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2020 ; 8
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English Wikipedia
Tripartite Combination of Candidate Pandemic Mitigation Agents: Vitamin D,
Quercetin, and Estradiol Manifest Properties of Medicinal Agents for Targeted
Mitigation of the COVID-19 Pandemic Defined by Genomics-Guided Tracing of
SARS-CoV-2 Targets in Human Cells
#MMPMID32455629
Glinsky GV
Biomedicines
2020[May]; 8
(5
): ä PMID32455629
show ga
Genes required for SARS-CoV-2 entry into human cells, ACE2 and FURIN, were
employed as baits to build genomic-guided molecular maps of upstream regulatory
elements, their expression and functions in the human body, and
pathophysiologically relevant cell types. Repressors and activators of the ACE2
and FURIN genes were identified based on the analyses of gene silencing and
overexpression experiments as well as relevant transgenic mouse models. Panels of
repressors (VDR; GATA5; SFTPC; HIF1a) and activators (HMGA2; INSIG1; RUNX1;
HNF4a; JNK1/c-FOS) were then employed to identify existing drugs manifesting in
their effects on gene expression signatures of potential coronavirus infection
mitigation agents. Using this strategy, vitamin D and quercetin have been
identified as putative 2019 coronavirus disease (COVID-19) mitigation agents.
Quercetin has been identified as one of top-scoring candidate therapeutics in the
supercomputer SUMMIT drug-docking screen and Gene Set Enrichment Analyses (GSEA)
of expression profiling experiments (EPEs), indicating that highly structurally
similar quercetin, luteolin, and eriodictyol could serve as scaffolds for the
development of efficient inhibitors of SARS-CoV-2 infection. In agreement with
this notion, quercetin alters the expression of 98 of 332 (30%) of human genes
encoding protein targets of SARS-CoV-2, thus potentially interfering with
functions of 23 of 27 (85%) of the SARS-CoV-2 viral proteins in human cells.
Similarly, Vitamin D may interfere with functions of 19 of 27 (70%) of the
SARS-CoV-2 proteins by altering expression of 84 of 332 (25%) of human genes
encoding protein targets of SARS-CoV-2. Considering the potential effects of both
quercetin and vitamin D, the inference could be made that functions of 25 of 27
(93%) of SARS-CoV-2 proteins in human cells may be altered. GSEA and EPEs
identify multiple drugs, smoking, and many disease conditions that appear to act
as putative coronavirus infection-promoting agents. Discordant patterns of
testosterone versus estradiol impacts on SARS-CoV-2 targets suggest a plausible
molecular explanation of the apparently higher male mortality during the
coronavirus pandemic. Estradiol, in contrast with testosterone, affects the
expression of the majority of human genes (203 of 332; 61%) encoding SARS-CoV-2
targets, thus potentially interfering with functions of 26 of 27 SARS-CoV-2 viral
proteins. A hypothetical tripartite combination consisting of quercetin/vitamin
D/estradiol may affect expression of 244 of 332 (73%) human genes encoding
SARS-CoV-2 targets. Of major concern is the ACE2 and FURIN expression in many
human cells and tissues, including immune cells, suggesting that SARS-CoV-2 may
infect a broad range of cellular targets in the human body. Infection of immune
cells may cause immunosuppression, long-term persistence of the virus, and spread
of the virus to secondary targets. Present analyses and numerous observational
studies indicate that age-associated vitamin D deficiency may contribute to the
high mortality of older adults and the elderly. Immediate availability for
targeted experimental and clinical interrogations of potential COVID-19 pandemic
mitigation agents, namely vitamin D and quercetin, as well as of the highly
selective (Ki, 600 pm) intrinsically specific FURIN inhibitor (a1-antitrypsin
Portland (a1-PDX), is considered an encouraging factor. Observations reported in
this contribution are intended to facilitate follow-up targeted experimental
studies and, if warranted, randomized clinical trials to identify and validate
therapeutically viable interventions to combat the COVID-19 pandemic.
Specifically, gene expression profiles of vitamin D and quercetin activities and
their established safety records as over-the-counter medicinal substances
strongly argue that they may represent viable candidates for further
considerations of their potential utility as COVID-19 pandemic mitigation agents.
In line with the results of present analyses, a randomized interventional
clinical trial evaluating effects of estradiol on severity of the coronavirus
infection in COVID19+ and presumptive COVID19+ patients and two interventional
randomized clinical trials evaluating effects of vitamin D on prevention and
treatment of COVID-19 were listed on the ClinicalTrials.gov website.