1. Identification of antiviral antihistamines for COVID-19 repurposing
- Author
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Reznikov, Leah R, Norris, Michael H, Vashisht, Rohit, Bluhm, Andrew P, Li, Danmeng, Liao, Yan-Shin J, Brown, Ashley, Butte, Atul J, and Ostrov, David A
- Subjects
Biochemistry and Cell Biology ,Medicinal and Biomolecular Chemistry ,Chemical Sciences ,Biological Sciences ,Prevention ,Clinical Research ,Emerging Infectious Diseases ,Infectious Diseases ,Vaccine Related ,Biodefense ,5.1 Pharmaceuticals ,Development of treatments and therapeutic interventions ,Good Health and Well Being ,Angiotensin-Converting Enzyme 2 ,Animals ,Antiviral Agents ,Catalytic Domain ,Chlorocebus aethiops ,Drug Repositioning ,HEK293 Cells ,Histamine Antagonists ,Humans ,Ligands ,Protein Binding ,Receptors ,Histamine ,Receptors ,sigma ,SARS-CoV-2 ,Vero Cells ,COVID-19 Drug Treatment ,Angiotensin converting Enzyme-2 ,Sigma-1 receptor ,Repurposing ,Docking ,Medical Biochemistry and Metabolomics ,Biochemistry & Molecular Biology ,Biochemistry and cell biology ,Medicinal and biomolecular chemistry - Abstract
There is an urgent need to identify therapies that prevent SARS-CoV-2 infection and improve the outcome of COVID-19 patients. Although repurposed drugs with favorable safety profiles could have significant benefit, widely available prevention or treatment options for COVID-19 have yet to be identified. Efforts to identify approved drugs with in vitro activity against SARS-CoV-2 resulted in identification of antiviral sigma-1 receptor ligands, including antihistamines in the histamine-1 receptor binding class. We identified antihistamine candidates for repurposing by mining electronic health records of usage in population of more than 219,000 subjects tested for SARS-CoV-2. Usage of diphenhydramine, hydroxyzine and azelastine was associated with reduced incidence of SARS-CoV-2 positivity in subjects greater than age 61. We found diphenhydramine, hydroxyzine and azelastine to exhibit direct antiviral activity against SARS-CoV-2 in vitro. Although mechanisms by which specific antihistamines exert antiviral effects is not clear, hydroxyzine, and possibly azelastine, bind Angiotensin Converting Enzyme-2 (ACE2) and the sigma-1 receptor as off-targets. Clinical studies are needed to measure the effectiveness of diphenhydramine, hydroxyzine and azelastine for disease prevention, for early intervention, or as adjuvant therapy for severe COVID-19.
- Published
- 2021