An ACAT inhibitor suppresses SARS-CoV-2 replication and boosts antiviral T cell activity.

The severity of disease following infection with SARS-CoV-2 is determined by viral replication kinetics and host immunity, with early T cell responses and/or suppression of viraemia driving a favourable outcome. Recent studies uncovered a role for cholesterol metabolism in the SARS-CoV-2 life cycle...

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Main Authors: Peter A C Wing, Nathalie M Schmidt, Rory Peters, Maximilian Erdmann, Rachel Brown, Hao Wang, Leo Swadling, COVIDsortium Investigators, Joseph Newman, Nazia Thakur, Kaho Shionoya, Sophie B Morgan, Timothy Sc Hinks, Koichi Watashi, Dalan Bailey, Scott B Hansen, Andrew D Davidson, Mala K Maini, Jane A McKeating
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-05-01
Series:PLoS Pathogens
Online Access:https://doi.org/10.1371/journal.ppat.1011323
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Summary:The severity of disease following infection with SARS-CoV-2 is determined by viral replication kinetics and host immunity, with early T cell responses and/or suppression of viraemia driving a favourable outcome. Recent studies uncovered a role for cholesterol metabolism in the SARS-CoV-2 life cycle and in T cell function. Here we show that blockade of the enzyme Acyl-CoA:cholesterol acyltransferase (ACAT) with Avasimibe inhibits SARS-CoV-2 pseudoparticle infection and disrupts the association of ACE2 and GM1 lipid rafts on the cell membrane, perturbing viral attachment. Imaging SARS-CoV-2 RNAs at the single cell level using a viral replicon model identifies the capacity of Avasimibe to limit the establishment of replication complexes required for RNA replication. Genetic studies to transiently silence or overexpress ACAT isoforms confirmed a role for ACAT in SARS-CoV-2 infection. Furthermore, Avasimibe boosts the expansion of functional SARS-CoV-2-specific T cells from the blood of patients sampled during the acute phase of infection. Thus, re-purposing of ACAT inhibitors provides a compelling therapeutic strategy for the treatment of COVID-19 to achieve both antiviral and immunomodulatory effects. Trial registration: NCT04318314.
ISSN:1553-7366
1553-7374