Debulking SARS-CoV-2 in saliva using angiotensin converting enzyme 2 in chewing gum to decrease oral virus transmission and infection

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School of Dental Medicine::Departmental Papers (Dental)
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Dentistry
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debulking; transmission; oral virus; topical delivery; plant cells; COVID chewing gum; SARS-CoV-2; angiotensin; virus trap protein; biomarker
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2021
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Henry Daniell; Smruti K. Nair; Nardana Esmaeili; Geetanjali Wakade; Naila Shahid; Prem Kumar Ganesan; Md Reyazul Islam; Ariel Shepley-McTaggart; Sheng Feng; Ebony N. Gary; Ali R. Ali; Manunya Nuth; Selene Nunez Cruz; Jevon Graham-Wooten; Stephen J. Streatfield; Ruben Montoya-Lopez; Paul Kaznica; Margaret Mawson; Brian J. Green; Robert Ricciardi; Michael Milone; Ronald N. Harty; Ping Wang; David B. Weiner; Kenneth B. Margulies; and Ronald G. Collman
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Abstract

To advance a novel concept of debulking virus in the oral cavity, the primary site of viral replication, virus-trapping proteins CTB-ACE2 were expressed in chloroplasts and clinical-grade plant material was developed to meet FDA requirements. Chewing gum (2 g) containing plant cells expressed CTB-ACE2 up to 17.2 mg ACE2/g dry weight (11.7% leaf protein), have physical characteristics and taste/flavor like conventional gums, and no protein was lost during gum compression. CTB-ACE2 gum efficiently (>95%) inhibited entry of lentivirus spike or VSV-spike pseudovirus into Vero/CHO cells when quantified by luciferase or red fluorescence. Incubation of CTB-ACE2 microparticles reduced SARS-CoV-2 virus count in COVID-19 swab/saliva samples by >95% when evaluated by microbubbles (femtomolar concentration) or qPCR, demonstrating both virus trapping and blocking of cellular entry. COVID-19 saliva samples showed low or undetectable ACE2 activity when compared with healthy individuals (2,582 versus 50,126 ΔRFU; 27 versus 225 enzyme units), confirming greater susceptibility of infected patients for viral entry. CTB-ACE2 activity was completely inhibited by pre-incubation with SARS-CoV-2 receptor-binding domain, offering an explanation for reduced saliva ACE2 activity among COVID-19 patients. Chewing gum with virus-trapping proteins offers a general affordable strategy to protect patients from most oral virus re-infections through debulking or minimizing transmission to others.

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2022-05-04
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Molecular Therapy
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