Emergence of prions selectively resistant to combination drug therapy

PLoS Pathog. 2020 May 18;16(5):e1008581. doi: 10.1371/journal.ppat.1008581. eCollection 2020 May.

Abstract

Prions are unorthodox infectious agents that replicate by templating misfolded conformations of a host-encoded glycoprotein, collectively termed PrPSc. Prion diseases are invariably fatal and currently incurable, but oral drugs that can prolong incubation times in prion-infected mice have been developed. Here, we tested the efficacy of combination therapy with two such drugs, IND24 and Anle138b, in scrapie-infected mice. The results indicate that combination therapy was no more effective than either IND24 or Anle138b monotherapy in prolonging scrapie incubation times. Moreover, combination therapy induced the formation of a new prion strain that is specifically resistant to the combination regimen but susceptible to Anle138b. To our knowledge, this is the first report of a pathogen with specific resistance to combination therapy despite being susceptible to monotherapy. Our findings also suggest that combination therapy may be a less effective strategy for treating prions than conventional pathogens.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Benzodioxoles / pharmacology*
  • Drug Therapy, Combination
  • Mice
  • PrPSc Proteins / metabolism*
  • PrPSc Proteins / pathogenicity
  • Pyrazoles / pharmacology*
  • Scrapie / drug therapy*
  • Scrapie / metabolism
  • Scrapie / pathology

Substances

  • 3-(1,3-benzodioxol-5-yl)-5-(3-bromophenyl)-1H-pyrazole
  • Benzodioxoles
  • PrPSc Proteins
  • Pyrazoles