Synergistic anti-SARS-CoV-2 activity of repurposed anti-parasitic drug combinations
Kunlakanya Jitobaom, Chompunuch Boonarkart, Suwimon Manopwisedjaroen, Nuntaya Punyadee, Suparerk Borwornpinyo, Arunee Thitithanyanont, Panisadee Avirutnan, Prasert Auewarakul
BMC Pharmacology and Toxicology, doi:10.1186/s40360-022-00580-8
Background: COVID-19 pandemic has claimed millions of lives and devastated the health service system, livelihood, and economy in many countries worldwide. Despite the vaccination programs in many countries, the spread of the pandemic continues, and effective treatment is still urgently needed. Although some antiviral drugs have been shown to be effective, they are not widely available. Repurposing of anti-parasitic drugs with in vitro anti-SARS-CoV-2 activity is a promising approach being tested in many clinical trials. Combination of these drugs is a plausible way to enhance their effectiveness.
Methods: The in vitro anti-SARS-CoV-2 activity of combinations of niclosamide, ivermectin and chloroquine were evaluated in Vero E6 and lung epithelial cells, Calu-3. Results: All the two-drug combinations showed higher potency resulting in up to 4-fold reduction in the half maximal inhibitory concentration (IC 50 ) values compared to individual drugs. Among these combinations, niclosamideivermectin achieved the highest inhibitory level of over 99%. Combination synergy analysis showed niclosamideivermectin combination to have the best synergy score with a mean Loewe synergy score of 4.28 and a peak synergy score of 24.6 in Vero E6 cells and a mean Loewe synergy score of 3.82 and a peak synergy score of 10.86 in Calu-3 cells.
Conclusions: The present study demonstrated the benefit of drug combinations on anti-SARS-CoV-2 activity. Niclosamide and ivermectin showed the best synergistic profile and should be further tested in clinical trials.
Abbreviations
Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1186/ s40360-022-00580-8.
Additional file 1. Authors' contributions KJ performed drug treatment experiments, viral quantifications, analysis and was a major contributor in writing and revising the manuscript. CB performed virus infection, viral quantifications, and the optimization of the plaque assay for SARS-CoV-2 and prepared virus stock. SM performed virus isolation and the optimization of the plaque assay for SARS-CoV-2. NP performed analysis and prepared drug stock solutions. SB prepared cell lines and drug stock solutions. AT designed the study and edited the manuscript. PA 3, 4 reviewed and edited the manuscript. PA 1* designed and supervised the study, performed funding acquisitions, writing, and editing the manuscript. All authors read and approved the final manuscript.
Declarations Ethics approval and consent to participate Not applicable. This work does not involve the use of human subjects and animals. All the procedures do not require IRB approval.
Consent for publication Not applicable. This work does not contain data from any individual person.
Competing interests The authors declare that they have no competing interests. • fast, convenient online submission • thorough peer review by experienced researchers in your field • rapid publication on acceptance • support for research data, including large and complex data types •..
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