Drug Repurposing for COVID-19 Therapy: Pipeline, Current Status and Challenges

Repurposed drugs such as Remdesivir, Fabipiravir and Molnupiravir became life saver drugs during the peak of the COVID-19 pandemic, attesting the efficacy of the repurposing approach. By definition, drug repurposing is the process of identification of new therapeutic use of an existing drug or drug candidate that has already passed the safety, toxicity and pharmacology tests for human use. Although drug repurposing approach involves a significant level of challenge, affordability and faster discovery pipeline outweighs the risks in the event of emergency situations like the current COVID-19 pandemic. In this chapter, we provide a brief summary of the advantages of the drug repurposing approach, followed by an overview of the drug repurposing pipeline and finally end with an update on the status of drug repurposing in developing effective anti-viral therapeutics against COVID-19. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.

Antiviral activity of the human endogenous retrovirus-R envelope protein against SARS-CoV-2

Coronavirus-induced disease-19 (COVID-19), caused by SARS-CoV-2, is still a major global health challenge. Human endogenous retroviruses (HERVs) represent retroviral elements that were integrated into the ancestral human genome. HERVs are important in embryonic development as well as in the manifestation of diseases, including cancer, inflammation, and viral infections. Here, we analyze the expression of several HERVs in SARS-CoV-2-infected cells and observe increased activity of HERV-E, HERV-V, HERV-FRD, HERV-MER34, HERV-W, and HERV-K-HML2. In contrast, the HERV-R envelope is downregulated in cell-based models and PBMCs of COVID-19 patients. Overexpression of HERV-R inhibits SARS-CoV-2 replication, suggesting its antiviral activity. Further analyses demonstrate the role of the extracellular signal-regulated kinase (ERK) in regulating HERV-R antiviral activity. Lastly, our data indicate that the crosstalk between ERK and p38 MAPK controls the synthesis of the HERV-R envelope protein, which in turn modulates SARS-CoV-2 replication. These findings suggest the role of the HERV-R envelope as a prosurvival host factor against SARS-CoV-2 and illustrate a possible advantage of integration and evolutionary maintenance of retroviral elements in the human genome.Copyright © 2023 The Authors.