Broad Spectrum Antiviral Properties of Cardiotonic Steroids Used as Potential Therapeutics for Emerging Coronavirus Infections

• Published in: Pharmaceutics Vol. 13; no. 11; p. 1839
• Main Authors: Jin, Young-Hee, Jeon, Sangeun, Lee, Jihye, Kim, Seungtaek, Jang, Min Seong, Park, Chul Min, Song, Jong Hwan, Kim, Hyoung Rae, Kwon, Sunoh
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 02.11.2021; MDPI
• Subjects: Antibiotics; antiviral; cardiotonic steroid; coronavirus; Coronaviruses; COVID-19; Drinking water; Drug dosages; Enzymes; Experiments; Genes; Humidity; Infections; Laboratories; Mass spectrometry; MERS; Middle East respiratory syndrome; Pandemics; pharmacokinetics; Scientific imaging; Severe acute respiratory syndrome coronavirus 2; Steroids; Viruses; United States > US
• ISSN: 1999-4923; 1999-4923
• DOI: 10.3390/pharmaceutics13111839

Cardiotonic steroids are steroid-like natural compounds known to inhibit Na+/K+-ATPase pumps. To develop a broad-spectrum antiviral drug against the emerging coronavirus infection, this study assessed the antiviral properties of these compounds. The activity of seven types of cardiotonic steroids against the MERS-CoV, SARS-CoV, and SARS-CoV-2 coronavirus varieties was analyzed using immunofluorescence antiviral assay in virus-infected cells. Bufalin, cinobufagin, and telocinobufagin showed high anti-MERS-CoV activities (IC50, 0.017~0.027 μM); bufalin showed the most potent anti-SARS-CoV and SARS-CoV-2 activity (IC50, 0.016~0.019 μM); cinobufotalin and resibufogenin showed comparatively low anti-coronavirus activity (IC50, 0.231~1.612 μM). Differentially expressed genes in Calu3 cells treated with cinobufagin, telocinobufagin, or bufalin, which had high antiviral activity during MERS-CoV infection were analyzed using QuantSeq 3′ mRNA-Seq analysis and data showed similar gene expression patterns. Furthermore, the intraperitoneal administration of 10 mg/kg/day bufalin, cinobufagin, or digitoxin induced 100% death after 1, 2, and 4 days in 5-day repeated dose toxicity studies and it indicated that bufalin had the strongest toxicity. Pharmacokinetic studies suggested that telocinobufagin, which had high anti-coronavirus activity and low toxicity, had better microsomal stability, lower CYP inhibition, and better oral bioavailability than cinobufagin. Therefore, telocinobufagin might be the most promising cardiotonic steroid as a therapeutic for emerging coronavirus infections, including COVID-19.