- Chaturvedi, Sonali;
- Vasen, Gustavo;
- Pablo, Michael;
- Chen, Xinyue;
- Beutler, Nathan;
- Kumar, Arjun;
- Tanner, Elizabeth;
- Illouz, Sylvia;
- Rahgoshay, Donna;
- Burnett, John;
- Holguin, Leo;
- Chen, Pei-Yi;
- Ndjamen, Blaise;
- Ott, Melanie;
- Rodick, Robert;
- Rogers, Thomas;
- Smith, Davey M;
- Weinberger, Leor S
Viral-deletion mutants that conditionally replicate and inhibit the wild-type virus (i.e., defective interfering particles, DIPs) have long been proposed as single-administration interventions with high genetic barriers to resistance. However, theories predict that robust, therapeutic DIPs (i.e., therapeutic interfering particles, TIPs) must conditionally spread between cells with R0 >1. Here, we report engineering of TIPs that conditionally replicate with SARS-CoV-2, exhibit R0 >1, and inhibit viral replication 10- to 100-fold. Inhibition occurs via competition for viral replication machinery, and a single administration of TIP RNA inhibits SARS-CoV-2 sustainably in continuous cultures. Strikingly, TIPs maintain efficacy against neutralization-resistant variants (e.g., B.1.351). In hamsters, both prophylactic and therapeutic intranasal administration of lipid-nanoparticle TIPs durably suppressed SARS-CoV-2 by 100-fold in the lungs, reduced pro-inflammatory cytokine expression, and prevented severe pulmonary edema. These data provide proof of concept for a class of single-administration antivirals that may circumvent current requirements to continually update medical countermeasures against new variants.