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潜在抗乙型肝炎病毒药物的最新进展:结构与药理学视角

Recent progress in potential anti-hepatitis B virus agents: Structural and pharmacological perspectives.

作者信息

Sun Dejuan, Zhu Lingjuan, Yao Dahong, Chen Lixia, Fu Leilei, Ouyang Liang

机构信息

Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, 110016, China.

Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, Wuya College of Innovation, Shenyang Pharmaceutical University, Shenyang, 110016, China.

出版信息

Eur J Med Chem. 2018 Mar 10;147:205-217. doi: 10.1016/j.ejmech.2018.02.001. Epub 2018 Feb 5.

Abstract

Hepatitis B virus (HBV) infections affect about 240 million patients worldwide and increase the risk of liver cirrhosis and hepatocellular carcinoma. It is estimated that about 686 thousand people died annually of liver damage resulted from HBV infections. At present, two classes of antiviral drugs have been approved by the Food and Drug Administration (FDA) for the treatment of hepatitis B, immunomodulators (interferon [IFN]-a and pegylated-interferon [PEG-IFN]-a) and nucleos(t)ide analogs (lamivudine, telbivudine, adefovir, tenofovir [TDF], and entecavir [ETV]). However, it still remains a daunting challenge for curing HBV, because of the low sustained response rates (20-30%) and many side effects of IFN and peg-IFN. Although nucleoside analogues are well tolerated and exhibit an early and potent antiviral effect, the selection of resistant mutants and nephrotoxicity during long-term therapy limit their use. Here, we focus on summarizing the currently approved anti-HBV drugs and characterization of novel HBV inhibitors and analysing their structures, targets, anti-HBV effects and mechanisms of action, which may shed new light on the discovery of small compounds as potential anti-HBV drugs for treatment of HBV.

摘要

乙型肝炎病毒(HBV)感染影响着全球约2.4亿患者,并增加了肝硬化和肝细胞癌的风险。据估计,每年约有68.6万人死于HBV感染导致的肝损伤。目前,美国食品药品监督管理局(FDA)已批准两类抗病毒药物用于治疗乙型肝炎,即免疫调节剂(干扰素[IFN]-α和聚乙二醇化干扰素[PEG-IFN]-α)和核苷(酸)类似物(拉米夫定、替比夫定、阿德福韦、替诺福韦[TDF]和恩替卡韦[ETV])。然而,治愈HBV仍然是一项艰巨的挑战,因为IFN和聚乙二醇化干扰素的持续应答率较低(20%-30%)且存在许多副作用。尽管核苷类似物耐受性良好,并具有早期强效抗病毒作用,但长期治疗期间耐药突变体的产生和肾毒性限制了它们的使用。在此,我们着重总结目前已批准的抗HBV药物以及新型HBV抑制剂的特性,并分析它们的结构、靶点、抗HBV作用及作用机制,这可能为发现作为潜在抗HBV药物用于治疗HBV的小分子化合物提供新线索。

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