School of Pharmacy, University of Otago, Dunedin, New Zealand.
School of Life Sciences, University of Technology Sydney, Ultimo, NSW, Australia.
Med Res Rev. 2018 Jul;38(4):1295-1331. doi: 10.1002/med.21475. Epub 2017 Nov 17.
There are numerous proteases of pathogenic organisms that are currently targeted for therapeutic intervention along with many that are seen as potential drug targets. This review discusses the chemical and biological makeup of some key druggable proteases expressed by the five major classes of disease causing agents, namely bacteria, viruses, fungi, eukaryotes, and prions. While a few of these enzymes including HIV protease and HCV NS3-4A protease have been targeted to a clinically useful level, a number are yet to yield any clinical outcomes in terms of antimicrobial therapy. A significant aspect of this review discusses the chemical and pharmacological characteristics of inhibitors of the various proteases discussed. A total of 25 inhibitors have been considered potent and safe enough to be trialed in humans and are at different levels of clinical application. We assess the mechanism of action and clinical performance of the protease inhibitors against infectious agents with their developmental strategies and look to the next frontiers in the use of protease inhibitors as anti-infective agents.
有许多病原体蛋白酶目前是治疗干预的目标,还有许多被视为潜在的药物靶点。本综述讨论了由五类致病因子(细菌、病毒、真菌、真核生物和朊病毒)表达的一些关键可成药蛋白酶的化学和生物学特性。虽然少数几种酶,包括 HIV 蛋白酶和 HCV NS3-4A 蛋白酶,已经达到了临床有用的水平,但在抗菌治疗方面,还有许多酶尚未产生任何临床效果。本综述的一个重要方面讨论了各种蛋白酶抑制剂的化学和药理学特性。共有 25 种抑制剂被认为足够有效和安全,可以在人体中进行试验,并且处于不同的临床应用阶段。我们评估了针对感染因子的蛋白酶抑制剂的作用机制和临床性能,以及它们的开发策略,并展望了蛋白酶抑制剂作为抗感染药物的下一个前沿领域。