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    Can endolysosomal deacidification and inhibition of autophagy prevent severe COVID-19?

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    Author
    Morris, G; Athan, E; Walder, K; Bortolasci, CC; O'Neil, A; Marx, W; Berk, M; Carvalho, AF; Maes, M; Puri, BK
    Date
    2020-12-01
    Source Title
    Life Sciences
    Publisher
    PERGAMON-ELSEVIER SCIENCE LTD
    University of Melbourne Author/s
    Berk, Michael; O'Neil, Adrienne
    Affiliation
    Psychiatry
    Melbourne School of Population and Global Health
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Morris, G., Athan, E., Walder, K., Bortolasci, C. C., O'Neil, A., Marx, W., Berk, M., Carvalho, A. F., Maes, M. & Puri, B. K. (2020). Can endolysosomal deacidification and inhibition of autophagy prevent severe COVID-19?. LIFE SCIENCES, 262, https://doi.org/10.1016/j.lfs.2020.118541.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/254556
    DOI
    10.1016/j.lfs.2020.118541
    Open Access URL
    https://europepmc.org/articles/PMC7537668?pdf=render
    Abstract
    The possibility is examined that immunomodulatory pharmacotherapy may be clinically useful in managing the pandemic coronavirus disease 2019 (COVID-19), known to result from infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a positive-sense single-stranded RNA virus. The dominant route of cell entry of the coronavirus is via phagocytosis, with ensconcement in endosomes thereafter proceeding via the endosomal pathway, involving transfer from early (EEs) to late endosomes (LEs) and ultimately into lysosomes via endolysosomal fusion. EE to LE transportation is a rate-limiting step for coronaviruses. Hence inhibition or dysregulation of endosomal trafficking could potentially inhibit SARS-CoV-2 replication. Furthermore, the acidic luminal pH of the endolysosomal system is critical for the activity of numerous pH-sensitive hydrolytic enzymes. Golgi sub-compartments and Golgi-derived secretory vesicles also depend on being mildly acidic for optimal function and structure. Activation of endosomal toll-like receptors by viral RNA can upregulate inflammatory mediators and contribute to a systemic inflammatory cytokine storm, associated with a worsened clinical outcome in COVID-19. Such endosomal toll-like receptors could be inhibited by the use of pharmacological agents which increase endosomal pH, thereby reducing the activity of acid-dependent endosomal proteases required for their activity and/or assembly, leading to suppression of antigen-presenting cell activity, decreased autoantibody secretion, decreased nuclear factor-kappa B activity and decreased pro-inflammatory cytokine production. It is also noteworthy that SARS-CoV-2 inhibits autophagy, predisposing infected cells to apoptosis. It is therefore also suggested that further pharmacological inhibition of autophagy might encourage the apoptotic clearance of SARS-CoV-2-infected cells.

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