Repurposing of the antihistamine chlorcyclizine and related compounds for treatment of hepatitis C virus infection.

Abstract

Hepatitis C virus (HCV) infection affects an estimated 185 million people worldwide, with chronic infection often leading to liver cirrhosis and hepatocellular carcinoma. Although HCV is curable, there is an unmet need for the development of effective and affordable treatment options. Through a cell-based high-throughput screen, we identified chlorcyclizine HCl (CCZ), an over-the-counter drug for allergy symptoms, as a potent inhibitor of HCV infection. CCZ inhibited HCV infection in human hepatoma cells and primary human hepatocytes. The mode of action of CCZ is mediated by inhibiting an early stage of HCV infection, probably targeting viral entry into host cells. The in vitro antiviral effect of CCZ was synergistic with other anti-HCV drugs, including ribavirin, interferon-α, telaprevir, boceprevir, sofosbuvir, daclatasvir, and cyclosporin A, without significant cytotoxicity, suggesting its potential in combination therapy of hepatitis C. In the mouse pharmacokinetic model, CCZ showed preferential liver distribution. In chimeric mice engrafted with primary human hepatocytes, CCZ significantly inhibited infection of HCV genotypes 1b and 2a, without evidence of emergence of drug resistance, during 4 and 6 weeks of treatment, respectively. With its established clinical safety profile as an allergy medication, affordability, and a simple chemical structure for optimization, CCZ represents a promising candidate for drug repurposing and further development as an effective and accessible agent for treatment of HCV infection.

• Authors: Shanshan He, Billy Lin, Virginia Chu, Zongyi Hu, Xin Hu, Jingbo Xiao, Amy Q Wang, Cameron J Schweitzer, Qisheng Li, Michio Imamura, Nobuhiko Hiraga, Noel Southall, Marc Ferrer, Wei Zheng, Kazuaki Chayama, Juan J Marugan, T Jake Liang
• Journal: Science translational medicine (Sci Transl Med) Vol. 7 Issue 282 Pg. 282ra49 (Apr 08 2015) ISSN: 1946-6242 [Electronic] United States
• PMID: 25855495 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, N.I.H., Intramural)
• Copyright: Copyright © 2015, American Association for the Advancement of Science.

Chemical References

• Antiviral Agents
• Histamine Antagonists
• Piperazines
• chlorcyclizine

Topics

• Animals
• Antiviral Agents (pharmacokinetics, pharmacology, therapeutic use)
• Drug Resistance, Viral (drug effects)
• Genotype
• Hepacivirus (drug effects, genetics, physiology)
• Hepatitis C, Chronic (drug therapy, virology)
• High-Throughput Screening Assays
• Histamine Antagonists (pharmacology, therapeutic use)
• Humans
• Mice, SCID
• Piperazines (pharmacokinetics, pharmacology, therapeutic use)
• Reproducibility of Results
• Virus Replication (drug effects)