Could the multiple sclerosis drug dimethyl fumarate help treat coronavirus?

In laboratory experiments, Danish researchers examined the effects of the multiple sclerosis drug dimethyl fumarate on the coronavirus.

The COVID-19 pandemic caused by the SARS-CoV-2 virus underscores the need for a wide range of effective antiviral drugs. Viral infections can cause disease in humans by directly damaging cells in the body and causing an inflammatory response. The SARS-CoV-2 virus causes a severe inflammatory reaction in some patients, which leads to serious illness and can be fatal.

Before the outbreak of the COVID-19 pandemic, researchers at Aarhus University, Denmark, were conducting laboratory tests on a group of antiviral drugs that both inhibit the growth of a wide variety of viruses and have anti-inflammatory effects. With the onset of the pandemic, they began testing the effects of these drugs on SARS-CoV-2. One of the drugs, dimethyl fumarate, is currently used to treat multiple sclerosis, a complex disease in which the body's immune system attacks nerve fibers. The researchers recently published their results in Nature Communications.

Antiviral drugs, which are needed to reduce virus growth and the inflammatory response

The researchers first looked at the effects of 4-octyl itaconate – a drug of the same type as dimethyl fumarate – on reducing the growth of a number of viruses, including herpes, smallpox, and Zika virus, in human cell cultures. After the outbreak of the COVID-19 pandemic, they tested 4-octyl itaconate for the SAR-CoV-2 virus. They found that it inhibited SARS-CoV-2 growth in human cells and reduced inflammatory pathways. Encouraged by these results, they repeated the tests with dimethyl fumarate, a drug already approved for use in multiple sclerosis patients. Dimethyl fumarate showed similar inhibitory effects on SARS-CoV-2 growth in cells and on reducing the cellular inflammatory response.

Dimethyl fumarate shows promise for treatment with coronaviruses

Researchers are encouraged by these initial results, but emphasize that they are laboratory tests rather than clinical studies on patients. "While we are doing basic research, we obviously don't know if the drug (dimethyl fumarate) will work in human infections and it is up to the infectious disease experts to test it. I have to say, however, that I am very optimistic," commented Dr Christian Holm, one of the lead authors of the study.

Dimethyl fumarate has the advantage that it is already being used in multiple sclerosis patients, which means that it can quickly move on to clinical trials. "You can really save a lot of time by testing a drug that has already been approved and tested in a different context," added Dr. Holm added. The researchers hope that dimethyl fumarate will soon be used in human studies.

Written by Julie McShane, MA MB BS

References

1. Olagnier D., Farahani E., Holm C. et al. The SarS-CoV2-mediated suppression of NRF2 signal transmission shows strong antiviral and anti-inflammatory activity of 4-octyl itaconate and dimethyl fumarate. Nature Communications 11, item number: 4938 (2020). https://doi.org/10.1038/s41467-020-18764-3

2. Aarhus University, press release of October 2, 2020. Medicine for multiple sclerosis patients inhibits the coronavirus – at least in a test tube. https://www.eurekalert.org/pub_releases/2020-10/au-mfm100220.php

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