# Advanced bioinformatics rapidly identifies existing therapeutics for patients with coronavirus disease-2019 (COVID-19)

**Authors:** Jason Kim, Jenny Zhang, Yoonjeong Cha, Sarah Kolitz, Jason Funt, Renan Escalante Chong, Scott Barrett, Rebecca Kusko, Ben Zeskind, Howard Kaufman

PMC · DOI: 10.1186/s12967-020-02430-9 · 2020-06-25

## TL;DR

This study uses bioinformatics to find existing drugs that could help treat or prevent COVID-19 by targeting virus entry and gene expression.

## Contribution

The novel use of two computational platforms to rapidly screen FDA-approved drugs for potential repurposing against SARS-CoV-2.

## Key findings

- ACE2 and TMPRSS2 binding analysis identified drugs like ACE inhibitors, beta-lactam antibiotics, and antivirals as potential candidates.
- Disease Cancelling Technology highlighted compounds like Vitamin E, ruxolitinib, and glutamine for their gene expression counteracting potential.
- Glutathione and glutamine were top hits across both platforms, suggesting their dual therapeutic potential.

## Abstract

The recent global pandemic has placed a high priority on identifying drugs to prevent or lessen clinical infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused by Coronavirus disease-2019 (COVID-19).

We applied two computational approaches to identify potential therapeutics. First, we sought to identify existing FDA approved drugs that could block coronaviruses from entering cells by binding to ACE2 or TMPRSS2 using a high-throughput AI-based binding affinity prediction platform. Second, we sought to identify FDA approved drugs that could attenuate the gene expression patterns induced by coronaviruses, using our Disease Cancelling Technology (DCT) platform.

Top results for ACE2 binding iincluded several ACE inhibitors, a beta-lactam antibiotic, two antiviral agents (Fosamprenavir and Emricasan) and glutathione. The platform also assessed specificity for ACE2 over ACE1, important for avoiding counterregulatory effects. Further studies are needed to weigh the benefit of blocking virus entry against potential counterregulatory effects and possible protective effects of ACE2. However, the data herein suggest readily available drugs that warrant experimental evaluation to assess potential benefit. DCT was run on an animal model of SARS-CoV, and ranked compounds by their ability to induce gene expression signals that counteract disease-associated signals. Top hits included Vitamin E, ruxolitinib, and glutamine. Glutathione and its precursor glutamine were highly ranked by two independent methods, suggesting both warrant further investigation for potential benefit against SARS-CoV-2.

While these findings are not yet ready for clinical translation, this report highlights the potential use of two bioinformatics technologies to rapidly discover existing therapeutic agents that warrant further investigation for established and emerging disease processes.

## Linked entities

- **Genes:** ACE2 (angiotensin converting enzyme 2) [NCBI Gene 59272], TMPRSS2 (transmembrane serine protease 2) [NCBI Gene 7113]
- **Chemicals:** Fosamprenavir (PubChem CID 131536), Emricasan (PubChem CID 12000240), glutathione (PubChem CID 124886), Vitamin E (PubChem CID 14985), ruxolitinib (PubChem CID 17754772), glutamine (PubChem CID 738)
- **Diseases:** Coronavirus disease-2019 (MONDO:0100096), severe acute respiratory syndrome coronavirus 2 (MONDO:0100096)

## Full-text entities

- **Genes:** IRF7 (interferon regulatory factor 7) [NCBI Gene 3665] {aka IMD39, IRF-7, IRF-7H, IRF7A, IRF7B, IRF7C}, Ace2 (angiotensin converting enzyme 2) [NCBI Gene 70008] {aka 2010305L05Rik}, Casp3 (caspase 3) [NCBI Gene 12367] {aka A830040C14Rik, AC-3, CASP-3, CC3, CPP-32, CPP32}, CASP3 (caspase 3) [NCBI Gene 836] {aka CPP32, CPP32B, SCA-1}, VTN (vitronectin) [NCBI Gene 7448] {aka V75, VN, VNT}, SLC5A2 (solute carrier family 5 member 2) [NCBI Gene 6524] {aka SGLT2}, AP2B1 (adaptor related protein complex 2 subunit beta 1) [NCBI Gene 163] {aka ADTB2, AP105B, AP2-BETA, CLAPB1}, AGT (angiotensinogen) [NCBI Gene 183] {aka ANHU, SERPINA8, hFLT1}, ACE2 (angiotensin converting enzyme 2) [NCBI Gene 59272] {aka ACEH}, F2 (coagulation factor II, thrombin) [NCBI Gene 2147] {aka PT, RPRGL2, THPH1}, LGALS9 (galectin 9) [NCBI Gene 3965] {aka HUAT, LGALS9A}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, REN (renin) [NCBI Gene 5972] {aka ADTKD4, HNFJ2, RTD}, IFIT3 (interferon induced protein with tetratricopeptide repeats 3) [NCBI Gene 3437] {aka CIG-49, GARG-49, IFI60, IFIT4, IRG2, ISG60}, TMPRSS2 (transmembrane serine protease 2) [NCBI Gene 7113] {aka PRSS10}, SYK (spleen associated tyrosine kinase) [NCBI Gene 6850] {aka IMD82, p72-Syk}, IFNB1 (interferon beta 1) [NCBI Gene 3456] {aka IFB, IFF, IFN-beta, IFNB}, TOR3A (torsin family 3 member A) [NCBI Gene 64222] {aka ADIR, ADIR2}, USP18 (ubiquitin specific peptidase 18) [NCBI Gene 11274] {aka ISG43, PTORCH2, UBP43}, INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}, APOD (apolipoprotein D) [NCBI Gene 347], ACE (angiotensin I converting enzyme) [NCBI Gene 1636] {aka ACE1, CD143, DCP, DCP1}, SLC5A1 (solute carrier family 5 member 1) [NCBI Gene 6523] {aka D22S675, NAGT, SGLT-1, SGLT1}, FGB (fibrinogen beta chain) [NCBI Gene 2244] {aka HEL-S-78p}
- **Diseases:** cystic fibrosis (MESH:D003550), tumor (MESH:D009369), Zika virus (MESH:D000071243), hyperglycemic (MESH:D006944), liver disease (MESH:D008107), hematologic malignancies (MESH:D019337), viral infection (MESH:D014777), Coronavirus (MESH:D018352), Parkinson's disease (MESH:D010300), COVID-19 infection (MESH:D000086382), platelet aggregation (MESH:D001791), rheumatoid arthritis (MESH:D001172), ischemic stroke (MESH:D002544), pneumonia (MESH:D011014), type I diabetes (MESH:D003922), Immuneering's Disease (MESH:D007154), HIV disease (MESH:D015658), hepatic injury (MESH:D056486), respiratory illness (MESH:D012140), immune thrombocytopenic purpura (MESH:D016553), upper respiratory tract infections (MESH:D012141), acute coronary syndrome (MESH:D054058), thrombocytopenia (MESH:D013921), hypertension (MESH:D006973), diabetes mellitus (MESH:D003920), obesity (MESH:D009765), -sensitive potassium (K + ATP) channel on pancreatic beta-cells; anti-diabetic (MESH:C538111), SARS (MESH:D045169), type 2 diabetes mellitus (MESH:D003924), autoimmune diseases (MESH:D001327), R&amp;D (MESH:C580424), Graft vs Host disease (MESH:D006086), heart failure (MESH:D006333), infectious (MESH:D003141), herpes virus (HSV) infections (MESH:D020031), -infection (MESH:D007239), chronic hepatitis C (MESH:D019698), influenza (MESH:D007251),  (MESH:D011024)
- **Chemicals:** cinnarizine (MESH:D002936), Sotagliflozin (MESH:C575681), Captopril (MESH:D002216), Benzathine penicilline (-), Daclatasvir (MESH:C549273), beta-lactam (MESH:D047090), Monopril (MESH:D017328), Benazepril (MESH:C044946), proline (MESH:D011392), Lisinopril (MESH:D017706), Elbasvir (MESH:C000589335), Teicoplanin (MESH:D017334), Orlistat (MESH:D000077403), tyrosine (MESH:D014443), Piperacillin (MESH:D010878), Ombitasvir (MESH:C586094), glucose (MESH:D005947), Nafamostat mesylate (MESH:C032855), ruxolitinib (MESH:C540383), Bictegravir (MESH:C000620396), beta-lactam antibiotic (MESH:D008997), Vitamin E (MESH:D014810), Trandolapril (MESH:C052035), ampicillin (MESH:D000667), Tirofiban (MESH:D000077466), Enalaprilat (MESH:D015773), Glutamine (MESH:D005973), Aleuritic Acid (MESH:C059860), zinc (MESH:D015032), Fosamprenavir (MESH:C426859), poly(A) (MESH:D011061), Ledipasvir (MESH:C586541), Cefotiam Hexetil Hydrochloride (MESH:C067049), Vorapaxar (MESH:C530299), Nateglinide (MESH:D000077715), Camostat Mesilate (MESH:C034532), phenylalanine (MESH:D010649), ramiprilat (MESH:C052549), chloroquine diphosphate (MESH:C023676), sulfhydryl (MESH:D013438), sodium (MESH:D012964), Capecitabine (MESH:D000069287), fosinoprilat (MESH:C046965), Emricasan (MESH:C487112), Ramipril (MESH:D017257), Trifluoroacetate (MESH:D014269), hydroxychloroquine (MESH:D006886), Sulbutiamine (MESH:C031331), heparin (MESH:D006493), Glutathione (MESH:D005978), Brigatinib (MESH:C000598580), amprenavir (MESH:C095108), Ceritinib (MESH:C586847), Argatroban (MESH:C031942), Fostamatinib (MESH:C523665), azithromycin (MESH:D017963),  (MESH:D007703)
- **Species:** Severe acute respiratory syndrome coronavirus 2 (no rank) [taxon 2697049], Zika virus (no rank) [taxon 64320], Homo sapiens (human, species) [taxon 9606], Streptomyces toxytricini (species) [taxon 67369], Chiroptera (bats, order) [taxon 9397], Human immunodeficiency virus 1 (no rank) [taxon 11676], Mus musculus (house mouse, species) [taxon 10090], Gammacoronavirus (genus) [taxon 694013], Severe acute respiratory syndrome-related coronavirus (no rank) [taxon 694009], Betacoronavirus (genus) [taxon 694002], Orthocoronavirinae (subfamily) [taxon 2501931]
- **Cell lines:** MA15 — Homo sapiens (Human), Xeroderma pigmentosum, complementation group C, Finite cell line (CVCL_ZQ80), C57BL/6NJ — Mus musculus (Mouse), Hybridoma (CVCL_KS11)

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC7315012/full.md

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Source: https://tomesphere.com/paper/PMC7315012