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Synthetic heparan sulfate mimetic pixatimod (PG545) potently inhibits SARS-CoV-2 by disrupting the Spike-ACE2 interaction

Synthetic heparan sulfate mimetic pixatimod (PG545) potently inhibits SARS-CoV-2 by disrupting the Spike-ACE2 interaction
Synthetic heparan sulfate mimetic pixatimod (PG545) potently inhibits SARS-CoV-2 by disrupting the Spike-ACE2 interaction

Heparan sulfate (HS) is a cell surface polysaccharide recently identified as a coreceptor with the ACE2 protein for the S1 spike protein on SARS-CoV-2 virus, providing a tractable new therapeutic target. Clinically used heparins demonstrate an inhibitory activity but have an anticoagulant activity and are supply-limited, necessitating alternative solutions. Here, we show that synthetic HS mimetic pixatimod (PG545), a cancer drug candidate, binds and destabilizes the SARS-CoV-2 spike protein receptor binding domain and directly inhibits its binding to ACE2, consistent with molecular modeling identification of multiple molecular contacts and overlapping pixatimod and ACE2 binding sites. Assays with multiple clinical isolates of SARS-CoV-2 virus show that pixatimod potently inhibits the infection of monkey Vero E6 cells and physiologically relevant human bronchial epithelial cells at safe therapeutic concentrations. Pixatimod also retained broad potency against variants of concern (VOC) including B.1.1.7 (Alpha), B.1.351 (Beta), B.1.617.2 (Delta), and B.1.1.529 (Omicron). Furthermore, in a K18-hACE2 mouse model, pixatimod significantly reduced SARS-CoV-2 viral titers in the upper respiratory tract and virus-induced weight loss. This demonstration of potent anti-SARS-CoV-2 activity tolerant to emerging mutations establishes proof-of-concept for targeting the HS-Spike protein-ACE2 axis with synthetic HS mimetics and provides a strong rationale for clinical investigation of pixatimod as a potential multimodal therapeutic for COVID-19.

2374-7943
527-545
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Suhrbier, Andreas
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Watterson, Daniel
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Khromykh, Alexander A
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Carroll, Miles W
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Trybala, Edward
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Bergström, Tomas
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Ferro, Vito
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Skidmore, Mark A
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Turnbull, Jeremy E
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Guimond, Scott E, Mycroft-West, Courtney J, Gandhi, Neha S, Tree, Julia A, Le, Thuy T, Spalluto, C Mirella, Humbert, Maria V, Buttigieg, Karen R, Coombes, Naomi, Elmore, Michael J, Wand, Matthew, Nyström, Kristina, Said, Joanna, Setoh, Yin Xiang, Amarilla, Alberto A, Modhiran, Naphak, Sng, Julian D J, Chhabra, Mohit, Young, Paul R, Rawle, Daniel J, Lima, Marcelo A, Yates, Edwin A, Karlsson, Richard, Miller, Rebecca L, Chen, Yen-Hsi, Bagdonaite, Ieva, Yang, Zhang, Stewart, James, Nguyen, Dung, Laidlaw, Stephen, Hammond, Edward, Dredge, Keith, Wilkinson, Tom M A, Watterson, Daniel, Khromykh, Alexander A, Suhrbier, Andreas, Carroll, Miles W, Trybala, Edward, Bergström, Tomas, Ferro, Vito, Skidmore, Mark A and Turnbull, Jeremy E (2022) Synthetic heparan sulfate mimetic pixatimod (PG545) potently inhibits SARS-CoV-2 by disrupting the Spike-ACE2 interaction. ACS Central Science, 8 (5), 527-545. (doi:10.1021/acscentsci.1c01293).

Record type: Article

Abstract

Heparan sulfate (HS) is a cell surface polysaccharide recently identified as a coreceptor with the ACE2 protein for the S1 spike protein on SARS-CoV-2 virus, providing a tractable new therapeutic target. Clinically used heparins demonstrate an inhibitory activity but have an anticoagulant activity and are supply-limited, necessitating alternative solutions. Here, we show that synthetic HS mimetic pixatimod (PG545), a cancer drug candidate, binds and destabilizes the SARS-CoV-2 spike protein receptor binding domain and directly inhibits its binding to ACE2, consistent with molecular modeling identification of multiple molecular contacts and overlapping pixatimod and ACE2 binding sites. Assays with multiple clinical isolates of SARS-CoV-2 virus show that pixatimod potently inhibits the infection of monkey Vero E6 cells and physiologically relevant human bronchial epithelial cells at safe therapeutic concentrations. Pixatimod also retained broad potency against variants of concern (VOC) including B.1.1.7 (Alpha), B.1.351 (Beta), B.1.617.2 (Delta), and B.1.1.529 (Omicron). Furthermore, in a K18-hACE2 mouse model, pixatimod significantly reduced SARS-CoV-2 viral titers in the upper respiratory tract and virus-induced weight loss. This demonstration of potent anti-SARS-CoV-2 activity tolerant to emerging mutations establishes proof-of-concept for targeting the HS-Spike protein-ACE2 axis with synthetic HS mimetics and provides a strong rationale for clinical investigation of pixatimod as a potential multimodal therapeutic for COVID-19.

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acscentsci.1c01293 - Version of Record
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e-pub ahead of print date: 25 May 2022
Published date: 25 May 2022
Additional Information: © 2022 The Authors. Published by American Chemical Society.

Identifiers

Local EPrints ID: 470019
URI: http://eprints.soton.ac.uk/id/eprint/470019
ISSN: 2374-7943
PURE UUID: 0a35dd2c-d17b-4b4e-9ee9-567655301d18
ORCID for C Mirella Spalluto: ORCID iD orcid.org/0000-0001-7273-0844
ORCID for Maria V Humbert: ORCID iD orcid.org/0000-0002-5728-6981

Catalogue record

Date deposited: 30 Sep 2022 16:40
Last modified: 06 Jun 2024 01:53

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Contributors

Author: Scott E Guimond
Author: Courtney J Mycroft-West
Author: Neha S Gandhi
Author: Julia A Tree
Author: Thuy T Le
Author: C Mirella Spalluto ORCID iD
Author: Maria V Humbert ORCID iD
Author: Karen R Buttigieg
Author: Naomi Coombes
Author: Michael J Elmore
Author: Matthew Wand
Author: Kristina Nyström
Author: Joanna Said
Author: Yin Xiang Setoh
Author: Alberto A Amarilla
Author: Naphak Modhiran
Author: Julian D J Sng
Author: Mohit Chhabra
Author: Paul R Young
Author: Daniel J Rawle
Author: Marcelo A Lima
Author: Edwin A Yates
Author: Richard Karlsson
Author: Rebecca L Miller
Author: Yen-Hsi Chen
Author: Ieva Bagdonaite
Author: Zhang Yang
Author: James Stewart
Author: Dung Nguyen
Author: Stephen Laidlaw
Author: Edward Hammond
Author: Keith Dredge
Author: Tom M A Wilkinson
Author: Daniel Watterson
Author: Alexander A Khromykh
Author: Andreas Suhrbier
Author: Miles W Carroll
Author: Edward Trybala
Author: Tomas Bergström
Author: Vito Ferro
Author: Mark A Skidmore
Author: Jeremy E Turnbull

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