The antiandrogen enzalutamide downregulates TMPRSS2 and reduces cellular entry of SARS-CoV-2 in human lung cells

D. A. Leach, A. Mohr, E. S. Giotis, E. Cil, A. M. Isac, L. L. Yates, W. S. Barclay, R. M. Zwacka, C. L. Bevan () and G. N. Brooke ()
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D. A. Leach: Imperial College London
A. Mohr: University of Essex
E. S. Giotis: University of Essex
E. Cil: University of Essex
A. M. Isac: University of Essex
L. L. Yates: Imperial College London
W. S. Barclay: Imperial College London
R. M. Zwacka: University of Essex
C. L. Bevan: Imperial College London
G. N. Brooke: Imperial College London

Nature Communications, 2021, vol. 12, issue 1, 1-12

Abstract: Abstract SARS-CoV-2 attacks various organs, most destructively the lung, and cellular entry requires two host cell surface proteins: ACE2 and TMPRSS2. Downregulation of one or both of these is thus a potential therapeutic approach for COVID-19. TMPRSS2 is a known target of the androgen receptor, a ligand-activated transcription factor; androgen receptor activation increases TMPRSS2 levels in various tissues, most notably prostate. We show here that treatment with the antiandrogen enzalutamide—a well-tolerated drug widely used in advanced prostate cancer—reduces TMPRSS2 levels in human lung cells and in mouse lung. Importantly, antiandrogens significantly reduced SARS-CoV-2 entry and infection in lung cells. In support of this experimental data, analysis of existing datasets shows striking co-expression of AR and TMPRSS2, including in specific lung cell types targeted by SARS-CoV-2. Together, the data presented provides strong evidence to support clinical trials to assess the efficacy of antiandrogens as a treatment option for COVID-19.

Date: 2021
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DOI: 10.1038/s41467-021-24342-y

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