12 phenothrin, membrane fusion 13 Word Count (Abstract): 221 14 Word Count (Text): 4,034 ABSTRACT Lassa virus (LASV) belongs to the Mammarenavirus genus (family 22 Arenaviridae) and causes severe hemorrhagic fever in humans. At present, there are 23 no Food and Drug Administration (FDA)-approved drugs or vaccines specific for 24 LASV. Herein, high-throughput screening of an FDA-approved drug library was 25 performed against LASV entry using a pseudo-type virus enveloping LASV 26 glycoproteins. Two hit drugs, lacidipine and phenothrin, were identified as LASV 27 entry inhibitors in the micromolar range. A mechanistic study revealed that both drugs 28 inhibited LASV entry by blocking low-pH-induced membrane fusion. Moreover, 29 lacidipine irreversibly bound to the LASV glycoprotein complex (GPC), resulting in 30 virucidal activity. Adaptive mutant analyses demonstrated that replacement of T40, 31 located in the ectodomain of the stable-signal peptide (SSP), with lysine (K) conferred 32LASV resistance to lacidipine without apparent loss of the viral growth profile.
33Furthermore, lacidipine showed antiviral activity and specificity against both LASV 34 and the Guanarito virus (GTOV), which is also a category A new world arenavirus.
35Drug-resistant variants indicate that the V36M in ectodomain of SSP mutant and 36 V436A in the transmembrane domain of GP2 mutant conferred GTOV resistance to 37 lacidipine, suggesting that lacidipine might act via a novel mechanism other than 38 calcium inhibition. This study shows that both lacidipine and phenothrin are 39 candidates for LASV therapy, and the membrane-proximal external region of the GPC 40 might provide an entry-targeted platform for inhibitors. 41 42 IMPORTANCE Currently, there is no approved therapy to treat Lassa fever; 43 3 therefore, repurposing of approved drugs will accelerate the development of a 44 therapeutic stratagem. In this study, we screened an FDA-approved library of drugs 45 and identified two drugs, lacidipine and phenothrin, which inhibit Lassa virus entry by 46 blocking low-pH-induced membrane fusion. Additionally, both drugs extended their 47 inhibition against the entry of Guanarito virus, and the viral targets of lacidipine were 48 identified. 49 50 Lassa virus (LASV) is an enveloped, negative-sense, bi-segmented RNA virus 51 belonging to the Mammarenavirus genus (family Arenaviridae) (1). 52 Mammarenaviruses consist of 35 unique species currently recognized by the 53 International Committee on Taxonomy of Viruses. The original classification of 54 mammarenaviruses, based mainly on virus antigenic properties; serological, genetic, 55 and geographical relationships; and the rodent host, divided them into new world 56 (NW) and old world (OW) mammarenaviruses (2). The OW Lassa virus and some 57 NW mammarenaviruses, including the Junín virus (JUNV), Machupo virus (MACV), 58 Guanarito virus (GTOV), and Sabiá virus (SABV), are known to cause severe 59 hemorrhagic fever and are listed as biosafety level (BSL) 4 agents (3, 4). LASV 60 infections caus...