Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2017-04-19T14:24:39Z No. of bitstreams: 2 Dissertação - Diego Alves Rodrigues - 2014.pdf: 3563553 bytes, checksum: 740d277eef5f559b08bdd1742e750f6e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-04-19T14:24:54Z (GMT) No. of bitstreams: 2 Dissertação - Diego Alves Rodrigues - 2014.pdf: 3563553 bytes, checksum: 740d277eef5f559b08bdd1742e750f6e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-04-19T14:24:54Z (GMT). No. of bitstreams: 2 Dissertação - Diego Alves Rodrigues - 2014.pdf: 3563553 bytes, checksum: 740d277eef5f559b08bdd1742e750f6e (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2014-09-01 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The commercialization of drugs most often occurs through their solid forms, and the caracteriscas of drugs should be kept throughout the process of production and storage. Upon this fact the characterization studies of the drugs in the solid state are in constant growth. NMR solid state high resolution can provide important complementary information current techniques, through the changes of the chemical shifts.The objective of this study is the characterization of the drug efavirenz (EVZ) and oseltamivir by the technique of nuclear magnetic resonance both in solution and solid state data together with the theoretical computations. Efavirenz drug was characterized by X diffraction (XRD), nuclear magnetic resonance in solution (1H NMR and 13C {1H}) and solid (CPMAS NMR and 13C CPTOSS e15N), and the use of theoretical calculations in solution GIAO using the model for unambiguous assignment of NMR signals. The same techniques of structural characterization and theoretical calculations were used in drug Oseltamivir, reeking the technique of X diffraction (XRD), and this drug hitherto considered amorphous.The experimental data obtained by NMR analyzes were consistent with the structure of drug efavirenz and oseltamivir; and the results of theoretical calculations were tabulated, a work of statistical analysis is performed in order to correlate the experimental data with the theoretical data, the analysis of the standard deviation (SD), mean deviation (MD), linear coefficient (R) . Notably, the theoretical values of the chemical shifts of 1H and 13C NMR in solution, obtained at the level of theory DFT/B3LYP, allowed for the drugs in question a considerable correlation with experimental values and permitted to associate a low computational cost of a good precision results.Thus using NMR experiments in solution 1D and 2D allies the results of computational theoretical calculations was possible the elucidation and assignment of all NMR signals of 1H and 13C of both drugs. efined experiments 1D solid state NMR (CP / TOSS and 13C CP / MASS de15N) allowed identification of these atoms in the solid state. Combined with theoretical calculations GIPAW provided valuable information on the molecules within the asymmetric unit of each drug. / A comercialização de medicamentos na maioria das vezes ocorre mediante suas formas sólidas, sendo que as caracteriscas dos fármacos devem ser conservadas durante todo processo de produção e estocagem. Mediante este fato os estudos de caracterização dos fármacos em estado sólido estão em constante crescimento. A RMN em estado sólido de alta resolução pode fornecer informações complementares importantes as atuais técnicas, através das mudanças dos deslocamentos químicos. O objetivo deste presente estudo é a caracterização dos fármacos Efavirenz (EVZ) e Oseltamivir pela técnica de ressonância magnética nuclear tanto em solução como em estado sólido aliado aos dados teóricos de cálculos computacionais. O fármaco Efavirenz foi caracterizado por Difratometria de raios X (DRX), ressonância magnética nuclear em solução (RMN de 1H e 13C{1H}) e de sólidos (RMN CPMAS e CPTOSS de 13C e15N), além do uso de cálculos teóricos em solução utilizando o modelo GIAO para uma atribuição inequívoca dos sinais de RMN. As mesmas técnicas de caracterização estrutural e cálculos teóricos foram utilizadas no fármaco Oseltamivir, rescendendo a técnica de Difratometria de raios X (DRX), sendo este fármaco até então considerado amorfo. Os dados obtidos pelas análises experimentais de RMN foram coerentes com a estrutura dos fármacos Efavirenz e Oseltamivir; e os resultados dos cálculos teóricos foram dispostos em tabelas, sendo realizado um trabalho de análises estatísticas de forma a correlacionar os dados experimentais com os dados teóricos, pela análise do desvio padrão (SD), desvio médio (MD), coeficiente linear (R). Notavelmente os valores teóricos dos deslocamentos químicos de RMN 1H e 13C em solução, obtidos com o nível de teoria DFT/B3LYP, possibilitaram para os fármacos em questão uma correlação considerável com os valores experimentais e permitiram associar um baixo custo computacional a uma boa precisão dos resultados obtidos. Desta forma utilizando experimentos de RMN em solução 1D e 2D aliados aos resultados dos cálculos teóricos computacionais foi possível a elucidação e atribuição de todos os sinais de RMN de 1H e 13C de ambos os fármacos. Experimentos refinados de RMN em estado sólido 1D (CP/TOSS de 13C e CP/MASS de15N) possibilitaram a identificação destes átomos em estado sólido. Aliados a cálculos teóricos GIPAW forneceram valiosas informações sobre as moléculas dentro da unidade assimétrica de cada fármaco.

La grippe est une infection respiratoire aiguë, due au virus Influenza, qui touche en moyenne chaque hiver 2,5 millions de personnes. C'est un enjeu de santé publique majeur par son impact économique et en santé humaine. Les traitements actuellement disponibles contre le virus Influenza repose sur des antiviraux ciblant la neuraminidase (inhibiteur de la neuraminidase). Jusqu'en 2007 moins de 5% des souches de virus Influenza circulantes dans le monde étaient résistantes à ces INA. Contre toute attente, l'hiver 2007/2008 a été marqué par l'émergence simultanée d'une nouvelle souche apparentée au virus A/Brisbane/59/2007(H1N1) et d'une augmentation massives des résistances à l'Oseltamivir. Nous avons caractérisés les propriétés enzymatiques des souches sensibles et résistantes isolées dans la communauté au cours des saisons 2007/2008, 2008/2009 pour les comparer à un panel de souches de référence des virus A(H1N1). Les résultats obtenus soulignent la particularité des propriétés enzymatiques de la NA de A/Brisbane/59/2007(H1N1) et le rôle de la balance HA-NA dans la diffusion mondiale de cette souche résistante en l'absence de pression de sélection La pandémie de 2009 au virus A(H1N1)pdm09 a été l'occasion de décrire le rôle de l'infection respiratoire basse, virale isolée ou dans le cadre d'une co-infection bactérienne, dans les patients décédés d'un syndrome de détresse respiratoire. La forte proportion de pneumonies virales observées dans les études épidémiologiques réalisées au cours de la pandémie de 2009/2010 et de la saison 2010/2011 suggère la présence de facteurs de virulence permettant au virus A(H1N1)pdm09 de se lier aux récepteurs présents au niveau de l'appareil respiratoire bas. Nous avons étudié l'impact du polymorphisme en position 222 de la HA du virus A(H1N1)pdm09 sur les propriétés de liaison de la HA à son récepteur, sur la balance HA-NA et, in fine, sur le phénotype des virus in vitro et in vivo. Nos résultats montrent que les substitutions D222G, D222E et D222N de la HA du virus A(H1N1)pdm09 favorisent la liaison aux acides sialiques présents au niveau de l'alvéole pulmonaire. Cette propriété pourrait expliquer la plus forte pathogénicité pulmonaire de ce virus. Par ailleurs nos résultats montrent également une association entre l'équilibre de la balance HA-NA et le profil de réplication de ces souches in vitro / Influenza is responsible of 2,5 million cased of respiratory infection, each winter, in France. It is a main human health threat and a main public health concern. The current treatment of flu relies on antiviral drug targeting viral proteins that can induce the appearance of resistant virus. Until 2007, less than 5% of all circulating Influenza strains were resistant to neuraminidase inhibitors. Against all odds, Oseltamivir resistant A/Brisbane/59/2007(H1N1) emerged and spread during 2007/2008 and 2008/2009 season. To understand the driving force of this emergence we tested clinical strains from 2007 to 2011 for Oseltamivir and Zanamivir resistance, sequenced their HA and NA gene, and compared their NA enzymatic properties with A(H1N1) reference strain from 1977 to 2007. Our results showed that A/Brisbane/59/2007 displayed a high affinity compare with NA of previous A(H1N1) reference strains. Moreover these results suggested that HA-NA balance underlie the worldwide emergence of the Oseltamivir resistance without any selection pressure. The A(H1N1)pdm09 pandemic highlighted the importance of lower tract respiratory infection in the severe influenza case. The high proportion of viral pneumonia observed during the 2009 pandemic and the following season suggest that A(H1N1)pdm harbored a virulence factor that allowed the virus replication in the lower respiratory tracts. We studied the effect of HA 222 polymorphism on HA properties, HA-NA balance and in vitro and in vivo Influenza phenotype. Our results demonstrated that G222, E222 or N222 HA mutation increased the binding of A(H1N1)pdm09 mutation to the lower respiratory tract receptor. This may explain the A(H1N1)pdm09 increase pathogenicity. Moreover our results show than an optimal HA-NA balance is link to an efficient replication profile in vitro

The natural reservoir of influenza A virus (IAV) is wild waterfowl, and all human IAVs have their genetic origins from avian viruses. Neuraminidase inhibitors (NAIs) are currently the best drugs for treatment of human influenza; therefore, the orally available NAI oseltamivir (Tamiflu®) has been stockpiled worldwide as part of pandemic preparedness planning. Re-sistance to NAIs is related to worse clinical outcomes and if a new pandemic influenza virus would be oseltamivir-resistant its public health impact would be substantially worsened. The active metabolite oseltamivir carboxylate (OC) is not removed by sewage treatment and ends up in river water, where OC-concentrations up to 0.86µg/L have been detected. We hypothesize that occasional OC exposure of wild waterfowl carrying IAVs may result in circulation of resistant variants that may potentially evolve to become human-pathogenic. We tested the hypothesis in an in vivo Mallard (Anas platyrhynchos) model in which birds were infected with avian IAVs and exposed to OC. Excreted viruses were analyzed regarding genotypic and phenotypic resistance by neuraminidase (NA) sequencing and a functional NA inhibition assay. Two viruses with NAs of the phylogenetic N2-group, H6N2 and H7N9, acquired the NA substitutions R292K and I222T when host ducks were exposed to 12µg/L and 2.5µg/L of OC, respectively. Drug susceptibilities were at previously described levels for the substitutions. To test persistence of resistance, an OC resistant avian H1N1/H274Y virus (with a group N1 NA-protein) from a previous study, and three resistant H6N2/R292K variants were allowed to replicate in Mallards without drug pressure. Resistance was entirely maintained in the H1N1/H274Y virus, but the H6N2/R292K variants were outcompeted by wild type virus, indicating retained fitness of the resistant H1N1 but not the H6N2 variants. We conclude that OC in the environment may generate resistant IAVs in wild birds. Resistant avian IAVs may become a problem to humans, should the resistance trait become part of a new human pathogenic virus. It implies a need for prudent use of available NAIs, optimized sewage treatment and resistance surveillance of avian IAVs of wild birds.

La grippe est une infection respiratoire causée par le virus influenza, ayant d'importants impacts socio-économiques.La grande capacité mutagénique de ce virus nous oblige à développer notre arsenal pharmacologique vu l'augmentation du nombre de résistances aux antiviraux. Ce projet propose d'utiliser des médicaments accessibles et disponibles pour le traitement de diverses maladies qui sont susceptibles de limiter la propagation virale en ciblant des voies cellulaires essentielles pour la réplication virale (acidification endosomales et niveaux de calcium cellulaire). Les résultats obtenus ont démontré que l'utilisation d'agents lysosomotropes alcalinisants et de modulateurs du calcium inhibait de façon significative la réplication virale.La sensibilité des souches à ces traitements était les suivantes : H1N1 et H3N2 adaptées à la souris, H1N1 humaine, H1N1 porcine et H5N1 et N5N2 [i.e. H5N2] aviaire. Des concentrations plus élevées étaient nécessaires pour un traitement post-infection.La combinaison de traitements entre eux ou avec l'oseltamivir (inhibiteur de la neuraminidase) ont démontré un effet inhibiteur additif significatif. L'inhibition de l'induction de la polymérase acide virale tôt dans l'infection a indiqué que les traitements empêchent le relâchement du génome viral dans la cellule. In vivo, seule la chloroquine (50 mg/kg/jr) inhibait significativement la réplication virale pulmonaire. Néanmoins cette section du projet soutient l'idée d'exploiter des mécanismes cellulaires cruciaux pour le virus afin de développer de nouveaux traitements antiviraux. L'oseltamivir réduit la réplication du virus influenza et l'inflammation excessive dans les poumons durant l'infection. Cependant, les effets du traitement antiviral et d'une réduction de la dose infectieuse, suite aux traitements ou lors d'une infection avec une faible dose infectieuse sur la réponse immune sont mal connus.La seconde partie du projet soutient que malgré les réductions de la sévérité de l'infection et de la réplication virale pulmonaire observées, la réponse immune adaptative T CD8[indice supérieur +] permettrait la génération de cellules mémoires conférant une immunité secondaire hétérotypique. Les résultats obtenus ont démontré qu'une réduction de la charge virale pulmonaire diminuait le recrutement de cellules de l'immunité innée et de lymphocytes T CD8[indice supérieur +] spécifiques au virus au site d'infection, comparativement à forte charge virale pulmonaire.La génération des lymphocytes T CD8[indice supérieur +] dans les organes lymphoïdes secondaires n'était pas affectée. Ces deux situations ont diminué la persistance de la population mémoire dans les poumons ce qui diminue la protection des souris lors de l'infection secondaire. Notre étude aurait donc démontré qu'une diminution de la charge virale pulmonaire pourrait avoir d'importantes conséquences négatives sur la génération de la réponse immune adaptative et mémoire.

Submitted by Heitor Rapela Medeiros (heitor.rapela@ufpe.br) on 2015-03-06T13:45:50Z No. of bitstreams: 2 TESE MARIA JOSE COUTO OLIVEIRA.pdf: 3444115 bytes, checksum: 23f3f8857155eb1b13b9abe031e11e3b (MD5) license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) / Made available in DSpace on 2015-03-06T13:45:50Z (GMT). No. of bitstreams: 2 TESE MARIA JOSE COUTO OLIVEIRA.pdf: 3444115 bytes, checksum: 23f3f8857155eb1b13b9abe031e11e3b (MD5) license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Previous issue date: 2012-02-29 / Durante a pandemia (2009-2010) com o vírus influenza A(H1N1)pdm09 foi recomendado o tratamento com o oseltamivir ou zanamivir. Com o aumento da detecção de vírus de Influenza A (H1N1) sazonal resistente ao oseltamivir houve a preocupação de que o mesmo ocorresse com o novo vírus pandêmico. Nesta pandemia, muitos pacientes com suspeita de infecção pelo vírus A(H1N1)pdm09 tiveram o teste negativo para influenza A, ficando sem uma definição do agente etiológico. Testes moleculares podem detectar a presença de mutações relacionadas à resistência ao oseltamivir, à virulência e antigenicidade do vírus, assim como podem definir o diagnóstico etiológico por vírus respiratórios. Para esclarecer essas questões dois estudos foram realizados. O primeiro foi a “Caracterização genética dos vírus influenza A (H1N1)pdm09 detectados no Estado de Pernambuco, Brasil, no período de maio de 2009 a maio de 2010”, com o objetivo de verificar a resistência desse vírus ao oseltamivir e também avaliar a diversidade genética dos vírus circulantes. Foram analisadas 118 amostras do vírus A(H1N1)pdm09 através de pirosequenciamento, precedida da transcrição reversa e reação em cadeia da polimerase em tempo real (rRT-PCR) para amplificação do H1N1pdm-N1 fragmento C e posterior detecção da mutação H274Y, utilizando o equipamento PyroMark Q-96 ID no modo SNP (single nucleotide polymorphism). Foram sequenciados os genes da hemaglutinina de 31 amostras, pela técnica de Sanger, de acordo com o Protocolo do CDC para Influenza. Foi utilizado o kit “Big Dye® terminator Cycle Sequencing” (Applied Biosystem) e o produto submetido ao método de precipitação X-terminator. A mutação H274Y não foi observada, indicativo de que os vírus sequenciados eram sensíveis ao oseltamivir. As 31 amostras sequenciadas mostraram-se intimamente relacionadas com a cepa de referência A/California/7/2009(H1N1), entretanto, foram detectados 14 tipos de mutações, porém sem implicação no aumento da virulência. O segundo estudo realizado: ”Aspectos epidemiológicos e virológicos da infecção por Influenza A(H1N1)pdm09 e frequência de outros vírus respiratórios no Estado de Pernambuco, Brasil: 2009 – 2010” teve como objetivo analisar a pandemia de influenza no estado e identificar os vírus respiratórios responsáveis pelo quadro clínico que levou à hipótese diagnóstica da influenza pandêmica. Foram analisados espécimes de 705 casos para detecção do vírus da influenza A, utilizando-se a PCR em tempo real, sistema TaqMan, de acordo com o Centers for Disease Control and Prevention / Atlanta, das quais, 26,3% (186/705) foram positivas para o vírus A(H1N1)pdm09 e 2,3% (16/705) positivas para influenza A sazonal. Para detecção de outros vírus respiratórios foram analisadas 146 amostras negativas para o vírus A (H1N1)pdm09 por RT-PCR multiplex, com o kit “FTD Respiratory21 PLUS”. Entre as amostras negativas para o vírus A(H1N1)pdm09, 36,5% (53/146) foram positivas para outros vírus respiratórios, com três casos de infecção viral múltipla. Foram detectados: rhinovírus (41%), coronavírus 43 (14,3%), metapneumovírus humano (14,3%), bocavírus (7,1%), vírus respiratório sincicial (5,3%), influenza B (3,6%), parainfluenza 2 (3,6%), parainfluenza 3 (3,6%), adenovírus (1,8%), coronavírus HKU (1,8%), enterovírus (1,8%) e parainfluenza 1 (1,8%). Estes resultados mostram a circulação, além da Influenza A(H1N1)pdm09, de outros vírus respiratórios no estado em 2009-2010; evidenciam a necessidade da análise laboratorial dos casos suspeitos de influenza e a importância do monitoramento laboratorial das infecções respiratórias, uma vez que o diagnóstico etiológico baseado apenas em critérios clínicos nem sempre é acurado.

Influenza A viruses are important pathogens of humans, other mammals and birds. Swine are considered to be the ‘mixing vessel’ for influenza viruses because of their susceptibility to infection with not only swine influenza viruses but also human and avian influenza viruses. After infection of pigs with different influenza viruses, reassortment events between genomic RNA segments and point mutations can take place which can result in novel influenza virus strains capable of causing human pandemics. To combat infections, vaccination is available in many countries for humans, but not typically used in pigs. However, anti-influenza drugs have been used to treat livestock, and mutations conferring drug resistance occur in circulating strains. The mechanisms responsible for the emergence and spread of drug resistant mutations against amantadine and oseltamivir have been studied previously but often gave conflicting results. Therefore, this PhD thesis focused on resolving the mechanisms responsible for this rapid drug resistance spread. In chapter one I examine the extent of reassortment events in swine influenza A viruses by analysing within subtype reassortment and extrapolating the results for the between subtype reassortment. Reassortment is one of the mechanisms that can be responsible for mutations, conferring resistance to drugs, to spread between strains, and thus spread in the host population. The findings of this chapter show that the genomic segments most prone to reassortment code for a polymerase (PB1) and both glycoproteins, within all three subtypes studied. Since particular mutations in the matrix protein (MP) segment cause resistance to amantadine, my study focused on MP compared to other segments and revealed moderate level of reassortment. MP reassorts well with polymerases, both within and between subtype, while nonstructural (NS) is least likely to reassort. Chapter two of this thesis aimed at resolving the origin and spread of the most common drug resistance conferring mutation in swine influenza viruses which causes amantadine resistance. I show first that this mutation occurred in swine influenza viruses and was therefore not transmitted from the recently ancestral avian influenza strains, and second that the prevalence of resistance in swine influenza viruses is due to functional linkage of mutations at other sites and not by direct drug pressure. In chapter three I examine the mechanisms responsible for the rapid rise and spread of oseltamivir resistance in human influenza H1N1 viruses which arose in the absence of drug use. The primary mutation lies in the neuraminidase glycoprotein but because of the close functional interaction I focus on changes in haemagglutinin that occurred in association with resistance. The results showed several mutations in haemagglutinin were associated with resistance suggesting selection acting on haemagglutinin in order to balance the activity of both glycoproteins. Overall these results show the importance of functional linkage between segments as a mechanism for the occurrence of drug resistance conferring mutations, and reassortment as a means of spreading these mutations into newly emerging strains.

Influenza A viruses cause seasonal and pandemic outbreaks that range from mild infections to the disastrous Spanish Flu. Resistance to neuraminidase inhibitors (NAIs) is a growing problem as these drugs constitute a vital part of treatment strategies and pandemic preparedness plans worldwide. Oseltamivir (Tamiflu®) is the mostly used NAI. Its active metabolite, oseltamivir carboxylate (OC), is excreted from treated patients and degrades poorly in sewage treatment plants and surface water. Thus, OC can enter aquatic environments where the natural influenza reservoir, dabbling ducks, can be exposed to the substance and resistance could develop. If NAI resistance is established in influenza viruses circulating among wild birds, the resistance can form part of a virus re-entering the human population either by reassortment or by direct transmission. In this thesis, evidence is presented that OC is present in the waterways during a seasonal influenza outbreak in Japan, a country in which oseltamivir is liberally used. Furthermore, when mallards were infected with an influenza A/H1N1 virus and subjected to low, environmental-like concentrations of OC, resistance developed through acquisition of the well-known resistance mutation H274Y. The influenza infection in the mallards was mainly intestinal, had a rapid onset and was progressing in a longitudinal fashion in the intestine. Finally, influenza A viruses isolated from wild mallards in Sweden and containing resistance-related mutations were examined by a neuraminidase inhibition assay. The viruses did not have a decreased sensitivity to NAIs, but had mutations with a resistance-enhancing potential. Thus, OC is present in the environment and environmental-like concentrations of OC induce resistance in influenza viruses of dabbling ducks. The present resistance situation among wild birds is not well understood but the existence of H274Y among wild birds, though rare, and the spread of the former seasonal A/H1N1 virus containing H274Y among humans indicate that resistance mutations could establish themselves also among wild birds. An oseltamivir-resistant pandemic or a human-adapted highly-pathogenic avian influenza virus are frightening scenarios as oseltamivir is a cornerstone in the defense in those situations. There is a need for further studies, surveillance in wild birds and for a prudent use of antivirals.

Les virus influenzae sont des pathogènes importants ayant un impact à la fois écologique et en santé publique humaine. En effet chez l’Homme, ces virus sont responsables de la grippe, qu’elle soit saisonnière, pandémique ou zoonotique. Face à ces infections très peu d’options thérapeutiques sont disponibles : seuls les inhibiteurs de neuraminidases (INA) sont recommandés par l’OMS mais des résistances ont été décrites. Les substitutions H274Y, E119V et R292K sont les substitutions de résistance retrouvées le plus fréquemment dans les neuraminidases des virus influenzae humains. Dans notre travail, l’étude des résistances aux INA a été organisée autour de deux axes, d’une part via le suivi clinique et biologique de la résistance chez les patients et d’autre part via l’étude de l’impact des substitutions de résistance dans des neuraminidases aviaires. La surveillance de ces résistances au sein du CNR des virus des infections respiratoires a permis la caractérisation du génome de virus influenza A(H1N1)pdm09 dans un contexte d’excrétion chronique en présence d’un traitement par INA chez un patient atteint de déficit immunitaire combiné sévère mais aussi le développement et l’évaluation de la PCR digitale pour le diagnostic de la substitution H274Y des virus A(H1N1). Au niveau mécanistique, notre travail a permis l’analyse des substitutions (H274Y, R292K, E119V±I222L) sur l’ensemble des sous-types de neuraminidases des virus influenzae A. La substitution H274Y se retrouve préférentiellement dans les N1 mais est responsable d’une diminution de la sensibilité à l’oseltamivir pour toutes les neuraminidases du groupe 1 (N1, N4, N5 et N8). La substitution E119V entraine une diminution de la sensibilité à l’oseltamivir variable en fonction des neuraminidases avec un impact plus important pour les N2, N7, N9 et N5. De plus l’association des substitutions E119V+I222L entraine un effet synergique sur le phénotype de résistance à l’oseltamivir. Enfin la substitution R292K entraine une diminution de la sensibilité à tous les INA dans toutes les neuraminidases du groupe 2 (N2, N3, N6, N7 et N9). La production d’une N9 recombinante portant la substitution R292K a montré un impact majeur de la substitution sur l’activité enzymatique. Un développement technologique toujours en cours au laboratoire va nous permettre d’aller plus loin dans l’analyse des mécanismes qui sous-tendent l’apparition de ces résistances / Influenza viruses are important human pathogens that are responsible for flu, whether seasonal, pandemic or zoonotic. Very few therapeutic options are available against these pathogens and neuraminidase inhibitors (NAI) are the only antiviral agents recommended by the WHO for treatment and prophylaxis of influenza virus infections. NAI resistance has already been described and the H274Y, E119V and R292K neuraminidase substitutions are the most frequently encountered substitutions responsible for oseltamivir resistance. During this work, we focused the NAI resistance study around two main objectives: first, we monitored clinical and biological resistance in treated patients and then we studied the impact of substitutions responsible for NAI resistance using avian neuraminidases. For NAI resistance monitoring, viral genomic diversity of a child's influenza A(H1N1)pdm09 was characterized in the context of a severe combined immunodeficiency and a chronic viral excretion despite antiviral treatment. For a better detection of H274Y substitution in A(H1N1) influenza viruses, a digital droplet PCR was developed and evaluated. At a more fundamental level, resistance substitutions (H274Y, R292K, E119V ± I222L) were analysed using all neuraminidase subtypes of influenza A viruses. To summarize, H274Y substitution is preferentially isolated in N1 but also decreases oseltamivir susceptibility in all group 1 neuraminidases (N1, N4, N5 and N8). The E119V substitution impact on oseltamivir susceptibility depends on the neuraminidase and decreases oseltamivir susceptibility especially within N2, N7, N9 and N5. Moreover, the E119V+I222L substitutions has a synergistic effect on oseltamivir resistance profile. The R292K substitution decreases all NAI susceptibility for all group 2 neuraminidases (N2, N3, N6, N7 and N9). The production of a recombinant N9 bearing the R292K substitution allows to highlight the substitution impact on the sialidasic activity. Development of new technological tools are still in progress to allow a more accurate analysis of the mechanisms that underlie the NAI resistance

Seventeen Cree anti-diabetic herbal medicines and eight Traditional Chinese Medicines have been examined for their potential to cause interactions with drugs, which is considered as a major reason for adverse drug effects. Specifically, the effect of these natural health products was examined on major Phase I drug metabolism enzymes including cytochrome P450, human carboxylesterase-1 and flavin-containing monooxygenases. Several of these natural health products have the potential to cause adverse drug effect through the inhibition of major drug metabolism enzymes. The results indicated that 7 Cree medicines plant extracts inhibited CYP3A4 activity, and 3 of them have been proven to cause potent mechanism-based inactivation of CYP3A4. Seven of eight Traditional Chinese Medicines have been identified as strong CYP3A4 inhibitors; the ethanol extract of Goji has identified as a potent inhibitor for CYP2C9 and 2C19. Goji juice showed universal inhibitory effects on most of the tested enzymes except flavin-containing monooxygenases 3.

Seventeen Cree anti-diabetic herbal medicines and eight Traditional Chinese Medicines have been examined for their potential to cause interactions with drugs, which is considered as a major reason for adverse drug effects. Specifically, the effect of these natural health products was examined on major Phase I drug metabolism enzymes including cytochrome P450, human carboxylesterase-1 and flavin-containing monooxygenases. Several of these natural health products have the potential to cause adverse drug effect through the inhibition of major drug metabolism enzymes. The results indicated that 7 Cree medicines plant extracts inhibited CYP3A4 activity, and 3 of them have been proven to cause potent mechanism-based inactivation of CYP3A4. Seven of eight Traditional Chinese Medicines have been identified as strong CYP3A4 inhibitors; the ethanol extract of Goji has identified as a potent inhibitor for CYP2C9 and 2C19. Goji juice showed universal inhibitory effects on most of the tested enzymes except flavin-containing monooxygenases 3.