medline database was searched using combinations and variations of terms, including 'Middle East respiratory syndrome coronavirus', 'MERS-CoV', 'SARS', 'therapy', 'molecular', 'vaccine', 'prophylactic', 'S protein', 'DPP4', 'heptad repeat', 'protease', 'inhibitor', 'anti-viral', 'broad-spectrum', 'interferon', 'convalescent plasma', 'lopinavir ritonavir', 'antibodies', 'antiviral peptides' and 'live attenuated viruses'. There are many options for the development of MERS-CoV-specific therapies. Currently, MERS-CoV is not considered to have pandemic potential. However, the high mortality rate and potential for mutations that could increase transmissibility give urgency to the search for direct, effective therapies. Well-designed and controlled clinical trials are needed, both for existing therapies and for prospective direct therapies. SN - 1473-5644 UR - https://www.unboundmedicine.com/medline/citation/28855003/A_review_of_candidate_therapies_for_Middle_East_respiratory_syndrome_from_a_molecular_perspective_ DB - PRIME DP - Unbound Medicine ER -