Can endolysosomal deacidification and inhibition of autophagy prevent severe COVID-19?

LIFE SCIENCES

卷:262

Review

Morris, Gerwyn¹  Athan, Eugene^1,2  Walder, Ken¹  Bortolasci, Chiara C.^1,3  O'Neil, Adrienne¹  Marx, Wolf¹  Berk, Michael^1,4  Carvalho, Andre F.^5,8  Maes, Michael^1,6  Puri, Basant K.⁷ 

[1] Deakin Univ, Inst Mental & Phys Hlth & Clin Translat, Sch Med, IMPACT,Barwon Hlth, Geelong, Vic, Australia

[2] Barwon Hlth, Dept Infect Dis, Geelong, Vic, Australia

[3] Deakin Univ, Sch Med, Ctr Mol & Med Res, Geelong, Vic, Australia

[4] Univ Melbourne, Natl Ctr Excellence Youth Mental Hlth, Florey Inst Neurosci & Mental Hlth, Dept Psychiat,Orygen, Parkville, Vic, Australia

[5] Univ Toronto, Dept Psychiat, Toronto, ON, Canada

[6] Chulalongkorn Univ, Dept Psychiat, Bangkok, Thailand

[7] CAR, Cambridge, England

[8] Ctr Addict & Mental Hlth CAMH, Toronto, ON, Canada

关键词: Antiviral treatment;    COVID-19;    SARS-CoV-2;    Immunomodulation;    Macrolide;   

DOI  :  10.1016/j.lfs.2020.118541

来源: Elsevier

【 摘 要 】

The possibility is examined that immunomodulatory pharmacotherapy may be clinically useful in managing the pandemic coronavirus disease 2019 (COVID-19), known to result from infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a positive-sense single-stranded RNA virus. The dominant route of cell entry of the coronavirus is via phagocytosis, with ensconcement in endosomes thereafter proceeding via the endosomal pathway, involving transfer from early (EEs) to late endosomes (LEs) and ultimately into lysosomes via endolysosomal fusion. EE to LE transportation is a rate-limiting step for coronaviruses. Hence inhibition or dysregulation of endosomal trafficking could potentially inhibit SARS-CoV-2 replication. Furthermore, the acidic luminal pH of the endolysosomal system is critical for the activity of numerous pH-sensitive hydrolytic enzymes. Golgi sub-compartments and Golgi-derived secretory vesicles also depend on being mildly acidic for optimal function and structure. Activation of endosomal toll-like receptors by viral RNA can upregulate inflammatory mediators and contribute to a systemic inflammatory cytokine storm, associated with a worsened clinical outcome in COVID-19. Such endosomal toll-like receptors could be inhibited by the use of pharmacological agents which increase endosomal pH, thereby reducing the activity of acid-dependent endosomal proteases required for their activity and/or assembly, leading to suppression of antigen-presenting cell activity, decreased autoantibody secretion, decreased nuclear factor-kappa B activity and decreased pro-inflammatory cytokine production. It is also noteworthy that SARS-CoV-2 inhibits autophagy, predisposing infected cells to apoptosis. It is therefore also suggested that further pharmacological inhibition of autophagy might encourage the apoptotic clearance of SARS-CoV-2-infected cells.

【 授权许可】

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