Therapeutic choices against Novel CoronaVirus
Posted on 07 May 2020; 01:00 AM IST. Last Updated 07 May 2020; 01:00 AM IST.Summary: The Novel Coronavirus (covid-19) is giving a tough fight, to medical experts all across the world. To win and survive in this long drawn battle, it is imperative that we deploy all the available therapeutic choices, against the virus.
The Novel CoronaVirus (Covid-19) must be defeated, in one way or the other, and as soon as possible. The health, social, and economic impact inflicted by this virus, is placing a heavy burden on people, across all countries in the world. Today, there is no person in this world, who is unaffected by the Novel Coronavirus, in one way or the other.
This article presents the therapeutic choices or strategies at our disposal to fight the virus.
First Therapeutic Choice (Attack outside the Cell): The first therapeutic choice is to target the spike protein or any other membrane protein of the Novel Coronavirus. In this classical approach, the virus is targeted, before it infects the host cell. The big pharma companies took this approach, and are trying to develop vaccines, all across the world. The vaccine helps our immune system to recognize the virus, and to produce appropriate antibodies, to neutralize the virus.
The problem with this approach is, it takes at least 12 months, to get the vaccine. On the benefit side, a good vaccine is a foolproof solution to the problem, and we can forget about Novel Coronavirus, like the rest of the viruses.
Second Therapeutic Choice (Attack inside the Cell): The second therapeutic choice is to prevent the virus from replicating in the host cell. A drug called "Remdesivir", from Gilead Sciences, does this job. Another drug HydroxyChloroquine does a similar job, i.e prevent viral replication, by employing a different mechanism of action. These drugs have demonstrated some success, but they must be administered and monitored by qualified physicians, in a hospital setting, by taking into account a large number of medical conditions of the patient.
Third Therapeutic Choice (Attack at the entry of Cell): The third therapeutic choice is to prevent the virus from binding on to the host cell. The Novel Coronavirus uses its spike protein to bind to the ACE2 receptor of the human cells.
What if we can prevent the binding? This question is not new, and was pursued earlier, for preventing "SARS", and "Dengue Mosquito Virus" infections.
The theory behind the approach is explained below.
Most viruses need to bind to a receptor, to enter the host cell. To facilitate this binding, they make use of a key enzyme called protease, produced in the host cells. The virus cannot enter the host cell, without help from one of the proteases. Protease inhibitors are therefore likely drug candidates.
Furin is one of the well known proteases, but not the only one, which can help the novel coronavirus, get into the host cell. Furin is mainly active in the lung, and is the most probable cause for letting coronavirus infect the lung.
Protease inhibitor drugs already known in Pharma are HIV drugs, which are highly toxic. Most of them cannot be easily mixed with other drugs, and unless they alone can prevent the disease, they are not highly preferable.
There are several natural compounds, which serve as protease inhibitors. Luteolin, is a common flavonoid, which is known to inhibit Furin. Polyarginines (natural foods) are also known inhibitors of Furin. More information on this topic is available at:
http://ukrbiochemjournal.org/2016/12/chemical-structure-and-properties-of-low-molecular-furin-inhibitors.html
An ideal drug candidate, must therefore be a natural compound, readily available as a food supplement. If such a drug candidate exists, which selectively inhibits the binding of spike protein with ACE2 receptor, then it can be considered as a "Gift of God".
Conclusion: As stated above, the first therapeutic choice is the most ideal solution, but due to the long wait for the vaccine, we need to explore other alternatives. In other words, the disease must be managed with the other two approaches, until a vaccine is ready.
The second therapeutic choice available for managing the disease is not a silver bullet, which could take down the virus.
If the third therapeutic choice, yields a natural compound like a flavonoid (or food supplement), then it can be combined with the second therapeutic choice, to produce a widely acceptable solution, for managing the disease.