Calcium channel blockers reduce severe fever with thrombocytopenia syndrome virus (SFTSV) related fatality

Cell Res. 2019 Sep;29(9):739-753. doi: 10.1038/s41422-019-0214-z. Epub 2019 Aug 23.

Abstract

Severe fever with thrombocytopenia syndrome (SFTS), an emerging tick-borne infectious disease caused by a novel phlebovirus (SFTS virus, SFTSV), was listed among the top 10 priority infectious diseases by the World Health Organization due to its high fatality of 12%-50% and possibility of pandemic transmission. Currently, effective anti-SFTSV intervention remains unavailable. Here, by screening a library of FDA-approved drugs, we found that benidipine hydrochloride, a calcium channel blocker (CCB), inhibited SFTSV replication in vitro. Benidipine hydrochloride was revealed to inhibit virus infection through impairing virus internalization and genome replication. Further experiments showed that a broad panel of CCBs, including nifedipine, inhibited SFTSV infection. The anti-SFTSV effect of these two CCBs was further analyzed in a humanized mouse model in which CCB treatment resulted in reduced viral load and decreased fatality rate. Importantly, by performing a retrospective clinical investigation on a large cohort of 2087 SFTS patients, we revealed that nifedipine administration enhanced virus clearance, improved clinical recovery, and remarkably reduced the case fatality rate by >5-fold. These findings are highly valuable for developing potential host-oriented therapeutics for SFTS and other lethal acute viral infections known to be inhibited by CCBs in vitro.

MeSH terms

  • Animals
  • Calcium Channel Blockers / pharmacology
  • Calcium Channel Blockers / therapeutic use
  • Calcium Channels, L-Type / chemistry
  • Calcium Channels, L-Type / genetics
  • Calcium Channels, L-Type / metabolism
  • Cell Line
  • Chlorocebus aethiops
  • Disease Models, Animal
  • Female
  • Humans
  • Mice
  • Mice, Inbred C57BL
  • Nifedipine / analogs & derivatives
  • Nifedipine / pharmacology
  • Nifedipine / therapeutic use
  • Phlebotomus Fever / drug therapy
  • Phlebotomus Fever / pathology
  • Phlebotomus Fever / virology
  • Phlebovirus / physiology*
  • RNA Interference
  • RNA, Small Interfering / metabolism
  • Retrospective Studies
  • Vero Cells
  • Viral Load
  • Virus Replication / drug effects

Substances

  • CACNA1C protein, human
  • Calcium Channel Blockers
  • Calcium Channels, L-Type
  • RNA, Small Interfering
  • benidipine hydrochloride
  • Nifedipine

Supplementary concepts

  • SFTS phlebovirus