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ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Aug. 2003, p. 2674–2681 Vol. 47, No. 8
0066-4804/03/$08.00ϩ0 DOI: 10.1128/AAC.47.8.2674–2681.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Dinucleotide Analogues as Novel Inhibitors of RNA-Dependent
RNA Polymerase of Hepatitis C Virus
Weidong Zhong,* Haoyun An, Dinesh Barawkar, and Zhi Hong
Drug Discovery, Ribapharm, Inc., Costa Mesa, California 92626
Received 5 March 2003/Returned for modification 12 May 2003/Accepted 23 May 2003
Replication of hepatitis C virus (HCV) RNA is catalyzed by the virally encoded RNA-dependent RNA poly-
merase NS5B. It is believed that the viral polymerase utilizes a de novo or primer-independent mechanism for
initiation of RNA synthesis. Our previous work has shown that dinucleotides were efficient initiation molecules
for NS5B in vitro (W. Zhong, E. Ferrari, C. A. Lesburg, D. Maag, S. K. Ghosh, C. E. Cameron, J. Y. Lau, and
Z. Hong, J. Virol. 74:9134-9143, 2000). In this study, we further demonstrated that dinucleotide analogues
could serve as inhibitors of de novo initiation of RNA synthesis directed by HCV NS5B. Both mononucleotide-
and dinucleotide-initiated RNA syntheses were affected by dinucleotide analogues. The presence of the 5؅-
phosphate group in the dinucleotide compounds was required for efficient inhibition of de novo initiation.
Optimal inhibitory activity also appeared to be dependent on the base-pairing potential between the com-
pounds and the template terminal bases. Because the initiation process is a rate-limiting step in viral RNA
replication, inhibitors that interfere with the initiation process will have advantages in suppressing virus
replication. The use of dinucleotide analogues as inhibitor molecules to target viral replication initiation
represents a novel approach to antiviral interference.
Hepatitis C virus (HCV) infection is an important public
health problem worldwide and is recognized as the major cause
of non-A, non-B hepatitis. It is estimated that HCV affects 4
million people in the United States, 8 million people in Europe
and Japan, and, collectively, 170 million people worldwide (22,
24). Although HCV infection resolves in some cases, the virus
establishes chronic infection in up to 80% of the infected
individuals and persists for decades. It is estimated that about
20% of these infected individuals will go on to develop cirrho-
sis, and 1 to 5% will develop liver failure and hepatocellular
carcinoma (23, 24, 26). Chronic hepatitis C is the leading cause
of chronic liver disease and the leading indication for liver
transplantation in the United States. The Centers for Disease
Control and Prevention estimate that hepatitis C currently is
responsible for approximately 8,000 to 10,000 deaths in the
United States annually. This number is projected to increase
significantly over the next decade. Currently, there is no vac-
cine for HCV infection due to the high degree of heterogeneity
of this virus.
The objectives for the treatment of chronic hepatitis C are to
achieve complete and sustained clearance of HCV RNA in
serum and normalization of serum alanine aminotransferase
levels. In the absence of a prophylactic vaccine or a highly
specific antiviral agent, treatment options for chronically in-
fected individuals are limited. The current treatment options
for chronic hepatitis C include (pegalated) alpha interferon
(IFN-␣) monotherapy and (pegalated) IFN-␣–ribavirin com-
bination therapy, with sustained virological response rates of
between 10 and 60% (4, 7, 15–17, 20, 21). Clearly, more effec-
tive and direct antiviral interventions are necessary for further
prevention and treatment of the life-threatening complications
caused by HCV infection. Efforts to identify and develop high-
ly specific and potent HCV inhibitors have intensified recently.
Investigators have targeted all regions of the HCV genome and
virally encoded replication enzymes for potential therapeutic
discovery.
HCV is a positive-strand RNA virus belonging to the family
Flaviviridae (3). This virus family also contains about 40 flavi-
viruses that are associated with human diseases, including the
dengue fever viruses, yellow fever viruses and Japanese en-
cephalititis virus, as well as pestiviruses, whose infection of
domesticated livestock can cause significant economic losses
worldwide. Like other RNA viruses, a virally encoded replica-
tion enzyme, RNA-dependent RNA polymerase (RdRp), plays
a central role in viral RNA replication of HCV and other
members of the family Flaviviridae. In the case of HCV, the
replication protein is termed “NS5B” (nonstructural protein
5B) (2, 5, 6, 12, 13). RdRp proteins are the key components of
the viral replicase complexes and therefore serve as attractive
targets for antiviral development (1, 8, 9, 11).
It is generally believed that HCV RNA replication is initi-
ated by NS5B RdRp via a de novo or primer-independent
mechanism (10, 14, 18, 19, 25, 28). Our previous observations
suggest that dinucleotides can be used more efficiently as ini-
tiation molecules by HCV NS5B than mononucleotides in the
in vitro RNA replication assay (27). It is thus perceivable that
dinucleotide analogues may have potential to inhibit initiation
of HCV RNA replication. Because the initiation process is
considered to be the rate-limiting step in viral RNA replica-
tion, inhibitors that interfere with the initiation process will
have advantages in suppressing virus replication. The use of
dinucleotide analogues as inhibitor molecules to target the
initiation step of viral RNA synthesis represents a novel ap-
proach to antiviral interference.
* Corresponding author. Mailing address: Ribapharm, Inc., 3300
Hyland Ave., Costa Mesa, CA 92626. Phone: (714) 427-6236, ext. 2201.
Fax: (714) 668-3141. E-mail: wzhong@ribapharm.com.
2674
FIG. 1. Chemical synthesis schemes of dinucleotide analogues I (A) and II (B).
VOL. 47, 2003 NOTES 2675
FIG. 2. Inhibition of HCV NS5B-catalyzed de novo initiation of RNA synthesis by dinucleotide analogues. (A) Structures of dinucleotide
analogues I and II. (B) Inhibition of NS5B-directed de novo initiation of RNA synthesis. A short synthetic RNA (5Ј AAAAAAAAGC 3Ј) was used
as a template in the de novo initiation assay. GTP and radiolabeled CTP were used as the initiating and the elongating nucleotides, respectively.
A standard reaction mixture in a total volume of 20 ␮l contained 50 mM HEPES (pH 7.5), 10 mM ␤-mercaptoethanol (␤-ME), 10 mM MgCl2,
5 ␮M RNA template, 100 ␮M GTP, 100 ␮M CTP–10 ␮Ci of [␣-33
P]CTP, 1 ␮M HCV NS5B, and increasing concentrations (0 to 300 ␮M) of the
analogue compounds. The reaction mixture was incubated at 30°C for 30 min, and the RNA products were resolved on a 25% polyacrylamide gel
electrophoresis–6 M urea–Tris-borate-EDTA gel prior to PhosphorImaging analysis. Compounds I and II are shown in lanes 2 to 6 and 7 to 11,
respectively. The labeled dinucleotide product (pppGpC) is indicated on the left.
2676 NOTES ANTIMICROB. AGENTS CHEMOTHER.
Synthesis of dinucleotide compounds. We initiated this
study by synthesizing two dinucleotide analogues (I and II)
(Fig. 1) that contained a guanine base at the 5Ј end and a cy-
tosine base at the 3Ј end. Modifications were introduced in the
sugar moieties (2Ј or 3Ј-O-methyl) and the linker (phosphoro-
thioate) for improvement of compound stability. In addition, a
5Ј-phosphate group was added to further mimic the natural
dinucleotides. These compounds were guanine-cytosine an-
alogues (pGpsC).
The dinucleotide compounds were synthesized on solid sup-
port at a 10-␮mol scale with an Applied Biosystems 394 DNA/
RNA synthesizer. For dinucleotide I, 3Ј-dC-CPG 500 (Glen
Research) (compound 1 in Fig. 1A) was used as the starting
material. For dinucleotide II, 5Ј-O-dimethoxytrityl-N4
-benzoyl-3Ј-
O-methylcytidine-2Ј-O-[(2-cyanoethyl)-(N,N-diisopopyl)]
phosphoramidite (compound 7 in Fig. 1B) was linked to uni-
versal solid support. The synthesis of the dinucleotide com-
pounds was carried out with the following common steps (Fig.
1): (i) detritylation (3% dichloroacetic acid [DCA] in CH2Cl2
for 3 min); (ii) coupling with the next monomer, 5Ј-O-
dimethoxytrityl-N-isobutyryl-2Ј-O-methylguanosine-3Ј-O-[(2-cya-
noethyl)-(N,N-diisopopyl)]phosphoramidite (compound 2 in Fig.
1A), using tetrazole as the coupling agent; (iii) oxidation using
Beaucage reagent to the phosphorothioate; (iv) detritylation; (v)
coupling of the 5Ј-phosphate group using chemical phosphoryla-
tion reagent 4 (compound 4 in Fig. 1A) (Glen Research); and (vi)
oxidation using iodine-water to 5Ј-phosphate.
The chemical phosphorylation reagent used for addition of
the 5Ј-phosphate had a terminal dimethoxytrityl (DMTr)
group, which was utilized to facilitate reverse-phase high-per-
formance liquid chromatography (HPLC) purification. After
completion of the synthesis, dinucleotide I was treated with
NH4OH at 60°C for 22 h, while dinucleotide II was treated at
80°C for 8 h. This NH4OH treatment cleaved dinucleotides
from solid support and removed protecting groups from nucleo-
bases and internucleoside phosphate linkage. The compounds
were then purified with C18 columns (Waters). The dilute
trifluoroacetic acid solution was used as a mobile phase to
remove the DMTr protection group. The purified dinucleotide
compounds were characterized by mass spectrum (I, MϩHϩ
ϭ
683.62; II, MϩHϩ
ϭ 713.42). HPLC purity was more than
85%, with the single largest impurity not more than 3%.
Dinucleotide analogues inhibited de novo initiation of RNA
synthesis directed by HCV NS5B. To determine whether the
synthesized dinucleotide compounds (pGpsC analogues) can
inhibit initiation of RNA replication by HCV NS5B, a de novo
initiation assay was performed, which used a small synthetic
10-mer RNA (5Ј AAAAAAAAGC 3Ј) as the template. In this
assay, GTP (at 100 ␮M) was used as the initiating nucleotide,
and formation of the dinucleotide product pppGpC was mon-
itored by inclusion of [␣-33
P]CTP as the elongating nucleotide
in the reaction. The 3Ј-terminal bases (GC-3Ј) of the template
RNA were chosen based on the following considerations. (i)
FIG. 3. Requirement of the 5Ј-phosphate group in the dinucleotide
compound for inhibitory activity. Inhibitory effects on de novo initia-
tion of RNA synthesis by dinucleotide analogues I (lanes 2 and 3), II
(lanes 4 and 5), and III (lanes 6 and 7) were compared (50 and 200
␮M). A short synthetic RNA (5Ј AAAAAAAAGC 3Ј) was used as the
template in the de novo initiation assay. GTP and radiolabeled CTP
were used as the initiating and elongating nucleotides, respectively (see
the legend to Fig. 2 for assay details). The structure of compound III
is shown on the right.
VOL. 47, 2003 NOTES 2677
The 3Ј-terminal sequence of negative-strand HCV RNA
(ϪGC 3Ј) serves as a template for multiple rounds of positive-
strand RNA synthesis. (ii) The dinucleotide compounds syn-
thesized mimick guanine-cytosine analogues. It has been
demonstrated previously that GTP is an efficient initiation
molecule for HCV NS5B in a number of assays (14, 19, 25, 28).
As shown in Fig. 2, both dinucleotide analogues I (lanes 2 to 6)
and II (lanes 7 to 11) had an inhibitory effect on NS5B-directed
de novo initiation, with 50% inhibitory concentrations (IC50s)
of 20 and 65 ␮M, respectively. This result indicated that the
dinucleotide compounds were able to efficiently compete with
the initiating nucleotide GTP for binding to the polymerase
protein and were able to inhibit the initiation of RNA syn-
thesis.
The difference between these two dinucleotide analogues
was that one contains a 3Ј-O-methyl group at the C3Јof the
second ribose moiety (II), while the other contains a hydrogen
(3Ј-H) at the same position (I). The relatively weaker activity
for analogue II (higher IC50) implied that addition of a larger
group at the 3Ј position reduced the binding affinity to the
NS5B polymerase and thus competed less effectively with the
initiating GTP
The 5؅-phosphate group was important for the inhibitory
activity of the dinucleotide analogues. Both analogues tested in
Fig. 2 contained a phosphate group at the 5Ј terminus. This was
based on the assumption that the phosphate group might con-
tribute to the binding affinity with NS5B polymerase. To dem-
onstrate that such a phosphate group was indeed important for
the inhibitory activity of the dinucleotide compounds, a third
analogue (III) was tested in the same replication initiation
assay. Analogue III possessed a similar structure to analogues
I and II, except the 5Ј-phosphate group was deleted. As shown
in Fig. 3, analogue III lost its inhibitory activity on de novo
initiation of RNA synthesis, with an IC50 of Ͼ200 ␮M (com-
FIG. 4. Base pairing between the dinucleotide analogue and the template 3Ј-terminal bases is important for optimal activity. De novo initiation
of RNA synthesis was tested with two synthetic RNA templates, which differ only in the terminal base (U versus C), in the presence of increasing
concentrations of dinucleotide analogue I (see Fig. 2 for structure). ATP and GTP were used as the initiating nucleotides, respectively, based on
the terminal base of the template RNA (ATP for 5Ј AAAAAAAAGU 3Ј and GTP for 5Ј AAAAAAAAGC 3Ј).
2678 NOTES ANTIMICROB. AGENTS CHEMOTHER.
pare lanes 6 and 7 with lanes 2 to 5). This result suggested that
the 5Ј-phosphate group of the dinucleotide analogues played
an important role in the interaction with NS5B protein, the
lack of which resulted in loss of binding affinity required for
efficient competition with the initiating GTP.
Optimal inhibitory activity of the dinucleotide analogues
was dependent on the base-pairing potential between the an-
alogues and the template 3؅-terminal bases. To determine
whether the inhibition of de novo initiation by dinucleotide
analogues was template sequence specific and whether base-
pairing potential between the compounds and the template
RNA played a role in stabilizing the compound-NS5B interac-
tion, de novo initiation assays were performed with two sepa-
rate RNA templates that contained different 3Ј-terminal bases
(Fig. 4). One template (5Ј AAAAAAAAGU 3Ј) used ATP as
the initiating nucleotide, whereas the other (5Ј AAAAAAAA
GC 3Ј) used GTP as the initiating nucleotide. The radiolabeled
dinucleotide products generated from the de novo initiation
assays were pppApC and pppGpC, respectively. The inhibitory
effects of analogue I (which showed the highest activity in
previous assays) on RNA initiation from the two RNA tem-
plates were compared. As shown in Fig. 4, this compound
showed a more profound effect on GTP-initiated RNA synthe-
sis (IC50 of ϳ20 ␮M) than on ATP-initiated RNA synthesis
(IC50 of ϳ90 ␮M). This result, together with the fact that the
dinucleotide compound tested was a guanine-cytosine (GC)
analogue, suggested that the base-pairing potential between
the compound and the 3Ј-terminal bases of the template RNA
played a positive role in maximizing the inhibitory activity on
de novo initiation of RNA synthesis.
Inhibition of RNA synthesis initiated by dinucleotide prim-
ers. Prior assays in determining the compounds’ activity were
performed using mononucleotide (GTP or ATP) as the initi-
ating molecule. We have shown previously that dinucleotides
were more efficient as initiating molecules than mononucle-
otide in NS5B-directed RNA replication assays (27). It would
be interesting to determine whether the dinucleotide ana-
logues were capable of inhibiting RNA synthesis initiated from
dinucleotide primers. To this end, radiolabeled dinucleotide
primer ([33
P]GpC) was used to prime RNA synthesis (UTP
incorporations) from the template RNA 5Ј AAAAAAAAGC
3Ј in the presence of increasing concentrations of compound I.
As shown in Fig. 5, the dinucleotide analogue was also active in
inhibiting pGpC-initiated RNA synthesis (multiple rounds of
UMP incorporations), with an IC50 of approximately 50 ␮M
(lanes 1 to 6). This result confirmed that the dinucleotide
inhibitors were capable of competing with dinucleotide initiat-
ing molecules and inhibiting RNA replication. The apparent
reduction in the potency of the compound likely reflected the
tighter binding between the enzyme and dinucleotide initiat-
ing molecule, resulting in less efficient competition by the
compound.
Initiation of RNA synthesis by viral replication machinery
represents a key step in the replication cycle of RNA viruses.
It is generally believed that initiation is a rate-limiting step in
viral RNA replication and that therapeutic interference at this
step will effectively reduce the level of virus replication. So far,
compounds specifically targeting the initiation process of viral
RNA replication have not been thoroughly documented. In
this study, we showed that dinucleotide compounds could serve
as potential inhibitors of de novo initiation of RNA synthesis
FIG. 5. Inhibition of RNA synthesis initiated from a dinucleotide
primer (pGpC). The initiation assay reaction mixture contained, in
addition to the standard components listed in the legend to Fig. 2, 5
␮M template RNA (5Ј AAAAAAAAGC 3Ј), 5 ␮M end-labeled
[33
P]GpC primer, 100 ␮M UTP, and 1 ␮M NS5B enzyme. Extended
RNA products were detected from extension of the labeled primer due
to multiple UMP incorporations.
VOL. 47, 2003 NOTES 2679
directed by HCV NS5B polymerase. This observation was in
accordance with our previous results showing that dinucleo-
tides were efficient initiating molecules for HCV NS5B-di-
rected RNA replication. The use of dinucleotide analogues as
inhibitors to target the initiation step of viral RNA synthesis
represents a novel approach to antiviral interference.
Despite the successful confirmation of the concept that dinu-
cleotide analogues are effective inhibitors of de novo RNA
replication, significant challenges remain before further devel-
opment of this class of compounds for direct therapeutic ap-
plication can be considered. Dinucleotide molecules, especially
RNA, are generally unstable. The intramolecular nucleophilic
attack by the 2Ј-hydroxyl group in the sugar moiety on the ad-
jacent phosphate bond causes the degradation of the dinucleo-
tides to mononucleotides and even further to nucleosides.
Dinucleotides can also be hydrolyzed by water and other nu-
cleophiles present in the biological system. In addition, the
5Ј-phosphate dinucleotides, which were shown to be more ef-
fective in inhibiting de novo initiation of RNA replication, are
even less stable because of the presence of the additional
phosphate group. Furthermore, the polyanionic nature of the
dinucleotide molecules strongly hampers the penetration of
such compounds through cell membrane due to the high lipo-
philicity on the membrane surface. Finally, dinucleotide mol-
ecules can also bind to other nucleic acids through hydrogen
bonds, which may result in a loss of selectivity for a predeter-
mined target in vivo.
The pGpsC type of dinucleotide analogues used in this study
contained a phosphorothioate linker. Such linker is believed to
enhance the stability of the dinucleotide compounds over the
natural nucleic acid. For the same purpose, the 2Ј-hydroxyl
group of the sugar moiety was further modified by methylation
so that the 2Ј-hydroxyl group is not available for intramolecular
hydrolysis. Nucleic acids with 2Ј-O-methyl modifications have
been reported to possess improved stability, lipophilicity, and
bioavailability, as well as other pharmacological properties.
The physicochemical and pharmacological features of the
dinucleotide compounds can be further improved by modi-
fications of the phosphate groups in reducing their anionic
character and, in the mean time, increasing lipophilicity. In
this case, the various conjugation strategies used for improv-
ing properties of oligonucleotide compounds may be ap-
plied.
Despite all of these challenges, the demonstration that dinu-
cleotide analogues can effectively inhibit de novo initiation of
RNA replication by HCV NS5B confirms the proof of princi-
ple for this novel antiviral approach. With future advance-
ments in addressing the outstanding issues related to the dinu-
cleotide compounds, this class of compounds may eventually
reach a stage of development for therapy against important
viral diseases.
We thank Wayne Cheney, Vicky Lai, Nigel Horscroft, Jim Wu, Jae
Hoon Shim, Todd Appleby, and Nanhua Yao for helpful discussions.
This work was supported by Ribapharm, Inc.
REFERENCES
1. Ali, S., K. D. Tardif, and A. Siddiqui. 2003. Cell-free replication of the
hepatitis C virus subgenomic replicon. J. Virol. 76:12001–12007.
2. Behrens, S.-E., L. Tomei, and R. De Francesco. 1996. Identification and
properties of the RNA-dependent RNA polymerase of hepatitis C virus.
EMBO J. 15:12–22.
3. Choo, Q. L., G. Kuo, A. J. Weiner, L. R. Overby, D. W. Bradley, and M.
Houghton. 1989. Isolation of a cDNA clone derived from a blood-borne
non-A, non-B viral hepatitis genome. Science 244:359–362.
4. Davis, G. L., R. Esteban-Mur, V. Rustgi, J. Hoefs, S. C. Gordon, C. Trepo,
M. L. Shiffman, S. Zeuzem, A. Craxi, M. H. Ling, and J. Albrecht. 1998.
Interferon alfa-2b alone or in combination with ribavirin for the treatment of
relapse of chronic hepatitis C. N. Engl. J. Med. 339:1493–1499.
5. De Francesco, R., S. E. Behrens, L. Tomei, S. Altamura, and J. Jiricny. 1996.
RNA-dependent RNA polymerase of hepatitis C virus. Methods Enzymol.
275:58–67.
6. Ferrari, E., J. Wright-Minogue, J. W. S. Fang, B. M. Baroudy, J. Y. N. Lau,
and Z. Hong. 1999. Characterization of soluble hepatitis C virus RNA-
dependent RNA polymerase expressed in Escherichia coli. J. Virol. 73:1649–
1654.
7. Fried, M. W., M. Shiffman, K. R. Reddy, C. Smith, G. Marinos, F. L. J.
Goncales, D. Haussinger, M. Diago, G. Carosi, D. Dhumeaux, A. Craxi, A.
Lin, J. Hoffman, and J. Yu. 2002. Peginterferon alfa-2a plus ribavirin for
chronic hepatitis C virus infection. N. Engl. J. Med. 347:975–982.
8. Gosert, R., D. Egger, V. Lohmann, R. Bartenschlager, H. E. Blum, K. Bienz,
and D. Moradpour. 2003. Identification of the hepatitis C virus RNA repli-
cation complex in Huh-7 cells harboring subgenomic replicons. J. Virol.
77:5487–5492.
9. Hardy, R. W., J. Marcotrigiano, K. J. Blight, J. E. Majors, and C. M. Rice.
2003. Hepatitis C virus RNA synthesis in a cell-free system isolated from
replicon-containing hepatoma cells. J. Virol. 77:2029–2037.
10. Hong, Z., C. E. Cameron, M. P. Walker, C. Castro, N. Yao, J. Y. Lau, and W.
Zhong. 2001. A novel mechanism to ensure terminal initiation by hepatitis C
virus NS5B polymerase. Virology 285:6–11.
11. Lai, V. C. H., S. Dempsey, J. Y. N. Lau, Z. Hong, and W. Zhong. 2003. In vitro
RNA replication directed by replicase complexes isolated from the sub-
genomic replicon cells of hepatitis C virus. J. Virol. 77:2295–2300.
12. Lohmann, V., F. Ko¨rner, U. Herian, and R. Bartenschlager. 1997. Biochem-
ical properties of hepatitis C virus NS5B RNA-dependent RNA polymerase
and identification of amino acid sequence motifs essential for enzymatic
activity. J. Virol. 71:8416–8428.
13. Lohmann, V., A. Roos, F. Korner, J. O. Koch, and R. Bartenschlager. 1998.
Biochemical and kinetic analyses of NS5B RNA-dependent RNA polymer-
ase of the hepatitis C virus. Virology 249:108–118.
14. Luo, G., R. K. Hamatake, D. M. Mathis, J. Racela, K. L. Rigat, J. Lemm, and
R. J. Colonno. 2000. De novo initiation of RNA synthesis by the RNA-
dependent RNA polymerase (NS5B) of hepatitis C virus. J. Virol. 74:851–
863.
15. Manns, M. P., J. G. McHutchison, S. C. Gordon, V. K. Rustgi, M. Shiffman,
R. Reindollar, Z. D. Goodman, K. Koury, M. Ling, and J. K. Albrecht. 2001.
Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus
ribavirin for initial treatment of chronic hepatitis C: a randomised trial.
Lancet 358:958–965.
16. McHutchison, J. G., S. C. Gordon, E. R. Schiff, M. L. Shiffman, W. M. Lee,
V. K. Rustgi, Z. D. Goodman, M. H. Ling, S. Cort, and J. K. Albrecht. 1998.
Interferon alfa-2b alone or in combination with ribavirin as initial treatment
for chronic hepatitis C. N. Engl. J. Med. 339:1485–1492.
17. Michielsen, P., R. Brenard, and H. Reynaert. 2002. Treatment of hepatitis C:
impact on the virus, quality of life and the natural history. Acta Gastroen-
terol. Belg. 65:90–94.
18. Oh, J.-W., T. Ito, and M. M. C. Lai. 1999. A recombinant hepatitis C virus
RNA-dependent RNA polymerase capable of copying the full-length viral
RNA. J. Virol. 73:7694–7702.
19. Oh, J. W., G. T. Sheu, and M. M. Lai. 2000. Template requirement and
initiation site selection by hepatitis C virus polymerase on a minimal viral
RNA template. J. Biol. Chem. 275:17710–17717.
20. Poynard, T., P. Marcellin, S. S. Lee, C. Niederau, G. S. Minuk, G. Ideo, V.
Bain, J. Heathcote, S. Zeuzem, C. Trepo, and J. Albrecht. 1998. Randomised
trial of interferon alpha2b plus ribavirin for 48 weeks or for 24 weeks versus
interferon alpha2b plus placebo for 48 weeks for treatment of chronic in-
fection with hepatitis C virus. Lancet 352:1426–1432.
21. Reichard, O., G. Norkrans, A. Fryden, J. H. Braconier, A. Sonnerborg, and
O. Weiland. 1998. Randomised, double-blind, placebo-controlled trial of
interferon alpha-2b with and without ribavirin for chronic hepatitis C. Lancet
351:83–87.
22. Rice, C. M. 1996. Flaviviridae: the viruses and their replication, p. 931–960.
In B. N. Fields, D. M. Knipe, and P. M. Howley (ed.), Fields virology. Raven
Press, New York, N.Y.
23. Saito, I., T. Miyamura, A. Ohbayashi, H. Harada, T. Katayama, S. Kiku-
chi, T. Y. Watanabe, S. Koi, M. Onji, Y. Ohta, Q.-L. Choo, M. Houghton,
and G. Kuo. 1990. Hepatitis C virus infection is associated with the de-
velopment of hepatocellular carcinoma. Proc. Natl. Sci. Acad. USA 87:
6547–6549.
24. Seeff, L. B. 1999. Natural history of hepatitis C. Am. J. Med. 107:10S–15S.
25. Sun, X.-L., R. B. Johnson, M. A. Hockman, and Q. M. Wang. 2000. De novo
2680 NOTES ANTIMICROB. AGENTS CHEMOTHER.
RNA synthesis catalyzed by HCV RNA-dependent RNA polymerase. Bio-
chem. Biophys. Res. Commun. 268:798–803.
26. World Health Organization. 1996. Hepatitis C. Seroprevalence of hepati-
tis C virus (HCV) in a population sample. Wkly. Epidemiol. Rec. 71:346–
349.
27. Zhong, W., E. Ferrari, C. A. Lesburg, D. Maag, S. K. B. Ghosh, C. E.
Cameron, J. Y. N. Lau, and Z. Hong. 2000. Template/primer requirements
and single nucleotide incorporation by hepatitis C virus nonstructural pro-
tein 5B polymerase. J. Virol. 74:9134–9143.
28. Zhong, W., A. S. Uss, E. Ferrari, J. Y. N. Lau, and Z. Hong. 2000. De novo
initiation of RNA synthesis by hepatitis C virus nonstructural protein 5B
polymerase. J. Virol. 74:2017–2022.
VOL. 47, 2003 NOTES 2681

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Antimicrobial Agents and Chemotherapy 2003 47(8)2674-2681

  • 1. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Aug. 2003, p. 2674–2681 Vol. 47, No. 8 0066-4804/03/$08.00ϩ0 DOI: 10.1128/AAC.47.8.2674–2681.2003 Copyright © 2003, American Society for Microbiology. All Rights Reserved. Dinucleotide Analogues as Novel Inhibitors of RNA-Dependent RNA Polymerase of Hepatitis C Virus Weidong Zhong,* Haoyun An, Dinesh Barawkar, and Zhi Hong Drug Discovery, Ribapharm, Inc., Costa Mesa, California 92626 Received 5 March 2003/Returned for modification 12 May 2003/Accepted 23 May 2003 Replication of hepatitis C virus (HCV) RNA is catalyzed by the virally encoded RNA-dependent RNA poly- merase NS5B. It is believed that the viral polymerase utilizes a de novo or primer-independent mechanism for initiation of RNA synthesis. Our previous work has shown that dinucleotides were efficient initiation molecules for NS5B in vitro (W. Zhong, E. Ferrari, C. A. Lesburg, D. Maag, S. K. Ghosh, C. E. Cameron, J. Y. Lau, and Z. Hong, J. Virol. 74:9134-9143, 2000). In this study, we further demonstrated that dinucleotide analogues could serve as inhibitors of de novo initiation of RNA synthesis directed by HCV NS5B. Both mononucleotide- and dinucleotide-initiated RNA syntheses were affected by dinucleotide analogues. The presence of the 5؅- phosphate group in the dinucleotide compounds was required for efficient inhibition of de novo initiation. Optimal inhibitory activity also appeared to be dependent on the base-pairing potential between the com- pounds and the template terminal bases. Because the initiation process is a rate-limiting step in viral RNA replication, inhibitors that interfere with the initiation process will have advantages in suppressing virus replication. The use of dinucleotide analogues as inhibitor molecules to target viral replication initiation represents a novel approach to antiviral interference. Hepatitis C virus (HCV) infection is an important public health problem worldwide and is recognized as the major cause of non-A, non-B hepatitis. It is estimated that HCV affects 4 million people in the United States, 8 million people in Europe and Japan, and, collectively, 170 million people worldwide (22, 24). Although HCV infection resolves in some cases, the virus establishes chronic infection in up to 80% of the infected individuals and persists for decades. It is estimated that about 20% of these infected individuals will go on to develop cirrho- sis, and 1 to 5% will develop liver failure and hepatocellular carcinoma (23, 24, 26). Chronic hepatitis C is the leading cause of chronic liver disease and the leading indication for liver transplantation in the United States. The Centers for Disease Control and Prevention estimate that hepatitis C currently is responsible for approximately 8,000 to 10,000 deaths in the United States annually. This number is projected to increase significantly over the next decade. Currently, there is no vac- cine for HCV infection due to the high degree of heterogeneity of this virus. The objectives for the treatment of chronic hepatitis C are to achieve complete and sustained clearance of HCV RNA in serum and normalization of serum alanine aminotransferase levels. In the absence of a prophylactic vaccine or a highly specific antiviral agent, treatment options for chronically in- fected individuals are limited. The current treatment options for chronic hepatitis C include (pegalated) alpha interferon (IFN-␣) monotherapy and (pegalated) IFN-␣–ribavirin com- bination therapy, with sustained virological response rates of between 10 and 60% (4, 7, 15–17, 20, 21). Clearly, more effec- tive and direct antiviral interventions are necessary for further prevention and treatment of the life-threatening complications caused by HCV infection. Efforts to identify and develop high- ly specific and potent HCV inhibitors have intensified recently. Investigators have targeted all regions of the HCV genome and virally encoded replication enzymes for potential therapeutic discovery. HCV is a positive-strand RNA virus belonging to the family Flaviviridae (3). This virus family also contains about 40 flavi- viruses that are associated with human diseases, including the dengue fever viruses, yellow fever viruses and Japanese en- cephalititis virus, as well as pestiviruses, whose infection of domesticated livestock can cause significant economic losses worldwide. Like other RNA viruses, a virally encoded replica- tion enzyme, RNA-dependent RNA polymerase (RdRp), plays a central role in viral RNA replication of HCV and other members of the family Flaviviridae. In the case of HCV, the replication protein is termed “NS5B” (nonstructural protein 5B) (2, 5, 6, 12, 13). RdRp proteins are the key components of the viral replicase complexes and therefore serve as attractive targets for antiviral development (1, 8, 9, 11). It is generally believed that HCV RNA replication is initi- ated by NS5B RdRp via a de novo or primer-independent mechanism (10, 14, 18, 19, 25, 28). Our previous observations suggest that dinucleotides can be used more efficiently as ini- tiation molecules by HCV NS5B than mononucleotides in the in vitro RNA replication assay (27). It is thus perceivable that dinucleotide analogues may have potential to inhibit initiation of HCV RNA replication. Because the initiation process is considered to be the rate-limiting step in viral RNA replica- tion, inhibitors that interfere with the initiation process will have advantages in suppressing virus replication. The use of dinucleotide analogues as inhibitor molecules to target the initiation step of viral RNA synthesis represents a novel ap- proach to antiviral interference. * Corresponding author. Mailing address: Ribapharm, Inc., 3300 Hyland Ave., Costa Mesa, CA 92626. Phone: (714) 427-6236, ext. 2201. Fax: (714) 668-3141. E-mail: wzhong@ribapharm.com. 2674
  • 2. FIG. 1. Chemical synthesis schemes of dinucleotide analogues I (A) and II (B). VOL. 47, 2003 NOTES 2675
  • 3. FIG. 2. Inhibition of HCV NS5B-catalyzed de novo initiation of RNA synthesis by dinucleotide analogues. (A) Structures of dinucleotide analogues I and II. (B) Inhibition of NS5B-directed de novo initiation of RNA synthesis. A short synthetic RNA (5Ј AAAAAAAAGC 3Ј) was used as a template in the de novo initiation assay. GTP and radiolabeled CTP were used as the initiating and the elongating nucleotides, respectively. A standard reaction mixture in a total volume of 20 ␮l contained 50 mM HEPES (pH 7.5), 10 mM ␤-mercaptoethanol (␤-ME), 10 mM MgCl2, 5 ␮M RNA template, 100 ␮M GTP, 100 ␮M CTP–10 ␮Ci of [␣-33 P]CTP, 1 ␮M HCV NS5B, and increasing concentrations (0 to 300 ␮M) of the analogue compounds. The reaction mixture was incubated at 30°C for 30 min, and the RNA products were resolved on a 25% polyacrylamide gel electrophoresis–6 M urea–Tris-borate-EDTA gel prior to PhosphorImaging analysis. Compounds I and II are shown in lanes 2 to 6 and 7 to 11, respectively. The labeled dinucleotide product (pppGpC) is indicated on the left. 2676 NOTES ANTIMICROB. AGENTS CHEMOTHER.
  • 4. Synthesis of dinucleotide compounds. We initiated this study by synthesizing two dinucleotide analogues (I and II) (Fig. 1) that contained a guanine base at the 5Ј end and a cy- tosine base at the 3Ј end. Modifications were introduced in the sugar moieties (2Ј or 3Ј-O-methyl) and the linker (phosphoro- thioate) for improvement of compound stability. In addition, a 5Ј-phosphate group was added to further mimic the natural dinucleotides. These compounds were guanine-cytosine an- alogues (pGpsC). The dinucleotide compounds were synthesized on solid sup- port at a 10-␮mol scale with an Applied Biosystems 394 DNA/ RNA synthesizer. For dinucleotide I, 3Ј-dC-CPG 500 (Glen Research) (compound 1 in Fig. 1A) was used as the starting material. For dinucleotide II, 5Ј-O-dimethoxytrityl-N4 -benzoyl-3Ј- O-methylcytidine-2Ј-O-[(2-cyanoethyl)-(N,N-diisopopyl)] phosphoramidite (compound 7 in Fig. 1B) was linked to uni- versal solid support. The synthesis of the dinucleotide com- pounds was carried out with the following common steps (Fig. 1): (i) detritylation (3% dichloroacetic acid [DCA] in CH2Cl2 for 3 min); (ii) coupling with the next monomer, 5Ј-O- dimethoxytrityl-N-isobutyryl-2Ј-O-methylguanosine-3Ј-O-[(2-cya- noethyl)-(N,N-diisopopyl)]phosphoramidite (compound 2 in Fig. 1A), using tetrazole as the coupling agent; (iii) oxidation using Beaucage reagent to the phosphorothioate; (iv) detritylation; (v) coupling of the 5Ј-phosphate group using chemical phosphoryla- tion reagent 4 (compound 4 in Fig. 1A) (Glen Research); and (vi) oxidation using iodine-water to 5Ј-phosphate. The chemical phosphorylation reagent used for addition of the 5Ј-phosphate had a terminal dimethoxytrityl (DMTr) group, which was utilized to facilitate reverse-phase high-per- formance liquid chromatography (HPLC) purification. After completion of the synthesis, dinucleotide I was treated with NH4OH at 60°C for 22 h, while dinucleotide II was treated at 80°C for 8 h. This NH4OH treatment cleaved dinucleotides from solid support and removed protecting groups from nucleo- bases and internucleoside phosphate linkage. The compounds were then purified with C18 columns (Waters). The dilute trifluoroacetic acid solution was used as a mobile phase to remove the DMTr protection group. The purified dinucleotide compounds were characterized by mass spectrum (I, MϩHϩ ϭ 683.62; II, MϩHϩ ϭ 713.42). HPLC purity was more than 85%, with the single largest impurity not more than 3%. Dinucleotide analogues inhibited de novo initiation of RNA synthesis directed by HCV NS5B. To determine whether the synthesized dinucleotide compounds (pGpsC analogues) can inhibit initiation of RNA replication by HCV NS5B, a de novo initiation assay was performed, which used a small synthetic 10-mer RNA (5Ј AAAAAAAAGC 3Ј) as the template. In this assay, GTP (at 100 ␮M) was used as the initiating nucleotide, and formation of the dinucleotide product pppGpC was mon- itored by inclusion of [␣-33 P]CTP as the elongating nucleotide in the reaction. The 3Ј-terminal bases (GC-3Ј) of the template RNA were chosen based on the following considerations. (i) FIG. 3. Requirement of the 5Ј-phosphate group in the dinucleotide compound for inhibitory activity. Inhibitory effects on de novo initia- tion of RNA synthesis by dinucleotide analogues I (lanes 2 and 3), II (lanes 4 and 5), and III (lanes 6 and 7) were compared (50 and 200 ␮M). A short synthetic RNA (5Ј AAAAAAAAGC 3Ј) was used as the template in the de novo initiation assay. GTP and radiolabeled CTP were used as the initiating and elongating nucleotides, respectively (see the legend to Fig. 2 for assay details). The structure of compound III is shown on the right. VOL. 47, 2003 NOTES 2677
  • 5. The 3Ј-terminal sequence of negative-strand HCV RNA (ϪGC 3Ј) serves as a template for multiple rounds of positive- strand RNA synthesis. (ii) The dinucleotide compounds syn- thesized mimick guanine-cytosine analogues. It has been demonstrated previously that GTP is an efficient initiation molecule for HCV NS5B in a number of assays (14, 19, 25, 28). As shown in Fig. 2, both dinucleotide analogues I (lanes 2 to 6) and II (lanes 7 to 11) had an inhibitory effect on NS5B-directed de novo initiation, with 50% inhibitory concentrations (IC50s) of 20 and 65 ␮M, respectively. This result indicated that the dinucleotide compounds were able to efficiently compete with the initiating nucleotide GTP for binding to the polymerase protein and were able to inhibit the initiation of RNA syn- thesis. The difference between these two dinucleotide analogues was that one contains a 3Ј-O-methyl group at the C3Јof the second ribose moiety (II), while the other contains a hydrogen (3Ј-H) at the same position (I). The relatively weaker activity for analogue II (higher IC50) implied that addition of a larger group at the 3Ј position reduced the binding affinity to the NS5B polymerase and thus competed less effectively with the initiating GTP The 5؅-phosphate group was important for the inhibitory activity of the dinucleotide analogues. Both analogues tested in Fig. 2 contained a phosphate group at the 5Ј terminus. This was based on the assumption that the phosphate group might con- tribute to the binding affinity with NS5B polymerase. To dem- onstrate that such a phosphate group was indeed important for the inhibitory activity of the dinucleotide compounds, a third analogue (III) was tested in the same replication initiation assay. Analogue III possessed a similar structure to analogues I and II, except the 5Ј-phosphate group was deleted. As shown in Fig. 3, analogue III lost its inhibitory activity on de novo initiation of RNA synthesis, with an IC50 of Ͼ200 ␮M (com- FIG. 4. Base pairing between the dinucleotide analogue and the template 3Ј-terminal bases is important for optimal activity. De novo initiation of RNA synthesis was tested with two synthetic RNA templates, which differ only in the terminal base (U versus C), in the presence of increasing concentrations of dinucleotide analogue I (see Fig. 2 for structure). ATP and GTP were used as the initiating nucleotides, respectively, based on the terminal base of the template RNA (ATP for 5Ј AAAAAAAAGU 3Ј and GTP for 5Ј AAAAAAAAGC 3Ј). 2678 NOTES ANTIMICROB. AGENTS CHEMOTHER.
  • 6. pare lanes 6 and 7 with lanes 2 to 5). This result suggested that the 5Ј-phosphate group of the dinucleotide analogues played an important role in the interaction with NS5B protein, the lack of which resulted in loss of binding affinity required for efficient competition with the initiating GTP. Optimal inhibitory activity of the dinucleotide analogues was dependent on the base-pairing potential between the an- alogues and the template 3؅-terminal bases. To determine whether the inhibition of de novo initiation by dinucleotide analogues was template sequence specific and whether base- pairing potential between the compounds and the template RNA played a role in stabilizing the compound-NS5B interac- tion, de novo initiation assays were performed with two sepa- rate RNA templates that contained different 3Ј-terminal bases (Fig. 4). One template (5Ј AAAAAAAAGU 3Ј) used ATP as the initiating nucleotide, whereas the other (5Ј AAAAAAAA GC 3Ј) used GTP as the initiating nucleotide. The radiolabeled dinucleotide products generated from the de novo initiation assays were pppApC and pppGpC, respectively. The inhibitory effects of analogue I (which showed the highest activity in previous assays) on RNA initiation from the two RNA tem- plates were compared. As shown in Fig. 4, this compound showed a more profound effect on GTP-initiated RNA synthe- sis (IC50 of ϳ20 ␮M) than on ATP-initiated RNA synthesis (IC50 of ϳ90 ␮M). This result, together with the fact that the dinucleotide compound tested was a guanine-cytosine (GC) analogue, suggested that the base-pairing potential between the compound and the 3Ј-terminal bases of the template RNA played a positive role in maximizing the inhibitory activity on de novo initiation of RNA synthesis. Inhibition of RNA synthesis initiated by dinucleotide prim- ers. Prior assays in determining the compounds’ activity were performed using mononucleotide (GTP or ATP) as the initi- ating molecule. We have shown previously that dinucleotides were more efficient as initiating molecules than mononucle- otide in NS5B-directed RNA replication assays (27). It would be interesting to determine whether the dinucleotide ana- logues were capable of inhibiting RNA synthesis initiated from dinucleotide primers. To this end, radiolabeled dinucleotide primer ([33 P]GpC) was used to prime RNA synthesis (UTP incorporations) from the template RNA 5Ј AAAAAAAAGC 3Ј in the presence of increasing concentrations of compound I. As shown in Fig. 5, the dinucleotide analogue was also active in inhibiting pGpC-initiated RNA synthesis (multiple rounds of UMP incorporations), with an IC50 of approximately 50 ␮M (lanes 1 to 6). This result confirmed that the dinucleotide inhibitors were capable of competing with dinucleotide initiat- ing molecules and inhibiting RNA replication. The apparent reduction in the potency of the compound likely reflected the tighter binding between the enzyme and dinucleotide initiat- ing molecule, resulting in less efficient competition by the compound. Initiation of RNA synthesis by viral replication machinery represents a key step in the replication cycle of RNA viruses. It is generally believed that initiation is a rate-limiting step in viral RNA replication and that therapeutic interference at this step will effectively reduce the level of virus replication. So far, compounds specifically targeting the initiation process of viral RNA replication have not been thoroughly documented. In this study, we showed that dinucleotide compounds could serve as potential inhibitors of de novo initiation of RNA synthesis FIG. 5. Inhibition of RNA synthesis initiated from a dinucleotide primer (pGpC). The initiation assay reaction mixture contained, in addition to the standard components listed in the legend to Fig. 2, 5 ␮M template RNA (5Ј AAAAAAAAGC 3Ј), 5 ␮M end-labeled [33 P]GpC primer, 100 ␮M UTP, and 1 ␮M NS5B enzyme. Extended RNA products were detected from extension of the labeled primer due to multiple UMP incorporations. VOL. 47, 2003 NOTES 2679
  • 7. directed by HCV NS5B polymerase. This observation was in accordance with our previous results showing that dinucleo- tides were efficient initiating molecules for HCV NS5B-di- rected RNA replication. The use of dinucleotide analogues as inhibitors to target the initiation step of viral RNA synthesis represents a novel approach to antiviral interference. Despite the successful confirmation of the concept that dinu- cleotide analogues are effective inhibitors of de novo RNA replication, significant challenges remain before further devel- opment of this class of compounds for direct therapeutic ap- plication can be considered. Dinucleotide molecules, especially RNA, are generally unstable. The intramolecular nucleophilic attack by the 2Ј-hydroxyl group in the sugar moiety on the ad- jacent phosphate bond causes the degradation of the dinucleo- tides to mononucleotides and even further to nucleosides. Dinucleotides can also be hydrolyzed by water and other nu- cleophiles present in the biological system. In addition, the 5Ј-phosphate dinucleotides, which were shown to be more ef- fective in inhibiting de novo initiation of RNA replication, are even less stable because of the presence of the additional phosphate group. Furthermore, the polyanionic nature of the dinucleotide molecules strongly hampers the penetration of such compounds through cell membrane due to the high lipo- philicity on the membrane surface. Finally, dinucleotide mol- ecules can also bind to other nucleic acids through hydrogen bonds, which may result in a loss of selectivity for a predeter- mined target in vivo. The pGpsC type of dinucleotide analogues used in this study contained a phosphorothioate linker. Such linker is believed to enhance the stability of the dinucleotide compounds over the natural nucleic acid. For the same purpose, the 2Ј-hydroxyl group of the sugar moiety was further modified by methylation so that the 2Ј-hydroxyl group is not available for intramolecular hydrolysis. Nucleic acids with 2Ј-O-methyl modifications have been reported to possess improved stability, lipophilicity, and bioavailability, as well as other pharmacological properties. The physicochemical and pharmacological features of the dinucleotide compounds can be further improved by modi- fications of the phosphate groups in reducing their anionic character and, in the mean time, increasing lipophilicity. In this case, the various conjugation strategies used for improv- ing properties of oligonucleotide compounds may be ap- plied. Despite all of these challenges, the demonstration that dinu- cleotide analogues can effectively inhibit de novo initiation of RNA replication by HCV NS5B confirms the proof of princi- ple for this novel antiviral approach. With future advance- ments in addressing the outstanding issues related to the dinu- cleotide compounds, this class of compounds may eventually reach a stage of development for therapy against important viral diseases. We thank Wayne Cheney, Vicky Lai, Nigel Horscroft, Jim Wu, Jae Hoon Shim, Todd Appleby, and Nanhua Yao for helpful discussions. This work was supported by Ribapharm, Inc. REFERENCES 1. Ali, S., K. D. Tardif, and A. Siddiqui. 2003. Cell-free replication of the hepatitis C virus subgenomic replicon. J. Virol. 76:12001–12007. 2. Behrens, S.-E., L. Tomei, and R. De Francesco. 1996. Identification and properties of the RNA-dependent RNA polymerase of hepatitis C virus. EMBO J. 15:12–22. 3. Choo, Q. L., G. Kuo, A. J. Weiner, L. R. Overby, D. W. Bradley, and M. Houghton. 1989. Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science 244:359–362. 4. Davis, G. L., R. Esteban-Mur, V. Rustgi, J. Hoefs, S. C. Gordon, C. Trepo, M. L. Shiffman, S. Zeuzem, A. Craxi, M. H. Ling, and J. Albrecht. 1998. Interferon alfa-2b alone or in combination with ribavirin for the treatment of relapse of chronic hepatitis C. N. Engl. J. Med. 339:1493–1499. 5. De Francesco, R., S. E. Behrens, L. Tomei, S. Altamura, and J. Jiricny. 1996. RNA-dependent RNA polymerase of hepatitis C virus. Methods Enzymol. 275:58–67. 6. Ferrari, E., J. Wright-Minogue, J. W. S. Fang, B. M. Baroudy, J. Y. N. Lau, and Z. Hong. 1999. Characterization of soluble hepatitis C virus RNA- dependent RNA polymerase expressed in Escherichia coli. J. Virol. 73:1649– 1654. 7. Fried, M. W., M. Shiffman, K. R. Reddy, C. Smith, G. Marinos, F. L. J. Goncales, D. Haussinger, M. Diago, G. Carosi, D. Dhumeaux, A. Craxi, A. Lin, J. Hoffman, and J. Yu. 2002. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N. Engl. J. Med. 347:975–982. 8. Gosert, R., D. Egger, V. Lohmann, R. Bartenschlager, H. E. Blum, K. Bienz, and D. Moradpour. 2003. Identification of the hepatitis C virus RNA repli- cation complex in Huh-7 cells harboring subgenomic replicons. J. Virol. 77:5487–5492. 9. Hardy, R. W., J. Marcotrigiano, K. J. Blight, J. E. Majors, and C. M. Rice. 2003. Hepatitis C virus RNA synthesis in a cell-free system isolated from replicon-containing hepatoma cells. J. Virol. 77:2029–2037. 10. Hong, Z., C. E. Cameron, M. P. Walker, C. Castro, N. Yao, J. Y. Lau, and W. Zhong. 2001. A novel mechanism to ensure terminal initiation by hepatitis C virus NS5B polymerase. Virology 285:6–11. 11. Lai, V. C. H., S. Dempsey, J. Y. N. Lau, Z. Hong, and W. Zhong. 2003. In vitro RNA replication directed by replicase complexes isolated from the sub- genomic replicon cells of hepatitis C virus. J. Virol. 77:2295–2300. 12. Lohmann, V., F. Ko¨rner, U. Herian, and R. Bartenschlager. 1997. Biochem- ical properties of hepatitis C virus NS5B RNA-dependent RNA polymerase and identification of amino acid sequence motifs essential for enzymatic activity. J. Virol. 71:8416–8428. 13. Lohmann, V., A. Roos, F. Korner, J. O. Koch, and R. Bartenschlager. 1998. Biochemical and kinetic analyses of NS5B RNA-dependent RNA polymer- ase of the hepatitis C virus. Virology 249:108–118. 14. Luo, G., R. K. Hamatake, D. M. Mathis, J. Racela, K. L. Rigat, J. Lemm, and R. J. Colonno. 2000. De novo initiation of RNA synthesis by the RNA- dependent RNA polymerase (NS5B) of hepatitis C virus. J. Virol. 74:851– 863. 15. Manns, M. P., J. G. McHutchison, S. C. Gordon, V. K. Rustgi, M. Shiffman, R. Reindollar, Z. D. Goodman, K. Koury, M. Ling, and J. K. Albrecht. 2001. Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet 358:958–965. 16. McHutchison, J. G., S. C. Gordon, E. R. Schiff, M. L. Shiffman, W. M. Lee, V. K. Rustgi, Z. D. Goodman, M. H. Ling, S. Cort, and J. K. Albrecht. 1998. Interferon alfa-2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C. N. Engl. J. Med. 339:1485–1492. 17. Michielsen, P., R. Brenard, and H. Reynaert. 2002. Treatment of hepatitis C: impact on the virus, quality of life and the natural history. Acta Gastroen- terol. Belg. 65:90–94. 18. Oh, J.-W., T. Ito, and M. M. C. Lai. 1999. A recombinant hepatitis C virus RNA-dependent RNA polymerase capable of copying the full-length viral RNA. J. Virol. 73:7694–7702. 19. Oh, J. W., G. T. Sheu, and M. M. Lai. 2000. Template requirement and initiation site selection by hepatitis C virus polymerase on a minimal viral RNA template. J. Biol. Chem. 275:17710–17717. 20. Poynard, T., P. Marcellin, S. S. Lee, C. Niederau, G. S. Minuk, G. Ideo, V. Bain, J. Heathcote, S. Zeuzem, C. Trepo, and J. Albrecht. 1998. Randomised trial of interferon alpha2b plus ribavirin for 48 weeks or for 24 weeks versus interferon alpha2b plus placebo for 48 weeks for treatment of chronic in- fection with hepatitis C virus. Lancet 352:1426–1432. 21. Reichard, O., G. Norkrans, A. Fryden, J. H. Braconier, A. Sonnerborg, and O. Weiland. 1998. Randomised, double-blind, placebo-controlled trial of interferon alpha-2b with and without ribavirin for chronic hepatitis C. Lancet 351:83–87. 22. Rice, C. M. 1996. Flaviviridae: the viruses and their replication, p. 931–960. In B. N. Fields, D. M. Knipe, and P. M. Howley (ed.), Fields virology. Raven Press, New York, N.Y. 23. Saito, I., T. Miyamura, A. Ohbayashi, H. Harada, T. Katayama, S. Kiku- chi, T. Y. Watanabe, S. Koi, M. Onji, Y. Ohta, Q.-L. Choo, M. Houghton, and G. Kuo. 1990. Hepatitis C virus infection is associated with the de- velopment of hepatocellular carcinoma. Proc. Natl. Sci. Acad. USA 87: 6547–6549. 24. Seeff, L. B. 1999. Natural history of hepatitis C. Am. J. Med. 107:10S–15S. 25. Sun, X.-L., R. B. Johnson, M. A. Hockman, and Q. M. Wang. 2000. De novo 2680 NOTES ANTIMICROB. AGENTS CHEMOTHER.
  • 8. RNA synthesis catalyzed by HCV RNA-dependent RNA polymerase. Bio- chem. Biophys. Res. Commun. 268:798–803. 26. World Health Organization. 1996. Hepatitis C. Seroprevalence of hepati- tis C virus (HCV) in a population sample. Wkly. Epidemiol. Rec. 71:346– 349. 27. Zhong, W., E. Ferrari, C. A. Lesburg, D. Maag, S. K. B. Ghosh, C. E. Cameron, J. Y. N. Lau, and Z. Hong. 2000. Template/primer requirements and single nucleotide incorporation by hepatitis C virus nonstructural pro- tein 5B polymerase. J. Virol. 74:9134–9143. 28. Zhong, W., A. S. Uss, E. Ferrari, J. Y. N. Lau, and Z. Hong. 2000. De novo initiation of RNA synthesis by hepatitis C virus nonstructural protein 5B polymerase. J. Virol. 74:2017–2022. VOL. 47, 2003 NOTES 2681