Exploring antiviral and anti-inflammatory effects of thiol drugs in COVID-19

The redox status of the cysteine-rich SARS-CoV-2 spike glycoprotein (SARS-2-S) is important for the binding of SARS-2-S to angiotensin-converting enzyme 2 (ACE2), suggesting that drugs with a functional thiol group (“thiol drugs”) may cleave cystines to disrupt SARS-CoV-2 cell entry. In addition, neutrophil-induced oxidative stress is a mechanism of COVID-19 lung injury, and the antioxidant and anti-inflammatory properties of thiol drugs, especially cysteamine, may limit this injury. To first explore the antiviral effects of thiol drugs in COVID-19, we used an ACE-2 binding assay and cell entry assays utilizing reporter pseudoviruses and authentic SARS-CoV-2 viruses. We found that multiple thiol drugs inhibit SARS-2-S binding to ACE2 and virus infection. The most potent drugs were effective in the low millimolar range, and IC₅₀ values followed the order of their cystine cleavage rates and lower thiol pK_a values. To determine if thiol drugs have antiviral effects in vivo and to explore any anti-inflammatory effects of thiol drugs in COVID-19, we tested the effects of cysteamine delivered intraperitoneally to hamsters infected with SARS-CoV-2. Cysteamine did not decrease lung viral infection, but it significantly decreased lung neutrophilic inflammation and alveolar hemorrhage. We speculate that the concentration of cysteamine achieved in the lungs with intraperitoneal delivery was insufficient for antiviral effects but sufficient for anti-inflammatory effects. We conclude that thiol drugs decrease SARS-CoV-2 lung inflammation and injury, and we provide rationale for future studies to test if direct (aerosol) delivery of thiol drugs to the airways might also result in antiviral effects.

Thiol drugs decrease SARS-CoV-2 lung injury in vivo and disrupt SARS-CoV-2 spike complex binding to ACE2 in vitro

Neutrophil-induced oxidative stress is a mechanism of lung injury in COVID-19, and drugs with a functional thiol group (“thiol drugs”), especially cysteamine, have anti-oxidant and anti-inflammatory properties that could limit this injury. Thiol drugs may also alter the redox status of the cysteine-rich SARS-CoV-2 spike glycoprotein (SARS-2-S) and thereby disrupt ACE2 binding. Using ACE2 binding assay, reporter virus pseudotyped with SARS-CoV-2 spikes (ancestral and variants) and authentic SARS-CoV-2 (Wuhan-1), we find that multiple thiol drugs inhibit SARS-2-S binding to ACE2 and virus entry into cells. Pseudoviruses carrying variant spikes were less efficiently inhibited as compared to pseudotypes bearing an ancestral spike, but the most potent drugs still inhibited the Delta variant in the low millimolar range. IC50 values followed the order of their cystine cleavage rates and lower thiol pKa values. In hamsters infected with SARS-CoV-2, intraperitoneal (IP) cysteamine decreased neutrophilic inflammation and alveolar hemorrhage in the lungs but did not decrease viral infection, most likely because IP delivery could not achieve millimolar concentrations in the airways. These data show that thiol drugs inhibit SARS-CoV-2 infection in vitro and reduce SARS-CoV-2-related lung injury in vivo and provide strong rationale for trials of systemically delivered thiol drugs as COVID-19 treatments. We propose that antiviral effects of thiol drugs in vivo will require delivery directly to the airways to ensure millimolar drug concentrations and that thiol drugs with lower thiol pKa values are most likely to be effective.

The effect of cysteamine to decrease SARS-CoV-2 pneumonia in vivo and of multiple thiol drugs to inhibit SARS-CoV-2 infection in vitro provides rationale for clinical trials of thiol drugs in COVID-19.

Modulation of Protein Fouling and Interfacial Properties at Carbon Surfaces via Immobilization of Glycans Using Aryldiazonium Chemistry

Carbon materials and nanomaterials are of great interest for biological applications such as implantable devices and nanoparticle vectors, however, to realize their potential it is critical to control formation and composition of the protein corona in biological media. In this work, protein adsorption studies were carried out at carbon surfaces functionalized with aryldiazonium layers bearing mono- and di-saccharide glycosides. Surface IR reflectance absorption spectroscopy and quartz crystal microbalance were used to study adsorption of albumin, lysozyme and fibrinogen. Protein adsorption was found to decrease by 30–90% with respect to bare carbon surfaces; notably, enhanced rejection was observed in the case of the tested di-saccharide vs. simple mono-saccharides for near-physiological protein concentration values. ζ-potential measurements revealed that aryldiazonium chemistry results in the immobilization of phenylglycosides without a change in surface charge density, which is known to be important for protein adsorption. Multisolvent contact angle measurements were used to calculate surface free energy and acid-base polar components of bare and modified surfaces based on the van Oss-Chaudhury-Good model: results indicate that protein resistance in these phenylglycoside layers correlates positively with wetting behavior and Lewis basicity.

Enhanced Antifouling Properties of Carbohydrate Coated Poly(ether sulfone) Membranes

Poly(ether sulfone) membranes (PES) were modified with biologically active monosaccharides and disaccharides using aryldiazonium chemistry as a mild, one-step, surface-modification strategy. We previously proposed the modification of carbon, metals, and alloys with monosaccharides using the same method; herein, we demonstrate modification of PES membranes and the effect of chemisorbed carbohydrate layers on their resistance to biofouling. Glycosylated PES surfaces were characterized using spectroscopic methods and tested against their ability to interact with specific carbohydrate-binding proteins. Galactose-, mannose-, and lactose-modified PES surfaces were exposed to Bovine Serum Albumin (BSA) solutions to assess unspecific protein adsorption in the laboratory and were found to adsorb significantly lower amounts of BSA compared to bare membranes. The ability of molecular carbohydrate layers to impart antifouling properties was further tested in the field via long-term immersive tests at a wastewater treatment plant. A combination of ATP content assays, infrared spectroscopic characterization and He-ion microscopy (HIM) imaging were used to investigate biomass accumulation at membranes. We show that, beyond laboratory applications and in the case of complex aqueous environments that are rich in biomass such as wastewater effluent, we observe significantly lower biofouling at carbohydrate-modified PES than at bare PES membrane surfaces.

Photoaffinity labeling of mitochondrial proteins with 2-azido [32P]palmitoyl CoA

A long-chain fatty acyl CoA photolabel, 2-azido [32P]palmitoyl CoA, was synthesized and its covalent interaction with mitochondrial membrane proteins examined. On binding of 2-azido [32P]palmitoyl CoA to beef heart mitochondria, two polypeptides were primarily labeled, the 30 kDa ADP/ATP carrier and a 41 kDa protein of unknown identity. Carboxyatractyloside and palmitoyl CoA completely protected against labeling of the 30 kDa protein indicating that it was the ADP/ATP carrier. With inverted submitochondrial particles, only the 30 kDa polypeptide was labeled by 2-azido [32P]palmitoyl CoA. The labeling was inhibited by bongkrekic acid and palmitoyl CoA but not carboxyatractyloside, providing evidence that the ADP/ATP carrier was covalently bound from the matrix side of the membrane. In brown adipose tissue mitochondria, 2-azido [32P]palmitoyl CoA photolabeled the ADP/ATP carrier and the 32 kDa uncoupling protein with some minor labeling of 36 and 68 kDa polypeptides. The results indicated that this physiological photolabeling reagent with the azido group on the CoA portion of the molecule interacts like 2-azido ADP with nucleotide binding sites of a number of important enzymes in cell metabolism. Moreover, the evidence strongly supports the hypothesis that long chain fatty acyl CoA esters are natural ligands for key nucleotide binding proteins.

Photoaffinity labeling of hamster brown adipose tissue mitochondria by an [125I] coenzyme A derivative: differential interaction with the uncoupling protein and ADP/ATP carrier

We have recently synthesized an azido [125I] CoA photolabel, N-(3-iodo-4-azidophenyl propionamide) cysteinyl-5-(2'thiopyridyl cysteine) CoA that specifically labeled the ADP/ATP carrier in beef heart mitochondria. In this study brown adipose tissue mitochondria were photolabeled with the azido [125I] ACT-CoA derivative with or without inhibitors. SDS gel electrophoresis and autoradiography of the separated proteins revealed exclusive photolabeling of two polypeptides corresponding to the ADP/ATP carrier and uncoupling protein. In the presence of carboxyatracytloside only the 32 kD UCP was labeled by [125I] ACT-CoA, whereas preincubation with GDP resulted in exclusive photolabeling of the 30 kD ADP/ATP carrier. Palmitoyl CoA but not palmitic acid inhibited photolabeling of both polypeptides.

MR imaging in the management of supratentorial intracranial AVMs

The MR images, CT scans, and angiograms of 15 consecutive patients with intracranial, supratentorial arteriovenous malformations (AVMs) were studied retrospectively. The three imaging techniques were evaluated separately to assess their utility in defining the size, characteristics, and location of the AVM nidus, its arterial supply, and venous drainage. The studies were also evaluated for their ability to show associated parenchymal abnormalities, the presence of mass effect, and changes occurring after embolization. MR was superior to both CT and angiography in showing the exact anatomic relationships of the nidus, feeding arteries, and draining veins, as well as in demonstrating the extent of AVM nidus obliteration after embolization. MR was more sensitive than CT in revealing associated parenchymal abnormalities and subacute hemorrhage. Because of flow-related artifacts and low sensitivity in distinguishing calcification from rapid flow and/or hemosiderin, MR seemed to have a low sensitivity for detecting old hemorrhage within an AVM nidus. Angiography is still needed in the planning of either surgical or endovascular treatment of AVMs.

Tricyclic antidepressant poisoning in children

The MR images, CT scans, and angiograms of 15 consecutive patients with intracranial, supratentorial arteriovenous malformations (AVMs) were studied retrospectively. The three imaging techniques were evaluated separately to assess their utility in defining the size, characteristics, and location of the AVM nidus, its arterial supply, and venous drainage. The studies were also evaluated for their ability to show associated parenchymal abnormalities, the presence of mass effect, and changes occurring after embolization. MR was superior to both CT and angiography in showing the exact anatomic relationships of the nidus, feeding arteries, and draining veins, as well as in demonstrating the extent of AVM nidus obliteration after embolization. MR was more sensitive than CT in revealing associated parenchymal abnormalities and subacute hemorrhage. Because of flow-related artifacts and low sensitivity in distinguishing calcification from rapid flow and/or hemosiderin, MR seemed to have a low sensitivity for detecting old hemorrhage within an AVM nidus. Angiography is still needed in the planning of either surgical or endovascular treatment of AVMs.