Drug Repurposing with Tetracycline and Kampo Medicine (Sho-Sai-Koto and Saiko-Keishi-to) for Crimean-Congo Hemorrhagic Fever: Predicting Efficacy Through In Silico Studies

The Crimean-Congo hemorrhagic fever virus is a tick-borne bunyavirus that leads to acute febrile illness with myalgia, dizziness, neck pain and headache and a high mortality rate in humans. Currently, no specific antiviral drugs have been approved for treatment, making the search for effective drugs against this virus and the execution of clinical trials a significant concern. Drug repurposing is a well-established strategy for redeploying existing licensed drugs for newer indications, facilitating the quickest transition from bench to bedside. Computational screening through in silico studies offer a cost-effective and time-efficient approach for identifying potential drug candidates for repurposing. This approach demonstrated that tetracyclines such as doxycycline and minocycline, along with the phytochemical skullcapflavone I, are efficacious against Crimean-Congo hemorrhagic fever virus. Scutellaria, which contains skullcapflavone I in its extracts, is a component of the traditional Japanese medicines Shosaiko-to and Saiko-keishi-to (Kampo medicines). Kampo medicines are primarily formulated with organic plant-based ingredients and are known to have fewer adverse reactions compared to Western medicine. In the near future, the aforementioned drugs may be recognized as Crimean-Congo hemorrhagic fever virus inhibitors following in vitro and in vivo examinations.