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Drug-induced phospholipidosis confounds drug repurposing for SARS-CoV-2

Tummino, Tia, Rezelj, Veronica, Fischer, Benoit, Fischer, Audrey, o'Donnel, Henry, Monel, Blandine, Vallet, Thomas, Zhang, Ziyang, Alon, Assaf, Lyu, Jiankun, Schadt, Heiko, White, Kris, o'Meara, Matthew, Krogan , Nevan, Shokat, Kevan, Urban, Laszlo, Kruse, Andrew, Garcia-Sastre, Adolfo, Schwarz, Olivier, Moretti, Francesca, Vignuzzi, Marco, Pognan, Francois and Shoichet, Brian (2021) Drug-induced phospholipidosis confounds drug repurposing for SARS-CoV-2. Science. ISSN 0036-8075


Repurposing drugs as treatments for COVID-19 has drawn much attention. Beginning with sigma receptor ligands, and expanding to other drugs from screening in the field, we became concerned that phospholipidosis was a shared mechanism underlying the antiviral activity of many repurposed drugs. For all of the 23 cationic amphiphilic drugs tested, including hydroxychloroquine, azithromycin, amiodarone, and four others already in clinical trials, phospholipidosis was monotonically correlated with antiviral efficacy. Conversely, drugs active against the same targets that did not induce phospholipidosis were not antiviral. Phospholipidosis depends on the physicochemical properties of drugs, and does not reflect specific target-based activities, rather it may be considered a toxic confound in early drug discovery. Early detection of phospholipidosis could eliminate these artifacts, enabling a focus on molecules with therapeutic potential.

Item Type: Article
Keywords: Phospholipidosis SARS-CoV-2 Drug repurposing Confound Cationic-amphiphilic drugs
Date Deposited: 27 Jul 2021 00:45
Last Modified: 27 Jul 2021 00:45


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