EP4149433A1

EP4149433A1 - Compatible solutes for preventing or treating sars-cov-2 infections

Info

Publication number: EP4149433A1
Application number: EP21725470.5A
Authority: EP
Inventors: Eva Galik; Dieter Oesterhelt
Original assignee: Bitop AG
Current assignee: Bitop AG
Priority date: 2020-05-10
Filing date: 2021-05-10
Publication date: 2023-03-22
Also published as: JP2023526200A; CN115443126A; WO2021228750A1; DE102020112603A1; US20230226056A1

Abstract

The present invention relates to the use of organic and highly water-soluble compatible solutes or of a solute mixture, preferably in the form of an inhalable composition suitable for oropharyngeal, nasal and intravenous administration, in the prevention or treatment of diseases caused by ss(+)RNA viruses of the Coronaviridae family, preferably diseases caused by SARS-CoV-1, SARS-CoV-2, MERS-CoV, HCoV-HKU1, HCoV-OC43, HCoV-NL63 and/or HCoV-229E. Particularly suitable solutes according to the invention are ectoine and its derivatives, glycoin, mannosylglycerate (firoin) and mannosylglyceramide (firoin-A), which, by virtue of their strong water-binding capacity, reduce the binding of the viruses to the receptors of the host cell in the transitional epithelium, e.g. eye, in the inner epithelium, e.g. lung, and in the endothelium and thus reduce or prevent the reproduction of the virus. According to the invention, prevention is made possible by sputum and breath which are less infectious, and treatment and rehabilitation of the affected tissues are made possible by the membrane-protecting properties of the compatible solutes according to the invention.

Description

Compatible solutes for the prevention or treatment of SARS-CoV-2 infections

The present invention relates to the use of organic and highly water-soluble compatible solutes or a mixture of solutes, preferably in the form of an inhalable, oropharyngeal, nasal and intravenous composition, in the prevention or treatment of diseases caused by ss (+) RNA viruses of the Coronavriridae family , preferably those diseases that are caused by SARS-CoV-1, SARS-CoV-2, MERS-CoV, HCoV-HKLH, HCoV-OC43, HCoV-NL63 and / or HCoV-229E. Particularly suitable solutes within the meaning of the invention are ectoin and its derivatives, glycoin, mannosylglycerate (Firoin) and mannosylglyceramide (Firoin-A), which, due to their strong water-binding capacity, bind the viruses to the receptors of the host cell in the transitional epithelium, e.g. the eye, inside Epithelium, for example lungs, and in the endothelium are reduced and thus the multiplication of viruses is reduced or prevented. According to the invention, prevention through a reduced infectious sputum and breath as well as treatment and rehabilitation of the affected tissue through the membrane-protecting properties of the compatible solutes according to the invention are made possible.

The new SARS coronavirus 2 (SARS-CoV-2) has quickly developed into a global challenge. Within a very short time, the spread was declared a pandemic. Although the course of the disease is mild in many to most cases and only shows mild symptoms such as malaise, fever and possibly cough, the disease can develop into acute respiratory distress syndrome (ARDS) and severe acute respiratory syndrome (severe acute respiratory syndrome, SARS). The mortality rate increases with the severity of the disease and can reach up to 49% in critically ill patients. There is currently no targeted treatment of the Covid-19 diseases caused by the Sars-CoV-2 virus, synonymous with "Coronavirus Disease 2019". At the moment, only supportive measures can be used because at the moment there is no effective therapeutic agent against Covid-19 diseases and no vaccination against the SARS-CoV-2 virus is available.

Against this background, the present invention is based on the object of providing a compound, an agent, a medical product and / or a medicament which is used for the prevention and / or treatment of diseases which are triggered by ss (+) RNA viruses of the Coronavriridae family, in particular viral infections and / or inflammations caused by the virus SARS-CoV-1, SARS-CoV-2, MERS-CoV, HCoV-HKU1, HCoV-OC43, HCoV-NL63 and / or HCoV-229E. The task is to prevent the penetration of the aforementioned viruses, in particular SARS-CoV-1, SARS-CoV-2 and / or MERS-CoV, to prevent or reduce in a host cell, where word cells are eukaryotic cells of humans and animals. This is intended to provide a compound, an agent, medical product and / or medicament for use in the prevention and treatment of the aforementioned diseases in humans and animals. In order to identify such compounds, the present invention has the further object of providing a method which identifies precisely those compounds which are suitable for the treatment and prevention of the aforementioned diseases. Another object of the present invention is to provide suitable medical products for individual prevention for daily use as well as an isolated and complementary therapy for the treatment of damaged epithelial tissue and the endothelium. It is therefore a further object to provide suitable formulations and dosage forms.

It has now surprisingly been found that compatible solutes such as ectoin and its derivatives glycoin, mannosylglycerate (Firoin) or mannosylglyceramide (Firoin-A) can solve the above problems, as was shown in the accompanying examples and FIGS. 3-5.

Therefore, an object of the present invention is a compatible solute or mixture of solutes for use in the prevention or treatment of diseases caused by ss (+) RNA viruses of the family Coronavriridae, wherein the at least one compatible solute of organic and highly water-soluble, preferably bio-based, compounds , is preferably selected from hydroxyectoine and ectoine and the derivatives. If “ectoin and / or the derivatives” or “ectoin and / or its derivatives” are mentioned in the present document, this includes all compounds of the formulas I and II.

The general classification of viruses is known to the person skilled in the art. To classify the viruses of the Coronaviridae family considered by the present invention, they are differentiated from the viruses of the Picornaviridae family (order Picornavirales), the Adenoviridae family (disorder unknown) and the Filoviridae family (Mononegavirales order). Viruses of the Picornaviridae family include rhinoviruses that have single-stranded RNA genome positive polarity. Viruses of the family Adenoviridae include adenoviruses based on ds-DNA and viruses of the family Filoviridae, to which e.g. B. the Ebola virus are also single-stranded RNA genomes but with negative polarity. Viruses for the purposes of this invention belong to the Coronaviridae family, which is divided into two subfamilies Coronavirinae and Torovirinae. Coronavirinae are divided into the genera of alpha, beta coronaviruses, which infect only mammals, and gamma and delta coronaviruses, which infect both mammals and birds. E229 and NL63 are human-pathogenic alphacoronaviruses, while OC43 and HKU1 and all new CoVs viruses, including the SARS-CoV2, belong to the genus Betacoronavirus. The present invention therefore also provides the use of at least one compatible solute or mixture of solutes, preferably of ectoin and its derivatives, in which the disease is triggered by an SS (+) RNA virus of the genus Betacoronavirus and / or Alphacoronavirus and preferably by a virus selected from SARS-CoV-1, SARS-CoV-2, MERS-CoV, HCoV-HKlM, HCoV-OC43, HCoV-NL63 and / or HCoV-229E.

The four viruses HCoV-HKlM, HCoV-OC43, HCoV-NL63 and HCoV-229E cause rhinitis, conjunctivitis, pharyngitis, occasionally laryngitis and / or otitis media and thus mainly diseases of the upper respiratory tract. In contrast, the remaining viruses can cause more severe lower respiratory diseases with or without systemic infections and / or inflammation. For the purposes of the invention, therefore, particularly preferred viruses are ARS-CoV (-1), SARS-CoV-2 and / or MERS-CoV.

Each of the above viruses comprises a surface protein bound in the virus envelope, which interacts with specific surface proteins of the host cells, binds to them, whereby the infection of the word cell is ultimately induced (Tay et al.). Therefore, in a particular embodiment of the present invention, at least one compatible solute or a solute mixture, preferably ectoin, is used, in which the ss (+) RNA virus interacts with at least one membrane-bound protein or component thereof on human cells (host cells) and this protein or uses the component of it as a receptor for binding to the cell. In the context of the invention, the at least one solute acts on all surface proteins of human cells which are bound by viral pathogens as receptors through pathogenic surface proteins. In a particular embodiment, the ss (+) RNA virus interacts with a receptor selected from angiotensin-converting enzyme 2 (ACE2), aminopeptidase N (APN) and / or dipeptidyl peptidase 4 (DPP4). These viral receptors interact with various proteins of the viruses for the purposes of the invention, as shown in FIG. 1 by Fang Li 2020. In particular, carboxypeptidases and aminopeptidases and dipeptidyl peptidases other than those already mentioned are also covered by the present invention. "Viral receptors" within the meaning of the invention are all membrane-bound proteins which are recognized by the ss (+) RNA viruses mentioned here as receptors on their word cells, preferably on human cells, particularly preferably on cells of the transitional epithelial tissue, the inner epithelial tissue and / or the endothelium. Therefore, in a special embodiment of the following method according to the invention for identifying potential compatible solutes within the meaning of the invention, the corresponding combinations according to Fang Li 2016 are tested in order to identify the most suitable compatible solute for the respective virus, which consists of organic and highly water-soluble, preferably bio-based, compounds, preferably selected from hydroxyectoine and ectoine and the derivatives. These solutes particularly preferably have a water binding capacity of greater than or equal to 7 mol / mol FhO / solute.

A further object of the present invention is namely a method for the identification of a compatible solute according to the invention for use in the prevention or treatment of diseases caused by ss (+) RNA viruses of the Coronavriridae family, in which the at least one compatible solute from organic and highly water-soluble, preferably bio-based, compounds is selected. The process (synonymous: biological assay) comprises the following steps:

Providing a cell line which has membrane surface proteins as potentially viral receptors, preferably a cell line from Table 5,

Bringing the cells into contact with a compound which is potentially a compatible solute within the meaning of the invention, preferably ectoin and / or another compound of the formula I and / or II, glyceryl glucoside (Glycoin), mannosyl glycerate (Firoin), mannosyl glycramide (Firoin- A), preferably an experimental approach to control without one of the potential solutes, adding a viral receptor binding domain which comprises a measurable signal, preferably a binding domain of the angiotensin-converting enzyme 2 (ACE2), the aminopeptidase N (APN) and / or dipeptidyl peptidase 4 ( DPP4), preferably the S1 protein or another according to Fang Li 2016,

Incubation of the batch, preferably for a sufficient period of time for the binding partners to interact and bind

Recording the signal that can be measured on the cell, preferably a fluorescence signal, and

Determination of a reduced binding between the viral receptor binding domain and the human membrane-bound surface protein.

If a reduction in the signal emanating from the viral protein is measured in the above-mentioned method in comparison to the control carried out, this indicates a reduced binding of the virus. Example 1 demonstrates the functionality of the assay. In the method according to the invention, the cells are preferably incubated with propidium iodide, so that membrane-damaged, preferably dead cells, are subtracted from the measurement signal. The potential compounds are made up of organic and highly water-soluble, preferably bio-based compounds are selected which preferably have a water binding capacity of greater than or equal to 7 mol / mol hhO / solute.

Compatible solutes within the meaning of the invention are preferably screened using the above method. The method according to the invention can be designed in two different embodiments. In a first alternative of an embodiment, compatible solutes with a water binding capacity of greater than or equal to 7 mol / mol hhO / solute are selected in an upstream method, in particular measured by atomic force spectroscopy according to Rouychoudhury et al 2011 and then fed to the biological assay described above. In a second alternative of an embodiment of the method according to the invention, potential solutes are first identified in the aforementioned biological assay and then the water-binding capacity according to Rouychoudhury et al 2011 is determined. In a further embodiment of the method and the alternatives, ectoin is carried along as an internal standard in order to identify compatible solutes according to the invention as measured by ectoin.

A compatible solute according to the invention, preferably according to formula I and / or II, can be of biological (bio-based) origin or it can also be produced synthetically. Bio-based compatible solutes, preferably compounds of the formula I and / or II, can be produced using natural strains (see also Costa et al), e.g. B. Halomonas elongata et al. (Table 1), or using genetically modified microorganisms, e.g. B Corynebacterium glutamicum, produced biotechnologically. The use of genetically modified microorganisms enables the production of larger quantities of compatible solutes according to the invention. Likewise, the synthetic production of compatible solutes according to the invention is advantageous in terms of quantity and cost.

Regardless of the production route, however, the water-binding capacity and the reducing / disruptive effect of the respective compatible solute on the binding between ss (+) RNA viruses and host cells are essential for the purposes of the invention, preferably on the binding between the viral peplomers or spike proteins, preferably the receptor binding domains (RBD), and the viral receptors on the host cell, preferably ACE2, APN and / or DPP4 (see above). Compatible solutes according to the invention have a water binding capacity of greater than or equal to 7 mol / mol H ₂ O / solute, preferably determined according to Rouychoudhury et al 2011.

Synthetically produced compatible solutes, such as ectoine, and ectoine produced by means of biosynthesis differ in several characteristics of the end product. The features include the purity of the end product in relation to residues of the chemicals used for synthetic production, the purity in relation to the enantiomeric purity, odor, color (Hazen number) and processing into a composition according to the invention. A comparative example of a commercially synthetically produced ectoin and a bio-based ectoin shows the following differences:

Ectoins come under the formulas I and II and can be present as optical isomers, diastereomers, racemates, zwitterions, cations or as a mixture of at least two of the aforementioned forms. Isomers include (R, R) -, (R, S) -, (S, S) - and (S, R) -configurations of the compounds of the formula I and the formula II, with an S-enantiomer according to the Fischer projection corresponds to the L-enantiomer and an R-enantiomer corresponds to the D-enantiomer, for example L-ectoine is S-ectoine, D-ectoine is the same. R-ectoin

In a preferred embodiment of the solute or mixture of solutes according to the invention, the at least one compatible solute is in enantiomerically pure form with a purity greater than or equal to 90%, preferably greater than or equal to 95%, greater than or equal to 97%, greater than or equal to 99%, particularly preferably equal to 100% . In relation to the solute mixture, this means that the mixture of two compounds has the respective compounds in enantiomerically pure form and preferably has no contamination of the selected compounds by the isomer.

Enantiomerically pure forms of the solute or mixture of solutes according to the invention particularly preferably have S and / or (S, S) isomers. In a preferred enantiomerically pure solute mixture, S-ectoine and (S, S) -hydroxyectoine are each present with a purity greater than or equal to 90%, greater than or equal to 95%, preferably greater than or equal to 97%, greater than or equal to 99%, particularly preferably equal to 100%. This solute mixture thus preferably has less than or equal to 10% less than or equal to 5%, preferably less than or equal to 3%, less than or equal to 1%, particularly preferably equal to 0%, R-ectoine or (R, S) - / (S, R) - or (R, R) -hydroxyectoine.

In a particular embodiment of the invention, the following racemates are preferred: S-ectoine and R-ectoine,

(S, S) -hydroxyectoin, (S, R) -hydroxyectoin, (R, S) -hydroxyectoin and (R, R) -hydroxyectoin, or

S-homoectoin and R-homoectoin.

In addition to isomers, the invention also relates to diastereomers, racemates, zwitterions, cations and mixtures of the aforementioned compounds. Derivatizations can be carried out with hydroxy, sulfonic acid, carboxy acid derivatives, such as amides, esters, etc., carbonyl, ethers, alkoxy and hydroxyl groups.

In a particular embodiment of the use according to the invention, at least one compatible solute is selected from glyceryl glucoside (Glycoin), glycine betaine, mannosyl glycerate (Firoin), mannosyl glycramide (Firoin-A), ectoin and its derivatives of the formula I and / or II and the physiologically compatible ones Salts, amides and esters of the aforementioned compounds, where in formula I and in formula II

R1 = H or alkyl,

R2 = H, COOH, COO-alkyl or CO-NH-R5,

R3 and R4 each independently of one another H or OH,

R5 = H, alkyl, an amino acid residue, dipeptide residue or tripeptide residue n = 1, 2 or 3,

Alkyl = an alkyl radical with C1-C4 carbon atoms. Likewise preferred compatible solutes within the meaning of the invention are compounds from the group comprising ectoin and derivatives thereof, glycoin (glyceryl glucoside), L-proline, mannosylglycerate, N-acetyl-diaminobutyric acid (NADA), trimethylamine N-oxide (TMAO) and / or Glycine betaine. Preferred derivatives of ectoine include S / R-ectoine, (S, S) / (R, R) -hydroxyectoine, (S, S) / (R, R) -hydroxyectoine and S-homoectoine, and the physiologically acceptable salts, amides and esters of the foregoing compounds.

In the context of the invention, a solute mixture of at least two of the aforementioned compounds is also used, preferably a solute mixture comprising at least two compounds according to formula I and / or according to formula II. The respective compatible solute according to formula I or II is preferably in enantiomerically pure form with a Purity greater than or equal to 90%. A particularly preferred solute mixture within the meaning of the invention of compounds of the formula I or II contains, based on the sum of all compounds with a total content of 100% by weight, greater than or equal to 85% by weight of S-ectoin and less than or equal to 15% by weight % (S, S) - Hydroxyectoin.

In a particular embodiment, compatible solutes according to the invention are bio-based, bio-based being understood to mean that the compound has a biological origin. Biological sources of solutes according to the invention include, for example, from algae, fungi, phototrophic bacteria, methanogenic bacteria, Actinopolyspora halophila, Gammaproteobacteria, Nocardiopsis sp., Brevibacteria, gram-positive cocci, many bacilli, algae, some bacilli and related species (Planococcus citreus), Staphylococcuscus sp., strain M96 / 12b, Sporosarcina halophila, methanogenic bacteria (ß-glutamine, Ne-acetyl-ß-lysine), Ectothiorhodospira marismortui (CGA), other anoxigenic phototrophic bacteria, Azospirillum brasilense, Rhizobium meliloti and many more. Some examples are summarized in Table 1 below.

A further summary of compatible solutes within the meaning of the invention is contained in Costa et al 1998. The compounds listed there from page 122 to page 141 are hereby incorporated as part of the present invention. The solutes mentioned there are suitable for use according to the invention, preferably those with a water binding capacity of greater than or equal to 7 mol / mol FhO / solute, preferably determined according to Rouychoudhury et al 2011. Table 1: Example of compatible solutes

For the purposes of the invention, therefore, compatible solutes are compounds from the classes of sugars, amino acids and polyols which are characterized by OH groups and / or amino and / or amide groups which have a high reactivity with water. These also include betaines, compounds of the formula I / II, proline, carboxamides, NAc-O, NAc-L and mannosyl glycerate.

Thus, a compatible solute according to the invention (synonym: solute) is an organic and highly water-soluble, preferably bio-based, compound which, in a particular embodiment, has a water-binding capacity of greater than or equal to 7 mol / mol FhO / solute. The water-binding capacity is preferably greater than or equal to 7.2, greater than or equal to 7.5, greater than or equal to 7.7, greater than or equal to 8.0, greater than or equal to 8.2, greater than or equal to 8.5, greater than or equal to 8.7, greater than or equal to 9, in each case as [mol / mol FfeO / solute]. The preferred solute in the context of the invention is ectoin with a water binding capacity greater than or equal to 9.0 mol / mol FhO / solute.

The respectively preferred solute or solute mixture within the meaning of the invention can be used alone or in combination with other physiological solutions, e.g. various infusion solutions used in clinics, NaCl solutions.

The solutes according to the invention, preferred ectoin and / or its derivatives or a composition containing the at least one preferred solute, are used in the prevention or treatment of viral diseases which include infection and / or inflammation of the transitional epithelial tissue and / or internal epithelial tissue. In a particular embodiment of the use according to the invention, the viral disease comprises an infection and / or inflammation of the endothelium.

Viral diseases in the context of the invention include an infection and / or inflammation of the endothelium, in particular the endothelium of the eye, the upper and / or lower respiratory tract, io the trachea, the lungs, the bronchi, the bronchial tree, the heart, the endothelium of the heart, blood-lymphatic vessels, brain vessels, kidney vessels, esophagus, gastric mucosa and / or thin / intestinal mucosa. Therefore, within the meaning of the invention, such viral diseases are included, each triggered by SARS-CoV-1, SARS-CoV-2, MERS-CoV, HC0V-HKUI, HCoV-OC43, HCoV-NL63 and / or HCoV-229E, the one Show infection and / or inflammation of the upper and / or lower airways, windpipe, lungs, bronchi and / or bronchial tree. These diseases are characterized and detectable in that the tissues affected in the aforementioned organs were infected by the virus and thus at least one component (viral RNA) of the virus can be detected in these tissues. Affected tissue within the meaning of the invention include

Transitional epithelial tissue including upper respiratory tract, oral cavity, oral mucosa, gums, tongue, tongue mucosa, nasal cavity, paranasal sinuses, nasal mucosa, eye, vocal folds, pharynx and genitals and / or inner epithelial tissue including lower respiratory tract, trachea, bronchi, bronchial tree, lungs, inner endothelium tissue continuous endothelium, in particular continuous endothelium of the lungs and heart, endothelium of the heart, blood and lymph vessels, esophagus, gastric mucosa and / or thin / intestinal mucosa.

Table 2: Epithelial tissue within the meaning of the invention Treatment and prevention within the meaning of the invention is to be interpreted broadly and also includes support for the rehabilitation of tissue damaged by the virus. This is particularly relevant when immunization by vaccines is the priority and the tissue damaged by the virus is to be rehabilitated using a solute according to the invention using a combination according to the invention, or the tissue is to be protected preventively.

In a particular embodiment of the use according to the invention, the at least one solute or mixture of solutes, preferably in the form of a composition according to the invention, is used in the prevention or treatment of diseases of the respiratory tract caused by the aforementioned viruses, preferably by SARS-Cov-2. Compositions according to the invention contain at least one compatible solute, which is selected from organic and highly water-soluble, preferably bio-based, compounds, preferably from hydroxyectoine and ectoine and the derivatives, and preferably have a water-binding capacity of greater than or equal to 7 mol / mol FhO / solute.

Viral diseases of the respiratory tract within the meaning of the invention include not only endothelial infections and / or inflammations, but also infections and / or inflammations of the alveolar epithelial cells. Viral diseases within the meaning of the invention which are caused by ss (+) - RNA viruses, preferably by SARS-Cov-2, include pneumonia, SARS (Severe Acute Respiratory Syndrome) and organ-wide damage to the aforementioned tissues. SARS-Cov-2 or COVID-19 patients have typical symptoms such as fever, malaise, tiredness and cough. Most adults or children infected with SARS-CoV-2 have mild flu-like symptoms. In some patients, especially those in the risk groups, these can quickly lead to acute respiratory distress syndrome (SARS), respiratory failure, multiple organ failure and even death.

Other symptoms are cough, sputum production, shortness of breath, sore throat and headache. Some patients have gastrointestinal symptoms with diarrhea and vomiting. Fever and cough are the dominant symptoms, while upper respiratory and gastrointestinal symptoms were rare.

The products according to the invention are particularly suitable for prevention or treatment in patients with the aforementioned symptoms of the upper and / or lower respiratory tract. Inhalable compositions and products are particularly preferred (FIG. 6). Likewise for patients with cough, sputum production and / or sore throat, the products according to the invention (FIG. 6) are preferred which contain at least one compatible solute which is made up of organic and highly water-soluble, preferably bio-based, compounds, preferably from hydroxyectoine, ectoine and / or the derivatives is selected. These compatible solutes particularly preferably have a water binding capacity of greater than or equal to 7 mol / mol hhO / solute. These products fulfill two functions. On the one hand, they support the rehabilitation of the affected tissue (see Table 2) and in this way treat the viral disease within the meaning of the invention. On the other hand, protection of the environment is achieved as a result, since a low level of infectious sputum and breath is achieved.

A particular embodiment of the use according to the invention is the use of the at least one compatible solute, preferably ectoin and / or its derivatives, in the treatment or prevention of systemic endothelliitis, such as that caused by SARS-Cov-2. The so-called Covid-19 endotheliitis is characterized by multiple organ damage and in particular by diffuse endothelial inflammation in the heart, liver and kidneys. Cardiovascular problems are also described. In these patients it is found that SARS-CoV-2 directly causes inflammation in the blood vessels. Other organs can have infections and / or inflammations.

In a particular embodiment of the use according to the invention of the at least one compatible solute or mixture of solutes, preferably contained in a composition according to the invention, the at least one compatible solute, preferably ectoine, reduces or prevents the unfolding and / or opening of the viral protein suitable for binding to the human receptor of the ss (+) RNA virus. The viral proteins, also called peplomers, of the ss (+) RNA viruses according to the invention include the so-called S1 spike proteins of the viruses according to the invention and in particular the respective binding domains comprising domain A of HCoV-OC43 S, domain B of SARS-CoV S, which interacts with the ACE2 receptor, HCoV-NL63 S, MERS-CoV S and HCoV-229E S (Tortoricia 2019). The disruptive effect of the solutes according to the invention on the interaction and binding between the peplomers and the viral receptors is shown in FIGS.

The viruses have the peplomers (spike proteins) on the virus envelope, the peplomer comprising a glycosylated S protein (spikes protein, 180 to 220 kDa), which forms a membrane-anchored trimer. These parts carry both (S1) the receptor binding domain (RBD), with which the virus can dock onto a cell, and (S2) a subunit which, as a fusion protein (FP), causes the virus envelope and cell membrane to fuse . The receptor binding domain (RBD) comprises an N-terminal domain (NTD) and a C-terminal domain (CTD), both of which can function as receptor binding domains and bind different proteins and sugars. The spike protein (S protein) of SARS-CoV-2 plays a central role in viral infection and pathogenesis. S1 recognizes and binds to host receptors, and subsequent conformational changes in S2 facilitate fusion between the virus envelope and the cell membrane. The mechanism of infection lies in the steps of binding the viral receptor-binding domain to the receptor of the host cell, followed by fusion of the membranes, penetration of the viral RNA into the host cell, multiplication of the viral RNA using the cellular machinery of the host cell and The virus escapes from the word cell

In a preferred embodiment of the use according to the invention, the at least one compatible solute or mixture of solutes, preferably ectoin and / or its derivatives, preferably contained in a composition according to the invention, reduces or prevents the fusion of the viral membranes with the membrane of the attacked cell, in particular an epithelial cell and / or endothelial cell. In a particular embodiment of the use according to the invention, the at least one compatible solute, preferably ectoin and / or its derivatives, preferably bio-based, preferably contained in a composition according to the invention, reduces the multiplication of the ss (+) RNA virus, in particular in the word cell or prevented.

The surprising effect of compatible solutes according to the invention is shown in, inter alia, Example 3 and in FIGS. 4 and 5. It could be shown significantly that A549 cells, which were preincubated with ectoine, had less or no bound viral Cov2 S1 protein on the cell surface. This clear and strong effect of ectoine is surprising and reproducible. It is also shown that the effect depends on the concentration of the ectoins. It is thus surprisingly shown that compatible solutes, depending on their concentration, have a significant protective effect on the heart cells of ss (+) - RNA viruses. This effect of solutes according to the invention enables prevention and treatment within the meaning of the present invention.

The observed effects of ectoine are currently based on a theory that is attributed to the protein and membrane stabilizing effects known for ectoine. It is assumed that compatible solutes according to the invention accumulate around the respective binding partner and shield by a hydration shell. Without being restricted to this theory, it is assumed that the hydrate shell of the solutes, which are supposed to attach themselves to the viral peplomers (spike proteins), stabilize the conformation of the folded or "closed" protein and in this way the unfolding or " Open “the spike protein and so that the accessibility of the receptor binding domain is reduced or prevented. As a result, the receptor binding domain of the Cov2 S1 protein and the “viral receptor” of the host cell do not come close enough to prevent binding.

A similar effect can also be assumed on the active side of the host cell. Here the solute according to the invention, preferably ectoine and / or its derivatives, appears to attach to the viral receptors. This achieves a double shielding of the receptor binding domain on the virus and of the viral receptor on the host cell, which leads to a reduction in the binding between these binding partners. It cannot be ruled out that the same applies to the cellular serine protease TMPRSS2, which is required for processing the SARS-CoV-2 spike protein in order to initiate the fusion (Hoffmann et al. 2020).

Therefore, in a particular embodiment of the use according to the invention of the at least one compatible solute or mixture of solutes, preferably ectoin and / or its derivative, preferably contained in a composition according to the invention, the membrane of the transitional epithelia, the inner epithelial tissue and / or the endothelium is shielded.

The surface structures on human cells (viral receptors) required by the ss (+) - RNA viruses according to the invention as binding domains are preferably shielded. Particularly preferred are the binding domains of the viral receptors, comprising the angiotensin converting enzyme 2 (ACE2), the aminopeptidase N (APN) and / or the dipeptidyl peptidase 4 (DPP4), through the at least one compatible solute or mixture of solutes, preferably ectoin and / or its Derivatives, shielded. The angiotensin converting enzyme 2 (ACE2) receptor is expressed in many organs, including the lungs, heart, liver, intestines, eyes and kidneys and used there by the viruses mentioned in the context of the invention as a receptor for binding to the respective cell.

Without being bound to it, one thesis on the mechanism of action is that by shielding membrane-bound surface proteins on the host cell, which the virus uses as a receptor to achieve a binding to the human cell ("viral receptor"), a binding of the virus and thus a viral infection of the cell is reduced or prevented. In particular, the sugar residues of the “viral receptor” required for the virus to bind are shielded. One thesis on the mechanism of action is that the shielding is achieved through the formation of hydrogen bridges between the OH groups of the viral receptors on the host cell and the solutes according to the invention, preferably ectoin. The strenght The water-binding capacity for ectoine is known, so that it appears reasonable to add the solutes and consequently to recruit water molecules to form at least one or more hydration shells. This would mean that, due to a lack of interaction between the binding partners, there would be no binding and thus ultimately no fusion of the membranes. On the basis of this theory, the prevention of the aforementioned steps would lead, according to the invention, to the prevention or reduction of the multiplication of the virus in the host cell. This would stop and / or alleviate the course of the viral diseases within the meaning of the invention, including infections and / or inflammations of the transitional epithelium, inner epithelium and endothelium. This treats a SARS-CoV-2 infection or prevents the onset of typical symptoms. This is the preferred way of treating or preventing Covid 19 endothelialitis.

Therefore, in a particular embodiment of the use according to the invention of the compatible solute or mixture of solutes, the membrane of the transitional epithelia, the inner epithelial tissue and / or the endothelium is shielded with compatible solutes.

In a further embodiment of the use according to the invention of the at least one compatible solute or mixture of solutes, preferably ectoin and / or its derivatives, the at least one solute or mixture of solutes is used in combination with anti-viral compounds, anti-inflammatory compounds, interleukin blockers, anti-inflammatory anti-cytokines , Inhibitors of the viral receptors and / or vaccines administered.

The group of the aforementioned anti-viral compounds includes antibodies and neutralizing antibodies selected from the group comprising casirivimab, imdevimab, bamlanivimab, etesevimab, VIR-7831, VIR-7832, tocilizumab, sarilumab, adalimumab, siltuximab, BTN162b2 (BioNtech / Pfizer), an ACE2-Fc fused to immunoglobulin and CR3022. Other anti-cytokine therapies for use in the treatment or prevention of diseases caused by ss (+) RNA viruses include etanercept, infliximab, golimumab, and certolizumab pegol.

The group of anti-viral compounds (antivirals) includes antivirals that are also used against other pathogens of the Coronavriridae family, the SARS-CoV-1, SARS-CoV-2, MERS-CoV, HCoV-HKLH, HCoV-OC43, HCoV- Including NL63 and / or HCoV-229E viruses. Known antivirals, which can be combined with ectoin and / or one of a derivatives, are selected from favipiravir, lopinavir, ritonavir, acyclovir, ganciclovir, ribavirin, foscavir (Foscarnet), penciclovir, alisporivir, remdesivir, molnupiravir (4482 2801), ivermectin, umifenovir, oseltamivir, ASC09F and galidesivir. The antiviral is preferably selected from acyclovir, ganciclovir, ribavirin, foscavir (Foscarnet), remdesivir, molnupiravir (4482 / El DD-2801) and ivermectin.

The group of anti-inflammatory compounds includes paracetamol, ibuprofen, immunoglobulin, IL-1 blockers, IL-6 inhibitors, tumor necrosis factors (e.g. adalimumab).

The group of inhibitors includes helicase inhibitors, complementary inhibitors (rheumatoid drugs), protease inhibitors, indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Fortovase), renin-angiotensin system (RAS) inhibitors, neuraminidase inhibitors (SARSiv) virus), , Zanamivir (Relenza), reverse transcriptase inhibitors (SARS virus), lamivudine (Epivir), and zidovudine (Retrovir). Ectoin and / or one of the derivatives described here is preferably combined with neuraminidase inhibitors or reverse transcriptase inhibitors, oseltamivir, zanamivir, lamivudine and zidovudine. Ectoin and / or one of the derivatives described here is particularly preferably combined with neuraminidase inhibitors or reverse transcriptase inhibitors.

Janus kinase inhibitors (JKI), which comprise baricitinib + remdesivir, ruxolitinib, tofacitinib and fedratinib, form another group. Other JKIs are the approved products oclacitinib, peficitinib, upadacitinib and filgotinib as well as the not yet approved products cerdulatinib, lestaurtinib, gandotinib, momelotinib, pacritinib, abrocitinib and deucravacitinib. Another group are the Bruton's tyrosine kinase inhibitors, which include acalabrutinib, ibrutinib and zanubrutinib, as well as the drugs spebrutinib, fenebrutinib, HM71224, ABBV-105 and ONO-4059, which are still in development.

The group of interferons includes interferon a- 2a (Roferon), interferon a- 2b (intron A), interferon a- nl (Wellferon), interferon a - n3 (Alferon), interferon ß-1a (Rebif) and interferon ß-1b (Betaferon). The group of interleukin blockers (immunosuppressors / immunodepressants) include dexamethasone, hydrocortisone, colchicine, fluvoxamine, anakinra (interleukin (IL) - 1 inhibitor) and interferon beta.

A combination according to the invention enables a combination therapy, for example an acute treatment to protect the still intact tissue, to support the rehabilitation of the already attacked tissue, to reduce the infectious breath / sputum, in each case in combination with an immunizing therapy with a vaccine. The combination of ectoin and one of the anti-viral compounds, anti-inflammatory compounds, interleukin blockers, anti-inflammatory anti-cytokines, inhibitors of the viral receptors and / or vaccines described here can take place at the same time, one after the other or also with a time delay. A combination therapy thus comprises two of the different compounds or active ingredients without being restricted to simultaneous administration. In one embodiment, the respective combination is present in a preparation as a mixture of one of the compounds described here and ectoin and / or one of the derivatives described here or as a combination of separate preparations. A separate preparation includes any spatial separation of the selected combination so that mixing of ectoine and the selected compound is prevented during storage,

One embodiment is a preparation in the form of a two-chamber system, in which ectoin and / or one of the derivatives described here is present in one chamber and one of the compounds described here is present in the second chamber. The two-chamber system preferably comprises an inhalable formulation in each case. An inhalable formulation is therefore to be understood as being suitable for taking up the active ingredient (s) into the lungs using suitable aids. This embodiment is particularly preferably suitable for use in a combination therapy for the treatment or prevention of diseases caused by ss (+) RNA viruses of the Coronavriridae family, preferably SARS-Cov-2, the combination being administered to the patient as an inhalant (see, for example, Fig. 5). This formulation can be administered through the lungs using an inhaler (PMDI or DPI) or nebulizer (mechanical or electric or pneumatic).

Alternative embodiments for inhalation as part of a combination therapy comprise separate chambers or cartridges which are alternately administered and inhaled according to instructions. Other routes of administration and formulations which are suitable for combination therapy within the meaning of this invention are shown in FIG. Thus, other embodiments of the combination therapy comprise an inhalant containing ectoine and / or one of the derivatives described here and another formulation of one of the anti-viral compounds described here, anti-inflammatory compounds, interleukin blockers, anti-inflammatory anti-cytokines, inhibitors of the viral receptors and / or Vaccines.

For example, ectoin and / or one of the derivatives described here with interferon beta can be provided as an inhalant. The inhalant can be a mixture of the preparations mentioned, or these are present separately in a two-chamber system or in separate ones Cartridges. In the first case, both preparations are inhaled in parallel or alternately from the two-chamber system. In the case of separate cartridges, it may be necessary to combine the cartridges alternately with a suitable tool and use them accordingly.

A combination therapy also comprises ectoin and / or one of the derivatives described here in the form of a nose, mouth and / or throat spray and one of the compounds described here.

Another embodiment of a combination is the use of the at least one solute or mixture of solutes according to the invention, preferably ectoin, with a corticoid preparation. This combination is preferably used for the treatment of viral diseases according to the invention of the lower respiratory tract, especially the lungs, particularly preferably in the form of an inhalant according to the invention.

In a further embodiment of the use according to the invention of the compatible solute or mixture of solutes, the at least one solute or mixture of solutes, preferably ectoin and / or its derivatives, preferably containing in a composition according to the invention, is used in patients who come from regions with high levels of particulate matter, an occupational group with high levels of particulate matter, pre-existing vascular disease and / or chronic respiratory diseases.

Special patient groups or patients at risk (Wang et al 2020) are patients with weakened endothelial function, such as B. patients with diabetes, heart failure, hypertension, coronary artery disease, cardiovascular impairment, peripheral vascular disease, cerebrovascular disease, cerebrovascular insufficiency, immunodeficiency and / or chronic obstructive pulmonary disease (COPD).

With regard to previous illnesses of the respiratory tract, smokers and people who are particularly exposed to particulate matter, asthmatics and the like also belong to the risk group (Zhao et al. 2020). In particular, it has been shown that the virus leads to a more severe course of the infection in people who are exposed to fine dust pollution than in people who are less exposed (Xiao Wu et al 2020).

Another subject matter is a composition for use in the prevention or treatment of diseases caused by ss (+) RNA viruses of the Coronavriridae family, in which at least one compatible solute or a solute mixture within the meaning of the present invention Invention is included. The composition preferably contains a solute selected from the group comprising glyceryl glucoside (Glycoin), mannosyl glycerate (Firoin), mannosyl glycramide (Firoin-A), ectoin and compounds of the formula I and / or II. Ectoin, hydroxyectoin and glycoin are particularly preferred.

In a further embodiment of the composition according to the invention comprising at least one solute or solute mixture, the at least one compatible solute or solute mixture is present in the composition with a proportion of greater than or equal to 0.0001% by weight to less than or equal to 70% by weight, based on the total content of the composition. Further embodiments of the composition according to the invention contain greater than or equal to 0.001% by weight, greater than or equal to 0.01% by weight, greater than or equal to 0.1% by weight, greater than or equal to 1.0% by weight, greater than or equal to 1.5% by weight %, greater than or equal to 2.0% by weight, greater than or equal to 2.5% by weight, greater than or equal to 3.0% by weight, in each case up to less than or equal to 65% by weight, less than or equal to 60% by weight , less than or equal to 55% by weight, less than or equal to 50% by weight, less than or equal to 45% by weight, less than or equal to 40% by weight, less than or equal to 35% by weight, less than or equal to 30% by weight, less equal to 25% by weight, less than or equal to 20% by weight.

Preferred proportions of the solute according to the invention in the composition depend on the particular formulation. A composition according to the invention preferably contains at least one compatible solute or the solute mixture, preferably ectoin and / or its derivatives, in a proportion of greater than or equal to 0.5% by weight to less than or equal to 15% by weight, preferably greater than or equal to 0.5% by weight % to less than or equal to 10% by weight, greater than or equal to 0.5% by weight to less than or equal to 5.0% by weight, particularly preferably greater than or equal to 0.5% by weight to less than or equal to 4.0% by weight .-%, based on the total content of the composition. The above ranges preferably apply to an infusion solution within the meaning of the present invention.

An embodiment of the inhalation solution according to the invention contains a proportion of greater than or equal to 2% by weight to less than or equal to 25% by weight, greater than or equal to 5% by weight to less than or equal to 25% by weight, preferably greater than or equal to 8% by weight less than or equal to 22% by weight, greater than or equal to 10% by weight to less than or equal to 20% by weight and preferably greater than or equal to 10% by weight to less than or equal to 18% by weight.

In another embodiment of the inhalation solution according to the invention, lower concentrations of the at least one solute or mixture of solutes according to the invention, preferably ectoin and / or its derivatives, are used. In this embodiment, repeated applications of the contents are preferred in order to achieve a comparably high dose even with a lower concentration than with a single application. which Concentration the inhalant should have depends on the patient's condition, the desired therapy, any previous damage to the lungs and / or other criteria such as B. Age and general constitution of the patient, which can influence the inhalation process itself.

In particular in the case of an already damaged lung, which has a lower absorption capacity compared to a healthy lung, the use of an inhalant with a lower proportion of the at least one solute according to the invention makes sense.

Another embodiment of an inhalation solution according to the invention therefore has a proportion greater than or equal to 0.5% by weight to less than or equal to 20% by weight, preferably greater than or equal to 1.3% by weight to less than or equal to 18% by weight, preferably greater equal to 2% by weight to less than or equal to 15% by weight and particularly preferably greater than or equal to 3% by weight to less than or equal to 10% by weight.

In a particular embodiment of the use of the invention

Composition, this is i) in solid forms comprising powder, granules, capsules, lozenges and effervescent tablets, ii) in liquid forms comprising solution, injection, infusion and suspension, and / or iii) as a mixture comprising spray, aerosols and inhalant.

The composition according to the invention can be administered topically (e.g. to the eye), orally, nasally, intravenously, inhalatively, intratracheally and / or buccally (e.g. lozenge). The composition according to the invention is preferably administered orally, intratracheally or by inhalation. It can be a dry inhaler or an aerosol. Solutions are preferably used for the mouth, nose, throat and eyes in the form of drops or spray. A combination is very possible, depending on the therapy required.

In a particular embodiment of the use according to the invention

Composition, this is in liquid form as an infusion solution or in liquid form which is suitable for use with a nebuliser and / or respirator.

For a maximally saturated solute solution, concentrations are preferred which are just below the solubility limit of the respective solute. Such a highly concentrated solute solution can be used as a starting solution for the preparation of the solution required on site. In this way, depending on the administration required, the condition (previous illnesses, age, etc.) of the patient and / or the therapy aimed at, individual solutions can be diluted. This is particularly advantageous when not differently concentrated solutions can be stored. A maximum solubility of about 620 g / L at 40 ° C and about 550 g / L at 25 ° C was determined for ectoin.

An infusion solution is preferably administered at approximate body temperature. An average infusion bag has a volume of 500 ml. Based on a single dose of the full volume of an infusion bag, the infusion solution has a maximum concentration of 4% (isotonic) so that the body does not suffer an osmotic shock. Repeated administration can be used, but depends on the doctor's decision.

The composition according to the invention is preferably used in the prevention or treatment of diseases caused by ss (+) RNA viruses of the Coronavriridae family, an infusion being administered in combination with an inhalant.

In particular, a medical product (e.g. FIG. 6) that can be self-administered in between is the subject of the present invention. It is well known that healthcare workers in particular are at high risk. This includes doctors and nursing staff in hospitals and staff in other facilities such as retirement homes, fire departments, kindergartens and schools. The risk can be reduced by using a nasal spray, eye drops, lozenge, mouth rinse and / or mouth sprays according to the invention. This significantly reduces the risk of droplet infection and protects the caring and treating people.

Possible products, in particular medical products, can be subdivided into the following applications: lungs, nose, mouth / throat and eye, as shown in FIG. 6. Each of the applications shown in FIG. 6 can be combined with the at least one solute according to the invention or a solute mixture. Fig. 6 is not an exhaustive list, but only the most frequently used products. For the purposes of the invention, these are suitable for use in the prevention and treatment of diseases caused by ss (+) - RNA viruses.

Another object of the present invention is a kit comprising at least one ready-to-use composition within the meaning of the invention for inhalation, preferably in ampoules or disposable cartridges, and a device, preferably for the immediate and controlled administration of the composition, in particular by inhalation. Another object of the present invention is the use of a composition within the meaning of the invention in a device for the controlled delivery of the composition, the device being suitable for generating aerosols of the composition, allowing inhalation of the composition via the mouth and / or nose, a metered dose Ensures delivery of a defined spray of a liquid or dry composition, ensures a dosed delivery of a liquid composition into the eyes, and / or enables the composition to be sprayed into the mouth, throat and / or nasal cavity.

Preferably, the device, preferably electronically controlled, achieves an aerosol particle size VMD (Volumetry Median Diameter) in a range from greater than or equal to 3 pm to less than or equal to 7 pm, whereby improved inhalation is achieved. Particle sizes in a range from greater than or equal to 3.0 μm to less than or equal to are particularly preferred

6.5 pm, greater than or equal to 3.0 pm to less than or equal to 6.0 pm, greater than or equal to 3.0 pm to less than or equal to

5.5 pm, greater than or equal to 3.0 pm to less than or equal to 5.0 pm, greater than or equal to 3.0 pm to less than or equal to

4.5 pm, greater than or equal to 3.5 pm to less than or equal to 5.0 pm, greater than or equal to 4.0 pm to less than or equal to

5.0 pm, each with a standard deviation of +/- 0.005-0.1 pm.

In one embodiment of the aforementioned device, a continuous rate of 0.5 ml_ ectoin / min is delivered. This results in a delivery of 20 mg / min of ectoine, starting from a 1.3% ectoine inhalation solution.

Description of the figures

Fig.1 Gating strategy for excluding dead cells from the analysis. A) FL1 shows the green fluorescence resulting from the detection of cell-bound SARS-Cov-2 S1. Dead cells were counterstained with propidium iodide. The staining of dead cells is visible through a shift on the FL2 axis. Thus cells in gate R2 are living cells. B) The cells in gate R2 were plotted as a histogram and the mean fluorescence intensity of these cells was determined.

Fig. 2 Detection of the binding of the Cov2 S1 protein to A549 cells by means of flow cytometry. The mean fluorescence intensity of living cells is shown. 3A demonstration of the effect of ectoin in comparison to NADA on the binding of the Cov2 S1 protein to A549 cells. The binding of the Cov2 S1 protein to A549 cells were measured by means of immunofluorescence and subsequent flow cytometry. The mean fluorescence intensity of living cells is shown. Measurement series n = 2 for 1.25% and 2.5%, n = 1 for 5%; the mean values from both measurements are shown.

3B shows the influence of ectoin on the binding of the Cov2 S1 protein to A549 cells (as in FIG. 3A), the concentration range being expanded to 0.25% to 7.5% ectoin. The mean values from both measurements are shown.

4A shows the results as a relative increase in fluorescence. The increase in the fluorescence of A549 cells due to the binding of the Cov2 S1 protein to the cell surface was calculated by dividing the mean fluorescence intensity of the cells stimulated with the protein by the intensity of the cells not stimulated with the protein.

4B The data of all experiments were summarized, the background fluorescence was eliminated and plotted against the concentration of the Cov2 S1 protein. The inhibitory effect of ectoine is significant even when the standard deviation is taken into account. In comparison, cells preincubated with NADA are comparable to cells that have not been treated

5 This figure summarizes all possible formulations and applications of the solutes according to the invention, or compositions containing the at least one solute or mixture of solutes, preferably ectoin and / or its derivatives. Only the infusion solution is not shown in this figure.

credentials

Costa et al. da Costa MS, Santos H, Galinski EA. An overview of the role and diversity of compatible solutes in Bacteria and Archaea .. Adv Biochem Eng Biotechnol. 1998; 61: 117-53.

Dong et al. Dong, J .; Xu, X .; Liang, Y .; Head, R .; Bennett, L. Inhibition of angiotensin converting enzyme (ACE) activity by polyphenols from tea (Camellia sinensis) and links to Processing method. Food Funct. 2011, 2, 310-319.

Fang Li Structure, Function, and Evolution of Coronavirus Spike Proteins. Annu. Rev. Virol. 2016. 3: 237-61. doi: 10.1146 / annurev-virology-110615-042301

Hahn et al. Marc Benjamin Hahn, Frank Uhlig, Tihomir Solomun, Jens Smiatek and Heinz Sturmad Combined influence of ectoine and salt: spectroscopic and numerical evidence for compensating effects on aqueous Solutions Phys.Chem.Chem.Phys., 2016, 18, 28398

Hoffmann et al. Markus Hoffmann, Hannah Kleine-Weber, Simon Schroeder, ..., Marcel A. Müller, Christian Drosten, Stefan Pöhlmann SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor Cell 181, 271-280 April 16, 2020 Elsevier Inc. https://doi.Org/10.1016/j.cell.2020.02.052 Roychoudhury et al. Roychoudhury A, Haussinger D, Oesterhelt F. Effect of the compatible solute ectoine on the stability of the membrane proteins. Protein Pept Lett. 2012 Aug; 19 (8): 791-4.

Tay et al. Matthew Zirui Tay, Chek Meng Poh, Laurent Renia, Paul A. MacAry and Lisa F. P. Ng The trinity of COVID-19: immunity, inflammation and Intervention. Nature Reviews, Immunology doi: 10.1038 / s41577-020-0311-8 Tortoricia M. Alejandra Tortoricia David Veeslera, Structural insights into Coronavirus entry.

Advances in Virus Research, Volume 105. 2019. doi.org/10.1016/bs.aivir.2019.08.002 Uhal et al. Bruce D. Uhal, MyTrang Dang, Vinh Dang, Roger Llatos, Esteban Cano, Amal Abdul-Hafez, Jonathan Markey, Christopher C. Piasecki and Maria Molina- Molina Cell cycle dependence of ACE-2 explains downregulation in idiopathic pulmonary fibrosis Eur Respir J 2013; 42: 198-210 doi: 10.1183 / 09031936.00015612 Wang et al. Bolin Wang, Ruobao Li, Zhong Lu, Yan Huang Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. AGING 2020, Vol. 12, No. 7 Wu et al. Xiao Wu MS, Rachel C. Nethery PhD, M. Benjamin Sabath MA, Danielle

Braun PhD, Francesca Dominici PhD. Exposure to air pollution and COVID-19 mortality in the United States preprint doi: 10.1101 / 2020.04.05.20054502 Zhao et al. Qianwen Zhao, Meng Meng, Rahul Kumar, Yinlian Wu, Jiaofeng Huang, Ningfang Lian, Yunlei Deng, Su Lin. The impact of COPD and smoking history on the severity of Covid-19: A systemic review and meta-analysis. Accepted article

The following examples show the effectiveness of selected compatible solutes in order to demonstrate the feasibility of the invention without, however, restricting the invention to these.

Examples

Example 1: Inhibition of the binding of the SARS-CoV-2 spike S1 protein to A549 cells by compatible solutes

material

Ectoin: (4S) -2-methyl-1,4,5,6-tetrahydropyrimidine-4-carboxylic acid, CAS No. 96702-03-3 NA DA: NY-Acetyl-L-2,4-diaminobutyric acid Product description, CAS No. 1190-46-1 Hydroxyectoin: CAS No. 165542-15-4 Glvcoin: CAS No. 22160-26-5 Mannosyl glycerate: CAS No. 164324-35-0

Glvcin-betaine: CAS No. 107-43-7 L-proline: CAS No. 147-85-3

SARS-CoV-2 Spike S1 protein: trenzyme life Science Services, Cat. No. P2020-001, Lot No .: 1IPO

method

A549 cells from the American Type Culture Collection (ATCC) expressing angiotensin-converting enzyme 2 (ACE2) were used (Uhal et al. 2013). The adherent cells were routinely cultured in T-75 flasks in DMEM with 10% FCS containing penicilin and streptomycin as antibiotics in a CC> 2 incubator (5% CO2, 37 ° C). When the bottom of the flask was 2/3 covered with cells, these were detached by Accutase

To perform the assay, the A549 cells were cultured to confluence in DMEM with 10% FCS, and the confluent culture was continued for four more days during which the cell culture medium was replaced.

For the inhibition experiment, the cells were detached with Accutase. In each case 105 cells were transferred to a test tube and pretreated with different concentrations of the compatible solute (Table 2) in order to give a final volume of 100 μl.

After 30 minutes of incubation, the HIS-labeled SARS-Cov2-S1 protein is added to each tube and incubated for a further 60 minutes on a tumble shaker at 450 rpm and room temperature.

Table 3: Compatible Solut + CoV2 S1

The evaluation was carried out using immunofluorescence using flow cytometry. The binding of the SARS-CoV-2 Spike S1 protein is analyzed by indirect immunofluorescence using a CyFlow SL (Sysmex GmbH) flow cytometer. The cells were centrifuged at 300 min first ^c g, 5 and then resuspended in 100 pl PBS with 1.5% fetal calf serum and 10 mM sodium azide. The cells were then countered with 5 pg / ml for 30 minutes the HIS-tag directed mouse antibody (Biolegend) was incubated. After washing (PBS with 1.5% fetal calf serum and 10 mM sodium azide), the cells were labeled with the secondary antibody (20 pg / ml, rabbit anti-mouse IgG (H + L), with Alexafluor 488, Invitrogen) incubated for 20 minutes. The cells were then washed once and resuspended in 1 ml PBS without azide / FCS. Shortly before the measurement, 10 μl of a 0.5 mg / ml propidium iodide solution were added. The cells were then immediately filtered through a 50 μm cell sieve and then measured immediately. All steps are carried out at 4 ° C in the dark.

The fluorescence of the A549 cells is then analyzed by flow cytometry. For this purpose, a region is placed on the living cells (the dead cells can be excluded from the analysis because they absorb the red propidium iodide dye) and the geometric mean relative fluorescence (MFI) of the cells in this region is determined as in FIG. 1 shown.

Example 2: Detection of the binding of the SARS-Cov2-S1 protein as a function of the concentration of A549 cells

A549 cells are grown to confluence in DMEM with 10% FCS. The cells were then supplied with fresh cell culture medium every day. The cells were then stimulated with different concentrations of the SARS-Cov2-S1 protein without an extremolyte, as described in Example 1. The analysis was carried out by means of cytometry.

Table 4: MFI values for FIG. 2. The corresponding coefficient of variation in percent (CV%) of the

The fluorescence intensity of the cells is also given.

In a comparison of unstained (“unstained A549”) and stained A549 control cells (“A549 control staining”), a slight background staining is measured. Stained A549 control cells are cells that have not been stimulated with Cov2 S1 protein, but have been treated with a Fite-labeled antibody for staining. Taking these controls into account, the signal of the bound spike protein was already detectable after stimulating the cells with 1 pg Cov2 S1. By using higher amounts of the protein, an increased protein binding to the A549 cells was detectable. Thus, by means of this assay, a concentration-dependent binding of a binding domain, such as Cov2 S1, to ACE-expressing cells, such as A549, can be detected and a substance can be examined for its effect on inhibiting the binding of Cov2 S1 to A549 cells.

The assay can be performed in a modified form using the cell lines mentioned below. Any cell line which expresses angiotensin-converting enzyme 2 (ACE2), aminopeptidase N (APN) and / or dipeptidyl peptidase 4 (DPP4) is a suitable cell line for the purposes of the assay according to the invention. The detailed properties of the cell lines listed below can be looked up in the protein atlas: https://www.proteinatlas.org/ENSG0000013Q234-ACE2/cell and are known to the person skilled in the art.

Table 5: Cell lines expressing ACE receptor

A suitable antibody which detects the expression of the receptor on the cell surface is preferably included in the assay. Cell lines which have a low mRNA expression for ACE are cultivated in DMEM with at least 10% FCS. Hep 2G cells show a high expression of the RNA for ACE. HUVEC cells express ACE2 and are cultured in Vascular Cell Basal Medium using the Endothelial Cell Growth Kit- (ATCC). MRC5 cells which do not express the ACE receptor are also used as a control. In addition, Hoffmann et al. It was shown in 2020 that the cells are not infected by SARS CoV2. Therefore, the MRC5 cells represent an excellent control for the specificity of the binding assay used. MRC5 cells are cultured in DMEM with 10% FCS.

The HUVEC cell line, which is already being used for ACE inhibition tests (Don et al.), Is particularly suitable to provide evidence of potential Covid-19 endotheliaiits as currently discussed and the positive effect of compatible solutes according to the invention, such as the ectoin to show.

In the binding experiment, the aforementioned cell lines are incubated with the CoV2 S1 concentrations shown in Table 6. Example 3: Influence of ectoin on the binding of the SARS-Cov2-S1 protein to A549 cells

Table 6: Compatible Solut + CoV2 S1

In order to investigate whether ectoin has an influence on the binding of the Cov2 S1 protein to A549 cells, detached cells were investigated with different concentrations of a solute according to the invention, such as ectoin. For this purpose, the cells were preincubated with the respective solute and then treated with different concentrations of the Cov2 S1 protein (see example 1 and 2).

In this “proof-of-concept” experiment with n = 1, a lower fluorescence of the Cov2 S1 protein bound to A549 cells could already be measured in the presence of 2.5% ectoin (data not shown). This indicates a reduced binding of the Cov2 S1 protein to A549 cells in the presence of ectoine. Compared to Ectoin, NADA was found to have no effect on the binding between Cov2 S1 and the A549 cells. Both the test batch [1.25 / 2.5% NADA + 5 pg Cov2 S1 + A549] and [5 pg Cov2 S1 + A549] show the same mean fluorescence (cf. FIGS. 2 and 3). Thus, NADA does not seem to affect the binding of the virus to the host cell.

To verify the experiment, the concentrations of 1.25% and 2.5% were repeated and 5% of the respective solute was additionally examined. The results are shown in Table 7.

Table 7: MFI values for FIG. 4. The corresponding coefficient of variation in percent (CV%) of the fluorescence intensity of the cells is also given.

With 5% ectoin, a complete inhibition of the binding of the Cov2 S1 protein to A549 cells could be shown. In comparison, no inhibition could be achieved with NADA. Here, the mean fluorescence in the presence of 1.25%, 2.5% or 5% NADA increases in a manner comparable to that of the mean fluorescence of the test set without a compatible solute (see FIG. 2). The experiment with NADA and Ectoin was repeated with the concentrations listed in Table 3. It was confirmed that NADA has no influence on the binding of the Cov2 S1 protein to A549 cells (data not shown), whereas ectoine repeatedly has a significant effect (FIG. 3B). All tests carried out were summarized in order to determine the significance of the effect. The background fluorescence of the A549 cells was subtracted and the specific values plotted against the binding concentration of the Cov2 S1 protein (FIG. 4B). It could be confirmed that ectoin has a significant effect on the A549 cells and inhibits the binding of the Cov2 S1 protein. Significance calculation:

Example 4: Influence of Glycoin and Ectoin on the binding of the SARS-Cov2-S1-

Protein

Experiments analogous to Example 3 are carried out with the cell lines HUVEC, HEK293, RPMI-8226 and Hep G2 (Table 5). Ectoin and Glycoin are tested in different concentrations as compatible solutes (Table 3).

Example 5: Influence of glycoin, mannosylglycerate, hydroxyectoin and ectoin on the binding of the SARS-Cov2-S1 protein. Experiments analogous to Example 3 are carried out with the cell lines HUVEC, HEK293, RPMI-8226 and Hep G2 (Table 5), with the Cells are not preincubated with ectoin, but ectoin or glycoin and Cov2 S1 protein are administered at the same time. Ectoine, hydroxyectoine, mannosylglycerate and glycoin are tested as solutes in different concentrations (Table 3).

As a further approach, the Cov2 S1 protein is preincubated with ectoin or glyocin and then the cells are incubated with the preincubated approach [Cov2 S1 protein + ectoin] in different concentrations according to Table 3. The preincubation [Cov2 S1 protein + ectoin] takes place for 5 min, 10 min and 30 min each at RT. The analysis is then carried out analogously as in Example 3. The experiment is carried out with the cell lines HUVEC, HEK293, RPMI-8226 and Hep G2 (Table 5) Example 6: Calculation of the increase in relative fluorescence

In order to make the experiments comparable, the increase in the fluorescence of A549 cells due to the binding of the Cov2 S1 protein to the cell surface was calculated by dividing the mean fluorescence intensity of the cells by the mean fluorescence intensity of the background staining. To determine the background staining, the cells were stained with an antibody in the absence of Cov2 S1. The results are shown in FIG.

It can be seen that in the absence of a compatible solute, a concentration-dependent increase in the mean fluorescence (fold fluorescence) is detected when the Cov2 S1 protein is added to A549 cells. While ectoin already shows a positive effect at 1.25% and inhibits the binding of Cov2 S1 protein to A549 cells, no significant effect can be demonstrated for NADA at the same concentration. The effect of ectoine increases with increasing concentration and with 5% ectoine it completely inhibits binding. In comparison, with 5% NADA, a slight inhibition of binding is shown.

Example 7: Atomic force spectroscopy to determine the effect of compatible solutes on the stability of membranes

Based on the Roychoudhury et al. a method using atomic force microscopy is carried out to detect a bond between a viral membrane-bound protein, in particular peplomer, and a human membrane-bound surface protein. The procedure is based on the following steps.

The binding domain to be tested or the complete protein is bound to a surface. The surface can be a membrane and even a whole cell that expresses the receptor such as ACE2, APN and / or DPP4. At least two different approaches are tested, one approach contains the human viral receptor with a compatible solute (Ectoin 1 M) in a buffer (300 mM KCl and 20 mM Tris at pH 7.8) and one approach contains the human viral receptor in the buffer without solute. In a next step, the tip of the atomically steerable arm (AFM tip) of the device (AFM device from Asylum Research, Olympus OMCL TR400 silicon nitride canilever with a spring constant of 20 pN / nm) is provided with a viral receptor binding domain, preferably S1, or the whole Protein, preferably SARS-CoV-2. The protein has an HIS label. This tip is then brought closer to the bound sample (viral receptor with / without solute) and gradually brought into contact. During the approach as well as during the removal of the bound protein, the Newton's force becomes against the distance between the potential binding partners - here ACE2 and S1 - determined and recorded as a force curve (withdrawal speed of 400 nm / s).

The measured power of the experiments with Solut compared to without Solut allow conclusions to be drawn about the molecular interactions between a membrane-bound protein, such as ACE2, and the potential binding partner, such as the SARS-CoV-2 protein, and statements about the shielding effect of the solute on membrane-bound protein , as it has already been done for ectoin in Roychoudhury et al. was shown. The method is suitable for testing all compatible solutes.

Atomic force spectroscopy is carried out using the following combinations as an example

Ectoin - Spike S1 protein

Hydroxyectoin - Spike S1 protein

Glycoin - Spike S1 protein

Mannosyl Glycerate - Spike S1 Protein

Example 8: Examples of formulations of the solute according to the invention A-1) Inhalation solution containing solute 13%

The aim of an inhalant in the context of the invention is to wet the lung surface as well as possible and over a large area with a thin layer of ectoin hydrate. A theoretically maximally and completely wetted lung is determined using the data from Hahn et al. and Roychoudhury et al.

The area of a hydrated ectoin: 3.5e10 ¹⁰ m * 3.5e10 ¹⁰ m * 3.14 = 3.85e10 ¹⁹ m ² (circular formula). Distance between ectoin and a water molecule = 0.35 nm

Assuming that this is equal to the radius and the surface of the lungs = ^{100-150 m 2} , it is calculated for a complete occupancy of the area that 2.6e10 ² ° ectoin molecules are required to achieve a single-layer hydration shell. For two hydrate shells, 5.2e10 ² ° ectoin molecules would be required

It should be noted that the above calculation applies to a rather small lung and the area can be up to 1.5 times larger. The assumed radius of the hydrated ectoins of 0.35 nm is the densest possible state. In a less dense state (r = 0.8 nm), less ectoin would be required. Therefore, the present calculation is to be regarded as indicative only and, if necessary, to be adapted to the size and / or age of the patient in individual cases. Molecular weight ectoin: 142.16 g / mol 1 mol = 6.022e10 ²³ particles

Amount of ectoin = 5.2e10 ² ° / (6.022e10 ²³ x mol-1) = 0.864e1C> - ³ mol = 0.123 g ectoin With a 13% solution (130 g / l) this would be 0.00094 I or 0, 94 mL

This means that an effective dose of between 1 - 1.5 mL of a 13% solute inhalation solution arriving in the lungs would be required so that ectoine is theoretically distributed homogeneously in the lungs. This determined concentration is based on the assumption of a single application

A-2) Solute-containing inhalation solution 3.9%

Starting from a 3.9% solute inhalation solution, a three-time application, e.g. B distributed over the day, required to achieve a dose comparable to the 13% solution.

A) 4% solution for infusion

An isotonic NaCl solution of 0.9% has an osmolar activity of 286 mOsmol / kg H2O. A 2% ectoin solution has an osmolarity of 147 mOsmol / kg H2O. An isotonic ectoin solution thus has a concentration of 3.89%.

An isotonic infusion solution is preferred so as not to irritate or damage the tissue. Therefore, an isotonic ectoin infusion solution is 3.89% ectoin. Another combination is an Ectoin infusion solution in combination with a NaCI solution suitable for infusion. Such a product contains a small amount of NaCl in combination with an adapted ectoin solution, so that overall an isotonic ectoin-NaCl infusion solution is present.

With the other solutes within the meaning of the invention, corresponding infusion solutions can be calculated according to their osmolarity.

'' to be determined according to the osmolarity or to adapt ++ to a physiologically compatible solution lv pharmacokinetic study of ectoine / kg in the rat

In an i.v. In the pharmacokinetic study, an amount of ectoin of 100 mg / kg was used in the rat. Oral toxicity data give a NOAL of 2000 mg / kg body weight / day. Orally ingested ectoin (1000 mg / kg) resulted in a plasma concentration of 99 pg / ml in the rat.

Claims

1. Compatible solute or mixture of solutes for use in the prevention or treatment of diseases caused by ss (+) RNA viruses of the family Coronavriridae, wherein the at least one compatible solute is selected from organic and highly water-soluble compounds.

2. Compatible solute or solute mixture for use according to claim 1, wherein the at least one solute has a water-binding capacity of greater than or equal to 7 mol / mol FhO / solute.

3. Compatible solute or solute mixture for use according to claim 1 or 2, wherein the at least one solute is selected from glyceryl glucoside (Glycoin), glycine betaine, mannosyl glycerate (Firoin), mannosyl glycramide (Firoin-A), ectoin and its derivatives of the formula I and / or II and the physiologically acceptable salts, amides and esters of the aforementioned compounds, where in formula I and in formula II

R1 = H or alkyl,

R2 = H, COOH, COO-alkyl or CO-NH-R5,

R3 and R4 each independently of one another H or OH,

Alkyl = an alkyl radical with C1-C4 carbon atoms.

4. Compatible solute or solute mixture for use according to one of claims 1 to 3, wherein the disease is triggered by an SS (+) RNA virus from the genus Betacoronavirus and / or Alphacoronavirus.

5. Compatible solute or solute mixture for use according to one of claims 1 to 4, wherein the disease is caused by an ss (+) RNA virus which is selected from SARS-CoV-1, SARS-CoV-2, MERS-CoV , HCoV-HKlM, HCoV-OC43, HCoV-NL63 and / or HCoV-229E.

6. Compatible solute or mixture of solutes for use according to any one of claims 1 to 5, wherein the viral disease comprises infection and / or inflammation of the transitional epithelial tissue and / or internal epithelial tissue.

7. Compatible solute or mixture of solutes for use according to any one of claims 1 to 6, wherein the viral disease comprises infection and / or inflammation of the endothelium.

8. Compatible solute or solute mixture for use according to one of claims 1 to 7, wherein the ss (+) RNA virus interacts with at least one membrane-bound protein or component thereof on human cells and this protein or the component thereof as a receptor for binding to the Cell uses.

9. Compatible solute or solute mixture for use according to one of claims 1 to 8, wherein the ss (+) RNA virus with a receptor selected from angiotensin converting enzyme 2 (ACE2), aminopeptidase N (APN) and / or dipeptidyl peptidase 4 (DPP4 ) interacts.

10. Compatible solute or solute mixture for use according to one of claims 1 to 9, wherein the at least one compatible solute reduces or prevents the unfolding and / or opening of the viral protein of the ss (+) RNA virus suitable for binding to the human receptor.

11. Compatible solute or solute mixture for use according to any one of claims 1 to

10, wherein the multiplication of the ss (+) RNA virus is reduced or prevented.

12. Compatible solute or solute mixture for use according to any one of claims 1 to

11, wherein the at least one compatible solute shields the membrane of the transitional epithelia, the inner epithelial tissue and / or the endothelium.

13. Compatible solute or solute mixture for use according to any one of claims 1 to

12, wherein the at least one solute is administered in combination with anti-viral compounds, anti-inflammatory compounds, interleukin blockers, anti-inflammatory anti-cytokines, inhibitors of the viral receptors and / or vaccines.

14. Compatible solute or solute mixture for use according to any one of claims 1 to

13, in which the at least one solute is used in patients who come from regions with high levels of particulate matter, belong to an occupational group with high levels of particulate matter, have a pre-existing vascular disease and / or have chronic respiratory diseases.

15. Composition containing at least one solute or solute mixture for use according to one of claims 1 to 14, wherein the at least one compatible solute or solute mixture with a proportion of greater than or equal to 0.0001% by weight to less than or equal to 70% by weight in the composition is present, based on the total content of the composition.

16. Composition for use according to claim 15, which is i) in solid forms comprising powder, granules, capsules, lozenges and effervescent tablets, ii) in liquid forms comprising solution, injection, infusion and suspension, and / or iii) as a mixture comprising Spray, aerosols and inhalant.

17. Composition for use according to claim 15 or 16, which is in liquid form as an infusion solution or in liquid form which is suitable for use with a nebuliser and / or respirator.

18. Composition for use according to one of claims 15 to 17, wherein in the prevention or treatment of diseases caused by ss (+) RNA viruses of the Coronavriridae family, an infusion is administered in combination with an inhalant.

19. A kit comprising at least one ready-to-use composition according to any one of claims 15 to 18 for inhalation and a device for administering the composition.

20. Composition according to one of claims 15 to 18 for use in a device for the controlled delivery of the composition, wherein the device is suitable for generating aerosols of the composition, allows inhalation of the composition via the mouth and / or nose, a metered delivery of a defined Ensured spray of a liquid or dry composition, ensures a metered delivery of a liquid composition in the eyes, and / or allows the composition to be sprayed in the mouth, throat and / or nasal cavity.

21. A method for identifying a compatible solute according to any one of claims 1 to 14, comprising the steps

Providing a cell line which has membrane-bound surface proteins as potentially viral receptors,

Bringing the cells into contact with a compound which is potentially a compatible solute according to any one of claims 1 to 14,

Adding a viral receptor binding domain that includes a measurable signal,

Incubation of the batch,

Recording of the signal that can be measured on the cell and determination of a reduced binding between the viral receptor binding domain and the human membrane-bound surface protein.