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Introduction: Influenza affects individuals of all ages and poses a significant threat during pandemics, epidemics, and sporadic outbreaks. Neuraminidase inhibitors (NAIs) are currently the first choice in the treatment and prevention of influenza, but their use can be hindered by viral resistance.
Areas Covered: This review summarizes current NAIs pharmacological profiles, their current place in therapy, and the mechanisms of viral resistance and outlines possible new indications, ways of administration, and novel candidate NAIs compounds.
Expert Opinion: NAIs represent a versatile group of compounds with diverse administration methods and pharmacokinetics. While the prevalence of influenza virus resistance to NAIs remains low, there is heightened vigilance due to the pandemic potential of influenza. Several novel NAIs and derivatives are currently under assessment at various stages of development for the treatment and prevention of influenza.
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http://dx.doi.org/10.1080/14656566.2024.2370895 | DOI Listing |
Respirology
August 2025
First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Osaka, Japan.
Since public health measures against COVID-19 were relaxed, widespread outbreaks of respiratory infections such as influenza and respiratory syncytial virus (RSV), as well as infectious diseases transmitted by droplets and droplet nuclei, have been reported around the world. While there is evidence of antiviral drug efficacy against non-severe influenza, the emergence of two genetic mutations (I223V or S247N) that reduce susceptibility to neuraminidase inhibitors has been confirmed. Influenza vaccines are less effective in older people than in younger people; so high-dose influenza vaccines are recommended.
View Article and Find Full Text PDFBiomed Chromatogr
October 2025
Malaria Research Group, Department of Biosciences and Bioengineering, Indian Institute of Technology-Guwahati, Guwahati, Assam, India.
Newcastle disease virus utilizes its multifunction hemagglutinin neuraminidase (HN) protein for sialic acid recognition and its cleavage from the adjacent lactose unit. Detection of neuraminidase activity of HN is crucial for studying NDV infection biology. Traditional neuraminidase assays predominantly employ synthetic fluorogenic substrates such as 2'-(4-methylumbelliferyl)-α-D-N-acetylneuraminic acid.
View Article and Find Full Text PDFACS Omega
August 2025
Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China.
Shikimic acid, a widely known hydroaromatic compound abundantly found in (commonly known as Chinese star anise), serves as a key intermediate in the synthesis of neuraminidase inhibitors such as oseltamivir. However, its pharmacokinetic (PK) properties and long-term safety profile remain inadequately characterized. This study systematically evaluated its PK behavior following both oral and intravenous administrations, along with its acute toxicity and 28-day subchronic oral toxicity in mice.
View Article and Find Full Text PDFOpen Forum Infect Dis
August 2025
Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Capital Medical University, Beijing, P.R. China.
Background: Combining baloxavir with neuraminidase inhibitors (NAIs) has not demonstrated significant benefits in severe influenza. High-risk populations with impaired viral clearance may represent the optimal candidates for this combination treatment.
Methods: We conducted a post hoc analysis of the Flagstone trial (NCT03684044), including patients hospitalized with severe influenza.
CNS Neurosci Ther
August 2025
Department of Emergency Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, School of Medicine, Southern University of Science and Technology), Shenzhen, Guangdong, China.
Background: In cardiac arrest (CA) patients undergoing cardiopulmonary resuscitation (CPR), neuroinflammation following return of spontaneous circulation (ROSC) contributes to brain ischemia/reperfusion injury and neurological dysfunction. Recent evidence suggested that neuraminidase could exacerbate inflammatory responses by disrupting CD24-Siglec-G/10 immune checkpoint axis. As a neuraminidase inhibitor, oseltamivir phosphate (OP) holds potential for immunomodulation beyond its antiviral use.
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