ChemDiv Inc., San Diego, CA 92130, USA.
ASAVI LLC, 1835 East Hallandale Blvd #442, Hallandale Beach, FL 33009, USA.
Int J Mol Sci. 2023 Jul 6;24(13):11173. doi: 10.3390/ijms241311173.
Aprotinin (APR) was discovered in 1930. APR is an effective pan-protease inhibitor, a typical "magic shotgun". Until 2007, APR was widely used as an antithrombotic and anti-inflammatory drug in cardiac and noncardiac surgeries for reduction of bleeding and thus limiting the need for blood transfusion. The ability of APR to inhibit proteolytic activation of some viruses leads to its use as an antiviral drug for the prevention and treatment of acute respiratory virus infections. However, due to incompetent interpretation of several clinical trials followed by incredible controversy in the literature, the usage of APR was nearly stopped for a decade worldwide. In 2015-2020, after re-analysis of these clinical trials' data the restrictions in APR usage were lifted worldwide. This review discusses antiviral mechanisms of APR action and summarizes current knowledge and prospective regarding the use of APR treatment for diseases caused by RNA-containing viruses, including influenza and SARS-CoV-2 viruses, or as a part of combination antiviral treatment.
抑肽酶(APR)于 1930 年被发现。APR 是一种有效的广谱蛋白酶抑制剂,是一种典型的“万能枪”。直到 2007 年,APR 被广泛用作心脏和非心脏手术中的抗血栓和抗炎药物,以减少出血,从而减少输血的需求。APR 抑制某些病毒的蛋白水解激活的能力使其可用作抗病毒药物,用于预防和治疗急性呼吸道病毒感染。然而,由于对几项临床试验的解释不当,随后文献中出现了令人难以置信的争议,APR 的使用在全球范围内几乎停止了十年。在 2015-2020 年,对这些临床试验数据进行重新分析后,全球范围内解除了 APR 使用的限制。本文讨论了 APR 作用的抗病毒机制,并总结了目前关于 APR 治疗含 RNA 病毒引起的疾病(包括流感和 SARS-CoV-2 病毒)的知识和前景,或作为联合抗病毒治疗的一部分。