Broad-spectrum viral biomarkers offer a promising approach to distinguishing viral from bacterial infections, thereby reducing inappropriate antibiotic use and improving diagnostic response during emerging infectious disease outbreaks. Among these, the deoxydidehydronucleoside (ddhN) class of nucleoside derivatives has emerged as a potential tool for early detection of viral infections in settings where pathogen-specific diagnostics are unavailable. To assess the clinical utility of these compounds, we investigated the metabolism and excretion rates of four principal ddhN metabolites, 3'-deoxy-3',4'-didehydrocytidine (ddhC), 3'-deoxy-3',4'-didehydrocytidine-5'-carboxylate (ddhC-5'CA), 3'-deoxy-3',4'-didehydrouridine (ddhU), and 3'-deoxy-3',4'-didehydrocytidine-5'-homocysteine (ddhC-5'Hcy), in the Sprague-Dawley rat model following a single intravenous dose. Time-resolved biological sampling was used to characterize urinary excretion and downstream biotransformation. All four metabolites exhibited rapid urinary clearance, ranging from approximately 3 to 8 h, consistent with a transient acute-phase profile. Notably, ddhC-5'Hcy underwent extensive biotransformation, with key metabolites produced via functionalization and conjugation identified following integration of nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS) analyses. No adverse clinical signs were observed in any treatment group at any time point. These findings support further research into the ddhN series as markers of active viral infection for clinical application, particularly in critical care environments, where timely differentiation of infectious etiology is essential.
Sala et al. (Wed,) studied this question.