PI3Kγ inhibition circumvents inflammation and vascular leak in SARS-CoV-2 and other infections

Sci Transl Med. 2024 Jul 3;16(754):eadi6887. doi: 10.1126/scitranslmed.adi6887. Epub 2024 Jul 3.

Abstract

Virulent infectious agents such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and methicillin-resistant Staphylococcus aureus (MRSA) induce tissue damage that recruits neutrophils, monocyte, and macrophages, leading to T cell exhaustion, fibrosis, vascular leak, epithelial cell depletion, and fatal organ damage. Neutrophils, monocytes, and macrophages recruited to pathogen-infected lungs, including SARS-CoV-2-infected lungs, express phosphatidylinositol 3-kinase gamma (PI3Kγ), a signaling protein that coordinates both granulocyte and monocyte trafficking to diseased tissues and immune-suppressive, profibrotic transcription in myeloid cells. PI3Kγ deletion and inhibition with the clinical PI3Kγ inhibitor eganelisib promoted survival in models of infectious diseases, including SARS-CoV-2 and MRSA, by suppressing inflammation, vascular leak, organ damage, and cytokine storm. These results demonstrate essential roles for PI3Kγ in inflammatory lung disease and support the potential use of PI3Kγ inhibitors to suppress inflammation in severe infectious diseases.

MeSH terms

  • Animals
  • COVID-19 Drug Treatment
  • COVID-19* / pathology
  • Capillary Permeability / drug effects
  • Class Ib Phosphatidylinositol 3-Kinase* / metabolism
  • Cytokine Release Syndrome / drug therapy
  • Humans
  • Inflammation* / pathology
  • Lung / pathology
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Mice
  • Mice, Inbred C57BL
  • Phosphoinositide-3 Kinase Inhibitors / pharmacology
  • Phosphoinositide-3 Kinase Inhibitors / therapeutic use
  • SARS-CoV-2* / physiology
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / pathology

Substances

  • Class Ib Phosphatidylinositol 3-Kinase
  • Phosphoinositide-3 Kinase Inhibitors
  • Pik3cg protein, mouse