Journal
UNITED EUROPEAN GASTROENTEROLOGY JOURNAL
Volume 11, Issue 5, Pages 431-447Publisher
JOHN WILEY & SONS LTD
DOI: 10.1002/ueg2.12417
Keywords
antiviral therapy; combination treatment; corticosteroids; COVID; immunosuppressants; JAK inhibitor; pandemic; pan-coronavirus; Sars-CoV-2; STAT3 phosphorylation
Categories
Ask authors/readers for more resources
Immunosuppressants have different effects on coronavirus replication, and 6-TG, MPA, tofacitinib, and filgotinib have pan-coronavirus antiviral activity. The combinations of MPA, 6-TG, tofacitinib, and filgotinib with antiviral drugs exhibit additive or synergistic antiviral activity. These findings provide an important reference for the optimal management of immunocompromised patients infected with coronaviruses.
BackgroundImmunocompromised populations, such as organ transplant recipients and patients with inflammatory bowel disease (IBD) receiving immunosuppressive/immunomodulatory medications, may be more susceptible to coronavirus infections. However, little is known about how immunosuppressants affect coronavirus replication and their combinational effects with antiviral drugs. ObjectiveThis study aims to profile the effects of immunosuppressants and the combination of immunosuppressants with oral antiviral drugs molnupiravir and nirmatrelvir on pan-coronavirus infection in cell and human airway organoids (hAOs) culture models. MethodsDifferent coronaviruses (including wild type, delta and omicron variants of SARS-CoV-2, and NL63, 229E and OC43 seasonal coronaviruses) were used in lung cell lines and hAOs models. The effects of immunosuppressants were tested. ResultsDexamethasone and 5-aminosalicylic acid moderately stimulated the replication of different coronaviruses. Mycophenolic acid (MPA), 6-thioguanine (6-TG), tofacitinib and filgotinib treatment dose-dependently inhibited viral replication of all tested coronaviruses in both cell lines and hAOs. The half maximum effective concentration (EC50) of tofacitinib against SARS-CoV-2 was 0.62 mu M and the half maximum cytotoxic concentration (CC50) was above 30 mu M, which resulted in a selective index (SI) of about 50. The anti-coronavirus effect of the JAK inhibitors tofacitinib and filgotinib is dependent on the inhibition of STAT3 phosphorylation. Combinations of MPA, 6-TG, tofacitinib, and filgotinib with the oral antiviral drugs molnupiravir or nirmatrelvir exerted an additive or synergistic antiviral activity. ConclusionsDifferent immunosuppressants have distinct effects on coronavirus replication, with 6-TG, MPA, tofacitinib and filgotinib possessing pan-coronavirus antiviral activity. The combinations of MPA, 6-TG, tofacitinib and filgotinib with antiviral drugs exerted an additive or synergistic antiviral activity. Thus, these findings provide an important reference for optimal management of immunocompromised patients infected with coronaviruses.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available