Amphotericin B as antiviral drug: Possible efficacy against COVID-19

Abstract

Since its discovery, amphotericin B (AmB) is still one of the most common first-line choices in treatment pulmonary mycoses for over seventh decades from discovery. AmB which is belonged to the polyene group has a wide spectrum in vitro and in vivo antimicrobial activity against fungi and parasites, resistance to AmB is rare despite extensive use. Recently, some studies focused on the potential antimicrobial action of AmB against some enveloped viruses such as human immunodeficiency virus, Japanese encephalitis virus, and rubella virus. Coronaviruses are enveloped positive-sense RNA nucleic acid viruses that have club-like spikes, characterized by a distinctive replication strategy; they are round and sometimes pleomorphic shapes. COVID-19 is regarding the new genera of coronaviridae that appear the first time in Wuhan, China, in early December 2019. Due to the continuous spreading of the novel COVID-19 with the exponential rise in death numbers, new therapeutic development is urgent, in general, there are no specific antiviral drugs or vaccines for 2019-novel coronavirus. Hence, this review may serve as an impetus for researchers working in the field of medical microbiology, vaccination, and antiviral drug design by discussion the most recent information about the antiviral action of AmB against COVID-19 infection as well as trying to a deep understanding of major properties, mechanisms of action, immune system responses, and antimicrobial efficiency of AmB. Since AmB is expected to alter the structure of the viral envelope, membrane integrity of cells, and internal cellular organelles, besides its other unique properties such as host immunomodulatory effects, so this review suggested that AmB as an effective anti-fungi drug thus may hold the promise of formulating a novel therapeutic option to treat COVID-19.

A connectivity map-based drug repurposing study and integrative analysis of transcriptomic profiling of SARS-CoV-2 infection

“…Besides, some studies have introduced already known antifungal agents as antiviral drugs for COVID-19 treatment. Al-Khikani (2020) suggested amphotericin B, an antifungal drug, as a potential antiviral agent against enveloped viruses. Terbinafine, another antifungal agent with the same mechanism of action with tolnaftate ( https://go.drugbank.com/drugs/DB00857, 2020 ), was also reported as a COVID-19 therapeutic option in some available literature.…”

Polyene Antibiotics Physical Chemistry and Their Effect on Lipid Membranes; Impacting Biological Processes and Medical Applications

“…Natamycin is used to treat blepharitis (Fungal infection of eye), fungal conjunctivitis, and fungal keratitis [ 317 ]. In addition to polyenes’ use as antimycotics and antiparasitics, experimental trials of other therapeutic applications have been reported [ 318 , 319 ].…”

Potent antifungal agents and use of nanocarriers to improve delivery to the infected site: A systematic review

“…Recently, the immunomodulation of AmB has been suggested for action against COVID‐19, as it is able to act on the cholesterol‐like structure of the viral envelope. The removal of the cholesterol‐like envelope reduces the viral load on treatment with AmB [58]. AmB can also weaken the attachment and uptake of enterovirus by host cells [59].…”