Naphazoline for COVID-19

Papain-like protease (PLpro) is a crucial enzyme for SARS-CoV-2 replication and immune evasion. Inhibiting PLpro could be a promising strategy to fight against COVID-19. This study aimed to identify potent inhibitors of PLpro among FDA-approved drugs using an in silico approach. The study also aimed to examine and confirm the binding of the selected compounds to the active pocket of PLpro using a multi-phased in silico approach, involving the screening of 3009 FDA-approved drugs to pinpoint the most similar compounds to, TTT, the co-crystallized ligand TTT of PLpro. The selected compounds were subjected to further analysis, including molecular docking, molecular dynamics simulations, MM-GPSA (molecular mechanics generalized Born surface area), and PLIP (Protein-Ligand Interaction Profiler) studies, to examine and confirm their binding to the active pocket of PLpro. Seven candidates (Vismodegib, Celecoxib, Ketoprofen, Indomethacin, Naphazoline, Valdecoxib, and Eslicarbazepine) showed promising in silico activities against the PLpro. The computational analysis confirmed the binding of Celecoxib to the active pocket of PLpro, suggesting its potential in the fight against COVID-19. This study identified seven FDA-approved drugs as potential inhibitors of PLpro, providing a feasible approach for drug repurposing against COVID-19. The results obtained from the in silico approach hold promise, but further in vitro and in vivo studies are warranted to validate the potential of these compounds.

Drug repurposing (or repositioning) is the process of finding new therapeutic uses for drugs already approved by drug regulatory authorities (e.g., the Food and Drug Administration (FDA) and Therapeutic Goods Administration (TGA)) for other diseases. This involves analyzing the interactions between different biological entities, such as drug targets (genes/proteins and biological pathways) and drug properties, to discover novel drug-target or drug-disease relations. Artificial intelligence methods such as machine learning and deep learning have successfully analyzed complex heterogeneous data in the biomedical domain and have also been used for drug repurposing. This study presents a novel unsupervised machine learning framework that utilizes a graph-based autoencoder for multi-feature type clustering on heterogeneous drug data. The dataset consists of 438 drugs, of which 224 are under clinical trials for COVID-19 (category A). The rest are systematically filtered to ensure the safety and efficacy of the treatment (category B). The framework solely relies on reported drug data, including its pharmacological properties, chemical/physical properties, interaction with the host, and efficacy in different publicly available COVID-19 assays. Our machine-learning framework reveals three clusters of interest and provides recommendations featuring the top 15 drugs for COVID-19 drug repurposing, which were shortlisted based on the predicted clusters that were dominated by category A drugs. The anti-COVID efficacy of the drugs should be verified by experimental studies. Our framework can be extended to support other datasets and drug repurposing studies, given open-source code and data availability.

(1) Background: Drug repositioning is an unconventional drug discovery approach to explore new therapeutic benefits of existing drugs. Currently, it emerges as a rapid avenue to alleviate the COVID-19 pandemic disease. (2) Methods: Herein, we tested the antiviral activity of anti-microbial and anti-inflammatory Food and Drug Administration (FDA)-approved drugs, commonly prescribed to relieve respiratory symptoms, against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the viral causative agent of the COVID-19 pandemic. (3) Results: Of these FDA-approved antimicrobial drugs, Azithromycin, Niclosamide, and Nitazoxanide showed a promising ability to hinder the replication of a SARS-CoV-2 isolate, with IC50 of 0.32, 0.16, and 1.29 µM, respectively. We provided evidence that several antihistamine and anti-inflammatory drugs could partially reduce SARS-CoV-2 replication in vitro. Furthermore, this study showed that Azithromycin can selectively impair SARS-CoV-2 replication, but not the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). A virtual screening study illustrated that Azithromycin, Niclosamide, and Nitazoxanide bind to the main protease of SARS-CoV-2 (Protein data bank (PDB) ID: 6lu7) in binding mode similar to the reported co-crystalized ligand. Also, Niclosamide displayed hydrogen bond (HB) interaction with the key peptide moiety GLN: 493A of the spike glycoprotein active site. (4) Conclusions: The results suggest that Piroxicam should be prescribed in combination with Azithromycin for COVID-19 patients.