Characterization of an unusual SARS-CoV-2 main protease natural variant exhibiting resistance to nirmatrelvir and ensitrelvir.

Publication date: Jul 17, 2025

We investigate the effects of two naturally selected substitution and deletion (Δ) mutations, constituting part of the substrate binding subsites S2 and S4, on the structure, function, and inhibition of SARS CoV-2 main protease. Comparable to wild-type, MPro undergoes N-terminal autoprocessing essential for stable dimer formation and mature-like catalytic activity. The structures are similar, but for an open active site conformation in MPro and increased dynamics of the S2 helix, S5 loop, and the helical domain. Some dimer interface contacts exhibit shorter H bond distances corroborating the ~40-fold enhanced dimerization of the mutant although its thermal sensitivity to unfolding is 8 ^0C lower, relative to wild-type. ITC reveals a 3- and 5-fold decrease in binding affinity for nirmatrelvir and ensitrelvir, respectively, and similar GC373 affinity, to MPro relative to wild-type. Structural differences in four inhibitor complexes of MPro compared to wild-type are described. Consistent with enhanced dynamics, the S2 helix and S5 loop adopting a more open conformation appears to be a unique feature of MPro both in the inhibitor-free and bound states. Our results suggest that mutational effects are compensated by changes in the conformational dynamics and thereby modulate N-terminal autoprocessing, K, catalytic efficiency, and inhibitor binding.

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Concepts Keywords
Efficiency Antiviral Agents
Gc373 Antiviral Agents
Mutations Coronavirus 3C Proteases
Nirmatrelvir Coronavirus 3C Proteases
Proteins COVID-19 Drug Treatment
Drug Resistance, Viral
ensitrelvir
Humans
Indazoles
Indazoles
Lactams
Lactams
Leucine
Leucine
Mutation
nirmatrelvir
Nitriles
Nitriles
Proline
Proline
Protein Conformation
SARS-CoV-2
Triazines
Triazines
Triazoles
Triazoles

Semantics

Type Source Name
disease IDO site
disease MESH deletion mutations
pathway REACTOME Release
disease IDO production
drug DRUGBANK Chymotrypsin
disease MESH dissociation
disease MESH Kidney Diseases
disease MESH infections
disease IDO cell
disease IDO assay
disease IDO replication
pathway REACTOME Translation
drug DRUGBANK Papain
drug DRUGBANK Aspartame
drug DRUGBANK Acetylcysteine
drug DRUGBANK Sodium lauryl sulfate
drug DRUGBANK Flunarizine
drug DRUGBANK Coenzyme M
drug DRUGBANK Amino acids
drug DRUGBANK Water
drug DRUGBANK Coagulation factor X human
drug DRUGBANK Nitrogen
drug DRUGBANK Activated charcoal
drug DRUGBANK Coenzyme A
drug DRUGBANK Tromethamine
drug DRUGBANK Urea
drug DRUGBANK Imidazole
drug DRUGBANK Dimethyl sulfoxide
drug DRUGBANK Ilex paraguariensis leaf
disease IDO protein
drug DRUGBANK Histidine
drug DRUGBANK L-Cysteine
disease MESH COVID 19
drug DRUGBANK Boceprevir
drug DRUGBANK (S)-Des-Me-Ampa
drug DRUGBANK Glycine
disease IDO quality
disease IDO algorithm
disease IDO facility
pathway REACTOME Reproduction
drug DRUGBANK L-Leucine
drug DRUGBANK Proline

Original Article

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