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Vlachou A, Nchioua R, Regensburger K, Kirchhoff F, Kmiec D. A Gaussia luciferase reporter assay for the evaluation of coronavirus Nsp5/3CLpro activity. Sci Rep 2024; 14:20697. [PMID: 39237598 PMCID: PMC11377810 DOI: 10.1038/s41598-024-71305-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 08/27/2024] [Indexed: 09/07/2024] Open
Abstract
Human coronaviruses (hCoVs) infect millions of people every year. Among these, MERS, SARS-CoV-1, and SARS-CoV-2 caused significant morbidity and mortality and their emergence highlights the risk of possible future coronavirus outbreaks. Therefore, broadly-active anti-coronavirus drugs are needed. Pharmacological inhibition of the hCoV protease Nsp5 (3CLpro) is clinically beneficial as shown by the wide and effective use of Paxlovid (nirmatrelvir, ritonavir). However, further treatment options are required due to the risk of drug resistance. To facilitate the assessment of coronavirus protease function and its pharmacological inhibition, we developed an assay allowing rapid and reliable quantification of Nsp5 activity under biosafety level 1 conditions. It is based on an ACE2-Gal4 transcription factor fusion protein separated by a Nsp5 recognition site. Cleavage by Nsp5 releases the Gal4 transcription factor, which then induces the expression of Gaussia luciferase. Our assay is compatible with Nsp5 proteases from all hCoVs and allows simultaneous measurement of inhibitory and cytotoxic effects of the tested compounds. Proof-of-concept measurements confirmed that nirmatrelvir, GC376 and lopinavir inhibit SARS-CoV-2 Nsp5 function. Furthermore, the assay accurately predicted the impact of Nsp5 mutations on catalytic activity and inhibitor sensitivity. Overall, the reporter assay is suitable for evaluating viral protease activity.
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Affiliation(s)
- Asimenia Vlachou
- Institute of Molecular Virology, Ulm University Medical Center, 89081, Ulm, Germany
| | - Rayhane Nchioua
- Institute of Molecular Virology, Ulm University Medical Center, 89081, Ulm, Germany
| | - Kerstin Regensburger
- Institute of Molecular Virology, Ulm University Medical Center, 89081, Ulm, Germany
| | - Frank Kirchhoff
- Institute of Molecular Virology, Ulm University Medical Center, 89081, Ulm, Germany
| | - Dorota Kmiec
- Institute of Molecular Virology, Ulm University Medical Center, 89081, Ulm, Germany.
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Rubio-Rivas M, Mora-Luján JM, Montero A, Aguilar García JA, Méndez Bailón M, Fernández Cruz A, Oriol I, Teigell-Muñoz FJ, Dendariena Borque B, De la Peña Fernández A, Fernández González R, Gil Sánchez R, Fernández Fernández J, Catalán M, Cortés-Rodríguez B, Mella Pérez C, Montero Rivas L, Suárez Fuentetaja R, Ternero Vega JE, Ena J, Martin-Urda Díez-Canseco A, Pérez García C, Varona JF, Casas-Rojo JM, Millán Núñez-Cortés J. The Use of Corticosteroids or Tocilizumab in COVID-19 Based on Inflammatory Markers. J Gen Intern Med 2022; 37:168-175. [PMID: 34664188 PMCID: PMC8523009 DOI: 10.1007/s11606-021-07146-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/08/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The inflammatory cascade is the main cause of death in COVID-19 patients. Corticosteroids (CS) and tocilizumab (TCZ) are available to treat this escalation but which patients to administer it remains undefined. OBJECTIVE We aimed to evaluate the efficacy of immunosuppressive/anti-inflammatory therapy in COVID-19, based on the degree of inflammation. DESIGN A retrospective cohort study with data on patients collected and followed up from March 1st, 2020, to May 1st, 2021, from the nationwide Spanish SEMI-COVID-19 Registry. Patients under treatment with CS vs. those under CS plus TCZ were compared. Effectiveness was explored in 3 risk categories (low, intermediate, high) based on lymphocyte count, C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and D-dimer values. PATIENTS A total of 21,962 patients were included in the Registry by May 2021. Of these, 5940 met the inclusion criteria for the present study (5332 were treated with CS and 608 with CS plus TCZ). MAIN MEASURES The primary outcome of the study was in-hospital mortality. Secondary outcomes were the composite variable of in-hospital mortality, requirement for high-flow nasal cannula (HFNC), non-invasive mechanical ventilation (NIMV), invasive mechanical ventilation (IMV), or intensive care unit (ICU) admission. KEY RESULTS A total of 5940 met the inclusion criteria for the present study (5332 were treated with CS and 608 with CS plus TCZ). No significant differences were observed in either the low/intermediate-risk category (1.5% vs. 7.4%, p=0.175) or the high-risk category (23.1% vs. 20%, p=0.223) after propensity score matching. A statistically significant lower mortality was observed in the very high-risk category (31.9% vs. 23.9%, p=0.049). CONCLUSIONS The prescription of CS alone or in combination with TCZ should be based on the degrees of inflammation and reserve the CS plus TCZ combination for patients at high and especially very high risk.
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Affiliation(s)
- Manuel Rubio-Rivas
- Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, Barcelona, Spain
| | - José M. Mora-Luján
- Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, Barcelona, Spain
| | - Abelardo Montero
- Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, Barcelona, Spain
| | | | - Manuel Méndez Bailón
- Department of Internal Medicine, San Carlos University Hospital, Complutense University, Madrid, Spain
| | - Ana Fernández Cruz
- Department of Internal Medicine, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain
| | - Isabel Oriol
- Infectious Disease Unit, Department of Internal Medicine, Moisès Broggi Hospital, Sant Joan Despí, Barcelona, Spain
| | | | | | | | | | | | | | - Marta Catalán
- Department of Internal Medicine, Sagunto University Hospital, Sagunto, Valencia Spain
| | | | - Carmen Mella Pérez
- Department of Internal Medicine, Ferrol Clinical University Hospital, El Ferrol, La Coruña, Spain
| | - Lorena Montero Rivas
- Department of Internal Medicine, Infanta Margarita Hospital, Cabra, Córdoba, Spain
| | | | | | - Javier Ena
- Department of Internal Medicine, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | | | - Cristina Pérez García
- Department of Internal Medicine, Do Salnes Hospital, Vilagarcía de Arousa, Pontevedra, Spain
| | - José F. Varona
- Department of Internal Medicine, HM Montepríncipe University Hospital, Madrid, Spain
- Department of Internal Medicine, Infanta Cristina University Hospital, Parla, Madrid Spain
| | - José Manuel Casas-Rojo
- Department of Internal Medicine, Infanta Cristina University Hospital, Parla, Madrid, Spain
| | | | - on behalf of the SEMI-COVID-19 Network
- Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, Barcelona, Spain
- Department of Internal Medicine, Costa del Sol Hospital, Marbella, Málaga, Spain
- Department of Internal Medicine, San Carlos University Hospital, Complutense University, Madrid, Spain
- Department of Internal Medicine, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain
- Infectious Disease Unit, Department of Internal Medicine, Moisès Broggi Hospital, Sant Joan Despí, Barcelona, Spain
- Department of Internal Medicine, Infanta Cristina University Hospital, Parla, Madrid, Spain
- Department of Internal Medicine, San Pedro Hospital, Logroño, Spain
- Department of Internal Medicine, Son Llàtzer University Hospital, Palma de Mallorca, Spain
- Department of Internal Medicine, Ourense University Hospital, Ourense, Spain
- Department of Internal Medicine, La Fe Hospital, Valencia, Spain
- Department of Internal Medicine, Mataró Hospital, Mataró, Barcelona, Spain
- Department of Internal Medicine, Sagunto University Hospital, Sagunto, Valencia Spain
- Department of Internal Medicine, Alto Guadalquivir Hospital, Andújar, Jaén, Spain
- Department of Internal Medicine, Ferrol Clinical University Hospital, El Ferrol, La Coruña, Spain
- Department of Internal Medicine, Infanta Margarita Hospital, Cabra, Córdoba, Spain
- Department of Internal Medicine, Monforte de Lemos Hospital, Monforte de Lemos, Lugo, Spain
- Department of Internal Medicine, Vírgen del Rocío University Hospital, Sevilla, Spain
- Department of Internal Medicine, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
- Department of Internal Medicine, Palamós Hospital, Palamós, Girona, Spain
- Department of Internal Medicine, Do Salnes Hospital, Vilagarcía de Arousa, Pontevedra, Spain
- Department of Internal Medicine, HM Montepríncipe University Hospital, Madrid, Spain
- Department of Internal Medicine, Infanta Cristina University Hospital, Parla, Madrid Spain
- Department of Internal Medicine, Gregorio Marañón General University Hospital, Madrid, Spain
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Alam S, Kamal TB, Sarker MMR, Zhou JR, Rahman SMA, Mohamed IN. Therapeutic Effectiveness and Safety of Repurposing Drugs for the Treatment of COVID-19: Position Standing in 2021. Front Pharmacol 2021; 12:659577. [PMID: 34220503 PMCID: PMC8243370 DOI: 10.3389/fphar.2021.659577] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/28/2021] [Indexed: 02/06/2023] Open
Abstract
COVID-19, transmitted by SARS-CoV-2, is one of the most serious pandemic situations in the history of mankind, and has already infected a huge population across the globe. This horrendously contagious viral outbreak was first identified in China and within a very short time it affected the world's health, transport, economic, and academic sectors. Despite the recent approval of a few anti-COVID-19 vaccines, their unavailability and insufficiency along with the lack of other potential therapeutic options are continuing to worsen the situation, with valuable lives continuing to be lost. In this situation, researchers across the globe are focusing on repurposing prospective drugs and prophylaxis such as favipiravir, remdesivir, chloroquine, hydroxychloroquine, ivermectin, lopinavir-ritonavir, azithromycin, doxycycline, ACEIs/ARBs, rivaroxaban, and protease inhibitors, which were preliminarily based on in vitro and in vivo pharmacological and toxicological study reports followed by clinical applications. Based on available preliminary data derived from limited clinical trials, the US National Institute of Health (NIH) and USFDA also recommended a few drugs to be repurposed i.e., hydroxychloroquine, remdesivir, and favipiravir. However, World Health Organization later recommended against the use of chloroquine, hydroxychloroquine, remdesivir, and lopinavir/ritonavir in the treatment of COVID-19 infections. Combining basic knowledge of viral pathogenesis and pharmacodynamics of drug molecules as well as in silico approaches, many drug candidates have been investigated in clinical trials, some of which have been proven to be partially effective against COVID-19, and many of the other drugs are currently under extensive screening. The repurposing of prospective drug candidates from different stages of evaluation can be a handy wellspring in COVID-19 management and treatment along with approved anti-COVID-19 vaccines. This review article combined the information from completed clinical trials, case series, cohort studies, meta-analyses, and retrospective studies to focus on the current status of repurposing drugs in 2021.
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Affiliation(s)
- Safaet Alam
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
| | | | - Md. Moklesur Rahman Sarker
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
- Pharmacology and Toxicology Research Division, Health Med Science Research Limited, Dhaka, Bangladesh
| | - Jin-Rong Zhou
- Nutrition/Metabolism Laboratory, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - S. M. Abdur Rahman
- Department of Clinical Pharmacy and Pharmacology, Faculty of Pharmacy, University of Dhaka, Dhaka, Bangladesh
| | - Isa Naina Mohamed
- Pharmacology Department, Medical Faculty, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
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Kumar A, Singh R, Kaur J, Pandey S, Sharma V, Thakur L, Sati S, Mani S, Asthana S, Sharma TK, Chaudhuri S, Bhattacharyya S, Kumar N. Wuhan to World: The COVID-19 Pandemic. Front Cell Infect Microbiol 2021; 11:596201. [PMID: 33859951 PMCID: PMC8042280 DOI: 10.3389/fcimb.2021.596201] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/09/2021] [Indexed: 12/24/2022] Open
Abstract
COVID-19 is a Severe Acute Respiratory Syndrome (SARS), caused by SARS-CoV-2, a novel virus which belongs to the family Coronaviridae. It was first reported in December 2019 in the Wuhan city of China and soon after, the virus and hence the disease got spread to the entire world. As of February 26, 2021, SARS-CoV-2 has infected ~112.20 million people and caused ~2.49 million deaths across the globe. Although the case fatality rate among SARS-CoV-2 patient is lower (~2.15%) than its earlier relatives, SARS-CoV (~9.5%) and MERS-CoV (~34.4%), the SARS-CoV-2 has been observed to be more infectious and caused higher morbidity and mortality worldwide. As of now, only the knowledge regarding potential transmission routes and the rapidly developed diagnostics has been guiding the world for managing the disease indicating an immediate need for a detailed understanding of the pathogen and the disease-biology. Over a very short period of time, researchers have generated a lot of information in unprecedented ways in the key areas, including viral entry into the host, dominant mutation, potential transmission routes, diagnostic targets and their detection assays, potential therapeutic targets and drug molecules for inhibiting viral entry and/or its replication in the host including cross-neutralizing antibodies and vaccine candidates that could help us to combat the ongoing COVID-19 pandemic. In the current review, we have summarized the available knowledge about the pathogen and the disease, COVID-19. We believe that this readily available knowledge base would serve as a valuable resource to the scientific and clinical community and may help in faster development of the solution to combat the disease.
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Affiliation(s)
- Ashok Kumar
- Translational Health Science and Technology Institute (THSTI), Faridabad, India
- Manipal Academy of Higher Education, Manipal, India
| | - Rita Singh
- Translational Health Science and Technology Institute (THSTI), Faridabad, India
- Jawaharlal Nehru University, New Delhi, India
| | - Jaskaran Kaur
- Translational Health Science and Technology Institute (THSTI), Faridabad, India
- Jawaharlal Nehru University, New Delhi, India
| | - Sweta Pandey
- Translational Health Science and Technology Institute (THSTI), Faridabad, India
- Jawaharlal Nehru University, New Delhi, India
| | - Vinita Sharma
- Translational Health Science and Technology Institute (THSTI), Faridabad, India
- Central University of Haryana, Mahendragarh, India
| | - Lovnish Thakur
- Translational Health Science and Technology Institute (THSTI), Faridabad, India
- Jawaharlal Nehru University, New Delhi, India
| | - Sangeeta Sati
- Translational Health Science and Technology Institute (THSTI), Faridabad, India
| | - Shailendra Mani
- Translational Health Science and Technology Institute (THSTI), Faridabad, India
| | - Shailendra Asthana
- Translational Health Science and Technology Institute (THSTI), Faridabad, India
| | - Tarun Kumar Sharma
- Translational Health Science and Technology Institute (THSTI), Faridabad, India
| | - Susmita Chaudhuri
- Translational Health Science and Technology Institute (THSTI), Faridabad, India
| | | | - Niraj Kumar
- Translational Health Science and Technology Institute (THSTI), Faridabad, India
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