bDengue virus has emerged as a global health threat to over one-third of humankind. As a positive-strand RNA virus, dengue virus relies on the host cell metabolism for its translation, replication, and egress. Therefore, a better understanding of the host cell metabolic pathways required for dengue virus infection offers the opportunity to develop new approaches for therapeutic intervention. In a recently described screen of known drugs and bioactive molecules, we observed that methotrexate and floxuridine inhibited dengue virus infections at low micromolar concentrations. Here, we demonstrate that all serotypes of dengue virus, as well as West Nile virus, are highly sensitive to both methotrexate and floxuridine, whereas other RNA viruses (Sindbis virus and vesicular stomatitis virus) are not. Interestingly, flavivirus replication was restored by folinic acid, a thymidine precursor, in the presence of methotrexate and by thymidine in the presence of floxuridine, suggesting an unexpected role for thymidine in flavivirus replication. Since thymidine is not incorporated into RNA genomes, it is likely that increased thymidine production is indirectly involved in flavivirus replication. A possible mechanism is suggested by the finding that p53 inhibition restored dengue virus replication in the presence of floxuridine, consistent with thymidine-less stress triggering p53-mediated antiflavivirus effects in infected cells. Our data reveal thymidine synthesis pathways as new and unexpected therapeutic targets for antiflaviviral drug development.
Dengue virus (DENV) poses a significant human health risk for approximately 40% of the world's population (http://www.who .int/mediacentre/factsheets/fs117/en/). DENV occurs as four serotypes, with increasing and widespread circulation of all serotypes considered a contributing factor for the rising incidence of dengue disease. A particularly severe complication is dengue hemorrhagic fever (DHF), which results in approximately 22,000 deaths annually and of which the incidence is currently on the rise (http://www .who.int/csr/disease/dengue/impact/en/index.html). However, even nonfatal, self-limiting DENV infection can result in a severe, painful disease that is also known as "break-bone fever." No vaccine or antiviral therapeutics are licensed to address DENV infections, and treatment is currently limited to supportive care.Many studies are ongoing with the hopes of identifying effective novel anti-DENV therapeutics and/or potential therapeutic targets. Several viral factors have been explored as therapeutic targets, including the viral protease, helicase, and RNA-dependent RNA polymerase (reviewed in reference 1). As an alternative to directly targeting viral proteins, it is conceivable to target host cell metabolic pathways that are required for viral replication. Flaviviruses, small RNA viruses that include DENV as well as West Nile virus (WNV), yellow fever virus, and Japanese encephalitis virus, are highly dependent on the host cell to provide support for viral entry, repl...