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The antiandrogen enzalutamide downregulates TMPRSS2 and reduces cellular entry of SARS-CoV-2 in human lung cells

Leach et al., Nature Communications, doi:10.1038/s41467-021-24342-y
Jul 2021  
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In Vitro and animal study showing that the antiandrogen enzalutamide reduces TMPRSS2 levels in human lung cells and in mouse lungs.
3 preclinical studies support the efficacy of antiandrogens for COVID-19:
Leach et al., 1 Jul 2021, peer-reviewed, 10 authors.
This PaperAntiandrogensAll
The antiandrogen enzalutamide downregulates TMPRSS2 and reduces cellular entry of SARS-CoV-2 in human lung cells
D A Leach, A Mohr, E S Giotis, E Cil, A M Isac, L L Yates, W S Barclay, R M Zwacka, C L Bevan, G N Brooke
Nature Communications, doi:10.1038/s41467-021-24342-y
SARS-CoV-2 attacks various organs, most destructively the lung, and cellular entry requires two host cell surface proteins: ACE2 and TMPRSS2. Downregulation of one or both of these is thus a potential therapeutic approach for COVID-19. TMPRSS2 is a known target of the androgen receptor, a ligand-activated transcription factor; androgen receptor activation increases TMPRSS2 levels in various tissues, most notably prostate. We show here that treatment with the antiandrogen enzalutamide-a well-tolerated drug widely used in advanced prostate cancer-reduces TMPRSS2 levels in human lung cells and in mouse lung. Importantly, antiandrogens significantly reduced SARS-CoV-2 entry and infection in lung cells. In support of this experimental data, analysis of existing datasets shows striking coexpression of AR and TMPRSS2, including in specific lung cell types targeted by SARS-CoV-2. Together, the data presented provides strong evidence to support clinical trials to assess the efficacy of antiandrogens as a treatment option for COVID-19.
Author contributions Competing interests The authors declare no competing interests. Additional information Supplementary information The online version contains supplementary material available at Correspondence and requests for materials should be addressed to C.L.B. or G.N.B. Peer review information Nature Communications thanks Changmeng Cai and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. Peer reviewer reports are available. Reprints and permission information is available at Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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