Distal protein-protein interactions contribute to nirmatrelvir resistance.

Publication date: Feb 01, 2025

SARS-CoV-2 main protease, M, is responsible for processing the viral polyproteins into individual proteins, including the protease itself. M is a key target of anti-COVID-19 therapeutics such as nirmatrelvir (the active component of Paxlovid). Resistance mutants identified clinically and in viral passage assays contain a combination of active site mutations (e. g., E166V, E166A, L167F), which reduce inhibitor binding and enzymatic activity, and non-active site mutations (e. g., P252L, T21I, L50F), which restore the fitness of viral replication. To probe the role of the non-active site mutations in fitness rescue, here we use an M triple mutant (L50F/E166A/L167F) that confers nirmatrelvir drug resistance with a viral fitness level similar to the wild-type. By comparing peptide and full-length M protein as substrates, we demonstrate that the binding of M substrate involves more than residues in the active site. Particularly, L50F and other non-active site mutations can enhance the M dimer-dimer interactions and help place the nsp5-6 substrate at the enzyme catalytic center. The structural and enzymatic activity data of M L50F, L50F/E166A/L167F, and others underscore the importance of considering the whole substrate protein in studying M and substrate interactions, and offers important insights into M function, resistance development, and inhibitor design.

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Concepts Keywords
Fitness Antiviral Agents
Mutants Antiviral Agents
Polyproteins Catalytic Domain
T21i Coronavirus 3C Proteases
Viral Coronavirus 3C Proteases
COVID-19
COVID-19 Drug Treatment
Drug Resistance, Viral
Humans
Mutation
Protein Binding
SARS-CoV-2
Virus Replication

Semantics

Type Source Name
disease IDO protein
disease MESH COVID-19
disease IDO site
pathway KEGG Viral replication
disease IDO role
drug DRUGBANK Etodolac
disease MESH infection
drug DRUGBANK Ritonavir
disease IDO replication
disease IDO cell
disease IDO assay
drug DRUGBANK Serine
drug DRUGBANK Albendazole
drug DRUGBANK L-Leucine
drug DRUGBANK Coenzyme M
drug DRUGBANK L-Isoleucine
drug DRUGBANK L-Alanine
disease IDO colony
drug DRUGBANK Kanamycin
drug DRUGBANK Chloramphenicol
drug DRUGBANK Isopropyl beta-D-thiogalactopyranoside
drug DRUGBANK Tromethamine
drug DRUGBANK Imidazole
drug DRUGBANK Glycerin
drug DRUGBANK Flunarizine
drug DRUGBANK Sodium lauryl sulfate
drug DRUGBANK Glycine
drug DRUGBANK Edetic Acid
drug DRUGBANK Nitrogen
drug DRUGBANK Adenosine 5′-phosphosulfate
drug DRUGBANK Trestolone
disease IDO algorithm
disease IDO history
disease MESH immunocompromised patient
disease MESH treatment failure
disease MESH persistent infections
disease IDO host
drug DRUGBANK Adamantane
disease MESH influenza
drug DRUGBANK Etoperidone
pathway REACTOME Reproduction

Original Article

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