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FDA approved drugs with antiviral activity against SARS-CoV-2: From structure-based repurposing to host-specific mechanisms - 29/04/23

Doi : 10.1016/j.biopha.2023.114614 
Mahmoud S. Ahmed a, j, , 1 , Ayman B. Farag a, 1, 2, Ian N. Boys b, 1, Ping Wang a, 1, Ivan Menendez-Montes a, Ngoc Uyen Nhi Nguyen a, Jennifer L. Eitson b, Maikke B. Ohlson b, Wenchun Fan b, Matthew B. McDougal b, Katrina Mar b, Suwannee Thet a, Francisco Ortiz f, Soo Young Kim a, Ashley Solmonson h, Noelle S. Williams f, Andrew Lemoff g, Ralph J. DeBerardinis h, i, John W. Schoggins b, , Hesham A. Sadek a, c, d, e,
a Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 
b Department of Microbiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 
c Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 
d Department of Biophysics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 
e Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 
f Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 
g Department Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 
h Children’s Medical Center Research Institute, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 
i Howard Hughes Medical Institute, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 
j Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, TX, 79106, USA 

Correspondence to: Departments of Microbiology and Internal medicine/Division of Cardiology, University of Texas Southwestern Medical Center, 6000 Harry Hines Blvd, Dallas, TX 75390, USA.Departments of Microbiology and Internal medicine/Division of Cardiology, University of Texas Southwestern Medical Center6000 Harry Hines BlvdDallasTX75390USA⁎⁎Corresponding author.

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Abstract

The continuing heavy toll of the COVID-19 pandemic necessitates development of therapeutic options. We adopted structure-based drug repurposing to screen FDA-approved drugs for inhibitory effects against main protease enzyme (Mpro) substrate-binding pocket of SARS-CoV-2 for non-covalent and covalent binding. Top candidates were screened against infectious SARS-CoV-2 in a cell-based viral replication assay. Promising candidates included atovaquone, mebendazole, ouabain, dronedarone, and entacapone, although atovaquone and mebendazole were the only two candidates with IC50s that fall within their therapeutic plasma concentration. Additionally, we performed Mpro assays on the top hits, which demonstrated inhibition of Mpro by dronedarone (IC50 18 µM), mebendazole (IC50 19 µM) and entacapone (IC50 9 µM). Atovaquone showed only modest Mpro inhibition, and thus we explored other potential mechanisms. Although atovaquone is Dihydroorotate dehydrogenase (DHODH) inhibitor, we did not observe inhibition of DHODH at the respective SARS-CoV-2 IC50. Metabolomic profiling of atovaquone treated cells showed dysregulation of purine metabolism pathway metabolite, where ecto-5′-nucleotidase (NT5E) was downregulated by atovaquone at concentrations equivalent to its antiviral IC50. Atovaquone and mebendazole are promising candidates with SARS-CoV-2 antiviral activity. While mebendazole does appear to target Mpro, atovaquone may inhibit SARS-CoV-2 viral replication by targeting host purine metabolism.

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Keywords : SARS-CoV-2, Structure-based drug repurposing, Purine Metabolism


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© 2023  The Authors. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 162

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