摘要：
50 INTRODUCTION 51 The emergence of swine influenza H1N1 virus infections in 2009 (2) highlights the need 52 for effective antiviral therapy in a largely immune-naive population. Treatment options for 53 influenza are becoming more limited because viruses, including the 2009 swine H1N1 54 virus, are resistant to the antiviral drugs amantadine and rimantadine (3, 4, 11, 13,20). 55 Oseltamivir-resistant viruses are also becoming more common in the environment, 56 particularly within the last two years (1, 5, 19). Thus, more potent and effective treatments 57 are needed to combat these growing threats. 58 More potent antiviral therapy can be achieved by using drugs in combination, as 59 demonstrated in mouse models (10, 14-17, 24, 26). Such treatment can slow down the 60 emergence of drug resistant viruses (12). The reported animal studies have primarily 61 focused on the known-active antiviral agents amantadine, rimantadine, oseltamivir, 62 peramivir, zanamivir, and ribavirin. The kinds of studies that can be performed have been 63 limited based upon the number of active antiviral compounds that are available. 64 In 2002 Furuta et al. reported a novel pyrazine molecule T-705 (6-fluoro-3-hydroxy-2- 65 pyrazinecarboxamide, now named favipiravir) as an inhibitor of influenza virus infections 66 in cell culture and in mice (8). T-705 inhibits both influenza A and B viruses (8, 23, 29). The 67 compound converts to nucleoside mono- (T-705 RMP), di- and triphosphate (T-705 RTP) 68 forms in cells (9). The mode of action of T-705 RTP is similar to that of ribavirin 69 triphosphate as an inhibitor of influenza virus RNA polymerase (6, 9). Unlike ribavirin 70 monophosphate, T-705 RMP is only weakly inhibitory to cellular inosine monophosphate 71 dehydrogenase (9, 28), thus it is less cytotoxic. These properties make T-705 a viable 72 candidate for the treatment of influenza virus infections in humans. The compound is 73 currently undergoing phase II clinical trials.
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