Evidence map›Paper›PMID 41931570›Full record

ArticlePLoS pathogens2026

Efficacy of the nucleoside analog 4'-Fluorouridine against Nipah virus in the Syrian hamster model.

Olivier Escaffre, Madison L Pearson, Terry L Juelich, Jennifer K Smith, Lihong Zhang, Carolin M Lieber, Dariia Vyshenska, Tetsuro Ikegami, Griffin D Haas, Rebecca E Krueger and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PLoS pathogens, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Olivier EscaffreDepartment of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America.ORCID https://orcid.org/0000-0003-0402-9698
Madison L PearsonInstitute for Translational Sciences, University of Texas Medical Branch, Galveston, Texas, United States of America.
Terry L JuelichDepartment of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America.
Jennifer K SmithDepartment of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America.
Lihong ZhangDepartment of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America.
Carolin M LieberCenter for Translational Antiviral Research, Georgia State University Institute for Biomedical Sciences, Atlanta, Georgia, United States of America.
Dariia VyshenskaDepartment of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, Washington, United States of America.
Tetsuro IkegamiDepartment of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America.
Griffin D HaasDepartment of Microbiology, Icahn School of Medicine at Mount Sinai, New York, United States of America.
Rebecca E KruegerEmory Institute for Drug Development, Emory University, Atlanta, GeorgiaUnited States of America.
Zachary SticherEmory Institute for Drug Development, Emory University, Atlanta, GeorgiaUnited States of America.
Alexander A KolykhalovEmory Institute for Drug Development, Emory University, Atlanta, GeorgiaUnited States of America.
Michael G NatchusEmory Institute for Drug Development, Emory University, Atlanta, GeorgiaUnited States of America.
George R PainterEmory Institute for Drug Development, Emory University, Atlanta, GeorgiaUnited States of America.
Kendra N JohnsonDepartment of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America.
Alexander L GreningerDepartment of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, Washington, United States of America.
Robert M CoxInstitute for Biomedical Sciences, Georgia State University, Atlanta, Georgia, United States of America.
Richard K PlemperInstitute for Biomedical Sciences, Georgia State University, Atlanta, Georgia, United States of America.
Benhur LeeDepartment of Microbiology, Icahn School of Medicine at Mount Sinai, New York, United States of America.
Alexander N FreibergDepartment of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America.

Funding

Biodefense Training ProgramT32AI060549 · NIAID · UNIVERSITY OF TEXAS MEDICAL BR GALVESTON · PI ASHOK K CHOPRA, Janice J Endsley · 2004 to 2026
$3.0M
NIAID NIH HHS T32 AI060549
6 · The paper itself

Abstract

Nipah virus (NiV) is a zoonotic paramyxovirus with pandemic potential, for which no licensed vaccines or therapeutics for human use are available. The nucleoside analog 4'-fluorouridine (4'-FlU, EIDD-2749) has broad activity against RNA viruses including in vitro activity against the Malaysia and Bangladesh clades of NiV (NiV-M and NiV-B, respectively). Here, we report the pharmacokinetic profile of orally administered 4'-FlU in Syrian Golden hamsters and its efficacy against NiV-B. 4'-FlU was orally bioavailable and provided sustained exposure of its bioactive anabolite 4'-FlU 5'-triphosphate (4'-FlU-TP) in the brain. A 7-day treatment course after NiV infection delayed time to death. Extending treatment to 21-28 days reduced viremia, incidence of lung disease, lung lesion severity, inflammation, and mortality. Lesions, viral antigen, or viral RNA could be detected in some survivors, suggesting persistent infections. Sequence analysis of NiV populations showed nonsynonymous single-nucleotide variants (SNVs) in some brain specimens from 4'-FlU-treated animals. Amino acid changes occurred in the nucleocapsid, the polymerase, or the phosphoprotein. It is currently unclear whether they reduce viral susceptibility to treatment or impact virulence but caused a slight increase in 4'-FlU potency compared to the genetic parent virus in vitro. However, none of these SNVs increased viral fitness in human brain astrocytes. This study established proof-of-concept for efficacious oral treatment of lethal NiV infection with a small-molecule nucleoside analog inhibitor in a relevant animal model.

Indexed as

Antiviral AgentsHenipavirus InfectionsNipah VirusUridineAnimalsBrainCricetinaeDisease Models, AnimalMesocricetusRNA, ViralAntiviral AgentsRNA, ViralUridine

Identifiers

PMID41931570
PMCPMC13048487

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.