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新型HIV-1整合抑制剂

Novel inhibitors of HIV-1 integration.

作者信息

Witvrouw M, Van Maele B, Vercammen J, Hantson A, Engelborghs Y, De Clercq E, Pannecouque C, Debyser Z

机构信息

Rega Institute for Medical Research, Minderbroedersstraat 10, B-3000 Leuven, Flanders, Belgium.

出版信息

Curr Drug Metab. 2004 Aug;5(4):291-304. doi: 10.2174/1389200043335487.

Abstract

Human immunodeficiency virus (HIV) is the etiological agent of the acquired immune deficiency syndrome (AIDS). The current strategy for the treatment of HIV infection is called Highly Active Antiretroviral Therapy (HAART) and is based on cocktails of drugs that are currently approved by the Food and Drug Administration. These drugs include compounds that target the viral entry step and the enzymes reverse transcriptase or protease. The introduction of HAART has dramatically changed the landscape of HIV disease. Death from AIDS-related diseases has been reduced significantly since HAART came into use. Nevertheless it is not clear how long clinical benefit will last taking into account the emergence of multiple drug-resistant viral strains. Addition of new anti-HIV drugs targeting other steps of the viral replication cycle may increase the potency of inhibition and delay resistance development. HIV integrase is an essential enzyme in the HIV life cycle and is an attractive target for new drug development. Despite years of intensive research, only two classes of compounds that inhibit integration have been identified until now, namely the diketo acids and the pyranodipyrimidines. In this review we will point to new potential antiviral targets related to retroviral integration that are amenable to drug development. We will describe the pitfalls of currently used integrase assays and propose new strategies and technologies for the discovery of HIV integration inhibitors. Furthermore, we will describe the two classes of integrase inhibitors and discuss their antiviral activity, molecular mechanism of anti-HIV action and the selection of HIV resistance against these drugs.

摘要

人类免疫缺陷病毒(HIV)是获得性免疫缺陷综合征(AIDS)的病原体。目前治疗HIV感染的策略称为高效抗逆转录病毒疗法(HAART),它基于美国食品药品监督管理局目前批准的药物组合。这些药物包括针对病毒进入步骤以及逆转录酶或蛋白酶等酶的化合物。HAART的引入极大地改变了HIV疾病的局面。自HAART投入使用以来,与艾滋病相关疾病导致的死亡人数已大幅减少。然而,考虑到多种耐药病毒株的出现,尚不清楚临床益处能持续多久。添加针对病毒复制周期其他步骤的新型抗HIV药物可能会增强抑制效力并延缓耐药性的产生。HIV整合酶是HIV生命周期中的一种关键酶,是新药研发的一个有吸引力的靶点。尽管经过多年深入研究,但迄今为止仅鉴定出两类抑制整合的化合物,即二酮酸类和吡喃二嘧啶类。在本综述中,我们将指出与逆转录病毒整合相关的新的潜在抗病毒靶点,这些靶点适合进行药物研发。我们将描述当前使用的整合酶检测方法的缺陷,并提出发现HIV整合酶抑制剂的新策略和新技术。此外,我们将描述这两类整合酶抑制剂,并讨论它们的抗病毒活性、抗HIV作用的分子机制以及HIV对这些药物耐药性的产生情况。

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