发现经美国食品和药物管理局批准的药物贝沙罗汀、西替利司他、二碘羟喹啉和阿比特龙可作为有强大双层筛选系统的潜在 COVID-19 治疗药物。

Discovery of the FDA-approved drugs bexarotene, cetilistat, diiodohydroxyquinoline, and abiraterone as potential COVID-19 treatments with a robust two-tier screening system.

机构信息

State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region; Centre for Virology, Vaccinology and Therapeutics, Health@InnoHK, The University of Hong Kong, Hong Kong Special Administrative Region.

State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region; Centre for Virology, Vaccinology and Therapeutics, Health@InnoHK, The University of Hong Kong, Hong Kong Special Administrative Region; Department of Clinical Microbiology and Infection Control, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province, China; Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Haikou, China; and The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region.

出版信息

Pharmacol Res. 2020 Sep;159:104960. doi: 10.1016/j.phrs.2020.104960. Epub 2020 May 28.

Abstract

Coronavirus Disease 2019 (COVID-19) caused by the emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a crude case fatality rate of about 0.5-10 % depending on locality. A few clinically approved drugs, such as remdesivir, chloroquine, hydroxychloroquine, nafamostat, camostat, and ivermectin, exhibited anti-SARS-CoV-2 activity in vitro and/or in a small number of patients. However, their clinical use may be limited by anti-SARS-CoV-2 50 % maximal effective concentrations (EC) that exceeded their achievable peak serum concentrations (Cmax), side effects, and/or availability. To find more immediately available COVID-19 antivirals, we established a two-tier drug screening system that combines SARS-CoV-2 enzyme-linked immunosorbent assay and cell viability assay, and applied it to screen a library consisting 1528 FDA-approved drugs. Cetilistat (anti-pancreatic lipase), diiodohydroxyquinoline (anti-parasitic), abiraterone acetate (synthetic androstane steroid), and bexarotene (antineoplastic retinoid) exhibited potent in vitro anti-SARS-CoV-2 activity (EC 1.13-2.01 μM). Bexarotene demonstrated the highest Cmax:EC ratio (1.69) which was higher than those of chloroquine, hydroxychloroquine, and ivermectin. These results demonstrated the efficacy of the two-tier screening system and identified potential COVID-19 treatments which can achieve effective levels if given by inhalation or systemically depending on their pharmacokinetics.

摘要

由新型严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的 2019 年冠状病毒病(COVID-19),其粗病死率约为 0.5-10%,取决于当地情况。一些已临床批准的药物,如瑞德西韦、氯喹、羟氯喹、那法莫司他、卡莫司他和伊维菌素,在体外和/或少数患者中表现出抗 SARS-CoV-2 活性。然而,其临床应用可能受到抗 SARS-CoV-2 的 50%最大有效浓度(EC)的限制,这些浓度超过了其可达到的血清峰值浓度(Cmax)、副作用和/或可获得性。为了寻找更直接可用的 COVID-19 抗病毒药物,我们建立了一个两级药物筛选系统,该系统结合了 SARS-CoV-2 酶联免疫吸附试验和细胞活力测定,并将其应用于筛选由 1528 种 FDA 批准的药物组成的文库。西替利司他(抗胰脂肪酶)、二碘羟基喹啉(抗寄生虫)、阿比特龙醋酸盐(合成雄烷类固醇)和贝沙罗汀(抗肿瘤维甲酸)表现出强烈的体外抗 SARS-CoV-2 活性(EC 1.13-2.01 μM)。贝沙罗汀显示出最高的 Cmax:EC 比值(1.69),高于氯喹、羟氯喹和伊维菌素。这些结果证明了两级筛选系统的有效性,并确定了潜在的 COVID-19 治疗方法,如果根据其药代动力学以吸入或系统方式给药,这些方法可能达到有效水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c67c/7254006/c40df7992a53/ga1_lrg.jpg

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