Abstract
More than one million patients worldwide have been diagnosed with
coronavirus disease 19 (COVID-19) to date (WHO situation report, 8th
April 2020). There is neither a vaccine to prevent infection with the
causative organism, severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2), nor a cure. In the struggle to devise potentially useful
therapeutics in record time, the repurposing of existing drugs is a key
route of action. In this review we argue that the bisbenzylisoquinoline
and calcium channel blocker tetrandrine, originally extracted from the
plant Stephania tetrandra and utilised in traditional Chinese medicine,
could be repurposed to treat COVID-19. We collate and review evidence
for tetrandrine’s putative mechanism of action in viral infection,
specifically its recently discovered antagonism of the two-pore channel
2 (TPC2). Consideration of its pharmacodynamics and pharmacokinetics
suggests that oral tetrandrine at doses currently used in clinical
practice could be an effective agent for the treatment of SARS-CoV-2
infection in humans.