Several nucleoside analogs are under clinical development for use against hepatitis B virus (HBV). Lamivudine (3TC), a nucleoside analog, and adefovir dipivoxil (ADV), an acyclonucleotide analog, are clinically approved. However, long-term treatment can induce viral resistance, and following the cessation of therapy, viral rebound is frequently observed. There continues to be a need for new antiviral agents with novel mechanisms of action. A library of more than 600 di-and trinucleotide compounds synthesized by parallel synthesis using a combinatorial strategy was screened for potential inhibitors of HBV replication using the chronically HBV-producing cell line 2. The discovery of safe and effective antiviral drugs continues to present considerable challenges. The rapid emergence of resistance to antiviral drugs is a major problem, and combinations of a limited repertoire of antiviral drugs often need to be employed as a therapeutic strategy. The major stumbling block in antiviral drug development is the limited structural, mechanistic, and functional information on many virus-specific molecular targets. Consequently, the design of target-specific compounds that interfere with viral life cycles is a difficult challenge. There continues to be a substantial unmet clinical need for antiviral drugs with different structures and unique mechanisms of action, other than those conferred by conventional nucleoside analogs (2).Given a lack of sufficient structural information on new targets, an approach that seems appropriate for antiviral drug discovery is the screening of structurally diverse compounds, generated using combinatorial approaches that would modulate biological pathways without regard to specific molecular targets. In theory, this approach would allow simultaneous functional validation of a target, as well as the discovery of a lead structure that modulates the function of the target. This strategy has been variously referred to as "diversity-oriented organic synthesis for therapeutic target validation" or "combinatorial target-guided ligand assembly" (6, 20).We describe here the application of this concept for the discovery of anti-hepatitis B virus (HBV) agents. In recent publications, we have reported methods of assembling various classes of di-and trinucleotide libraries (7,8,18). Through screening, as well as lead optimization work, and in conjunction with cell-based assays, we have discovered that certain molecules show very promising anti-HBV activity. Furthermore, some of these molecules display synergistic activity when used in combination with lamivudine (3TC) and adefovir dipivoxil (ADV), the two nucleoside analogs currently licensed for the treatment of chronic HBV infection. This work summarizes the in vitro analysis and preliminary toxicity evaluation of these compounds.(A preliminary report of this work was presented at the 14th International Conference for Antiviral Research, Seattle, Washington, 8 to 12 April 2001.)
MATERIALS AND METHODSTest compounds. Nucleotide libraries were synthesized ...