Key result
Rupintrivir and AG7404 potently inhibit enterovirus D68 3C protease at single-digit nanomolar levels.
Why the study?
Enterovirus-D68 causes respiratory and neurological illness with no specific treatments, and existing 3C protease inhibitors do not account for the emergence of drug resistance mutations.
Determining the crystal structures of EV68-3C protease bound to inhibitors provides structural insights for the rational design of enterovirus-D68 antivirals robust against drug resistance mutations.
Answers are grounded in this paper and cite their sources.
Supports further preclinical development of 3C inhibitors for EV-D68; leaves open clinical efficacy and resistance data.
Enterovirus-D68 (EV68) continues to present as a global health issue causing respiratory illness and outbreaks associated with long-lasting neurological disease, with no antivirals or specific treatment options. The development of antiviral therapeutics, such as small-molecule inhibitors that target conserved proteins like the enteroviral 3C protease, remains to be achieved. While various 3C inhibitors have been investigated, their design does not consider the potential emergence of drug resistance mutations. For other antivirals where resistance has been a challenge, we have demonstrated that the likelihood of resistance can be minimized by designing inhibitors that leverage the evolutionary constraints of the target. Here, we characterize a series of 3C inhibitors against EV68-3C protease through enzyme inhibition, protein crystallography, and structural analysis. We have determined and analyzed three high-resolution inhibitor-bound crystal structures of EV68-3C protease, which revealed possible sites of resistance mutations, a key structural water molecule conserved during ligand binding, and the conformational flexibility of the catalytic histidine H40. This structural analysis combined with enzymatic assays provides insights for the rational design of inhibitors that are robust against resistance toward developing antiviral treatments for EV68 infections.
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Azzolino et al. (2025) studied Enterovirus-D68 infection. 3C protease inhibitors (rupintrivir, AG7404, GC-376) was evaluated on Enzyme inhibition (IC50) and crystal structure. Structural analysis and enzymatic assays demonstrated that 3C protease inhibitors, notably rupintrivir and AG7404, potently inhibit EV68-3C protease with single-digit nanomolar IC50 values.
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