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Azar, S. R.

Publications and source records attributed to Azar, S. R..

3 recordsLinked to original sources

Emergence of Zika virus: Role of founder effects, drift and mutational reversions in spread to the Americas

Summary ParagraphMosquito-borne viruses have recently spread globally, with major impacts on human health. Zika virus (ZIKV) emerged from obscurity in 2013 to spread from Asia to the South Pacific and the Americas, where millions of people were infected. For the first time, severe clinical manifestations, including Guillain Barre syndrome and defects to the fetuses of pregnant women, were detected. Phylogenetic studies have shown that ZIKV evolved in Africa and later spread to Asia, and that the Asian lineage is responsible for the recent epidemics. However, the reasons for the sudden emergence of ZIKV remain incompletely understood. Accumulating evidence on other arboviruses like chikungunya and West Nile suggest the likelihood that viral mutations could be determinants of change in ZIKV transmission efficiency responsible for efficient spread. Using evolutionary analyses, we determined that four mutations, which occurred just before ZIKV introduction to the Americas, represent direct reversions of previous mutations that accompanied spread many decades ago from ZIKVs native Africa to Asia and early circulation there. Experimental infections of mosquitoes, human cells, and mice using ZIKV strains with and without these mutations demonstrated that the original mutations reduced fitness for urban transmission, while the reversions restored fitness, increasing epidemic risk. Overall, our findings include the three newly identified, transmission-adaptive ZIKV mutations, and demonstration that these and one identified previously restored fitness for epidemic transmission soon before introduction into the America. The initial mutations may have followed founder effects and/or drift when the virus was introduced into Asia, or could be related to changes on host or vector utilization within Asia.

microbiology

Evolution of resistance to fluoroquinolones by dengue virus serotype 4 provides insight into mechanism of action and consequences for viral fitness

Drugs against flaviviruses such as dengue (DENV) and Zika (ZIKV) virus are urgently needed. We previously demonstrated that three fluoroquinolones, ciprofloxacin, enoxacin, and difloxacin, suppress replication of six flaviviruses. To investigate the barrier to resistance and mechanism(s) of action of these drugs, DENV-4 was passaged in triplicate in HEK-293 cells in the presence or absence of each drug. Resistance to ciprofloxacin was detected by the seventh passage and to difloxacin by the tenth, whereas resistance to enoxacin did not occur within ten passages. Two putative resistance-conferring mutations were detected in the envelope gene of ciprofloxacin and difloxacin-resistant DENV-4. In the absence of ciprofloxacin, ciprofloxacin-resistant viruses sustained a significantly higher viral titer than control viruses in HEK-293 and HuH-7 cells and resistant viruses were more stable than control viruses at 37{degrees}C. These results suggest that the mechanism of action of ciprofloxacin and difloxacin involves interference with virus binding or entry.

evolutionary biology

Old drugs with new tricks: Efficacy of fluoroquinolones to suppress replication of flaviviruses

Antiviral therapies are urgently needed to treat infections with flaviviruses such as Zika (ZIKV) and dengue (DENV) virus. Repurposing FDA-approved compounds could provide the fastest route to alleviate the burden of flaviviral diseases. In this study, three fluoroquinolones, enoxacin, difloxacin and ciprofloxacin, curtailed replication of flaviviruses ZIKV, DENV, Langat (LGTV) and Modoc (MODV) in HEK-293 cells at low micromolar concentrations. Time-of-addition assays revealed that enoxacin suppressed ZIKV replication when added at 6 hours post-infection, suggesting inhibition of an intermediate step in the virus life cycle, whereas ciprofloxacin and difloxacin had a wider window of efficacy of 2, 6, and 8 hours post-infection for difloxacin and 2 to 8 hours post-infection for ciprofloxacin. The efficacy of enoxacin to suppress ZIKV replication in 5-week-old A129 mice was evaluated in two experiments. First, mice were infected with 1x105 plaque-forming units (pfu) ZIKV FSS13025 (n=20) or PBS (n=11) on day 0 and subsets were treated with enoxacin at 10mg/kg or 15mg/kg or diluent orally twice daily on days 1-5. Treated and control mice did not differ in weight change or virus titer in serum or brain. Mice treated with enoxacin showed a significant, 5-fold decrease in ZIKV titer in testes relative to controls. Second, mice were infected with 1x102 pfu ZIKV (n=13) or PBS (n=13) on day 0 and subsets were treated with 15mg/kg oral enoxacin or diluent twice daily on days 0 (pre-treatment) and 1-5. Mice treated with enoxacin showed a significant, 2.5-fold decrease in ZIKV titer in testes relative to controls, while weight and viral load in the serum, brain, and liver did not differ between treated and control mice. Enoxacin efficacy in cultured murine Sertoli cells was not enhanced compared to efficacy in HEK-293 cells. ZIKV can be sexually transmitted, so reduction of titer in the testes by enoxacin should be further investigated. Author SummaryFlaviviruses such as Zika and dengue virus pose a significant threat to public health worldwide, and there are currently no antiviral therapies to treat any flaviviral infection. Repurposing FDA-approved drugs as anti-flaviviral therapies can accelerate clinical use. We demonstrated that fluoroquinolone antibiotics exhibit anti-flaviviral efficacy, suppressing flavivirus replication in cultured human cells. Additionally, we found that the fluoroquinolone enoxacin suppressed Zika virus replication in mouse testes. While Zika virus is primarily transmitted via mosquitoes, the virus also undergoes sexual transmission. The importance of sexual transmission for the overall epidemiology of the virus remains unclear; nonetheless all routes of potential transmission to pregnant women are of concern as fetal infection in utero can have devastating effects. Thus, our data indicate that fluoroquinolones hold promise for treatment of flaviviral infections, particularly infection of the testes by Zika virus, and that this class of drugs warrants further study.

microbiology