A Treatment to Eliminate SARS-CoV-2 Replication in Human Airway Epithelial Cells Is Safe for Inhalation as an Aerosol in Healthy Human Subjects.

BACKGROUND: Low airway surface pH is associated with many airway diseases, impairs antimicrobial host defense, and worsens airway inflammation. Inhaled Optate is designed to safely raise airway surface pH and is well tolerated in humans. Raising intracellular pH partially prevents activation of SARS...

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Publicado en:Respiratory Care Vol. 66; no. 1; pp. 113 - 120
Autores principales: Davis, Michael D., Clemente, Tatiana M., Giddings, Olivia K., Ross, Kristie, Cunningham, Rebekah S., Smith, Laura, Simpson, Edward, Yunlong Liu, Kloepfer, Kirsten, Ramsey, I. Scott, Yi Zhao, Robinson, Christopher M., Gilk, Stacey D., Gaston, Benjamin
Formato: pictorial research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Jan2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2021
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      pub: Mary Ann Liebert, Inc.
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        10.4187/respcare.08425
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        atl: A Treatment to Eliminate SARS-CoV-2 Replication in Human Airway Epithelial Cells Is Safe for Inhalation as an Aerosol in Healthy Human Subjects.
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        au:
          Davis, Michael D.
          Clemente, Tatiana M.
          Giddings, Olivia K.
          Ross, Kristie
          Cunningham, Rebekah S.
          Smith, Laura
          Simpson, Edward
          Yunlong Liu
          Kloepfer, Kirsten
          Ramsey, I. Scott
          Yi Zhao
          Robinson, Christopher M.
          Gilk, Stacey D.
          Gaston, Benjamin
        affil: Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine
      sug:
        subj:
          SARS-CoV-2 Physiology
          Epithelial Cells
          Aerosols
          Administration, Inhalation
          Coronavirus Infections Microbiology
          Microbiologic Phenomena
          Human
          Cell Viability
      ab: BACKGROUND: Low airway surface pH is associated with many airway diseases, impairs antimicrobial host defense, and worsens airway inflammation. Inhaled Optate is designed to safely raise airway surface pH and is well tolerated in humans. Raising intracellular pH partially prevents activation of SARS-CoV-2 in primary normal human airway epithelial (NHAE) cells, decreasing viral replication by several mechanisms. METHODS: We grew primary NHAE cells from healthy subjects, infected them with SARS-CoV-2 (isolate USA-WA1/2020), and used clinical Optate at concentrations used in humans in vivo to determine whether Optate would prevent viral infection and replication. Cells were pretreated with Optate or placebo prior to infection (multiplicity of infection = 1), and viral replication was determined with plaque assay and nucleocapsid (N) protein levels. Healthy human subjects also inhaled Optate as part of a Phase 2a safety trial. RESULTS: Optate almost completely prevented viral replication at each time point between 24 h and 120 h, relative to placebo, on both plaque assay and N protein expression (P < .001). Mechanistically, Optate inhibited expression of major endosomal trafficking genes and raised NHAE intracellular pH. Optate had no effect on NHAE cell viability at any time point. Inhaled Optate was well tolerated in 10 normal subjects, with no change in lung function, vital signs, or oxygenation. CONCLUSIONS: Inhaled Optate may be well suited for a clinical trial in patients with pulmonary SARS-CoV-2 infection. However, it is vitally important for patient safety that formulations designed for inhalation with regard to pH, isotonicity, and osmolality be used. An inhalational treatment that safely prevents SARS-CoV-2 viral replication could be helpful for treating patients with pulmonary SARS-CoV-2 infection.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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