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Rapalogs downmodulate intrinsic immunity and promote cell entry of SARS-CoV-2.


ABSTRACT: SARS-CoV-2 infection in immunocompromised individuals is associated with prolonged virus shedding and the evolution of viral variants. Rapamycin and its analogs (rapalogs, including everolimus, temsirolimus, and ridaforolimus) are FDA-approved as mTOR inhibitors in clinical settings such as cancer and autoimmunity. Rapalog use is commonly associated with increased susceptibility to infection, which has been traditionally explained by impaired adaptive immunity. Here, we show that exposure to rapalogs increases susceptibility to SARS-CoV-2 infection in tissue culture and in immunologically naive rodents by antagonizing the cell-intrinsic immune response. By identifying one rapalog (ridaforolimus) lacking this function, we demonstrate that rapalogs promote Spike-mediated entry into cells by triggering the lysosomal degradation of IFITM2 and IFITM3. Rapalogs that promote virus entry inhibit the mTOR-mediated phosphorylation of TFEB, a transcription factor controlling lysosome biogenesis and degradative capacity. In the hamster model of infection, injection of rapamycin four hours prior to virus exposure resulted in elevated virus titers in lungs and accelerated weight loss, while ridaforolimus had milder effects. Furthermore, rapamycin significantly elevated mouse-adapted SARS-CoV-2 titers in lungs of mice. Overall, our findings indicate that preexisting use of certain rapalogs may elevate host susceptibility to SARS-CoV-2 infection and disease by activating a lysosome-mediated suppression of intrinsic immunity.

SUBMITTER: Shi G 

PROVIDER: S-EPMC8057238 | biostudies-literature |

REPOSITORIES: biostudies-literature

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