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Siniavin AE, Gushchin VA, Shastina NS, Darnotuk ES, Luyksaar SI, Russu LI, Inshakova AM, Shidlovskaya EV, Vasina DV, Kuznetsova NA, Savina DM, Zorkov ID, Dolzhikova IV, Sheremet AB, Logunov DY, Zigangirova NA, Gintsburg AL. New conjugates based on N4-hydroxycytidine with more potent antiviral efficacy in vitro than EIDD-2801 against SARS-CoV-2 and other human coronaviruses. Antiviral Res 2024; 225:105871. [PMID: 38555022 DOI: 10.1016/j.antiviral.2024.105871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/14/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
The spread of COVID-19 continues due to genetic variation in SARS-CoV-2. Highly mutated variants of SARS-CoV-2 have an increased transmissibility and immune evasion. Due to the emergence of various new variants of the virus, there is an urgent need to develop broadly effective specific drugs for therapeutic strategies for the prevention and treatment of COVID-19. Molnupiravir (EIDD-2801, MK-4482), is an orally bioavailable ribonucleoside analogue of β-D-N4-hydroxycytidine (NHC), has demonstrated efficacy against SARS-CoV-2 and was recently approved for COVID-19 treatment. To improve antiviral potency of NHC, we developed a panel of NHC conjugates with lipophilic vectors and ester derivatives with amino- and carboxylic-acids. Most of the synthesized compounds had comparable or higher (2-20 times) antiviral activity than EIDD-2801, against different lineages of SARS-CoV-2, MERS-CoV, seasonal coronaviruses OC43 and 229E, as well as bovine coronavirus. For further studies, we assessed the most promising compound in terms of activity, simplicity and cost of synthesis - NHC conjugate with phenylpropionic acid (SN_9). SN_9 has shown high efficacy in prophylactic, therapeutic and transmission models of COVID-19 infection in hamsters. Importantly, SN_9 profoundly inhibited virus replication in the lower respiratory tract of hamsters and transgenic mice infected with the Omicron sublineages XBB.1.9.1, XBB.1.16 and EG.5.1.1. These data indicate that SN_9 represents a promising antiviral drug candidate for COVID-19 treatment, and NHC modification strategies deserve further investigation as an approach to develop prodrugs against various coronaviruses.
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Affiliation(s)
- Andrei E Siniavin
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia; Department of Molecular Neuroimmune Signaling, Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997, Moscow, Russia.
| | - Vladimir A Gushchin
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia; Department of Medical Genetics, Federal State Autonomous Educational Institution of Higher Education I M Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119991, Moscow, Russia; Department of Virology, Faculty of Biology Lomonosov Moscow State University, 119234, Moscow, Russia.
| | - Natal'ya S Shastina
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia; Institute of Fine Chemical Technologies, MIREA-Russian Technological University, 119571, Moscow, Russia
| | - Elizaveta S Darnotuk
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia; Institute of Fine Chemical Technologies, MIREA-Russian Technological University, 119571, Moscow, Russia
| | - Sergey I Luyksaar
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia
| | - Leonid I Russu
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia
| | - Anna M Inshakova
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia; Institute of Fine Chemical Technologies, MIREA-Russian Technological University, 119571, Moscow, Russia
| | - Elena V Shidlovskaya
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia
| | - Daria V Vasina
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia
| | - Nadezhda A Kuznetsova
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia
| | - Daria M Savina
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia
| | - Ilya D Zorkov
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia
| | - Inna V Dolzhikova
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia
| | - Anna B Sheremet
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia
| | - Denis Y Logunov
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia
| | - Nailya A Zigangirova
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia
| | - Alexander L Gintsburg
- Department of Epidemiology, Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya" of the Ministry of Health of the Russian Federation, 123098, Moscow, Russia; Department of Infectology and Virology, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov, First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 119435, Moscow, Russia
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Bykonia EN, Kleymenov DA, Gushchin VA, Siniavin AE, Mazunina EP, Kozlova SR, Zolotar AN, Usachev EV, Kuznetsova NA, Shidlovskaya EV, Pochtovyi AA, Kustova DD, Ivanov IA, Dmitriev SE, Ivanov RA, Logunov DY, Gintsburg AL. Major Role of S-Glycoprotein in Providing Immunogenicity and Protective Immunity in mRNA Lipid Nanoparticle Vaccines Based on SARS-CoV-2 Structural Proteins. Vaccines (Basel) 2024; 12:379. [PMID: 38675761 PMCID: PMC11053793 DOI: 10.3390/vaccines12040379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/21/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
SARS-CoV-2 variants have evolved over time in recent years, demonstrating immune evasion of vaccine-induced neutralizing antibodies directed against the original S protein. Updated S-targeted vaccines provide a high level of protection against circulating variants of SARS-CoV-2, but this protection declines over time due to ongoing virus evolution. To achieve a broader protection, novel vaccine candidates involving additional antigens with low mutation rates are currently needed. Based on our recently studied mRNA lipid nanoparticle (mRNA-LNP) platform, we have generated mRNA-LNP encoding SARS-CoV-2 structural proteins M, N, S from different virus variants and studied their immunogenicity separately or in combination in vivo. As a result, all mRNA-LNP vaccine compositions encoding the S and N proteins induced excellent titers of RBD- and N-specific binding antibodies. The T cell responses were mainly specific CD4+ T cell lymphocytes producing IL-2 and TNF-alpha. mRNA-LNP encoding the M protein did not show a high immunogenicity. High neutralizing activity was detected in the sera of mice vaccinated with mRNA-LNP encoding S protein (alone or in combinations) against closely related strains, but was undetectable or significantly lower against an evolutionarily distant variant. Our data showed that the addition of mRNAs encoding S and M antigens to mRNA-N in the vaccine composition enhanced the immunogenicity of mRNA-N and induced a more robust immune response to the N protein. Based on our results, we suggested that the S protein plays a key role in enhancing the immune response to the N protein when they are both encoded in the mRNA-LNP vaccine.
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Affiliation(s)
- Evgeniia N. Bykonia
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
| | - Denis A. Kleymenov
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
| | - Vladimir A. Gushchin
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
- Department of Virology, Lomonosov Moscow State University, Moscow 119234, Russia
- Department of Medical Genetics, Federal State Autonomous Educational Institution of Higher Education I M Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow 119991, Russia
| | - Andrei E. Siniavin
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Sciences, Moscow 117997, Russia
| | - Elena P. Mazunina
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
| | - Sofia R. Kozlova
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
| | - Anastasia N. Zolotar
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
| | - Evgeny V. Usachev
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
| | - Nadezhda A. Kuznetsova
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
| | - Elena V. Shidlovskaya
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
| | - Andrei A. Pochtovyi
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
- Department of Virology, Lomonosov Moscow State University, Moscow 119234, Russia
- Department of Medical Genetics, Federal State Autonomous Educational Institution of Higher Education I M Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow 119991, Russia
| | - Daria D. Kustova
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
- Department of Virology, Lomonosov Moscow State University, Moscow 119234, Russia
| | - Igor A. Ivanov
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Sciences, Moscow 117997, Russia
| | - Sergey E. Dmitriev
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow 119234, Russia
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Moscow 119991, Russia
| | - Roman A. Ivanov
- Translational Medicine Research Center, Sirius University of Science and Technology, Sochi 354340, Russia;
| | - Denis Y. Logunov
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
| | - Alexander L. Gintsburg
- Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; (D.A.K.); (A.E.S.); (E.P.M.); (S.R.K.); (A.N.Z.); (E.V.U.); (N.A.K.); (E.V.S.); (A.A.P.); (D.D.K.); (I.A.I.); (S.E.D.); (D.Y.L.); (A.L.G.)
- Infectiology Department, I. M. Sechenov First Moscow State Medical University, Moscow 119991, Russia
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Zhou B, Chen D, Zhang T, Song C, Zhang X, Lin L, Huang J, Peng X, Liu Y, Wu G, Li J, Chen W. Recent advancements in the discovery of small-molecule non-nucleoside inhibitors targeting SARS-CoV-2 RdRp. Biomed Pharmacother 2024; 171:116180. [PMID: 38266622 DOI: 10.1016/j.biopha.2024.116180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/14/2024] [Accepted: 01/16/2024] [Indexed: 01/26/2024] Open
Abstract
The RNA-dependent RNA polymerase (RdRp) of SARS-CoV-2 plays a pivotal role in the life cycle of the novel coronavirus and stands as a significant and promising target for anti-SARS-CoV-2 drugs. Non-nucleoside inhibitors (NNIs), as a category of compounds directed against SARS-CoV-2 RdRp, exhibit a unique and highly effective mechanism, effectively overcoming various factors contributing to drug resistance against nucleoside inhibitors (NIs). This review investigates various NNIs, including both natural and synthetic inhibitors, that closely interacting with the SARS-CoV-2 RdRp with valid evidences from in vitro and in silico studies.
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Affiliation(s)
- Bangdi Zhou
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou 341000, PR China; The First School of Clinical Medicine, Gannan Medical University, Ganzhou 341000, PR China
| | - Dianming Chen
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou 341000, PR China; School of Pharmaceutical Sciences, Gannan Medical University, Ganzhou 341000, PR China
| | - Tingyan Zhang
- School of Nusing, Gannan Medical University, Ganzhou 341000, PR China
| | - Chenggui Song
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou 341000, PR China
| | - Xianwu Zhang
- The First School of Clinical Medicine, Gannan Medical University, Ganzhou 341000, PR China
| | - Leying Lin
- School of Basic Medicine, Gannan Medical University, Ganzhou 341000, PR China
| | - Jiuzhong Huang
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou 341000, PR China; School of Pharmaceutical Sciences, Gannan Medical University, Ganzhou 341000, PR China
| | - Xiaopeng Peng
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou 341000, PR China; School of Pharmaceutical Sciences, Gannan Medical University, Ganzhou 341000, PR China
| | - Yuanchang Liu
- School of Pharmaceutical Sciences, Gannan Medical University, Ganzhou 341000, PR China
| | - Gaorong Wu
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou 341000, PR China; School of Pharmaceutical Sciences, Gannan Medical University, Ganzhou 341000, PR China
| | - Jingyuan Li
- School of Pharmaceutical Sciences, Gannan Medical University, Ganzhou 341000, PR China
| | - Weiming Chen
- Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou 341000, PR China; School of Pharmaceutical Sciences, Gannan Medical University, Ganzhou 341000, PR China.
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Comunale BA, Larson RJ, Jackson-Ward E, Singh A, Koback FL, Engineer LD. The Functional Implications of Broad Spectrum Bioactive Compounds Targeting RNA-Dependent RNA Polymerase (RdRp) in the Context of the COVID-19 Pandemic. Viruses 2023; 15:2316. [PMID: 38140557 PMCID: PMC10747147 DOI: 10.3390/v15122316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND As long as COVID-19 endures, viral surface proteins will keep changing and new viral strains will emerge, rendering prior vaccines and treatments decreasingly effective. To provide durable targets for preventive and therapeutic agents, there is increasing interest in slowly mutating viral proteins, including non-surface proteins like RdRp. METHODS A scoping review of studies was conducted describing RdRp in the context of COVID-19 through MEDLINE/PubMed and EMBASE. An iterative approach was used with input from content experts and three independent reviewers, focused on studies related to either RdRp activity inhibition or RdRp mechanisms against SARS-CoV-2. RESULTS Of the 205 records screened, 43 studies were included in the review. Twenty-five evaluated RdRp activity inhibition, and eighteen described RdRp mechanisms of existing drugs or compounds against SARS-CoV-2. In silico experiments suggested that RdRp inhibitors developed for other RNA viruses may be effective in disrupting SARS-CoV-2 replication, indicating a possible reduction of disease progression from current and future variants. In vitro, in vivo, and human clinical trial studies were largely consistent with these findings. CONCLUSIONS Future risk mitigation and treatment strategies against forthcoming SARS-CoV-2 variants should consider targeting RdRp proteins instead of surface proteins.
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Affiliation(s)
- Brittany A. Comunale
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Robin J. Larson
- Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
- Department of Palliative Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA
| | - Erin Jackson-Ward
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Aditi Singh
- Department of Biological Sciences, University of California San Diego, La Jolla, CA 92161, USA
| | | | - Lilly D. Engineer
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
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