Fomivirsen (Vitravene)

  • antisense oligonucleotide (ASO) used specifically to treat retinitis (inflammation of the retina) caused by an infection with cytomegalovirus (CMV) in immunocompromised patients, particularly those with AIDS
    • CMV retinitis can progress to blindness, which sucks
    • CMV belongs to the same family as the viruses that cause chickenpox and herpes, and gets its name from the fact that it produces very large (-mega-) cells (cyto-)
    • most people become infected with CMV at some point in their lives, and it then sticks around for the rest of their lives, but a normal functioning immune system can usually keep it down such that it remains harmless
  • is injected directly into the vitreous humour of the eye (awesome and gross at the same time!) by an ophthalmologist (eye surgeon, often one who has specialized in vitreoretinal surgery)
  • reduces the levels of viral mRNA transcribed from certain immediate-early CMV genes, which in turn reduces the levels of the proteins that they encode
    • these proteins are required for viral replication and viral invasion of host cells and so these processes are disrupted by the drug
  • its unique mechanism of action makes it effective against varieties of CMV that are resistant to traditional antiviral drugs (traditional meaning drugs that aren't nucleic acids like ganciclovir and foscarnet)
Jason TL, Koropatnick J, Berg RW. Toxicology of antisense therapeutics. Toxicol Appl Pharmacol. 2004 Nov 15;201(1):66-83.

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