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Background The increase of inflammation-inducing enterobacteria was recently observed in severe hand, foot, and mouth disease (HFMD) caused by Enterovirus A71 (EV-A71). This study aimed to verify the occurrence of bacterial translocation (BT) and further explore the contributory role of BT to severity of EV-A71-mediated HFMD cases. Methods Serum specimens from 65 mild and 65 severe EV-A71-associated HFMD cases and 65 healthy children were collected. EV-A71 VP1 in serum, inflammatory mediators including C-reactive protein, IL-1β, IL-6, interferon-γ and tumor necrosis factor-α, BT related biomarkers including Claudin-3, intestinal fatty acid binding protein, lipopolysaccharide (LPS), soluble CD14 (sCD14) and endotoxin core antibody were measured by ELISA. Bacterial DNA (BactDNA) fragments were quantified by quantified PCR (qPCR). Rhabdomyosarcoma (RD) or SH-SY5Y cells, infected with LPS-pre-incubated EV-A71 or transfected with plasmid containing viral 2Apro or mRNA containing viral internal ribosomal entry site (IRES), were post-treated with or without LPS in vitro. EV-A71 RNA and viral or cellular proteins were determined by qPCR and western blot, respectively. Results Compared to mild HFMD patients, remarkably higher inflammatory mediators as well as BT-related biomarkers except BactDNA were observed in severe HFMD cases (all P P r = 0.341, P = 0.005) and serum sCD14 (r = 0.458, P pro-mediated IRES activity were significantly accelerated by LPS post-treatment. Conclusions Our results collectively indicate that gut-derived translocating LPS contributes to the severity of EV-A71-induced HFMD by driving inflammatory response and viral proliferation via viral 2Apro-mediated IRES.

Activation of the ERK signaling cascade in host cells has been demonstrated to be essential for enterovirus A71 (EV-A71) replication. Our previous study showed that MEK kinase, which specially activated downstream ERK kinase, is an important and potential target against EV-A71. Furthermore, we reported that a series of substituted 3-benzylcoumarins designed and synthesized as well as verified for inhibiting the MEK-ERK cascade were found to be effective on anti-EV-A71. In this study, we further demonstrated that two substituted 3-benzylcoumarins designated as 13 and 14 were more effective anti-MEK/ERK activity, less cytotoxicity and stronger antiviral effect represented by inhibition of viral-induced CPE, the expression of viral proteins and the replication of the viral genome, as well as the production of progeny virions, compared to those of U0126, an available MEK inhibitor, and sorafenib, a multiple-targeted kinase inhibitor in clinical use. Moreover, we explored that the likely mechanism of action of these two test compounds were to block EV-A71 2A dependent IRES-driven activity essential for successful viral replication. Hence, our results suggest that two substituted 3-benzylcoumarins 13 and 14 could be candidates as potential anti-EV-A71 agents.

In a previous study the ERK1/2 pathway was found to be crucially involved in positive regulation of the enterovirus A 71(EV-A71) IRES (vIRES), thereby contributing to the efficient replication of an important human enterovirus causing death in young children (

Currently, it is still controversial that if the pathogenicity of EV-A71 causing severe or mild hand, foot, and mouth disease (HFMD) is associated with viral nucleotide or amino acid sequence(s). In this study, 19 clinical strains were detected in samples from diagnosed patients of EV-A71-caused HFMD with mild or severe symptoms. Then, VP1-2A fragment sequences of 19 EV-A71 isolates were determined, the phylogenetic analysis, based on VP1 sequences of 19 EV-A71 stains in this study and which of 62 EV-A71 strains with different clinical phenotypes reported before, were carried out. Our results showed that no difference in the genotype and evolution distribution was observed among the EV-A71 strains mentioned above. Furthermore, two EV-A71 isolates, which with much close evolutionary relationship but different clinical manifestations, were purified by plaque assay, the complete genome sequencing was done, and deduced amino acid sequence analysis of 11 proteins coded by EV-A71 was carried out. Eight variable amino acid sites were found and further verified with those of 62 strains reported before. Our study provides further evidence that the potential pathogenicity of EV-A71 causing severe or mild HFMD seems not to be associated with viral genotype and even the amino acid substitution.

A series of novel oxazaphosphorine prodrugs of 9-(2-phosphonomethoxyethyl)adenine (PMEA, adefovir) were synthesized and their anti-hepatitis B virus (HBV) activity was evaluated in HepG2 2.2.15 cells, with adefovir dipivoxil as a reference drug. In the cell assays, compounds 7b and 7d exhibited anti-HBV activity comparable to that of adefovir dipivoxil, while compound 7c, with an IC(50) value of 0.12 microM, was found to be three times more potent than the reference compound. In vitro stability studies showed that (S(P),S)-7c, the diastereomer of compound 7c, was stable in human blood plasma but underwent rapid metabolism to release the parent drug PMEA in liver microsomes. The possible metabolic pathway of (S(P),S)-7c in human liver microsomes was described. These findings suggest that compound (S(P),S)-7c is a promising anti-HBV drug candidate for further development.

The metabolism of arbidol in humans was studied using liquid chromatography‐electrospray ionization (ESI) ion trap mass spectrometry (ITMS) after an oral dose of 300‐mg arbidol. A total of 17 metabolites were identified including the glucuronide arbidol and the glucuronide sulfinylarbidol as the major metabolites. Arbidol and its metabolites have some common fragmentation patterns as a result of a homolytic bond cleavage. This cleavage will form odd‐electron ions with the loss of a radical. The arbidol fragmentation sequence is first to lose dimethylamine (45 Da), followed by the loss of acetaldehyde (44 Da), and then the phenylthio radical (109 Da). This fragmentation sequence is also observed from N‐demethylarbidol, sulfonylarbidol, and N‐demethylsulfonylarbidol. However, for sulfinylarbidol and N‐demethylsulfinylarbidol, the fragmentation sequence is reversed so that the phenylsulfiny radical (125 Da) was lost first, followed by the loss of dimethylamine (45 Da), and then acetaldehyde (44 Da). The exact masses for arbidol and sulfinylarbidol fragment ions were determined by a quadrupole/time‐of‐flight mass spectrometer (Q‐TOF MS). The phase II metabolites, such as sulfate and glucuronide conjugates of arbidol, N‐demethylarbidol, sulfonylarbidol, and N‐demethylsulfonylarbidol were identified by observing the neutral loss of 80 Da (SO3) or 176 Da (glucuronic acid) from the MS2 spectra. The sulfate and glucuronide conjugates such as sulfinylarbidol and N‐demethylsulfinylarbidol had an unusual fragmentation pattern, in which the phenylsulfinyl radical (125 Da) was lost before the loss of SO3 group (80 Da) or glucuronic acid (176 Da) occurred. Copyright © 2008 John Wiley & Sons, Ltd.

Dauricine is one type of the bisbenzyltetrahydroisoquinoline alkaloid derivative with antiarrhythmic effects. Severe liver toxicity was observed in experimental animals treated with analogues of dauricine, which may be caused by covalent binding of reactive metabolite(s) to critical macromolecules in tissues. The study described herein aimed at characterizing pathways of dauricine bioactivation and the CYP enzyme involved. In incubations of dauricine with NADPH- and GSH-supplemented human liver microsomes, four GSH conjugates with [M + H]+ ions at m/z 930, 916, 916, and 902, respectively, were detected by liquid chromatography-ion trap mass spectrometry. The structures of the four metabolites were determined to be GSH conjugates of dauricine, 2-N-demethyl dauricine, 2'-N-demethyl dauricine, and N-demethyl-O-demethyl dauricine. GSH conjugation took place with a strong preference at C-17, suggesting that the phenol moiety of dauricine and its metabolites underwent oxidation to quinone methide intermediates. The formation of the GSH conjugates was found to require the presence of NADPH. To identify the CYP isoforms that are responsible for bioactivation, dauricine was also incubated with recombinant human CYP450 enzymes. The formation of GSH was only observed with the incubation of CYP3A4. In addition, the level of these GSH conjugates in human microsomes was reduced upon the addition of a CYP3A4 inhibitor ketoconazole. The same GSH conjugates were also observed in rat bile following a single oral dose of 40 mg/kg dauricine. These studies suggest that the CYP3A4 mediated quinone methide formation was associated with dauricine bioactivation.

The metabolism of lafutidine in human liver microsomes was studied using liquid chromatography/ion trap mass spectrometry with electrospray ionization (ESI) and atmospheric pressure chemical ionization (APCI) sources. A total of 14 metabolites were identified including hydroxylated lafutidine and sulfonyl lafutidine as the major metabolites. The chemical properties and the MS(n) behaviors of lafutidine and all of its identified metabolites were studied in detail. Lafutidine had a fragmentation pattern as a result of homolytic bond cleavage in the MS/MS spectrum. This cleavage can form an odd-electron ion with the loss of furan-2-ylmethyl radical (-81 Da with a proton shift), which then sequentially loses neutral groups in the MS(3) spectrum. This fragmentation sequence was also observed from the metabolites with the unchanged sulfinyl moiety. When the sulfinyl moiety was oxidized to the sulfonyl moiety, this fragmentation sequence did not exist, which could be used to identify S-oxidation metabolites of lafutidine. In general, N-oxides could produce distinct [M+H-O](+) ions under LC/APCI-MS due to the thermal activation in the desolvation region of the API source, which could be used to identify N-oxidation metabolites of lafutidine. In order to avoid the possibility of false positives, the MS/MS spectrum of the [M+H-O](+) ion was compared with that of the non-N-oxidation metabolites or parent drug in the APCI source. If they were consistent, the structure could be finally confirmed. The exact masses for lafutidine and lafutidine N-oxide fragment ions were determined using an LTQ/Orbitrap mass spectrometer.