Proteases and protease inhibitors in infectious diseases

Med Res Rev. 2018 Jul;38(4):1295-1331. doi: 10.1002/med.21475. Epub 2017 Nov 17.

Abstract

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.

Keywords: infectious disease; protease; protease inhibitors.

Publication types

  • Review

MeSH terms

  • Animals
  • Antiviral Agents / pharmacology
  • Bacterial Infections / drug therapy
  • Communicable Diseases / drug therapy*
  • Drug Design
  • HIV Protease / chemistry
  • Hepacivirus / drug effects
  • Hepatitis C / drug therapy
  • Humans
  • Peptide Hydrolases / physiology*
  • Protease Inhibitors / pharmacology*
  • Serine Proteases
  • Viral Nonstructural Proteins / antagonists & inhibitors

Substances

  • Antiviral Agents
  • Protease Inhibitors
  • Viral Nonstructural Proteins
  • NS3-4A serine protease, Hepatitis C virus
  • Peptide Hydrolases
  • Serine Proteases
  • HIV Protease