학술논문

Discovery of SARS-CoV-2 antiviral drugs through large-scale compound repurposing
Document Type
article
Source
Nature. 586(7827)
Subject
Medical Microbiology
Biomedical and Clinical Sciences
Emerging Infectious Diseases
Rare Diseases
Lung
Orphan Drug
Biodefense
Infectious Diseases
Vaccine Related
Pneumonia & Influenza
Pneumonia
Prevention
Development of treatments and therapeutic interventions
5.1 Pharmaceuticals
6.1 Pharmaceuticals
Evaluation of treatments and therapeutic interventions
Infection
Good Health and Well Being
Adenosine Monophosphate
Alanine
Alveolar Epithelial Cells
Antiviral Agents
Betacoronavirus
COVID-19
Cell Line
Coronavirus Infections
Cysteine Proteinase Inhibitors
Dose-Response Relationship
Drug
Drug Evaluation
Preclinical
Drug Repositioning
Drug Synergism
Gene Expression Regulation
Humans
Hydrazones
Induced Pluripotent Stem Cells
Models
Biological
Morpholines
Pandemics
Pneumonia
Viral
Pyrimidines
Reproducibility of Results
SARS-CoV-2
Small Molecule Libraries
Triazines
Virus Internalization
Virus Replication
COVID-19 Drug Treatment
General Science & Technology
Language
Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019 has triggered an ongoing global pandemic of the severe pneumonia-like disease coronavirus disease 2019 (COVID-19)1. The development of a vaccine is likely to take at least 12-18 months, and the typical timeline for approval of a new antiviral therapeutic agent can exceed 10 years. Thus, repurposing of known drugs could substantially accelerate the deployment of new therapies for COVID-19. Here we profiled a library of drugs encompassing approximately 12,000 clinical-stage or Food and Drug Administration (FDA)-approved small molecules to identify candidate therapeutic drugs for COVID-19. We report the identification of 100 molecules that inhibit viral replication of SARS-CoV-2, including 21 drugs that exhibit dose-response relationships. Of these, thirteen were found to harbour effective concentrations commensurate with probable achievable therapeutic doses in patients, including the PIKfyve kinase inhibitor apilimod2-4 and the cysteine protease inhibitors MDL-28170, Z LVG CHN2, VBY-825 and ONO 5334. Notably, MDL-28170, ONO 5334 and apilimod were found to antagonize viral replication in human pneumocyte-like cells derived from induced pluripotent stem cells, and apilimod also demonstrated antiviral efficacy in a primary human lung explant model. Since most of the molecules identified in this study have already advanced into the clinic, their known pharmacological and human safety profiles will enable accelerated preclinical and clinical evaluation of these drugs for the treatment of COVID-19.