Developing interventions that inhibit the transmission of HIV infection are critical for halting the HIV epidemic. Topical prevention strategies usually termed microbicides have been proposed as one strategy to halt or slow down the HIV epidemic. We have identified novel lead microbicides that potently inhibit HIV and SIV infection/replication in vitro. During our previous submission we reported an oligonucleotide with a phosphorothioate backbone (OPB) that could inhibit HIVBaL or SIVmac251 infection and/or replication in human or simian PBMC, respectively. OPB also inhibited infection/replication in cell-free infections of P4-R5 MAGI cells by HIVBaL and HIVIIIB. OPB exhibited no toxicity against PBMC or P4-R5 MAGI cells after 24h continuous exposure. Preliminary data suggested that OPB may also inhibit other viruses as it was also effective against influenza type A virus. Thus, our first generation OPB may be a potent microbicide against HIV that prevents infection at mucosal sites when topically applied. Our preliminary studies were carried out with a 13mer Poly T or Poly A oligonucleotide of OPB and this suggested that the effect was sequence independent and may even be mediated by the phosphorothioate deoxyribose sugar backbone. Indeed in our current re-submission we present data on our next generation compound, a baseless phosphorothioate 2'deoxyribose backbone (PDB) that has more potent HIV inhibitory activity than OPB. A 14mer PDB we show here has no toxicity, is a potent inhibitor of HIV and has the advantage of being a TLR7/9 antagonist that inhibits HIV-induced IFN? production. This later property is important as the establishment of HIV infection may depend on HIV-induced mucosal inflammation triggered by TLR. Importantly, we show that PDB is active when formulated in hydroxyethylcellulose (HEC) gel at pH 4.4, survives pH transition to a neutral pH, and in retains its activity in HEC for long periods. We hypothesize that PDB binds enveloped viruses and inhibits their infectivity by acting as a "chemical lectin". We further hypothesize that PDB can act as a microbicide against HIV and can prevent SIV vaginal infection of rhesus macaques. The studies planned in the R21 phase will further optimize and characterize the safety and effectiveness of PDB in vitro and its safety in the Swiss Webster mouse vaginal/cervical model of irritation. They will determine the optimal size and composition that remains effective against HIV and exhibits no toxicity. Finally, the mechanism of action of PDB will be investigated, the effect of inclusion into hydroxyethylcellulose gel will be tested and PDB's effect on the growth of commensal lactobacilli will be determined. Five specific milestones have been set for the progression from the R21 Phase to the R33 Phase. The R33 phase will test the effectiveness of PDB in preventing vaginal SIV infection, investigate the effect of seminal plasma and pH transition on the efficacy of OPB, determine its safety with human genital epithelial tissue, and investigate its effectiveness against HSV-2. The current application will allow for an extensive evaluation of PDB as possible novel microbicide candidates. The studies proposed here address the important public health problem of developing treatments that inhibit the transmission of HIV infection. The current application investigates a novel chemical that may be used to inhibit infection with HIV.
The studies proposed here address the important public health problem of developing treatments that inhibit the transmission of HIV infection. The current application investigates a novel chemical that may be used to inhibit infection with HIV.