In Silico Evaluation of Cyclophilin Inhibitors as Potential Treatment for SARS-CoV-2
Abstract The advent of SARS-CoV-2 provoked researchers to propose multiple antiviral strategies to improve patients' outcomes. Studies provide evidence that Cyclosporine A (CsA) decreases SARS-CoV-2 replication in vitro, and decreases mortality rates of COVID-19 patients. CsA binds Cyclophilins, which isomerize prolines, affecting viral protein activity. We investigated the proline composition from various Coronavirus proteomes to identify proteins that may critically rely on cyclophilin’s peptidyl-proline isomerase activity and found the Nucleocapsid (N) protein significantly depends on Cyclophilin A (CyPA). We modeled CyPA and N protein interactions to demonstrate the N protein as a potential indirect therapeutic target of CsA, which we propose may impede coronavirus replication by obstructing nucleocapsid folding. Finally, we analyzed literature and protein-protein interactions, finding evidence that, by inhibiting CyPA, CsA may impact coagulation proteins and hemostasis. Despite CsA’s promising antiviral characteristics, the interactions between cyclophilins and coagulation factors emphasize risk stratification for COVID patients with thrombosis dispositions.