RT Journal Article
SR Electronic
T1 Enantiomers of Chloroquine and Hydroxychloroquine Exhibit Different Activities Against SARS-CoV-2 <em>in vitro</em>, Evidencing <em>S</em>-Hydroxychloroquine as a Potentially Superior Drug for COVID-19
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 2020.05.26.114033
DO 10.1101/2020.05.26.114033
A1 Guanguan Li
A1 Jing Sun
A1 Yingjun Li
A1 Yongjie Shi
A1 Jincun Zhao
A1 Tony Y. Zhang
A1 Xumu Zhang
YR 2020
UL http://biorxiv.org/content/early/2020/07/15/2020.05.26.114033.abstract
AB In all of the clinical trials for COVID-19 conducted thus far and among those ongoing involving chloroquine or hydroxychloroquine, the drug substance used has invariably been chloroquine (CQ) diphosphate or hydroxychloroquine (HCQ) sulfate, i.e., the phosphoric or sulfuric acid salt of a racemic mixture of R- and S-enantiomer (50/50), respectively. As a result, the clinical outcome from previous CQ or HCQ trials were, in fact, the collective manifestation of both R and S-enantiomers with inherent different pharmacodynamic and pharmacokinetic properties, and toxicity liabilities. Our data for the first time demonstrated the stereoselective difference of CQ and HCQ against live SARS-CoV-2 virus in a Biosafety Level 3 laboratory. S-chloroquine (S-CQ) and S-hydroxychloroquine (S-HCQ) were found to be 31% and 60% more active against SARS-CoV-2, as compared to R-CQ and R-HCQ, respectively. With these data and previous work on stereoselective metabolism of CQ and HCQ, we recommend that future clinical studies should employ S-HCQ as a potentially superior drug substance for the treatment of COVID-19 for improved therapeutic index.Competing Interest StatementThe authors have declared no competing interest.