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The pH Dependence of Niclosamide Solubility, Dissolution, and Morphology: Motivation for Potentially Universal Mucin-Penetrating Nasal and Throat Sprays for COVID19, its Variants and other Viral Infections

Needham, D., Pharmaceutical Research, doi:10.1007/s11095-021-03112-x
Dec 2021  
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In Vitro study showing that niclosamide has potential as a prophylactic nasal spray and early treatment throat spray for COVID-19 and other respiratory viral infections. Authors find that niclosamide's solubility and dissolution rate are pH-dependent, with concentrations increasing from 2.53μM at pH 3.66 to 704μM at pH 9.63. A 20μM prophylactic nasal spray can be formulated at pH 7.96, while a 300μM early treatment throat spray can be formulated at pH 9.19. These concentrations are 10-150 times higher than the 100% inhibitory concentration of 1-3μM reported for SARS-CoV-2 infected Vero 6 and Calu-3 cells. Niclosamide's broad antiviral activity is attributed to its ability to disrupt pH gradients and reduce ATP production in host cells, inhibiting viral uncoating, replication, and assembly. Niclosamide inhibits the following stages of viral infection: uncoating - preventing viral RNA release from the endosome; replication - reducing ATP available for viral transcription and translation; and assembly - interfering with capsid assembly in the Golgi, promoting secretion of non-competent virions.
9 preclinical studies support the efficacy of niclosamide for COVID-19:
In Silico studies predict inhibition of SARS-CoV-2 with niclosamide or metabolites via binding to the spikeA,1, MproB,1, RNA-dependent RNA polymeraseC,1, PLproD,1, nucleocapsidE,1, and helicaseF,1 proteins. Niclosamide inhibits endolysosomal acidification and suppresses TLR3-mediated pro-inflammatory signaling in human small airway epithelial cells stimulated with TLR3 agonists mimicking viral RNA2, modulates host lipid metabolism and reduces infectious SARS-CoV-2 virion production in Vero E6 cells4, reduces CD147 protein levels and inhibits SARS-CoV-2-induced upregulation of CD147 in A549-ACE2 cells, including the highly glycosylated form of CD147 which has been implicated in COVID-19 disease progression and post-COVID-19 cardiac complications5, blocked the formation of syncytia mediated by SARS-CoV-2 spike protein pseudovirus-producing cells6, may reduce inflammation, NLRP3 formation, and caspase-1 activity9, may inhibit viral uncoating, replication, and assembly via disruption of pH gradients and reduced ATP production in host cells8, and shows strong synergy when combined with ivermectin7.
a. The trimeric spike (S) protein is a glycoprotein that mediates viral entry by binding to the host ACE2 receptor, is critical for SARS-CoV-2's ability to infect host cells, and is a target of neutralizing antibodies. Inhibition of the spike protein prevents viral attachment, halting infection at the earliest stage.
b. The main protease or Mpro, also known as 3CLpro or nsp5, is a cysteine protease that cleaves viral polyproteins into functional units needed for replication. Inhibiting Mpro disrupts the SARS-CoV-2 lifecycle within the host cell, preventing the creation of new copies.
c. RNA-dependent RNA polymerase (RdRp), also called nsp12, is the core enzyme of the viral replicase-transcriptase complex that copies the positive-sense viral RNA genome into negative-sense templates for progeny RNA synthesis. Inhibiting RdRp blocks viral genome replication and transcription.
d. The papain-like protease (PLpro) has multiple functions including cleaving viral polyproteins and suppressing the host immune response by deubiquitination and deISGylation of host proteins. Inhibiting PLpro may block viral replication and help restore normal immune responses.
e. The nucleocapsid (N) protein binds and encapsulates the viral genome by coating the viral RNA. N enables formation and release of infectious virions and plays additional roles in viral replication and pathogenesis. N is also an immunodominant antigen used in diagnostic assays.
f. The helicase, or nsp13, protein unwinds the double-stranded viral RNA, a crucial step in replication and transcription. Inhibition may prevent viral genome replication and the creation of new virus components.
Needham et al., 28 Dec 2021, peer-reviewed, 1 author. Contact: d.needham@duke.edu.
This PaperNiclosamideAll
The pH Dependence of Niclosamide Solubility, Dissolution, and Morphology: Motivation for Potentially Universal Mucin-Penetrating Nasal and Throat Sprays for COVID19, its Variants and other Viral Infections
David Needham
Pharmaceutical Research, doi:10.1007/s11095-021-03112-x
63. However, the "Sigma-polymorph" equilibrated to much lower final supernatant concentrations, reflective of more stable polymorphs at each pH. Similarly, when precipitated from supersaturated solution, or as cosolvates, niclosamide also equilibrated to lower final supernatant concentrations. Polymorph equilibration though was avoided by using a solvent-exchange technique to make the solutions. Conclusions Given niclosamide's activity as a host cell modulator, optimized niclosamide solutions could represent universal prophylactic nasal and early treatment throat sprays against COVID19, its more contagious variants, and other respiratory viral infections. They are the simplest and potentially most effective formulations from both an efficacy standpoint as well as manufacturing and distribution, (no cold chain). They now just need testing.
Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1007/ s11095-021-03112-x. Declarations Conflict of Interest Statement Duke University has assigned the rights for the provisional patent applications to David Needham and his entity, Needham Material Science LLC. Author contributions for all authors David Needham was the sole contributor and sole author. Data Availability Statement The datasets generated during and/ or analyzed during the current study are available from the corresponding author on reasonable request. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Global COVID-19 Vaccinations ' 'https://covid.cdc.gov/covid-data-tracker/#global-vaccinations. 2021 ' 'Accessed on 2021–11–21.'}], 'container-title': 'Pharmaceutical Research', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1007/s11095-021-03112-x.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1007/s11095-021-03112-x/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1007/s11095-021-03112-x.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 10, 28]], 'date-time': '2022-10-28T02:14:32Z', 'timestamp': 1666923272000}, 'score': 1, 'resource': {'primary': {'URL': 'https://link.springer.com/10.1007/s11095-021-03112-x'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2021, 12, 28]]}, 'references-count': 73, 'journal-issue': {'issue': '1', 'published-print': {'date-parts': [[2022, 1]]}}, 'alternative-id': ['3112'], 'URL': 'http://dx.doi.org/10.1007/s11095-021-03112-x', 'relation': { 'has-preprint': [ { 'id-type': 'doi', 'id': '10.1101/2021.08.16.456531', 'asserted-by': 'object'}]}, 'ISSN': ['0724-8741', '1573-904X'], 'subject': [ 'Pharmacology (medical)', 'Organic Chemistry', 'Pharmaceutical Science', 'Pharmacology', 'Molecular Medicine', 'Biotechnology'], 'container-title-short': 'Pharm Res', 'published': {'date-parts': [[2021, 12, 28]]}, 'assertion': [ { 'value': '13 August 2021', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '14 September 2021', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '28 December 2021', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'Duke University has assigned the rights for the provisional patent applications ' 'to David Needham and his entity, Needham Material Science LLC.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Conflict of Interest Statement'}}, { 'value': 'David Needham was the sole contributor and sole author.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Author contributions for all authors'}}, { 'value': 'The datasets generated during and/or analyzed during the current study are ' 'available from the corresponding author on reasonable request.', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Data Availability Statement'}}, { 'value': 'This content has been made available to all.', 'name': 'free', 'label': 'Free to read'}]}
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