The Molecular Mechanism of Action of the CR6261-Azichromycin Combination Found through Computational Analysis

BACKGROUND CR6261 was found in 2008 and F10 was found in 2009. In 2010 Friesen et al experimentally showed that Oseltamivir/Zanamivir may improve the therapeutic efficacy of CR6261. As a result, the use of CR6261 combined with a drug to provide an antibody-based therapy against all influenza A viruses was proposed. Although CR8020 may neutralize group 2 influenza viruses and FI6 may neutralize both group 1 and group 2 influenza viruses as determined in 2011, the insight of Friesen et al is still interesting. Here, we address the following questions: how to uncover the molecular mechanism of a drug, which improves the therapeutic efficacy of mAbs and how to find drugs that enable CR6261 (CR8020, F10) to become a universal mAb. METHODS AND FINDINGS Using the 3D structures of 3 gbn, 3 gbm, 3 ztn, 3 ztj, 3 fku and 3 sdy, we separate the 3D structures of CR6261, F10, CR8020 and FI6, and the 3D structures of trimer HAs of H3N2 and H5N1. Based on the experimental result of Friesen et al, we have found many clues, which reveal the molecular mechanism of action for a drug and an HA-mAb complex. CONCLUSIONS Oseltamivir/Zanamivir may congruously improve the therapeutic efficacies of CR6261, F10, CR8020 and FI6 by providing an additional affinity to compensate for the loss of affinity between HA and mAb resulting from mutations. However, Oseltamivir or Zanamivir are not expected to generally widen the spectrum of these mAbs. In order to enhance CR6261, CR8020, or for F10 to become universal, we may select Azichromycin, Oseltamivir, or the combination of Azichromycin and Oseltamivir, respectively.