Patent Grant
11850250
The present disclosure is based on and claims the priority of the Chinese Patent Application No. 202011018882.6, filed on Sep. 24, 2020, and the Chinese Patent Application No. 202010233854.X, filed on Mar. 30, 2020, the entire contents of which are incorporated herein by reference.
The embodiments of the present disclosure relate to a new use of a compound, and more particularly, to a use of homoharringtonine in preparation of a drug against betacoronavirus infection, a use of homoharringtonine in preparation of a betacoronavirus replication inhibitor in human, and a formulation and method for treating a disease caused by betacoronavirus.
Homoharringtonine (HHT) is an alkaloid extracted from Cephalotaxus fortunei or a congener thereof. The homoharringtonine is a frequently-used protein synthesis inhibitor and has been approved for the treatment of various leukemia and lymphoma (Jin, et al. 2013; Alvandi, et al. 2014; Lam, et al. 2016; Sanchez-Petitto, et al. 2018). Several studies in cell models or animal models have shown that the homoharringtonine has a certain effect on inhibiting virus replication (Kaur, et al. 2013; Cao, et al. 2015; Dong, et al. 2018; Andersen, et al. 2019). A recommended dose of the homoharringtonine for treating tumors is: intravenous drip: 1 mg to 4 mg/day, and 4 days to 6 days as a course of treatment.
The existing studies believe that the HHT achieves the effect of inhibiting virus replication by inhibiting the first step of protein synthesis.
CN109419804A discloses that the homoharringtonine (HHT) has broad-spectrum and high-efficiency antiviral activity, which can effectively inhibit 9 viruses (VSV, NDV, PEDV, TGEV, AIV, HSV-1, PRV, PRRSV, FMDV) belonging to 7 families from infecting host cells and animals (chickens, chicken embryos, pigs, or the like), significantly reduce the amounts of viruses in animals, and relieve infection symptoms. Specifically, when the HHT is used at a concentration of 20 nM to 300 nM, it can effectively inhibit 9 viruses (VSV, NDV, PEDV, TGEV, AIV, HSV-1, PRV, PRRSV, and FMDV) belonging to 7 families from infecting the host cells (HeLa, Vero, Marc145, PK15 cells, or the like). The influence result of the HHT on FMDV virus virulence (see FIG. 9 of CN109419804A) shows that in PK-15 cells, the HHT at a concentration of 50 nM can almost completely block the expression of FMDV virus proteins VP0, VP1, VP2 and VP3.
CN109745328A discloses a use of the homoharringtonine in preparation of a drug for preventing foot-and-mouth disease virus (FMDV) infection. The experimental data verifies that the homoharringtonine can provide effective protection for IBRS-2 cells only when the concentration of the HHT is 6.2 μM or higher. At the same time, the experimental data shows that the HHT will not affect the adsorption of FMDV and will not affect the ability of the virus to enter cells. The HHT only plays a role in the early stage of FMDV replication, but cannot prevent virus replication in the later stage of virus replication.
The experimental data disclosed by CN109745328A and CN109419804A suggest that, for the foot-and-mouth disease virus (FMDV) infection, the HHT plays different roles in different cells (IBRS-2 cells are used in CN109745328A, and PK-15 cells are used in CN109419804A), and differences of the effective concentrations of the HHT are more than 100 times (the concentration required in CN109745328A is more than 6.2 μM, while the concentration required in CN109419804A is 50 nM).
Therefore, it is necessary to deeply study the mechanisms of action of HHT, identify the indications of HHT in antiviral therapy, and develop new ways of administration so that the HHT can really be used in antiviral clinical therapy.
Coronaviruses are one of the main viral pathogens causing respiratory tract infections. According to genetic and antigenic criteria, the coronaviruses may be divided into four genera, namely alphacoronavirus, betacoronavirus, gammacoronavirus and deltacoronavirus. Up to now, seven coronaviruses (HCoV-229E, HCoV-OC43, SARS-CoV, HCoV-NL63, HCoV-HKU1, MERS-CoV, and SARS-CoV-2 which recently caused COVID-19) have been found to infect humans. HCoV-229E and HCoV-NL63 belong to alphacoronaviruses, while HCoV-OC43, SARS-CoV, HCoV-HKU1, MERS-CoV and SARS-CoV-2 are all betacoronaviruses. Beside humans, the coronaviruses can also cause multi-system infection in a plurality of animals. Mammalian coronaviruses are mainly alphacoronaviruses and betacoronaviruses, which can infect a plurality of animals including pigs, dogs, cats, mice, cattle, horses, and the like. Avian coronaviruses mainly come from gammacoronaviruses and deltacoronaviruses, which can cause diseases of a plurality of birds such as chickens, turkeys, sparrows, ducks, geese and pigeons (Cui, et al. 2019). Common coronaviruses are shown in Table 1.
There are obvious differences among different coronaviruses. For example, both belonging to the betacoronaviruses, the similarity of full-length genome sequences between SARS-CoV and SARS-CoV-2 is only about 80%, and the sequence similarity of S gene (encoding a spike protein responsible for receptor binding, which is closely related to virus pathogenicity) is only 73%, thus leading to difference of biological characteristics of pathogens between SARS-CoV and SARS-CoV-2, including severe illness rate, mortality rate, transmission ability, latency, and the like. The differences among coronaviruses belonging to different genus's are more obvious. For example, the betacoronaviruses such as HCoV-OC43, SARS-CoV, MERS-CoV and SARS-CoV-2 have longer open reading frames (ORFs) than those of the alphacoronaviruses. In addition, there are obvious differences between the alphacoronaviruses and the betacoronaviruses in hosts, pathogenicity, host cell receptors, vaccines and potential therapeutic drugs.
In recent years, the coronaviruses have done great harm to human beings. From 2002 to 2003, SARS-CoV caused an unprecedented “SARS” epidemic in the world, resulting in more than 8000 cases of infection and more than 800 cases of death. In 2012, MERS-CoV was first discovered in the Middle East and quickly spread to many countries and regions in Europe, Asia, America and Africa, causing a total of 1,368 cases of infection and 490 cases of death, affecting 26 countries (according to the statistics data of World Health Organization on Jul. 21, 2015). SARS-CoV-2 occurred at the end of 2019 had already caused 416,686 cases of infection and 18,589 cases of death, affecting 197 countries and regions (according to the statistics data of World Health Organization on Mar. 26, 2020). Up to now, there is no specific treatment method for infectious human coronaviruses (HCoV-229E, HCoV-OC43, SARS-CoV, HCoV-NL63, HCoV-HKU1, MERS-CoV, and SARS-CoV-2), and it is urgent to develop new treatment methods.
According to the embodiments of the present disclosure, provided is a technology which is expected to effectively inhibit replication of pathogenic coronaviruses such as betacoronavirus in vivo.
Through research, the inventors found that HHT not only has a good inhibitory effect on the first step of protein synthesis, but also has an unexpected inhibitory effect on every step of protein synthesis elongation, and can better inhibit the synthesis of long proteins. Because betacoronaviruses such as HCoV-HKU1, HCoV-OC43, SARS-CoV, MERS-CoV and SARS-CoV-2 have longer ORFs and are more sensitive to the HHT, the HHT has a better replication inhibition effect on the betacoronaviruses, thus providing a feasible solution for controlling the replication of coronaviruses, which is expected to be used in the treatment or adjuvant treatment of human diseases caused by betacoronaviruses.
The technical solution used in the present invention is as follows.
The embodiment according to a first aspect of the present invention provides:
use of homoharringtonine in preparation of a drug against betacoronavirus infection.
In some embodiments, the betacoronavirus is selected from HCoV-HKU1, HCoV-OC43, SARS-CoV, MERS-CoV and SARS-CoV-2.
In some embodiments, the betacoronavirus is SARS-CoV-2.
In some embodiments, the drug is in a dosage form of injection, oral formulation or inhalant.
The embodiment according to a second aspect of the present invention provides:
use of homoharringtonine in preparation of a betacoronavirus replication inhibitor in human.
In some embodiments, the betacoronavirus is selected from HCoV-HKU1, HCoV-OC43, SARS-CoV, MERS-CoV and SARS-CoV-2.
In some embodiments, the betacoronavirus is SARS-CoV-2.
In some embodiments, the inhibitor is in a dosage form of injection, oral formulation or inhalant.
The embodiment according to a third aspect of the present invention provides:
a formulation for treating a disease caused by betacoronavirus, comprising at least one drug capable of improving a symptom caused by betacoronavirus infection, and homoharringtonine, wherein the homoharringtonine is used for inhibiting replication of the betacoronavirus in vivo.
In some embodiments, the betacoronavirus is selected from HCoV-HKU1, HCoV-OC43, SARS-CoV, MERS-CoV and SARS-CoV-2.
In some embodiments, the betacoronavirus is SARS-CoV-2.
In some embodiments, the formulation is in a dosage form of injection, oral formulation or inhalant.
In some embodiments, the formulation further comprises an acceptable pharmaceutical excipient.
The embodiment according to a fourth aspect of the present disclosure provides:
a method for treating a disease caused by betacoronavirus, comprising the administration of homoharringtonine to patients.
In some embodiments, the betacoronavirus is selected from HCoV-HKU1, HCoV-OC43, SARS-CoV, MERS-CoV and SARS-CoV-2.
In some embodiments, the betacoronavirus is SARS-CoV-2.
In some embodiments, the method further comprises administering at least one drug capable of improving the symptoms caused by betacoronavirus infection to patients.
The embodiment according to a first aspect of the present invention provides: use of homoharringtonine in preparation of a drug against betacoronavirus infection.
In some embodiments, the betacoronavirus is selected from HCoV-HKU1, HCoV-OC43, SARS-CoV, MERS-CoV and SARS-CoV-2.
In some embodiments, the betacoronavirus is SARS-CoV-2.
In some embodiments, the drug is in a dosage form of injection, oral formulation or inhalant.
The embodiment according to a second aspect of the present invention provides: use of homoharringtonine in preparation of a betacoronavirus replication inhibitor in a human.
In some embodiments, the betacoronavirus is selected from HCoV-HKU1, HCoV-OC43, SARS-CoV, MERS-CoV and SARS-CoV-2.
In some embodiments, the betacoronavirus is SARS-CoV-2.
In some embodiments, the inhibitor is in a dosage form of injection, oral formulation or inhalant.
The embodiment according to a third aspect of the present invention provides: a formulation for treating a disease caused by betacoronavirus, comprising at least one drug capable of improving the symptoms caused by betacoronavirus infection, and homoharringtonine, wherein the homoharringtonine is used for inhibiting replication of the betacoronavirus in vivo.
In some embodiments, the betacoronavirus is selected from HCoV-HKU1, HCoV-OC43, SARS-CoV, MERS-CoV and SARS-CoV-2.
In some embodiments, the betacoronavirus is SARS-CoV-2.
In some embodiments, the formulation is in a dosage form of injection, oral formulation or inhalant.
In some embodiments, the formulation further comprises an acceptable pharmaceutical excipient.
The embodiment according to a fourth aspect of the present invention provides: a method for treating a disease caused by betacoronavirus, comprises the administration of homoharringtonine to patients.
In some embodiments, the betacoronavirus is selected from HCoV-HKU1, HCoV-OC43, SARS-CoV, MERS-CoV and SARS-CoV-2.
In some embodiments, the betacoronavirus is SARS-CoV-2.
In some embodiments, the method further comprises administering at least one drug capable of improving the symptoms caused by betacoronavirus infection in patients.
(1) Inhibiting the elongation step in protein synthesis is an effective method to control the protein synthesis.
The protein synthesis comprises the steps of initiation, elongation, termination, and recycling (Hershey, et al. 2019; Tahmasebi, et al. 2019). By controlling the elongation step in the protein synthesis, the protein synthesis can be effectively controlled, especially for those long proteins. The specific theoretical basis is:
T(p)=(1−p){circumflex over ( )}k˜e−pk (Formula 1).
In the formula, p is the inhibitory effect on each step, k is the number of elongation steps of the protein (which may be understood as a length of a polypeptide chain), and T(p) is a cumulative effect on the full-length protein.
According to this formula, when the inhibitory effect on a protein with a length of 500 amino acids is 20%, the inhibitory effect on a protein with a length of 8000 amino acids is 96%.
Therefore, inhibiting the elongation step in protein synthesis is the effective method to control the protein synthesis, and especially for long protein synthesis.
(2) The first step of coronaviruses replication needs to encode a very long protein (ORFlab, nearly 800 Kda), which may be particularly sensitive to a protein elongation inhibitor, thus providing a feasible solution for controlling coronaviruses replication.
By analyzing sequence information of viral genomes related to human diseases, the inventors found that several Coronaviridae viruses, such as HCoV-HKU1, HCoV-OC43, MERS-CoV, SARS-CoV, and SARS-CoV-2, had particularly long open reading frames (ORFs) with the length of over 20,000 nucleotides (
Therefore, the key genes in the process of virus replication can be inhibited by inhibiting the elongation step of the protein synthesis, while the protein synthesis of most genes in the human genome is not affected too much.
(3) Long proteins in mammalian genomes have a long half-life, so the long proteins are less affected by a protein synthesis inhibitor.
Since inhibiting the elongation step of the protein synthesis has less influence on short proteins and more obvious influence on long proteins in theory, it is necessary to pay special attention to the half-lives of those long proteins in the human genome, so as to evaluate the influence of this treatment method. By analyzing the half-lives of mRNAs and proteins of a large number of genes in the genome, the inventors found for the first time that the median half-lives of the mRNAs and the proteins of the genes encoding long proteins (over 5000 amino acids in length) were 8.3 hours and 56 hours respectively. The results showed that the median half-life of the long protein was longer than that of all the genes in the genome (
(4) Study on the toxicity of homoharringtonine to human cells.
By analyzing the effect of Homoharringtonine on 60 human cell lines, the inventors found that only a few cells died obviously after being treated with 1 micromolar (μM) concentration (or lower concentration) for 48 hours, and the cell viability in other cell lines was about 100% (
(5) Expression of long proteins in human genome.
The expression of those particularly long proteins (more than 5,000 amino acids in length) in human organs and tissues was analyzed, and the details were shown in Table 2.
The inventors found for the first time that most of the particularly long proteins had tissue-specific expression. For example, TTN, the longest gene in the human genome, and OBSCN, the third longest gene, were also specifically expressed in myocardium. In addition, MUC16, the second longest gene, and SYNE2, the sixth gene, were both highly expressed in a reproductive system. By analyzing the expression of these long proteins in the human tissues and organs, the inventors pointed out that when the HHT was used for antiviral treatment in human, it was necessary to pay special attention to the expression changes of these long proteins, and evaluate the damage.
(6) Effect of HHT for treating SARS-CoV-2 infection in Vero-E6 cell
1. Tested drugs: see Table 3 for drug names and concentrations.
2. Cells: VeroE6 cells, stored in the Viral Laboratory of State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health.
3. Virus: SARS-CoV-2, with a titer of TCID50=106/100 μL, stored at −80° C. by BSL-3 Laboratory of Guangzhou Customs Technology Center (Laboratory of Highly Pathogenic Microbes, State Key Laboratory of Respiratory Disease). The virus titer used was 100 TCID50.
(1) Tested drug:
(2) 100 μL of Veroe6 cells with a concentration of 2×105 cells/mL were added to each well of a sterile 96-well culture plate, and cultured in 5% CO2 at 37° C. for 24 hours.
(3) The 100 TCID50 virus solution was added into to the culture plate experimental group and the virus control group with the amount of 100 μL/well, incubated in a 5% CO2 incubator at 37° C. for 2 hours.
(4) After 2 hours, the cell culture fluid in the 96-well culture plate was discarded. The tested drugs were diluted to various concentrations in Table 1, each concentration was added in triplicate wells, and the above-mentioned drugs was added in a concentration of 100 μL/well.
(5) Cell control, blank control (solvent control), virus control (negative control) and positive drug control (chloroquine or remdesivir) were established at the same time.
(6) The cells were incubated in 5% CO2 incubator at 37° C. for 3 days to 4 days.
(7) The cytopathic effect (CPE) was observed under an optical microscope, and the degree of the CPE was recorded according to the following six standard: “−” denoted no CPE; “±” denoted that the CPE was less than 10%; “+” denoted that the CPE was about 25%; “++” denoted that the CPE was about 50%; “+++” denoted that the CPE was about 75%; and “++++” denoted that the CPE was more than 75%. A half effective concentration (IC50) was calculated by Reed-Muench method or GraphPad Prism5.0. Efficacy judging standard: a concentration with 50% inhibition of the virus CPE was regarded as an effective concentration.
(8) Experimental conditions: all the above experimental operations were completed in the BSL-3 Laboratory.
After observing the cytopathic effect (CPE) and recording the experimental results, the half effective concentration (IC50) was calculated by Reed-Muench method or GraphPad Prism5.0. The experimental results were shown in Table 4 below and
It could be seen from the results in Table 4 and
(7) Effect of HHT for treating SARS-CoV-2 infection in mouse model
1. Tested drug: HHT
2. Animal: male ACE2 humanized mice, provided by Guangzhou Institutes of Biomedicine and Health.
3. Virus: SARS-CoV-2, from Guangdong Provincial Center for Disease Control and Prevention, amplified and cultured by Kunming Institute of State Biological Safety Primate, Kunming Institute of Zoology, Chinese Academy of Sciences, and stored at −80° C. The infection dose was 2×106 TCID50.
Experimental Method:
1. On the day of virus infection, male ACE2 humanized mice were weighed first, and then HHT was injected intraperitoneally (dose: 80 μg/200 μL).
2. After the HHT was injected for 2 hours, the mice were infected by intranasal infection with a virus dose of 2×106 TCID50.
3. The ACE2 humanized mice were weighed every day after infection, and the HHT (40 μg/200 μL/day) was injected intraperitoneally on the first and second days after infection.
4. The mice were euthanized and dissected on the third day after infection, lung tissues were taken, viral load of lung tissues is detected, and HE staining is conducted.
5. The method for detecting the viral load in the lung tissues was: extracting tissue RNAs by TRIzol method, then detecting the viral load in the lung tissues by one-step RT-qPCR method (TaqMan method). The results of the viral loads were expressed as copies/μg of the total RNA.
The results were as shown in
The embodiments of the present disclosure skillfully take the betacoronavirus as the treatment target, and has the following advantages: 1) the first step of the coronavirus replication needs to translate a very long protein (the protein encoded by ORF1ab is nearly 800 KDa); 2) among the coronaviruses, the protein encoded by the ORF1ab of betacoronavirus is longer than that of the alphacoronavirus and gammacoronavirus; 3) in the host cells (mammalian cells) of the betacoronavirus, protein products of most genes are much shorter than 800 KDa, while half-lives of the gene products (comprising mRNA and protein) encoding long proteins are relatively long, so the betacoronavirus has little effect on the homoharringtonine; and 4) in the host cells of the betacoronavirus, the gene encoding long proteins is specifically expressed in tissues in general, which can further reduce the influence of the homoharringtonine.
The embodiments of the present disclosure provide use of the homoharringtonine in preparation of the drug for treating SARS-CoV-2 infection. It is confirmed for the first time that the homoharringtonine has an inhibitory effect on the SARS-CoV-2, can effectively eliminates the SARS-CoV-2 infection in the Vero-E6 cells, and effectively inhibit the virus from infecting host animals (mice). Therefore, the homoharringtonine can be used as an effective component against the SARS-CoV-2 and other betacoronaviruses.
The above embodiments are some embodiments of the present disclosure, but the embodiments of the present disclosure are not limited to the above embodiments, and any other changes, modifications, substitutions, combinations, and simplifications made without departing from the spirit and scope of the present disclosure should be equivalent replacement means, and are included in the protection scope of the present disclosure.
| Number | Date | Country | Kind |
|---|---|---|---|
| 202010233854.X | Mar 2020 | CN | national |
| 202011018882.6 | Sep 2020 | CN | national |
| Number | Date | Country |
|---|---|---|
| 109419804 | Mar 2019 | CN |
| 109745328 | May 2019 | CN |
| WO-2021195236 | Sep 2021 | WO |
| Entry |
|---|
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| Number | Date | Country | |
|---|---|---|---|
| 20220016129 A1 | Jan 2022 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | PCT/CN2020/130845 | Nov 2020 | US |
| Child | 17407689 | US |
