Nikhil Prasad Fact checked by:Thailand Medical News Team Aug 20, 2024 4 months, 2 days, 12 hours, 30 minutes ago
Mpox News: Researchers from various German institutions have identified a new potential treatment for ophthalmic Mpox (Monkeypox) infection -trifluridine (TFT). This
Mpox News report delves into the findings, which suggest that TFT could be a powerful weapon against Mpox, especially in cases where the virus has developed resistance to existing treatments.
German researchers find new treatment for ophthalmic Mpox infections
Background: The Ongoing Battle Against Mpox
Mpox, a viral infection that recently grabbed global attention, particularly during the 2022-2023 outbreak, has typically caused dermatologic and systemic symptoms. However, it has also shown the ability to cause severe ophthalmic complications such as conjunctivitis and keratitis. These complications can lead to serious outcomes, including visual impairment.
https://www.thailandmedical.news/news/monkeypox-mpox-can-cause-a-variety-of-eye-issues-that-can-result-in-vision-loss
With the eye being a vulnerable site, effective antiviral treatment becomes crucial.
Researchers from several leading institutions, including the Institute of Medical Virology at Goethe University Frankfurt, the Fraunhofer Institute for Translational Medicine and Pharmacology ITMP in Hamburg and Frankfurt, and the University of Kent, have been exploring treatment options for this potentially blinding condition. The study led by Dr Jindrich Cinatl and his team, has focused on the use of trifluridine (TFT) - a nucleoside analog that has shown efficacy in treating other viral infections, such as herpes simplex keratitis.
Understanding TFT's Role in Fighting Mpox
In the study, the researchers developed ophthalmic cell models to simulate Mpox infection. These models, which included conjunctival epithelial cells and keratocytes, were used to test the efficacy of TFT against the Mpox virus. The findings were promising. Trifluridine (TFT) effectively inhibited the virus across a broad range of Mpox isolates, including those resistant to tecovirimat, a drug that has been a cornerstone in Mpox treatment.
The study's significance lies in its detailed analysis of how trifluridine (TFT) performs in various cell types relevant to ophthalmic Mpox infection. Notably, the study found that while trifluridine (TFT) was effective across all tested cell types, its efficacy was somewhat reduced in keratocytes and conjunctival epithelial cells compared to dermal fibroblasts. Despite this, TFT’s ability to inhibit the virus, even in the presence of tecovirimat-resistant strains, is a critical finding.
Tackling Tecovirimat Resistance
One of the most concerning developments in recent Mpox outbreaks has been the emergence of tecovirimat-resistant strains. Tecovirimat resistance can develop rapidly, posing a significant challenge to public health. The study demonstrated that triflur
idine (TFT) remains effective against these resistant strains. In the experiments, TFT successfully inhibited the virus in all cell models, including those infected with the tecovirimat-resistant Mpox strain, MPXV1RTeco.
The emergence of resistance has been traced to specific mutations in the F13L gene of the Mpox virus. These mutations have been observed in patients who received tecovirimat treatment during the recent outbreaks. The study’s ability to test Trifluridine (TFT) against these resistant strains provides hope for those affected by resistant Mpox variants.
Drug Combinations: The Good, the Bad, and the Unexpected
The study also explored the potential benefits and risks of combining Trifluridine (TFT) with other antiviral drugs, such as tecovirimat and brincidofovir. Drug combinations are often employed in antiviral therapy to enhance efficacy and reduce the likelihood of resistance development. However, this article reports that the results were mixed.
In conjunctival epithelial cells, the combination of Trifluridine (TFT) and tecovirimat showed a nearly additive effect, suggesting that the two drugs could work together effectively. However, the combination of TFT with brincidofovir exhibited slight antagonism in both dermal fibroblasts and keratocytes. This antagonism indicates that the drugs might interfere with each other’s effectiveness, particularly in keratocytes where the antagonism was more pronounced.
Despite these findings, the researchers suggest that drug combinations could still be beneficial in preventing the selection of resistant mutations, though they also stress the need for careful monitoring and further preclinical evaluation. The conflicting results in different cell types underline the complexity of antiviral drug interactions and the importance of tailored approaches in treatment.
Conclusion: A Promising Future for Trifluridine (TFT) in Mpox Treatment
In conclusion, the study’s findings are a significant step forward in the fight against Mpox, particularly in cases involving ophthalmic complications. TFT has demonstrated its potential as a potent antiviral agent that can overcome resistance to existing treatments like tecovirimat. However, as with all antiviral therapies, the use of TFT, especially in combination with other drugs, requires careful consideration and further research.
The study findings were published in the peer-reviewed journal: Journal of Medical Virology.
https://onlinelibrary.wiley.com/doi/10.1002/jmv.29354
https://onlinelibrary.wiley.com/doi/epdf/10.1002/jmv.29354
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