Escaping from Flatland: Multiparameter Optimization Leads to the Discovery of Novel Tetrahydropyrido[4,3- d]pyrimidine Derivatives as Human Immunodeficiency Virus-1 Non-nucleoside Reverse Transcriptase Inhibitors with Superior Antiviral Activities against Non-nucleoside Reverse Transcriptase Inhibitor-Resistant Variants and Favorable Drug-like Profiles

J Med Chem. 2023 Jul 13;66(13):8643-8665. doi: 10.1021/acs.jmedchem.3c00275. Epub 2023 May 31.

Abstract

In the current landscape of antiretroviral options, there remains an urgent need for novel non-nucleoside reverse transcriptase inhibitors (NNRTIs) with improved resistance profiles and safety properties. Herein, a series of novel tetrahydropyrido[4,3-d]pyrimidine derivatives were discovered utilizing the "escape from flatland" strategy. The most potent inhibitor 10c was endowed with broad-spectrum antiviral activity and improved resistance profiles against NNRTI-resistant variants compared to efavirenz and etravirine. Molecular simulations were investigated to furnish insights into the biological results. Drug-likeness assessment showed that 10c exhibited desirable physicochemical properties and in vitro metabolic stability. Notably, lower cytochrome P450 inhibition and human ether-à-go-go-related gene blockade liability were observed for 10c than those for etravirine and rilpivirine. Besides, 10c was characterized by excellent in vivo safety properties without acute/subacute toxicity and organ pathological damage. Overall, our multiparameter optimization campaign led to the identification of 10c with excellent antiviral activities and favorable drug-like profiles that could serve as an ideal drug candidate for further development.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-HIV Agents* / chemistry
  • Drug Resistance, Viral
  • HIV Infections* / drug therapy
  • HIV Reverse Transcriptase / metabolism
  • HIV-1* / metabolism
  • Humans
  • Pyrimidines / chemistry
  • Reverse Transcriptase Inhibitors / chemistry

Substances

  • Anti-HIV Agents
  • etravirine
  • HIV Reverse Transcriptase
  • Pyrimidines
  • Reverse Transcriptase Inhibitors
  • tetrahydropyrido(4,3-d)pyrimidine