Structure-based discovery of highly bioavailable, covalent, broad-spectrum coronavirus MPro inhibitors with potent in vivo efficacy

Sci Adv. 2025 Apr 25;11(17):eadt7836. doi: 10.1126/sciadv.adt7836. Epub 2025 Apr 23.

Abstract

The main protease (MPro) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a validated drug target. Starting with a lead-like dihydrouracil chemotype identified in a large-library docking campaign, we improved MPro inhibition >1000-fold by engaging additional MPro subsites and using a latent electrophile to engage Cys145. Advanced leads from this series show pan-coronavirus antiviral activity, low clearance in mice, and for AVI-4773, a rapid reduction in viral titers >1,000,000 after just three doses. Both compounds are well distributed in mouse tissues, including brain, where concentrations >1000× the 90% effective concentration are observed 8 hours after oral dosing for AVI-4773. AVI-4516 shows minimal inhibition of major cytochrome P450s and human proteases. AVI-4516 also exhibits synergy with the RNA-dependent RNA polymerase inhibitor, molnupiravir, in cellular infection models. Related analogs strongly inhibit nirmatrelvir-resistant MPro mutant virus. The properties of this chemotype are differentiated from existing clinical and preclinical MPro inhibitors and will advance therapeutic development against emerging SARS-CoV-2 variants and other coronaviruses.

MeSH terms

  • Animals
  • Antiviral Agents* / chemistry
  • Antiviral Agents* / pharmacokinetics
  • Antiviral Agents* / pharmacology
  • COVID-19 / virology
  • COVID-19 Drug Treatment*
  • Coronavirus 3C Proteases* / antagonists & inhibitors
  • Coronavirus 3C Proteases* / chemistry
  • Coronavirus 3C Proteases* / metabolism
  • Cytidine / analogs & derivatives
  • Cytidine / pharmacology
  • Drug Discovery
  • Humans
  • Hydroxylamines / pharmacology
  • Lactams
  • Leucine
  • Mice
  • Molecular Docking Simulation
  • Nitriles
  • Proline
  • Protease Inhibitors* / chemistry
  • Protease Inhibitors* / pharmacokinetics
  • Protease Inhibitors* / pharmacology
  • SARS-CoV-2* / drug effects
  • SARS-CoV-2* / enzymology

Substances

  • Antiviral Agents
  • Coronavirus 3C Proteases
  • Protease Inhibitors
  • molnupiravir
  • nirmatrelvir
  • Hydroxylamines
  • Cytidine
  • Lactams
  • Leucine
  • Nitriles
  • Proline