Nebulized 2-deoxylated glucose analogues inhibit respiratory viral infection in advanced in vitro airway models

Abstract Respiratory viral infections caused by rhinoviruses (RVs), influenza A virus (IAV) and endemic corona viruses (HCoV) result in a serious strain on healthcare systems and public health, underscoring an urgent need for inhaled broad-spectrum antiviral therapies. However, their development is challenging, as no standardized in vitro methodologies that can fully replicate the in vivo environment have been established. In this work, we aimed to investigate the antiviral and anti-inflammatory effect of three 2-deoxylated glucose analogues (2-DGA): 2-deoxy-D-glucose, 2-fluoro-2-dexoy-D-glucose and 2-fluoro-2-dexoy-D-mannose (2-FDM), by utilizing advanced in vitro air-liquid interface (ALI) airway models. We demonstrated that commonly used ALI models have variable susceptibility to RV, IAV and HCoV infection. Further, we showed that 2-DGA have an anti-inflammatory effect and suppress respiratory viral replication in models mimicking the upper and lower respiratory airways. Moreover, we confirmed that 2-DGA can be delivered via nebulization in vitro, highlighting their potential to be used as broad-spectrum inhaled antivirals. Finally, our results demonstrate the importance of incorporating complex in vitro methodologies, such as primary cell ALI cultures and aerosol exposure, at an early stage of drug development. Competing Interest Statement The authors declare the following financial interests or personal relationships which may be considered as potential competing interests: All authors are former or current employees or shareholders of G.ST Antivirals GmbH, Vienna, Austria. G.G. and J.S. are co-inventors of patent application related to parts of the manuscript.