Severe acute respiratory syndrome (SARS) is caused by an emergent coronavirus (SARS-CoV), for which there is currently no effective treatment. SARS-CoV mediates receptor binding and entry by its spike (S) glycoprotein, and infection is sensitive to lysosomotropic agents that perturb endosomal pH. We demonstrate here that the lysosomotropic-agent-mediated block to SARSCoV infection is overcome by protease treatment of target-cellassociated virus. In addition, SARS-CoV infection was blocked by specific inhibitors of the pH-sensitive endosomal protease cathepsin L. A cell-free membrane-fusion system demonstrates that engagement of receptor followed by proteolysis is required for SARS-CoV membrane fusion and indicates that cathepsin L is sufficient to activate membrane fusion by SARS-CoV S. These results suggest that SARS-CoV infection results from a unique, three-step process: receptor binding and induced conformational changes in S glycoprotein followed by cathepsin L proteolysis within endosomes. The requirement for cathepsin L proteolysis identifies a previously uncharacterized class of inhibitor for SARSCoV infection.SARS ͉ viral entry ͉ proteolysis ͉ membrane fusion ͉ viral envelope S evere acute respiratory syndrome (SARS) is an acute respiratory illness caused by a newly described coronavirus (SARS-CoV) (1), the result of a zoonosis of a highly related animal coronavirus (2). There continues to be potential for further zoonotic transmission events, leading to the reintroduction of SARS-CoV into the human population. No effective antiviral treatments have been described for SARS, and, although several promising studies are ongoing, there is currently no licensed protective vaccine.SARS-CoV entry into target cells is initiated by engagement of its cellular receptor, angiotensin-converting enzyme 2 (ACE2) by spike (S) glycoprotein (3). Subsequent infection is sensitive to inhibitors of endosomal acidification such as ammonium chloride (4-6), suggesting that SARS-CoV requires a low-pH milieu for infection. On the other hand, S protein can mediate cell-cell fusion at neutral pH (3, 4), indicating that S protein-mediated fusion does not include an absolute requirement for an acidic environment. Given these discordant findings, we hypothesized that cellular factors sensitive to ammonium chloride, such as pH-dependent endosomal proteins, may play a role in mediating SARS-CoV entry. In this study, the requirements for proteases in the activation of viral infectivity and the effect of protease inhibitors on SARS-CoV infection are examined. Our results are consistent with a model in which SARS-CoV employs a unique three-step method for membrane fusion, involving receptorbinding and induced conformational changes in S glycoprotein followed by cathepsin L (CTSL) proteolysis and activation of membrane fusion within endosomes. Cells were maintained in DMEM10 (DMEM supplemented with 10% FBS). A HeLa͞Tva cell line was produced by using pcDNA6-Tva and selection with blasticidin. The 293T cells were transiently transfected wit...