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A glucose-like metabolite deficient in diabetes inhibits cellular entry of SARS-CoV-2

Liangqin Tong1,2,3, Xiaoping Xiao1,2,3, Min Li4

  • 1Tsinghua-Peking Joint Center for Life Sciences, School of Medicine, Tsinghua University, Beijing, China.

Nature Metabolism
|May 9, 2022
PubMed

Insights

Low levels of 1,5-anhydro-D-glucitol (1,5-AG) in diabetes increase SARS-CoV-2 replication. Supplementing 1,5-AG in diabetic individuals may reduce COVID-19 severity by blocking viral entry.

Area of Science:

  • Virology
  • Metabolomics
  • Immunology

Background:

  • COVID-19 severity and mortality are linked to comorbidities like diabetes mellitus.
  • The mechanisms behind increased viral susceptibility in diabetic patients remain unclear.

Purpose of the Study:

  • To identify small-molecule metabolites with antiviral activity against SARS-CoV-2.
  • To investigate the role of 1,5-anhydro-D-glucitol (1,5-AG) in COVID-19 pathogenesis in diabetic individuals.

Main Methods:

  • Screening of human blood metabolites for antiviral properties against SARS-CoV-2.
  • In vitro experiments using serum from diabetic and healthy individuals, with and without 1,5-AG supplementation.
  • In vivo studies using diabetic (db/db) and wild-type mice infected with SARS-CoV-2, with and without 1,5-AG supplementation.
  • Mechanistic studies involving direct binding assays of 1,5-AG to the SARS-CoV-2 spike protein.

Main Results:

  • 1,5-anhydro-D-glucitol (1,5-AG) demonstrated effective antiviral activity against SARS-CoV-2.
  • Serum 1,5-AG levels were significantly lower in diabetic patients.
  • SARS-CoV-2 replication was higher in serum from diabetic patients, an effect reversed by 1,5-AG supplementation.
  • Diabetic mice exhibited higher viral loads and lung damage; 1,5-AG supplementation mitigated these effects.
  • 1,5-AG was found to directly bind the S2 subunit of the SARS-CoV-2 spike protein, inhibiting membrane fusion.

Conclusions:

  • Reduced 1,5-AG levels in diabetes contribute to increased SARS-CoV-2 susceptibility and severity.
  • 1,5-AG inhibits SARS-CoV-2 by blocking virus-host membrane fusion.
  • 1,5-AG supplementation presents a potential therapeutic strategy for managing severe COVID-19 in diabetic patients.

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