Evaluation of In Vitro and In Vivo Antiviral Activities of Vitamin D for SARS-CoV-2 and Variants

The COVID-19 pandemic has brought about unprecedented medical and healthcare challenges worldwide. With the continual emergence and spread of new COVID-19 variants, four drug compound libraries were interrogated for their antiviral activities against SARS-CoV-2. Here, we show that the drug screen has resulted in 121 promising anti-SARS-CoV-2 compounds, of which seven were further shortlisted for hit validation: citicoline, pravastatin sodium, tenofovir alafenamide, imatinib mesylate, calcitriol, dexlansoprazole, and prochlorperazine dimaleate. In particular, the active form of vitamin D, calcitriol, exhibits strong potency against SARS-CoV-2 on cell-based assays and is shown to work by modulating the vitamin D receptor pathway to increase antimicrobial peptide cathelicidin expression. However, the weight, survival rate, physiological conditions, histological scoring, and virus titre between SARS-CoV-2 infected K18-hACE2 mice pre-treated or post-treated with calcitriol were negligible, indicating that the differential effects of calcitriol may be due to differences in vitamin D metabolism in mice and warrants future investigation using other animal models.

[1]  World Health Organizat,et al.  WHO consolidated guidelines on tuberculosis. Module 1: Prevention. Tuberculosis preventive treatment , 2021, Tuberculosis, Lung Diseases, HIV Infection.

[2]  Dongqing Wei,et al.  Human Cathelicidin Inhibits SARS-CoV-2 Infection: Killing Two Birds with One Stone , 2021, ACS infectious diseases.

[3]  Weijin Huang,et al.  Cathepsin L plays a key role in SARS-CoV-2 infection in humans and humanized mice and is a promising target for new drug development , 2020, Signal Transduction and Targeted Therapy.

[4]  J. Kos,et al.  The role of cysteine peptidases in coronavirus cell entry and replication: The therapeutic potential of cathepsin inhibitors , 2020, PLoS pathogens.

[5]  J. Chu,et al.  Current Perspective of Antiviral Strategies against COVID-19 , 2020, ACS infectious diseases.

[6]  S. Pierson,et al.  Treatments Administered to the First 9152 Reported Cases of COVID-19: A Systematic Review , 2020, Infectious Diseases and Therapy.

[7]  Guo‐Jun Zhang,et al.  Factors associated with prolonged viral shedding and impact of lopinavir/ritonavir treatment in hospitalised non-critically ill patients with SARS-CoV-2 infection , 2020, European Respiratory Journal.

[8]  Lee Smith,et al.  The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality , 2020, Aging Clinical and Experimental Research.

[9]  De-Ming Yang,et al.  A Review of SARS-CoV-2 and the Ongoing Clinical Trials , 2020, International journal of molecular sciences.

[10]  W. Grant,et al.  Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths , 2020, Nutrients.

[11]  Fabian J Theis,et al.  SARS-CoV-2 Entry Genes Are Most Highly Expressed in Nasal Goblet and Ciliated Cells within Human Airways , 2020, Nature Medicine.

[12]  A. M. Leontovich,et al.  The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2 , 2020, Nature Microbiology.

[13]  Kai Zhao,et al.  A pneumonia outbreak associated with a new coronavirus of probable bat origin , 2020, Nature.

[14]  D. Zillikens,et al.  Calcitriol Treatment Ameliorates Inflammation and Blistering in Mouse Models of Epidermolysis Bullosa Acquisita. , 2017, The Journal of investigative dermatology.

[15]  Qin Chen,et al.  Effects of calcitriol (1, 25-dihydroxy-vitamin D3) on the inflammatory response induced by H9N2 influenza virus infection in human lung A549 epithelial cells and in mice , 2017, Virology Journal.

[16]  D. Wang,et al.  Human nasal epithelial cells derived from multiple subjects exhibit differential responses to H3N2 influenza virus infection in vitro. , 2016, The Journal of allergy and clinical immunology.

[17]  S. Samsonov,et al.  Antimicrobial Peptide LL-37 Is Both a Substrate of Cathepsins S and K and a Selective Inhibitor of Cathepsin L. , 2015, Biochemistry.

[18]  Julie Dyall,et al.  Repurposing of Clinically Developed Drugs for Treatment of Middle East Respiratory Syndrome Coronavirus Infection , 2014, Antimicrobial Agents and Chemotherapy.

[19]  Glenville Jones,et al.  Cytochrome P450-mediated metabolism of vitamin D , 2014, Journal of Lipid Research.

[20]  D. Bikle Vitamin D: Production, Metabolism, and Mechanisms of Action , 2014 .

[21]  D. Wang,et al.  The use of Nasal Epithelial Stem/progenitor Cells to Produce Functioning Ciliated Cells in vitro , 2012, American journal of rhinology & allergy.

[22]  C. Dullin,et al.  Calcitriol Inhibits Hedgehog Signaling and Induces Vitamin D Receptor Signaling and Differentiation in the Patched Mouse Model of Embryonal Rhabdomyosarcoma , 2012, Sarcoma.

[23]  A. Gombart The vitamin D-antimicrobial peptide pathway and its role in protection against infection. , 2009, Future microbiology.

[24]  Bryan M. Gillard,et al.  Role of vitamin D receptor in the antiproliferative effects of calcitriol in tumor-derived endothelial cells and tumor angiogenesis in vivo. , 2009, Cancer research.

[25]  S. Harrison,et al.  SARS Coronavirus, but Not Human Coronavirus NL63, Utilizes Cathepsin L to Infect ACE2-expressing Cells , 2006, Journal of Biological Chemistry.

[26]  P. Lebon,et al.  Replication of respiratory viruses, particularly influenza virus, rhinovirus, and coronavirus in HuH7 hepatocarcinoma cell line , 2005, Journal of medical virology.

[27]  S. Diamond,et al.  Inhibitors of cathepsin L prevent severe acute respiratory syndrome coronavirus entry. , 2005, Proceedings of the National Academy of Sciences of the United States of America.

[28]  H. Koeffler,et al.  Human cathelicidin antimicrobial peptide (CAMP) gene is a direct target of the vitamin D receptor and is strongly up‐regulated in myeloid cells by 1,25‐dihydroxyvitamin D3 , 2005, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[29]  Xiaolei Yin,et al.  Highly infectious SARS-CoV pseudotyped virus reveals the cell tropism and its correlation with receptor expression , 2004, Biochemical and Biophysical Research Communications.

[30]  R. Balicer,et al.  Tackling the next influenza pandemic , 2004, BMJ : British Medical Journal.

[31]  D. Trump,et al.  Pharmacokinetics of 1α,25-Dihydroxyvitamin D3 in Normal Mice after Systemic Exposure to Effective and Safe Antitumor Doses , 2004, Oncology.

[32]  M. Otto,et al.  Inhibition of Severe Acute Respiratory Syndrome-Associated Coronavirus (SARSCoV) by Calpain Inhibitors and β-D-N4-Hydroxycytidine , 2004, Antiviral chemistry & chemotherapy.

[33]  H. DeLuca,et al.  Regulation of the murine renal vitamin D receptor by 1,25-dihydroxyvitamin D3 and calcium , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[34]  Johannes C. Jager,et al.  Pandemic Influenza and Healthcare Demand in the Netherlands: Scenario Analysis , 2003, Emerging infectious diseases.

[35]  M. Pfaffl,et al.  A new mathematical model for relative quantification in real-time RT-PCR. , 2001, Nucleic acids research.