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letter
. 2020 Apr 10;83(1):e33–e34. doi: 10.1016/j.jaad.2020.04.031

Table II.

Summary of the antiviral mechanism of action of chloroquine and hydroxychloroquine14,15

Mechanism Effect
Halts the glycosylation of ACE2R Reduces binding of spike protein of coronavirus to ACE2R on host cell
Increases the endosomal and lysosomal pH Prevents fusion of the virus with host cells and subsequent replication
Prevents antigen processing and MHC-II–mediated autoantigen presentation to T cells Reduces T-cell activation and expression of CD154 and other cytokines (IL-1, IL-6 and TNF-α)
Disrupts the interaction of cytosolic viral DNA/RNA with TLRs and the nucleic acid sensor cGAS∗ Halts transcription of proinflammatory genes attenuating the possibility of cytokine storm (type I interferons, IL-1, TNF-α)

ACE2R, Angiotensin-converting enzyme 2 receptor; cGAS, cyclic guanosine monophosphate- adenosine monophosphate synthase; IL, interleukin; MHC, major histocompatibility complex; TLR, Toll-like receptor; TNF, tumor necrosis factor.

∗

Hydroxychloroquine only.