Abstract
The cell surface serine protease Transmembrane Protease 2 (TMPRSS2) is required to cleave the spike protein of SARS-CoV-2 for viral entry into cells. We determined whether negatively-charged heparin enhanced TMPRSS2 inhibition by alpha-1-antitrypsin (AAT). TMPRSS2 activity was determined in HEK293T cells overexpressing TMPRSS2. We quantified infection of primary human airway epithelial cells (hAEc) with human coronavirus 229E (HCoV-229E) by immunostaining for the nucleocapsid protein and by the plaque assay. Detailed molecular modeling was undertaken with the heparin-TMPRSS2-AAT ternary complex. Enoxaparin enhanced AAT inhibition of both TMPRSS2 activity and infection of hAEc with HCoV-229E. Underlying these findings, detailed molecular modeling revealed that: (i) the reactive center loop of AAT adopts an inhibitory-competent conformation compared with the crystal structure of TMPRSS2 bound to an exogenous (nafamostat) or endogenous (HAI-2) TMPRSS2 inhibitor and (ii) negatively-charged heparin bridges adjacent electropositive patches at the TMPRSS2-AAT interface, neutralizing otherwise repulsive forces. In conclusion, enoxaparin enhances AAT inhibition of both TMPRSS2 and coronavirus infection. Such host-directed therapy is less likely to be affected by SARS-CoV-2 mutations. Furthermore, given the known anti-inflammatory activities of both AAT and heparin, this form of treatment may target both the virus and the excessive inflammatory consequences of severe COVID-19.
【초록키워드】 Treatment, SARS-CoV-2, Coronavirus infection, TMPRSS2, therapy, severe COVID-19, Infection, heparin, virus, anti-inflammatory activity, viral entry, Spike protein, nucleocapsid protein, Human coronavirus, Viral, cells, HCoV, Primary human airway epithelial cells, enoxaparin, HCoV-229E, nafamostat, epithelial cells, Neutralizing, SARS-CoV-2 mutations, molecular, crystal structure, alpha-1-antitrypsin, Plaque assay, Inflammatory, immunostaining, epithelial cell, the cell, Serine, complex, serine protease, TMPRSS2 inhibitor, antitrypsin, human coronavirus 229E, HEK293T cells, hAEC, primary human airway, Cell, consequence, reactive, ENhance, affected, required, was determined, less, the spike protein, quantified, cleave, HEK293T cell, overexpressing, 【제목키워드】 COVID-19, drug combination,