ReviewProgress on the development of therapeutics against West Nile virus
Section snippets
Ecology, epidemiology, and clinical manifestations
West Nile virus (WNV) was first isolated in 1937 in the West Nile district of Uganda from a woman with an undiagnosed febrile illness (Smithburn et al., 1940). It is an RNA virus that cycles in nature between Culex mosquitoes and birds but also infects and causes disease in humans, horses, and other vertebrate species. Although its enzootic cycle was believed to be almost exclusively between mosquitoes and birds, with vertebrate species serving as “dead-end” hosts because of low-level and
Candidate anti-WNV therapeutics
At present, no specific therapy has been approved for use in humans with WNV infection as current treatment is supportive. Tissue culture and animal model studies have applied multiple strategies for the generation of novel therapies against WNV, and possibly other flaviviruses. Nonetheless, the development of therapeutics that mitigate or abort disease is challenging as patients with the most severe disease often have underlying immune deficits and present to clinical attention relatively late
Conclusions
Given the lack of existing therapies and its continued global emergence, the development of antiviral agents against WNV is essential. At present, several candidate therapies that act through distinct mechanisms are moving through various stages of pre-clinical development. Based on the epidemiology and pathogenesis of severe WNV infection effective antiviral agents against WNV must have minimal detrimental effects on immune system function. Even with the identification of new classes of
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