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Indomethacin inhibits human seasonal coronaviruses at late stages of viral replication in lung cells: Impact on virus-induced COX-2 expression

Tramontozzi et al., Journal of Virus Eradication, doi:10.1016/j.jve.2024.100387
Sep 2024  
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In Vitro study showing that indomethacin inhibits the replication of human seasonal coronaviruses HCoV-229E (alpha-coronavirus) and HCoV-OC43 (beta-coronavirus) in lung-derived MRC-5 cells. Indomethacin acts at late stages of the viral life cycle, reducing viral RNA synthesis and production of infectious particles. Authors conclude that the antiviral effect of indomethacin is independent of its cyclooxygenase-inhibiting action. Authors found that indomethacin significantly reduced virus-induced COX-2 expression, suggesting potential anti-inflammatory and antiviral benefits for SAR-CoV-2.
5 preclinical studies support the efficacy of indomethacin for COVID-19:
Tramontozzi et al., 30 Sep 2024, peer-reviewed, 6 authors. Contact: santoro@uniroma2.it.
In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
This PaperIndomethacinAll
Indomethacin inhibits human seasonal coronaviruses at late stages of viral replication in lung cells: Impact on virus-induced COX-2 expression
Caterina Tramontozzi, Anna Riccio, Silvia Pauciullo, Simone La Frazia, Antonio Rossi, M Gabriella Santoro
Journal of Virus Eradication, doi:10.1016/j.jve.2024.100387
Coronaviruses (CoV), zoonotic viruses periodically emerging worldwide, represent a constant potential threat to humans. To date, seven human coronaviruses (HCoV) have been identified: HCoV-229E, HCoV-NL63, HCoV-OC43 and HCoV-HKU1, globally circulating in the human population (seasonal coronaviruses, sHCoV), and three highly-pathogenic coronaviruses, SARS-CoV, MERS-CoV and SARS-CoV-2. Although sHCoV generally cause only mild respiratory diseases, severe complications may occur in specific populations, highlighting the need for broad-spectrum anti-coronavirus drugs. Herein we show that indomethacin (INDO), a non-steroidal anti-inflammatory drug widely used in the clinic for its potent anti-inflammatory and analgesic properties, effectively inhibits the replication of Alpha-coronavirus HCoV-229E and Beta-coronavirus HCoV-OC43 in human lungderived cells. Indomethacin does not interfere with HCoV binding or entry into target cells, but acts at late stages of the virus life cycle, inhibiting viral RNA synthesis and infectious viral particles production. Although INDO anti-inflammatory action is mediated by blocking cyclooxygenase-1 and -2 (COX-1/2) enzymatic activity, the antiviral effect appears to be cyclooxygenase-independent and is not mimicked by the potent COX-1/2 inhibitor aspirin. Interestingly we found that both seasonal HCoVs markedly (>100 fold) induce the expression of the pro-inflammatory mediator COX-2 in lung cells; notably, INDO-treatment was found to effectively inhibit virus-induced COX-2 expression at the transcriptional level, revealing an additional mechanism to prevent COX-2-mediated inflammatory reactions in HCoV-infected lung cells, besides COX activity inhibition. Altogether the results indicate that indomethacin, possessing both potent anti-inflammatory properties and a direct antiviral activity against HCoV, could be effective in the treatment of Alpha-and Beta-coronavirus infections.
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Appendix A. Supplementary data Supplementary data to this article can be found online at https://doi. org/10.1016/j.jve.2024.100387 .
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