Drug-resistant strains have become a global health problem. Eliminating HSV infections in humans requires new strategies (
26). Because of the high incidence of HSV infection worldwide, it is unlikely to decrease very soon (
8). Increasing the number of immunocompromised patients and using appropriate treatments can exacerbate the problems associated with drug-resistant HSV. Despite existing effective standard therapies and low resistance rates, new therapies need to be developed to avoid future HSV epidemics (
10). As can be seen in the literature, natural agents rather than synthetic agents have proven to be the most effective sources of new drugs, especially antibacterial and antineoplastic agents (
11,
13,
27). So far, many studies were carried out on products, such as crude extracts, fractions, and pure compounds that were either isolated from plants, animals, microorganisms, or marine life for their antiviral effect on HSV. Therefore, these potential anti-HSV agents need to be studied as alternatives to nucleoside analogs to promote therapeutic efficacy (
14).
From 1981 to 2010, approximately 34% of the US Food and Drug Administration (FDA)-approved natural product fractions were either natural or the corresponding direct derivative (
15). To identify new inhibitors of HSV-1, we first screened a natural product library containing 133 compounds. In this study, we identified 10-HCPT among 2 selected compounds as inhibitors of HSV-1 infection through a screening assay. The inhibition hit rate was higher than the previous FDA-approved drug library screening (0.23%), the low cutoff for 30% CPE inhibition (
28). A molecule called 10-HCPT, a CPT, specifically blocks topoisomerase I that breaks and leaves the DNA strand during the replication stage. A few studies have reported that CPT inhibits the replication and packaging of double-stranded and single-stranded DNA containing HSV-2, adenovirus viruses, papovaviruses, and autonomous parvovirus (
29-
31).
As revealed, the natural product library possessed HSV-1 antiviral activity, but TP and 10-HCPT showed a significant inhibitory effect. We previously found that TP presented a significant inhibitory effect on HSV-1 plaque formation with an EC
50 of 0.05. Moreover, the time-of-addition assay suggested that TP had viral inhibitory effects when added 8 hours after infection with EC
50 of 0.07 µM in A549 cells (
1,
32,
33). As shown in the data, 10-HCPT was highly effective in the inhibition of virus titration on A549 and PRK cells with EC
50 of 0.068. The EC
50 value of ACV was 0.01-μg/mL concentration on A549 cells when used as a gold standard anti-HSV. It is noteworthy that the HSV-1 isolated in this study was sensitive to ACV, according to our previous experiment (
17).
The CC
50 value by the WST-1 assay to calculate the SI of 10-HCPT was 51.37 (
Table 2). According to Prichard et al., a SI value of > 1 was sufficient to show antiviral activity (
16). However, a higher SI value is needed to suggest a safe antiviral therapeutic range due to the significant difference between cytotoxic and antiviral concentrations. The antiviral activity of 10-HCPT was dose-dependently lower than the cytotoxic concentration, indicating that some mechanism rather than cytotoxicity mediated it. Liu et al. reported that the 10-hydroxy derivative of CPT showed the highest anti-HSV 2 activity, with an EC
50 value of 3.33 mg/mL and a SI value of 12.95 (
29).
We used a time-of-addition assay to further characterize the inhibitory effect of 3 × EC50 μM 10-HCPT. We assessed viral infectivity during different HSV-1 replication cycle steps in a time-dependent manner on A549 cells. The plaque reduction assays showed that 10-HCPT had effects in IE and L stages between 4 and 8 hours of viral replication. Thus, complementary assays targeting early virus production steps were also performed. The virus inactivation, attachment, and penetration assays showed that 10-HCPT could not affect viral attachment and penetrate cells at 0.01 MOI. Thus, 10-HCPT could not stop HSV-1 from attaching and being absorbed into the cells since the entry of herpesviruses into their target cells is complex at many levels depending on viral MOI and the kind of cells.
A virucidal assay was performed to indicate the inactivating capacity of 10-HCPT on virions. Our results showed that it was not effective in the inhibition of the virus compared to the DMSO group. It is generally admitted that a good antiviral drug must reduce viral infection by 2 log10 (99% inactive) or more (
34). In other studies, compounds (
25,
35) had no effect on adsorption and penetration stages like 10-HCPT. Interestingly, the time-of-addition assay results indicated that the critical time for the inhibition of 10-HCPT on HSV-1 replication was up to 8 hours after infection. The viral DNA replication, L gene transcription, and encapsidation of viral DNA occur at the HSV replication site (
36). On the other hand, 10-HCPT had HSV-1 replication inhibition effects. Using real-time PCR, we performed a kinetic study to assess the 10-HCPT effect on viral DNA replication. The DNA concentration in cultures containing 10-HCPT decreased in comparison with our DMSO. Hence, 10-HCPT can inhibit the expression of viral genes in the IE and L stages, respectively. However, the ICP4 protein expression was not impeded in the 10-HCPT-treated group, suggesting that HSV replication formation compartments with other genes in the IE and L stage may be inhibited in the presence of 10-HCPT. In this case, HSV-1 is actively replicated in the nucleus by entering the host cells.
5.1. Conclusions
Overall, 10-HCPT demonstrated anti-HSV activity on HSV-1. Their dose-dependent antiviral activity showed that specific cellular components might mediate their function rather than cytotoxicity. Unfortunately, to date, studies on those aspects related to the antiviral effect of this compound are limited. Further studies focusing on the activity of anti-HSV-1 mechanisms in vivo are necessary.