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IMMUNOMODULATORS: Antivirals pay the Toll
New questions are coming to light about whether Toll-like receptor 7 interacts directly with viruses on infection. Most of the antiviral agents that are either available, such as acyclovir and famciclovir, or in development, inhibit pathways that are involved in viral replication or assembly. By contrast, the antiviral drug imiquimod, which is an imidazoquinoline amine, is an immune-response modifier that activates immune function. In the February issue of Nature Immunology, Shizuo Akira and colleagues show that imidazoquinolines activate immune cells by means of the Toll-like receptor 7 (TLR7) signalling pathway, which leads to the induction of interferon-
Toll-like receptors (TLRs) are named from the
Toll
gene of Drosophila melanogaster. As well as being involved in development, TLRs are also a vital component in the fly's immune response to infections. So far, ten mammalian TLRs have been reported, each essential for recognition of specific bacterial, viral and fungal components. They associate with a protein, MYD88, which acts as an adaptor that leads to activation of both the transcription factor NF- The more potent resiquimod is undergoing Phase III clinical trials at present for genital herpes. The continuing trials indicate that resiquimod increases the time between genital herpes outbreaks, and could produce a long-lasting suppressive effect without the need for daily therapy. Through its novel approach of activating the immune system as if it is a vaccine, some clinical investigators believe resiquimod might reduce viral transmission and, with several courses of therapy, place the disease into clinical remission. Interferon- Melanie Brazil References
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