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Establishment of multicenter COVID-19 therapeutics preclinical test system in Republic of Korea - 20/05/23

Doi : 10.1016/j.pupt.2023.102189 
Hyuna Noh a, 1, Suhyeon Yoon a, 1, Sung-Hee Kim b, 1, Jiseon Kim b, Jung Seon Seo b, Jeong Jin Kim b, In Ho Park b, c, Jooyeon Oh d, Joon-Yong Bae e, Gee Eun Lee e, Sun-Je Woo f, Sun-Min Seo g, Na-Won Kim g, Youn Woo Lee h, Hui Jeong Jang h, Seung-Min Hong i, Se-Hee An i, Kwang-Soo Lyoo j, Minjoo Yeom k, Hanbyeul Lee k, Bud Jung k, Sun-Woo Yoon l, Jung-Ah Kang l, Sang-Hyuk Seok m, Yu Jin Lee m, Seo Yeon Kim n, Young Been Kim n, Ji-Yeon Hwang n, Dain On a, o, Soo-Yeon Lim a, Sol Pin Kim a, Ji Yun Jang p, q, Ho Lee p, Kyoungmi Kim r, Hyo-Jung Lee s, Hong Bin Kim t, Sun Bean Kim u, Jun Won Park m, Dae Gwin Jeong l, Daesub Song k, Kang-Seuk Choi i, Ho-Young Lee h, Yang-Kyu Choi g, Jung-ah Choi f, Manki Song f, Man-Seong Park e, Jun-Young Seo b, Jeon-Soo Shin b, c, d, Jun-Won Yun v, , Ki Taek Nam b, , Je Kyung Seong a, o, w,
a Korea Mouse Phenotyping Center, Seoul National University, Seoul, 08826, Republic of Korea 
b Severance Biomedical Science Institute, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea 
c Institute of Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea 
d Department of Microbiology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea 
e Department of Microbiology, Institute for Viral Diseases, Biosafety Center, Korea University College of Medicine, Seoul, 02841, Republic of Korea 
f Science Unit, International Vaccine Institute, Seoul, 08826, Republic of Korea 
g Department of Laboratory Animal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, 05029, Republic of Korea 
h Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, 13488, Republic of Korea 
i Laboratory of Avian Diseases, BK21 plus Program for Veterinary Science and Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Republic of Korea 
j Korea Zoonosis Research Institute, Chonbuk National University, Iksan, 54531, Republic of Korea 
k Department of Pharmacy, College of Pharmacy, Korea University, Sejong, 30019, Republic of Korea 
l Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, 34141, Republic of Korea 
m Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University, ChunCheon, 24341, Republic of Korea 
n Preclinical Research Center, Seoul National University Bundang Hospital, Seongnam, 13488, Republic of Korea 
o Laboratory of Developmental Biology and Genomics, Research Institute for Veterinary Science, and BK21 PLUS Program for Creative Veterinary Science Research, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Republic of Korea 
p Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi, 10408, Republic of Korea 
q College of Pharmacy, Dongguk University, Seoul, 04620, Republic of Korea 
r Department of Biomedical Sciences and Department of Physiology, Korea University College of Medicine, Seoul, 02841, Republic of Korea 
s Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, 13620, Republic of Korea 
t Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, 13620, Republic of Korea 
u Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, 02841, Republic of Korea 
v Laboratory of Veterinary Toxicology, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, Republic of Korea 
w Interdisciplinary Program for Bioinformatics, Program for Cancer Biology and BIO-MAX/N-Bio Institute, Seoul National University, Seoul, 08826, Republic of Korea 

Corresponding author. Korea Mouse Phenotyping Center, Seoul National University, Seoul, 08826, Republic of Korea.Korea Mouse Phenotyping CenterSeoul National UniversitySeoul08826Republic of Korea∗∗Corresponding author. Laboratory of Veterinary Toxicology, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Republic of Korea.Laboratory of Veterinary ToxicologyCollege of Veterinary MedicineSeoul National UniversitySeoul08826Republic of Korea∗∗∗Corresponding author.

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Abstract

Throughout the recent COVID-19 pandemic, South Korea led national efforts to develop vaccines and therapeutics for SARS-CoV-2. The project proceeded as follows: 1) evaluation system setup (including Animal Biosafety Level 3 (ABSL3) facility alliance, standardized nonclinical evaluation protocol, and laboratory information management system), 2) application (including committee review and selection), and 3) evaluation (including expert judgment and reporting). After receiving 101 applications, the selection committee reviewed pharmacokinetics, toxicity, and efficacy data and selected 32 final candidates. In the nonclinical efficacy test, we used golden Syrian hamsters and human angiotensin-converting enzyme 2 transgenic mice under a cytokeratin 18 promoter to evaluate mortality, clinical signs, body weight, viral titer, neutralizing antibody presence, and histopathology. These data indicated eight new drugs and one repositioned drug having significant efficacy for COVID-19. Three vaccine and four antiviral drugs exerted significant protective activities against SARS-CoV-2 pathogenesis. Additionally, two anti-inflammatory drugs showed therapeutic effects on lung lesions and weight loss through their mechanism of action but did not affect viral replication. Along with systematic verification of COVID-19 animal models through large-scale studies, our findings suggest that ABSL3 multicenter alliance and nonclinical evaluation protocol standardization can promote reliable efficacy testing against COVID-19, thus expediting medical product development.

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Highlights

In recent COVID-19 pandemic situation, we established a multicenter COVID-19 efficacy evaluation system.
After receiving 101 applications, the selection committee reviewed and selected 32 final candidates.
Mortality, body weight, viral titer, neutralizing antibody, and histopathology were evaluated in nonclinical efficacy test.
Three vaccines, four antiviral drugs, and two anti-inflammatory drugs showed significant efficacy against COVID-19.

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Keywords : SARS-CoV-2, COVID-19, Nonclinical, hACE2 mouse, Golden Syrian hamster

Abbreviations : ABSL3, COVID-19, SARS-CoV-2, ACE2, TMPRSS2, MOAs, DMEM, FBS, TCID50, PFU, CPE, H&E, LIMS, PK, dpi, NHPs, CCSP, SFTPB


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