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Efficacy and Mechanism of Action of Low Dose Emetine against Human Cytomegalovirus

Found this new study interesting: http://www.ncbi.nlm.nih.gov/pubmed/27336364 and the abstract is below. Emetine comes from a root and has been used as medicine for over 500 years.


Infection with human cytomegalovirus (HCMV) is a threat for pregnant women and immunocompromised hosts. Although limited drugs are available, development of new agents against HCMV is desired. Through screening of the LOPAC library, we identified emetine as HCMV inhibitor. Additional studies confirmed its anti-HCMV activities in human foreskin fibroblasts: EC50-40±1.72 nM, CC50-8±0.56 μM, and selectivity index of 200. HCMV inhibition occurred after virus entry, but before DNA replication, and resulted in decreased expression of viral proteins. Synergistic virus inhibition was achieved when emetine was combined with ganciclovir. In a mouse CMV (MCMV) model, emetine was well-tolerated, displayed long half-life, preferential distribution to tissues over plasma, and effectively suppressed MCMV. Since the in vitro anti-HCMV activity of emetine decreased significantly in low-density cells, a mechanism involving cell cycle regulation was suspected. HCMV inhibition by emetine depended on ribosomal processing S14 (RPS14) binding to MDM2, leading to disruption of HCMV-induced MDM2-p53 and MDM2-IE2 interactions. Irrespective of cell density, emetine induced RPS14 translocation into the nucleus during infection. In infected high-density cells, MDM2 was available for interaction with RPS14, resulting in disruption of MDM2-p53 interaction. However, in low-density cells the pre-existing interaction of MDM2-p53 could not be disrupted, and RPS14 could not interact with MDM2. In high-density cells the interaction of MDM2-RPS14 resulted in ubiquitination and degradation of RPS14, which was not observed in low-density cells. In infected-only or in non-infected emetine-treated cells, RPS14 failed to translocate into the nucleus, hence could not interact with MDM2, and was not ubiquitinated. HCMV replicated similarly in RPS14 knockdown or control cells, but emetine did not inhibit virus replication in the former cell line. The interaction of MDM2-p53 was maintained in infected RPS14 knockdown cells despite emetine treatment, confirming a unique mechanism by which emetine exploits RPS14 to disrupt MDM2-p53 interaction. Summarized, emetine may represent a promising candidate for HCMV therapy alone or in combination with ganciclovir through a novel host-dependent mechanism.


Senior Member
The downside of emetine is that it is an emetic (induces vomiting). Perhaps if taken with an antiemetic it would be OK.

I can't seem to find emetine for sale, though. Emetine comes from ipecac root (Carapichea ipecacuanha), and was made into syrup of ipecac, a drug that was once used as a cough syrup and to induce vomiting, but syrup of ipecac was discontinued in 2010.
I have seen that it induces vomiting but apparently in lower doses you can get around it with it still being effective. You can buy it here interestingly enough as a protozoa package and here in liquid form as an ameobocide although it does say that it induces vomiting and all that. Whats funny is that this all started for me when I lived in the middle of the jungle with the native population in Panama for 2 years. All along they told me about a local plant that they said would make me vomit and have diarrhea but it would clear the parasites and I would never get them again. I'm taking a wild guess and saying that it could be a related plant or have a similar effect to this one.

For me, a couple times vomiting might be worth a try considering my CMV antigen levels are up there with the highest Dr. Montoya has seen.