Hepatitis C Virus Protease Inhibitors Show Differential Efficacy and Interactions with Remdesivir for Treatment of SARS-CoV-2 in Vitro

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Abstract

Antivirals targeting SARS-CoV-2 could improve treatment of COVID-19. We evaluated the efficacy of clinically relevant hepatitis C virus (HCV) NS3 protease inhibitors (PI) against SARS-CoV-2 and their interactions with remdesivir, the only antiviral approved for treatment of COVID-19. HCV PI showed differential potency in VeroE6 cell-based antiviral assays based on detection of the SARS-CoV-2 Spike protein. Linear PI boceprevir, telaprevir and narlaprevir had 50% effective concentrations (EC50) of ~40 μM. Among macrocyclic PI simeprevir, paritaprevir, grazoprevir, glecaprevir, voxilaprevir, vaniprevir, danoprevir and deldeprevir, simeprevir had the highest (EC50 15 μM) and glecaprevir the lowest (EC50 >178 μM) potency. Acyclic PI asunaprevir and faldaprevir had EC50 of 72 and 23 μM, respectively. ACH-806, an HCV NS3 protease co-factor NS4A inhibitor, had EC50 of 46 μM. For selected PI, potency was similar in human hepatoma Huh7.5 cells. Selectivity indexes, based on antiviral and cell viability assays, were highest for linear PI. In combination with remdesivir, linear PI boceprevir and narlaprevir showed antagonism, while macrocyclic PI simeprevir, paritaprevir and grazoprevir showed synergism with drug reduction indexes of up to 27 for simeprevir. Treatment of infected cultures with equipotent concentrations (1-fold EC50) of HCV PI revealed minor differences in barrier to SARS-CoV-2 escape. Complete viral suppression was achieved treating with ≥3-fold EC50 boceprevir or combination of 1-fold EC50 simeprevir with 0.4-fold EC50 remdesivir, not leading to significant viral suppression in single treatments. Considering potency, human plasma concentrations and synergism with remdesivir, simeprevir seemed the most promising compound for optimization of future antiviral treatments of COVID-19.

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  1. SciScore for 10.1101/2020.12.02.408112: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.
    Cell Line Authenticationnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Then plates were washed 2 times with PBS-tween and incubated for 1 hour at room temperature with secondary antibody F(ab’)2-Goat anti-human IgG Fc Cross-Adsorbed Secondary Antibody, HRP (Invitrogen#A24476, Carlsbad, CA, USA) or Goat F(ab’)2 Anti-Human IgG – Fc (HRP), preadsorbed (Abcamab#98595, Cambridge, UK), diluted 1:2,000 in PBSK.
    anti-human IgG
    suggested: (Thermo Fisher Scientific Cat# A24476, RRID:AB_2535945)
    Experimental Models: Cell Lines
    SentencesResources
    Cell cultivation: African green monkey kidney VeroE6 cells (gift from J. Dubuisson) and human hepatoma Huh7.5 cells83 were maintained at 37°C and 5% CO2 in Dulbecco’s Modified Eagle Medium (Invitrogen, Paisley, UK) supplemented with 10% heat inactivated fetal bovine serum (Sigma, Saint Louis Missouri, USA) and 100 U/mL penicillin with 100μL streptomycin (Gibco/Invitrogen corporation, Carlsbad, California, USA).
    Huh7.5
    suggested: RRID:CVCL_YU20)
    In brief, VeroE6 cells were seeded at 10,000 cells per well in 96-well flat-bottom plates, medium was changed to 50 μL fresh medium, and cells were inoculated with SARS-CoV-2/human/Denmark/DK-AHH1/2020 at MOI 0.0016 by adding 50 μL virus stock diluted in medium to each well.
    VeroE6
    suggested: JCRB Cat# JCRB1819, RRID:CVCL_YQ49)
    Software and Algorithms
    SentencesResources
    Cell cultivation: African green monkey kidney VeroE6 cells (gift from J. Dubuisson) and human hepatoma Huh7.5 cells83 were maintained at 37°C and 5% CO2 in Dulbecco’s Modified Eagle Medium (Invitrogen, Paisley, UK) supplemented with 10% heat inactivated fetal bovine serum (Sigma, Saint Louis Missouri, USA) and 100 U/mL penicillin with 100μL streptomycin (Gibco/Invitrogen corporation, Carlsbad, California, USA).
    Gibco/Invitrogen
    suggested: None
    Sigmoidal concentration response curves were fitted and EC50 values calculated as described previously using Graphpad Prism 8.0.0 with a bottom constraint of 0 applying the formula Y= Top/(1+10(Log10EC50-X)*HillSlope).
    Graphpad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)
    The images were acquired with ZEN 3.0 software.
    ZEN
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: Please consider improving the rainbow (“jet”) colormap(s) used on pages 40, 38 and 39. At least one figure is not accessible to readers with colorblindness and/or is not true to the data, i.e. not perceptually uniform.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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