PT  - JOURNAL ARTICLE
AU  - Tianyang Mao
AU  - Benjamin Israelow
AU  - Carolina Lucas
AU  - Chantal B. F. Vogels
AU  - Olga Fedorova
AU  - Mallery I. Breban
AU  - Bridget L. Menasche
AU  - Huiping Dong
AU  - Melissa Linehan
AU  - Yale SARS-CoV-2 Genome Surveillance Initiative
AU  - Craig B. Wilen
AU  - Marie L. Landry
AU  - Nathan D. Grubaugh
AU  - Anna M. Pyle
AU  - Akiko Iwasaki
TI  - A stem-loop RNA RIG-I agonist confers prophylactic and therapeutic protection against acute and chronic SARS-CoV-2 infection in mice
AID  - 10.1101/2021.06.16.448754
DP  - 2021 Jan 01
TA  - bioRxiv
PG  - 2021.06.16.448754
4099  - http://biorxiv.org/content/early/2021/06/17/2021.06.16.448754.short
4100  - http://biorxiv.org/content/early/2021/06/17/2021.06.16.448754.full
AB  - As SARS-CoV-2 continues to cause morbidity and mortality around the world, there is an urgent need for the development of effective medical countermeasures. Here, we assessed the antiviral capacity of a minimal RIG-I agonist, stem-loop RNA 14 (SLR14), in viral control, disease prevention, post-infection therapy, and cross-variant protection in mouse models of SARS-CoV-2 infection. A single dose of SLR14 prevented viral replication in the lower respiratory tract and development of severe disease in a type I interferon (IFN-I) dependent manner. SLR14 demonstrated remarkable protective capacity against lethal SARS-CoV-2 infection when used prophylactically and retained considerable efficacy as a therapeutic agent. In immunodeficient mice carrying chronic SARS-CoV-2 infection, SLR14 elicited near-sterilizing innate immunity by inducing IFN-I responses in the absence of the adaptive immune system. In the context of infection with variants of concern (VOC), SLR14 conferred broad protection and uncovered an IFN-I resistance gradient across emerging VOC. These findings demonstrate the therapeutic potential of SLR14 as a host-directed, broad-spectrum antiviral for early post-exposure treatment and for treatment of chronically infected immunosuppressed patients.Competing Interest StatementA.I. served as a consultant for Spring Discovery, Boehringer Ingelheim, and Adaptive Biotechnologies. A.I., A.M.P., and T.M. filed a patent related to the manuscript as inventors (Application no.: US 2021/0102209). A.I. and A.M.P. are cofounders of RIGImmune. N.D.G. is a consultant for Tempus Labs. Yale University (C.B.W.) has a patent pending related to this work entitled Compounds and Compositions for Treating, Ameliorating, and/or Preventing SARS-CoV-2 Infection and/or Complications Thereof.