REPLICATION of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to be inhibited by an antiviral medication approved in the treatment against multiple sclerosis in vitro.
Dimethyl fumarate (DMF) is used in the treatment of adults with various forms of multiple sclerosis and may be a promising candidate for coronavirus disease (COVID-19) treatment, according to new research from Aarhus University, Aarhus, Denmark. Before the pandemic, Prof Christian Kanstrup Holm and his team tested the effects of the NRF2 agonist 4-octyl-itaconate (4-OI) as part of the search for a medication with broad-spectrum application. Prof Kanstrup Holm stated that the results were very promising and: “Then the coronavirus suddenly appeared, which we therefore also tested, and saw an enormous effect. The number of duplications that coronavirus makes of itself in the body’s cells were simply drastically reduced.”
The basic research study was conducted in cell cultures with human lung cells and 4-OI showed reassuring results, with a 102–104 reduction in SARS-CoV-2 RNA levels while not affecting cell viability. Furthermore, host inflammatory responses to SARS-CoV-2 infection, associated with airway COVID-19 pathology, were limited by 4-OI, and the inhibitory results also extended to other pathogenic viruses including herpes simplex virus 1 and 2, vaccinia virus, and Zika virus through a Type I IFN-independent mechanism. “At the same time, the drug inhibited the immune reaction or inflammatory condition that constitutes a large portion of the actual threat for coronavirus patients.”
Encouraged by these results, the team repeated the tests with DMF, which showed the same inhibitory effects. According to the researchers, a lot of time could be saved because the drug has already been approved and tested in another context. Therefore, if clinicians and the company that holds the patent are prepared to test in human trials, the effects of DMF on COVID-19 patients could be tested immediately. Compared to 4-OI, DMF has not been shown to lead to fetal defects. If infectious disease researchers assess the results and consider them worth proceeding, Prof Kanstrup Holm hopes to be included in the future clinical trials.