Background and Purpose Codonopsis lanceolata (CL) has long been used as
a medicinal herb in East Asian countries to treat inflammatory diseases
of the respiratory system but its antiviral activity has not been
investigated. Here, we evaluated the potential inhibitory activity of CL
extracts and their active compounds on SARS-CoV-2. Experimental Approach
Pseudotyped SARS-CoV-2 entry assay and dose-response curve analysis with
authentic SARS-CoV-2 and recombinant SARS-CoV-2 reporter virus
expressing the nanoluciferase were carried out to investigate the
effects of compounds against SARS-CoV-2 entry into host cells. Filipin
cholesterol staining, SARS-CoV-2 Spike (S)-ACE2 binding assay, and
S-mediated cell fusion assay using time-lapse imaging, flow cytometry,
and split-GFP fusion were conducted to understand the inhibitory
mechanisms. Key Results Lancemaside A (LA), a triterpenoid saponin
isolated from CL, impeded the endosomal entry pathway of SARS-CoV-2 and
its variants including Alpha, Beta, Delta, and Omicron with similar IC50
values of 2.23 ~ 3.37 μM as well as the TMPRSS2-mediated
viral entry pathway with IC50 value of 3.92 μM. LA was also able to
prevent the formation of S-induced multinucleated syncytia.
Mechanically, LA altered the distribution of host cell membrane
cholesterol and blocked the membrane fusion between SARS-CoV-2 and host
cells. Conclusion and implications LA can be a broad-spectrum antiviral
drug not only against SARS-CoV-2 but also against other novel enveloped
viral pathogens that might arise in the future by targeting viral
envelope fusion with the host cell membrane. Keywords SARS-CoV-2,
Omicron, COVID-19, Lancemaside A, triterpenoid saponin, membrane fusion