Challenges for Targeting SARS-CoV-2 Proteases as a Therapeutic Strategy for COVID-19

Two proteases produced by the SARS-CoV-2 virus, the main protease and papain-like protease, are essential for viral replication and have become the focus of drug development programs for treatment of COVID-19. We screened a highly focused library of compounds containing covalent warheads designed to target cysteine proteases to identify new lead scaffolds for both M-pro and PLpro proteases. These efforts identified a small number of hits for the M-pro protease and no viable hits for the PLpro protease. Of the M(pro )hits identified as inhibitors of the purified recombinant protease, only two compounds inhibited viral infectivity in cellular infection assays. However, we observed a substantial drop in antiviral potency upon expression of TMPRSS2, a transmembrane serine protease that acts in an alternative viral entry pathway to the lysosomal cathepsins. This loss of potency is explained by the fact that our lead M-pro inhibitors are also potent inhibitors of host cell cysteine cathepsins. To determine if this is a general property of M-pro inhibitors, we evaluated several recently reported compounds and found that they are also effective inhibitors of purified human cathepsins L and B and showed similar loss in activity in cells expressing TMPRSS2. Our results highlight the challenges of targeting M-pro and PLpro proteases and demonstrate the need to carefully assess selectivity of SARS-CoV-2 protease inhibitors to prevent clinical advancement of compounds that function through inhibition of a redundant viral entry pathway.

Automated summary

Two proteases produced by the SARS-CoV-2 virus play essential roles in viral replication, but inhibitors may also affect host cells; careful assessment of the selectivity of protease inhibitors is needed during drug development to avoid unnecessary interference with redundant pathways for viral entry.