Evaluation of a non-nucleoside inhibitor of the RSV RNA-dependent RNA polymerase in translatable animals models

J Infect. 2024 Dec;89(6):106325. doi: 10.1016/j.jinf.2024.106325. Epub 2024 Oct 23.

Abstract

Respiratory Syncytial Virus (RSV) causes severe respiratory infections and concomitant disease resulting in significant morbidity and mortality in infants, elderly, and immunocompromised adults. Vaccines, monoclonal antibodies, and small-molecule antivirals are now either available or in development to prevent and treat RSV infections. Although rodent and non-rodent preclinical animal models have been used to evaluate these emerging agents, there is still a need to improve our understanding of the pharmacokinetic (PK)-pharmacodynamic (PD) relationships within and between animal models to enable better design of human challenge studies and clinical trials. Herein, we report a PKPD evaluation of MRK-1, a novel small molecule non-nucleoside inhibitor of the RSV L polymerase protein, in the semi-permissive cotton rat and African green monkey models of RSV infection. These studies demonstrate a strong relationship between in vitro activity, in vivo drug exposure, and pharmacodynamic efficacy as well as revealing limitations of the cotton rat RSV model. Additionally, we report unexpected horizontal transmission of human RSV between co-housed African green monkeys, as well as a lack of drug specific resistant mutant generation. Taken together these studies further our understanding of these semi-permissive animal models and offer the potential for expansion of their preclinical utility in evaluating novel RSV therapeutic agents.

Keywords: African green monkey (AGM); Animal models; Antiviral; Cotton rats; Non-human primates (NHP); Non-nucleoside inhibitor (NNI); RNA-dependent RNA polymerase (RdRp); Respiratory Syncytial Virus (RSV); Small molecule direct-acting antivirals (DAAs); Transmission.

MeSH terms

  • Animals
  • Antiviral Agents* / pharmacokinetics
  • Antiviral Agents* / pharmacology
  • Antiviral Agents* / therapeutic use
  • Chlorocebus aethiops
  • Disease Models, Animal*
  • Female
  • Humans
  • RNA-Dependent RNA Polymerase* / antagonists & inhibitors
  • Rats
  • Respiratory Syncytial Virus Infections* / drug therapy
  • Respiratory Syncytial Virus Infections* / virology
  • Respiratory Syncytial Virus, Human / drug effects
  • Sigmodontinae*
  • Virus Replication / drug effects

Substances

  • Antiviral Agents
  • RNA-Dependent RNA Polymerase