Could proton pump inhibitors be re-purposed against SARS-CoV-2? - A
hypothesis based on existing evidences
Abstract
Proton pump inhibitors (PPIs) belong to a well-known class of
pharmaceutical agents which target the gastric epithelial H+/K+ ATPase.
Although the major therapeutic uses of the PPIs are in gastric-acid
related diseases, evidences are suggestive of a pleiotropic nature of
the compounds. They have been used for the treatment of conditions such
as eosinophilic esophagitis and Helicobacter pylori infection, in
addition to their conventional use in gastro-oesophageal reflux disease
and peptic ulcers. The current pandemic of COVID-19 has put forward a
challenge to find treatment options. While multiple studies have been
conducted, and many are currently on-going, we have not been able to
come up with any specific agent against SARS-CoV-2. PPIs have shown
antiviral potencies in various in vivo and in vitro studies. Results
from these studies point toward a promising role of PPIs for infections
caused by Marburg virus, Influenza virus and Rhinovirus to mention a
few. However, neither have they been considered for any clinical trials
nor have any guidelines suggested their re-purposing against SARS-CoV-2
till date. In this review, we discuss the probable pathways and cellular
machineries via which PPIs could show beneficial therapeutic effects
against the novel coronavirus based on the existing evidences.