Arginine depletion as a therapeutic approach for patients with COVID-19

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a source of significant morbidity and death worldwide, and effective treatments are urgently needed. Clinical trials have focused largely on direct antiviral therapies or on immunomodulation in patients with severe manifestations of COVID-19. One therapeutic approach that remains to be clinically investigated is disruption of the host-virus relationship through amino acid restriction, a strategy used successfully in the setting of cancer treatment. Arginine is an amino acid that has been shown in nonclinical studies to be essential in the life cycle of many viruses. Therefore, arginine depletion may be an effective therapeutic approach against SARS-CoV-2. Several arginine-metabolizing enzymes in clinical development may be a viable approach to induce a low arginine environment to treat COVID-19 and other viral diseases. Herein, we explore the rationale for arginine depletion as a therapeutic approach for COVID-19. (C) 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Automated summary

Arginine depletion may be an effective therapeutic approach against COVID-19 by disrupting the host-virus relationship and inhibiting the virus life cycle in a low arginine environment. Several arginine-metabolizing enzymes in clinical development could be a viable option for treating COVID-19 and other viral diseases.