Novel and repurposed antiviral molecules for arbovirus infections with epidemic Potential: A systematic review

Background: This systematic review investigates experimental and repurposed antiviral molecules for epidemic-potential arboviruses, including dengue (DENV), Zika (ZIKV), chikungunya (CHIKV), West Nile (WNV), and Usutu (USUV) viruses. Arboviral diseases pose a growing public health concern, exacerbat...

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Main Authors: Jacopo Logiudice, Giorgio Tiecco, Alessandro Pavesi, Francesca Bertoni, Roberta Gerami, Isabella Zanella, Anna Artese, Eugenia Quiros-Roldan, Francesco Castelli, Lina Rachele Tomasoni, Benedetta Rossi, Davide Lelli, Sabrina Canziani, Alessandro Russo, Guido Di Donato
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:New Microbes and New Infections
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Online Access:http://www.sciencedirect.com/science/article/pii/S2052297525000538
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author Jacopo Logiudice
Giorgio Tiecco
Alessandro Pavesi
Francesca Bertoni
Roberta Gerami
Isabella Zanella
Anna Artese
Eugenia Quiros-Roldan
Francesco Castelli
Lina Rachele Tomasoni
Benedetta Rossi
Davide Lelli
Sabrina Canziani
Alessandro Russo
Guido Di Donato
author_facet Jacopo Logiudice
Giorgio Tiecco
Alessandro Pavesi
Francesca Bertoni
Roberta Gerami
Isabella Zanella
Anna Artese
Eugenia Quiros-Roldan
Francesco Castelli
Lina Rachele Tomasoni
Benedetta Rossi
Davide Lelli
Sabrina Canziani
Alessandro Russo
Guido Di Donato
author_sort Jacopo Logiudice
collection DOAJ
description Background: This systematic review investigates experimental and repurposed antiviral molecules for epidemic-potential arboviruses, including dengue (DENV), Zika (ZIKV), chikungunya (CHIKV), West Nile (WNV), and Usutu (USUV) viruses. Arboviral diseases pose a growing public health concern, exacerbated by climate change and increased global travel. Despite the absence of approved antiviral therapies for most arboviruses, numerous in vitro, in vivo and in human studies have evaluated candidate molecules targeting the different stages of viral replication. Methods: Our methods adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Pubmed, Embase, and Cochrane Library trials were searched. Studies published until March 2024 were included. After abstract review and duplication removal, full-text articles were obtained for further review, reviewed by two independent reviewers, and disagreements were resolved by a third reviewer. Results: Our analysis, based on 185 studies, highlights the antiviral role of molecules such as nucleoside analogs, protease inhibitors, and immune-modulators. No studies conducted in humans have been reported to demonstrate the antiviral efficacy of any molecule. Favipiravir, ribavirin, and sofosbuvir demonstrated viremia reduction and symptoms improvement in vitro and in vivo experiments. Cholesterol-lowering agents, such as atorvastatin and ezetimibe, showed promise in disrupting viral assembly. Montelukast and doxycycline exhibited anti-inflammatory effects, contributing to improved clinical outcomes. The cytokine modulation profiles varied, with notable reductions in pro-inflammatory markers in certain studies. Conclusions: Currently, there are no studies in humans demonstrating effective treatments against arboviral infections. Although some molecules have shown efficacy in reducing viral titters, further clinical evaluation of promising candidates and the exploration of combination therapies targeting viral replication and host immune-response are needed.
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spelling doaj-art-934499120d7a4522b23288ffdd32ef672025-08-20T02:57:59ZengElsevierNew Microbes and New Infections2052-29752025-08-016610161410.1016/j.nmni.2025.101614Novel and repurposed antiviral molecules for arbovirus infections with epidemic Potential: A systematic reviewJacopo Logiudice0Giorgio Tiecco1Alessandro Pavesi2Francesca Bertoni3Roberta Gerami4Isabella Zanella5Anna Artese6Eugenia Quiros-Roldan7Francesco CastelliLina Rachele TomasoniBenedetta RossiDavide LelliSabrina CanzianiAlessandro RussoGuido Di DonatoASST Spedali Civili di Brescia. SC Malattie Infettive, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia 25123 Brescia, ItalyASST Spedali Civili di Brescia. SC Malattie Infettive, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia 25123 Brescia, ItalyASST Spedali Civili di Brescia. SC Malattie Infettive, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia 25123 Brescia, ItalyASST Spedali Civili di Brescia. SC Malattie Infettive, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia 25123 Brescia, ItalyASST Spedali Civili di Brescia. SC Malattie Infettive, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia 25123 Brescia, ItalyDepartment of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy; Medical Genetics Laboratory, Diagnostic Department, ASST Spedali Civili di Brescia, 25123 Brescia, ItalyDipartimento di Scienze della Salute, Università degli Studi “Magna Grecia” di Catanzaro, Campus “Salvatore Venuta”, Catanzaro, ItalyASST Spedali Civili di Brescia. SC Malattie Infettive, 25123 Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia 25123 Brescia, Italy; Corresponding author.Background: This systematic review investigates experimental and repurposed antiviral molecules for epidemic-potential arboviruses, including dengue (DENV), Zika (ZIKV), chikungunya (CHIKV), West Nile (WNV), and Usutu (USUV) viruses. Arboviral diseases pose a growing public health concern, exacerbated by climate change and increased global travel. Despite the absence of approved antiviral therapies for most arboviruses, numerous in vitro, in vivo and in human studies have evaluated candidate molecules targeting the different stages of viral replication. Methods: Our methods adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Pubmed, Embase, and Cochrane Library trials were searched. Studies published until March 2024 were included. After abstract review and duplication removal, full-text articles were obtained for further review, reviewed by two independent reviewers, and disagreements were resolved by a third reviewer. Results: Our analysis, based on 185 studies, highlights the antiviral role of molecules such as nucleoside analogs, protease inhibitors, and immune-modulators. No studies conducted in humans have been reported to demonstrate the antiviral efficacy of any molecule. Favipiravir, ribavirin, and sofosbuvir demonstrated viremia reduction and symptoms improvement in vitro and in vivo experiments. Cholesterol-lowering agents, such as atorvastatin and ezetimibe, showed promise in disrupting viral assembly. Montelukast and doxycycline exhibited anti-inflammatory effects, contributing to improved clinical outcomes. The cytokine modulation profiles varied, with notable reductions in pro-inflammatory markers in certain studies. Conclusions: Currently, there are no studies in humans demonstrating effective treatments against arboviral infections. Although some molecules have shown efficacy in reducing viral titters, further clinical evaluation of promising candidates and the exploration of combination therapies targeting viral replication and host immune-response are needed.http://www.sciencedirect.com/science/article/pii/S2052297525000538Antiviral treatmentAntiviral therapyArbovirusArbovirusesWest nileWNV
spellingShingle Jacopo Logiudice
Giorgio Tiecco
Alessandro Pavesi
Francesca Bertoni
Roberta Gerami
Isabella Zanella
Anna Artese
Eugenia Quiros-Roldan
Francesco Castelli
Lina Rachele Tomasoni
Benedetta Rossi
Davide Lelli
Sabrina Canziani
Alessandro Russo
Guido Di Donato
Novel and repurposed antiviral molecules for arbovirus infections with epidemic Potential: A systematic review
New Microbes and New Infections
Antiviral treatment
Antiviral therapy
Arbovirus
Arboviruses
West nile
WNV
title Novel and repurposed antiviral molecules for arbovirus infections with epidemic Potential: A systematic review
title_full Novel and repurposed antiviral molecules for arbovirus infections with epidemic Potential: A systematic review
title_fullStr Novel and repurposed antiviral molecules for arbovirus infections with epidemic Potential: A systematic review
title_full_unstemmed Novel and repurposed antiviral molecules for arbovirus infections with epidemic Potential: A systematic review
title_short Novel and repurposed antiviral molecules for arbovirus infections with epidemic Potential: A systematic review
title_sort novel and repurposed antiviral molecules for arbovirus infections with epidemic potential a systematic review
topic Antiviral treatment
Antiviral therapy
Arbovirus
Arboviruses
West nile
WNV
url http://www.sciencedirect.com/science/article/pii/S2052297525000538
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