SARS-CoV2-mediated suppression of NRF2-signaling reveals potent antiviral and anti-inflammatory activity of 4-octyl-itaconate and dimethyl fumarate
David Olagnier, Ensieh Farahani, Jacob Thyrsted, Julia Blay‐Cadanet, Angela Herengt, Manja Idorn, Alon Schneider Hait, Bruno Hernáez, Alice Knudsen, Marie B. Iversen, Mirjam Schilling, Sofie E. Jørgensen, Michelle M. Thomsen, Line S. Reinert, Michael Lappé, Huy‐Dung Hoang, Victoria H. Gilchrist, Anne Louise Hansen, Rasmus N. Ottosen, Camilla G. Nielsen, Charlotte Møller, Demi van der Horst, Suraj Peri, Siddharth Balachandran, Jinrong Huang, Martin R. Jakobsen, Esben B. Svenningsen, Thomas B. Poulsen, Lydia Bartsch, Anne L. Thielke, Yonglun Luo, Tommy Alain, Jan Rehwinkel, Antonio Alcamı́, John Hiscott, Trine H. Mogensen, Søren R. Paludan, Christian K. Holm
Abstract
Antiviral strategies to inhibit Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) and the pathogenic consequences of COVID-19 are urgently required. Here, we demonstrate that the NRF2 antioxidant gene expression pathway is suppressed in biopsies obtained from COVID-19 patients. Further, we uncover that NRF2 agonists 4-octyl-itaconate (4-OI) and the clinically approved dimethyl fumarate (DMF) induce a cellular antiviral program that potently inhibits replication of SARS-CoV2 across cell lines. The inhibitory effect of 4-OI and DMF extends to the replication of several other pathogenic viruses including Herpes Simplex Virus-1 and-2, Vaccinia virus, and Zika virus through a type I interferon (IFN)-independent mechanism. In addition, 4-OI and DMF limit host inflammatory responses to SARS-CoV2 infection associated with airway COVID-19 pathology. In conclusion, NRF2 agonists 4-OI and DMF induce a distinct IFN-independent antiviral program that is broadly effective in limiting virus replication and in suppressing the pro-inflammatory responses of human pathogenic viruses, including SARS-CoV2.