赛洛昔布在 COVID-19 患者中的作用机制得到解释:ACE2 是一个新的 ΔNp63α 靶基因。

Molecular mechanisms of thalidomide effectiveness on COVID-19 patients explained: ACE2 is a new ΔNp63α target gene.

机构信息

Dipartimento Di Ricerca E Tecnologie Avanzate, Istituto Nazionale Tumori Regina Elena IRCCS, 00144, Rome, Italy.

Dipartimento Di Bioscienze, Università Degli Studi Di Milano, Via Celoria 26, 20133, Milan, Italy.

出版信息

J Mol Med (Berl). 2024 Nov;102(11):1371-1380. doi: 10.1007/s00109-024-02485-x. Epub 2024 Sep 18.

Abstract

COVID-19 pandemic is caused by the SARS-CoV-2 virus, whose internalization and infection are mediated by the angiotensin-converting enzyme 2 (ACE2). The identification of novel approaches to tackle this step is instrumental for the development of therapies for the management of COVID-19 and other diseases with a similar mechanism of infection. Thalidomide, a drug sadly known for its teratogenic effects, has potent immunomodulatory and anti-inflammatory properties. Treatment with this drug has been shown to improve the immune functions of COVID-19 patients and proposed for the management of COVID-19 in clinical practice through drug repositioning. Here, we investigated the molecular details linking thalidomide to ACE2 and COVID-19, showing that in conditions mimicking SARS-CoV-2-associated cytokine storm, the transcription factor ΔNp63α and ACE2 are stabilized, and IL-8 production is increased. In such conditions, we found p63 to bind to and regulate the expression of the ACE2 gene. We previously showed that ΔNp63α is degraded upon thalidomide treatment and now found that treatment with this drug-or with its analogue lenalidomide-downregulates ACE2 in a p63-dependent manner. Finally, we found that thalidomide treatment reduces in vitro infection by pseudo-SARS-CoV-2, a baculovirus pseudotyped with the SARS-CoV-2 spike protein. Overall, we propose the dual effect of thalidomide in reducing SARS-CoV-2 viral re-entry and inflammation through p63 degradation to weaken SARS-CoV-2 entry into host cells and mitigate lung inflammation, making it a valuable option in clinical management of COVID-19. KEY MESSAGES: Thalidomide treatment results in p63-dependent ACE2 downregulation. ACE2 is a p63 transcriptional target. Thalidomide reduces the "cytokine storm" associated to COVID-19. Thalidomide prevents viral re-entry of SARS-CoV-2 by p63-dependent ACE2 downregulation. Thalidomide is a modulator of SARS-CoV-2 or other ACE2-dependent infections. ACE2 is modulated by a pharmacological substance.

摘要

新型冠状病毒肺炎是由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的,其内化和感染是由血管紧张素转换酶 2(ACE2)介导的。寻找针对这一环节的新方法对于开发治疗新型冠状病毒肺炎和其他具有相似感染机制的疾病的疗法至关重要。沙利度胺是一种药物,因其致畸作用而广为人知,但具有很强的免疫调节和抗炎作用。该药物的治疗已被证明可以改善新型冠状病毒肺炎患者的免疫功能,并通过药物重定位提出用于临床治疗新型冠状病毒肺炎。在这里,我们研究了将沙利度胺与 ACE2 和新型冠状病毒肺炎联系起来的分子细节,表明在模拟 SARS-CoV-2 相关细胞因子风暴的条件下,转录因子 ΔNp63α 和 ACE2 稳定,白细胞介素 8(IL-8)的产生增加。在这种情况下,我们发现 p63 结合并调节 ACE2 基因的表达。我们之前曾表明,ΔNp63α 在沙利度胺治疗后被降解,现在发现该药物或其类似物来那度胺以依赖于 p63 的方式下调 ACE2。最后,我们发现沙利度胺治疗可降低伪 SARS-CoV-2(一种用 SARS-CoV-2 刺突蛋白假型化的杆状病毒)的体外感染。总的来说,我们提出了沙利度胺通过降低 p63 来减少 SARS-CoV-2 病毒再进入和炎症的双重作用,从而削弱 SARS-CoV-2 进入宿主细胞并减轻肺部炎症的能力,使其成为治疗新型冠状病毒肺炎的有价值的选择。关键信息:沙利度胺治疗导致 p63 依赖性 ACE2 下调。ACE2 是 p63 的转录靶标。沙利度胺可减轻与新型冠状病毒肺炎相关的“细胞因子风暴”。沙利度胺通过 p63 依赖性 ACE2 下调防止 SARS-CoV-2 的病毒再进入。沙利度胺可通过下调 ACE2 来调节 SARS-CoV-2 或其他 ACE2 依赖性感染。ACE2 受药理物质调节。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0278/11525293/0102381ba34c/109_2024_2485_Fig1_HTML.jpg

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