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Targeting the DNA damage response for the treatment of oral mucosal HSV-1 infection
Dissertation   Open access

Targeting the DNA damage response for the treatment of oral mucosal HSV-1 infection

William Edward Donegan III
Doctor of Philosophy (Ph.D.), Drexel University
Dec 2016
DOI:
https://doi.org/10.17918/etd-7171
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Abstract

Cytology Genetics Molecular Biology
Herpes simplex virus type 1 (HSV-1) is a highly prevalent pathogen that infects 67% of the world's population. HSV-1 most commonly infects the oral mucosal epithelium and manifests as herpes simplex labialis (cold sore) or herpetic gingivostomatitis. Patients who have a compromised immune system are at serious risk for developing drug-resistant HSV-1 disease that can become life-threatening through dissemination to internal organs. Treatment options for drug-resistant HSV-1 infection are nonspecific and fraught with toxicity concerns. Thus, there is a critical need for the development of new therapeutics. HSV-1 engages the cellular DNA damage response (DDR) by activating Ataxia Telangiectasia Mutated (ATM) and its major downstream target, Checkpoint Kinase 2 (Chk2). We demonstrate that targeting ATM or Chk2 with small molecule inhibitors suppresses both wild type and acyclovir-resistant HSV-1 replication in normal human oral keratinocyte cells. Furthermore, topical application of ATM or Chk2 inhibitors reduces the severity of herpes simplex labialis in a mouse lip model. We also demonstrate for the first time that ATM signaling is required for circularization of the HSV-1 genome. Interestingly, Chk2 is not required for HSV-1 genome circularization, which suggests that additional functions of the DDR are required for HSV-1 replication. We also elucidate that ATM can be activated in both a de novo-dependent and de novo-independent manner through ICP4. These data establish that targeting the DDR has the potential for treating oral mucosal HSV-1 disease, and furthers our understanding of how the DDR is utilized during HSV-1 infection.

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