Nucleoside analogues are extremely useful for the development of therapeutic agents to control viral diseases and cancer. Replacement the oxygen of furanose ring of a nucleoside by a CH 2 unit results in carbocyclic nucleoside analogues. Carbocyclic nucleosides have emerged as targets of intense investigation due to their potent biological activity and greater metabolic activity and stability to nucleoside phosphorylases than the corresponding carbohydrate counterpart. Among these, aristeromycin (1), neplanocin (2), abacavir (3), lobucavir (4), synguanol (5) or the newly FDA-approved anti-HBV Baraclude Ò (6, Entecavir) ( Figure 15.1) are a few of the carbocyclic nucleosides that are useful antiviral drugs.The cellular processing and mechanism of action of carbocyclic nucleosides are, in general, similar to those of conventional nucleosides. They may undergo progressive phosphorylation to the corresponding mono-, di-, and triphosphates, and any of these activated forms may interact with natural cellular processes (Figure 15.2). On occasion, the interaction is innocuous and has little or no effect upon cell viability, but very often a significant inhibition of essential biochemical reactions occurs and in these cases measurable effects will be observable.One class of cellular enzymes to which carbocyclic nucleosides are not susceptible is the nucleoside phosphorylases, as a consequence of which they are extremely stable towards sugar-base cleavage. Most of those carbocyclic nucleosides which have been studied intensively are active as inhibitors of a viral enzyme (mainly a polymerase). Experience has shown that the essential structural features of carbocyclic nucleosides which must be retained are: the ability of the base to engage in base pairing with its DNA partner, and the presence of a 5 0 -hydroxyl group (or equivalent) which is capable of phosphorylation. The remainder of the sugar component can be regarded as a scaffold which ensures that the base pairing functionality and the 5 0 -phosphate (or phosphonate) are well distributed in space. The carbocyclic nucleosides do not have the same conformational data as the parent nucleosides; rather, in all cases they Modified Nucleosides: in Biochemistry, Biotechnology and Medicine. Edited by Piet Herdewijn