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Respiratory Antivirals - Drugs, Vaccines and Novel Therapies

Cryan S, Kelly C, Shoyele SA.

RDD Europe 2009. Volume 1, 2009: 49-56.

Abstract:

Respiratory viral infections continue to have a major health and economic impact worldwide and there is a growing interest in targeting the local delivery of respiratory antiviral agents via inhalation as evidenced by the licensing of Flumist® and inhaled Ribavirin. No licensed antivirals are available to treat a range of important respiratory viral infections, with notable exceptions such as the adamantanes and neuraminidase inhibitors for the treatment of influenza and ribavirin for the treatment of respiratory syncytial virus (RSV) in high risk patients. Prophylactic strategies for respiratory viruses are similarly limited with influenza vaccines and the immunoprophylactic agents (Synagis® and RespiGam®) for the prevention of RSV in premature infants being the exceptions. There is still therefore a great unmet need for effective vaccines and treatments against a range of common respiratory viruses. Along with the common respiratory viruses, influenza and RSV, there are emerging viruses such as severe acute respiratory syndromeassociated coronavirus (SARS-CoV) that are challenging the field to develop effective means for their treatment and prevention. The new RNA interference (RNAi) technology that has been applied so successfully as a molecular biology tool appears to offer a potentially exciting means of targeting a range of respiratory viruses including influenza, RSV and SARS-CoV. As a context for this work a brief review of the current status of treatments and vaccines for these viruses is provided. There is growing interest in the local delivery of RNAi. As was the case for previous gene-based therapies targeted to the lungs, if the technology is to reach its full potential, then the anatomical and cellular barriers to RNAi delivery in the lungs must be overcome.