Structural Basis of SARS-CoV-2- and SARS-CoV-Receptor Binding and Small-Molecule Blockers as Potential Therapeutics

Annu Rev Pharmacol Toxicol. 2021 Jan 6:61:465-493. doi: 10.1146/annurev-pharmtox-061220-093932. Epub 2020 Aug 21.

Abstract

Over the past two decades, deadly coronaviruses, with the most recent being the severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) 2019 pandemic, have majorly challenged public health. The path for virus invasion into humans and other hosts is mediated by host-pathogen interactions, specifically virus-receptor binding. An in-depth understanding of the virus-receptor binding mechanism is a prerequisite for the discovery of vaccines, antibodies, and small-molecule inhibitors that can interrupt this interaction and prevent or cure infection. In this review, we discuss the viral entry mechanism, the known structural aspects of virus-receptor interactions (SARS-CoV-2 S/humanACE2, SARS-CoV S/humanACE2, and MERS-CoV S/humanDPP4), the key protein domains and amino acid residues involved in binding, and the small-molecule inhibitors and other drugs that have (as of June 2020) exhibited therapeutic potential. Specifically, we review the potential clinical utility of two transmembrane serine protease 2 (TMPRSS2)-targeting protease inhibitors, nafamostat mesylate and camostat mesylate, as well as two novel potent fusion inhibitors and the repurposed Ebola drug, remdesivir, which is specific to RNA-dependent RNA polymerase, against human coronaviruses, including SARS-CoV-2.

Keywords: COVID-19; S-glycoprotein; coronavirus; host–pathogen interaction; inhibitors; receptor.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiotensin-Converting Enzyme 2 / drug effects*
  • Antiviral Agents / pharmacology*
  • Antiviral Agents / therapeutic use*
  • COVID-19 Drug Treatment*
  • Humans
  • Protease Inhibitors / therapeutic use
  • Receptors, Virus / drug effects*
  • Small Molecule Libraries*

Substances

  • Antiviral Agents
  • Protease Inhibitors
  • Receptors, Virus
  • Small Molecule Libraries
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2