A diamidobenzimidazole STING agonist protects against SARS-CoV-2 infection

Humphries, Fiachra; Shmuel-Galia, Liraz; Jiang, Zhaozhao; Wilson, Ruth; Landis, Philip; Ng, Sze-Ling; Parsi, Krishna-Mohan; Maehr, Rene; Cruz, John; Morales-Ramos, Angel; Ramanjulu, Joshi M.; Bertin, John; Pesiridis, G. Scott; Fitzgerald, Katherine A.

Coronaviruses are a family of RNA viruses that cause acute and chronic diseases of the upper and lower respiratory tract in humans and other animals. SARS-CoV-2 is a recently emerged coronavirus that has led to a global pandemic causing a severe respiratory disease known as COVID-19 with significant morbidity and mortality worldwide. The development of antiviral therapeutics are urgently needed while vaccine programs roll out worldwide. Here we describe a diamidobenzimidazole compound, diABZI-4, that activates STING and is highly effective in limiting SARS-CoV-2 replication in cells and animals. diABZI-4 inhibited SARS-CoV-2 replication in lung epithelial cells. Administration of diABZI-4 intranasally before or even after virus infection conferred complete protection from severe respiratory disease in K18-ACE2-transgenic mice infected with SARS-CoV-2. Intranasal delivery of diABZI-4 induced a rapid short-lived activation of STING, leading to transient proinflammatory cytokine production and lymphocyte activation in the lung associated with inhibition of viral replication. Our study supports the use of diABZI-4 as a host-directed therapy which mobilizes antiviral defenses for the treatment and prevention of COVID-19.