21Infection with hepatitis C virus (HCV) remains to be a major cause of morbidity and mortality 22 worldwide despite the recent advent of highly effective direct-acting antivirals. The envelope 23 glycoproteins of HCV are heavily glycosylated with a high proportion of high-mannose glycans 24 (HMGs), which serve as a shield against neutralizing antibodies and assist in the interaction with 25 cell-entry receptors. However, currently there is no approved therapeutic targeting this 26 potentially druggable biomarker. Here, we investigated the therapeutic potential of the lectibody 27 Avaren-Fc (AvFc), a HMG-binding lectin-Fc fusion protein. In vitro assays showed AvFc's 28 capacity to neutralize cell culture-derived HCV in a genotype independent manner with IC 50 29 values in the low nanomolar range. A histidine buffer-based AvFc formulation was developed 30 for in vivo studies using the PXB human liver chimeric mouse model. Systemic administration 31 of AvFc was well tolerated; after 11 consecutive doses every other day at 25 mg/kg, there were 32 no significant changes in body or liver weights, nor any impact noted in blood human albumin 33 levels or serum alanine aminotransferase activity. Gross necropsy and liver pathology further 34 confirmed the lack of discernible toxicity. This treatment regimen successfully prevented 35 genotype 1a HCV infection in all animals, while an AvFc mutant lacking HMG binding activity 36 failed to block the infection. These results suggest that targeting envelope HMGs is a promising 37 therapeutic approach against HCV infection. In particular, AvFc may provide a safe and 38 efficacious means to prevent recurrent infection upon liver transplantation in HCV-related end-39 stage liver disease patients.
42family Flaviviridae and the causative agent of hepatitis C disease. Its genome encodes three 43 structural (core, E1, E2) and seven non-structural proteins (p7, NS2, NS3, NS4A, NS4B, NS5A, 44 NS5B) (1). HCV is highly heterogenous and globally distributed, consisting of seven genotypes 45 each further subdivided into multiple subtypes. Genotype 1 is the predominant genotype 46 worldwide and particularly concentrated in high-income and upper-middle income countries, 47 whereas genotype 3 and 4 are more common in lower-middle and low-income countries (2). In 48 the United States, injection drug use represents the primary risk factor for contracting HCV 49 infection (3, 4). Around 15-25% of people acutely infected with HCV will clear the virus, while 50 the remainder will develop chronic infection that can persist largely unnoticed for decades.
51Indeed, many HCV carriers discover their chronic infection after they have developed cirrhosis 52 (5). Chronic HCV infection is also associated with the development of hepatocellular carcinoma, 53 and those with the disease are more likely to develop cryoglobulinemia and non-Hodgkin's 54 lymphoma (6).
55There is no vaccine currently available for HCV. Prior to 2011, the standard chronic 56 HCV treatment was a non-specific antiviral medica...