Apixaban, an orally available anticoagulant, inhibits SARS-CoV-2 replication and its major protease in a non-competitive way.

Apixaban, an orally available anticoagulant, inhibits SARS-CoV-2 replication and its major protease in a non-competitive way.
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DOI:
10.1093/jmcb/mjac039
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发表时间:
2022-09-21
影响因子:
5.5
通讯作者:
--
中科院分区:
生物学1区
文献类型:
--
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严重的2019冠状病毒病(COVID-19)与凝血功能障碍有关。因此,美国血液学会和国立卫生研究院推荐用于COVID-19患者的抗凝剂,如低分子量肝素、华法林、凝血酶抑制剂和Xa因子(FXa)抑制剂(Wenzler et al. 2020; Adam等人,2021年)。使用抗凝剂的临床试验显示,在非侵入性和侵入性辅助治疗下,重症COVID-19患者的存活率增加(Wenzler等人,2020; Adam等人,2021),沿着血小板和凝血因子消耗减少以及出血风险降低(Adam et al.,2021年)。在抗凝血剂中,早期使用口服可用的FXa和凝血酶抑制剂(Chowdhury等人,2020; Rentsch等人,2021)防止了高水平的D-二聚体,D-二聚体是凝血/纤维蛋白溶解级联的最终产物,并直接与严重的COVID-19有关(Rentsch等人,2021年)。奇怪的是,FXa、凝血酶和严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)主要蛋白酶(Mpro)的活性结合口袋具有相当大的相似性,这是通过它们的3D结构叠加来判断的(补充图S1; Biembengut和De Souza,2020)。虽然FXa和凝血酶与Mpro之间的结构相似性已经被证明是可能的。
The severe coronavirus disease 2019 (COVID-19) is associated with coagulopathy. Anticoagulants, such as low-molecular-weight heparin, warfarin, thrombin inhibitors, and factor Xa (FXa) inhibitors, are thus recommended by the American Society of Hematology and National Institutes of Health for COVID-19 patients ( Wenzler et al., 2020; Adam et al., 2021). Clinical trials with anticoagulants have shown the increased survival of critically ill COVID-19 patients under non-invasive and invasive ventilatory assistance (Wenzler et al., 2020; Adam et al., 2021), along with decreased consumption of platelets and clotting factors and a reduced risk of hemorrhage ( Adam et al., 2021). Among the anti-clotting agents, early use of orally available FXa and thrombin inhibitors ( Chowdhury et al., 2020; Rentsch et al., 2021) prevented high levels of D-dimer, which is the final product from the clotting/fibrinolysis cascade and is directly implicated with severe COVID-19 (Rentsch et al., 2021). Curiously, the active binding pockets of FXa, thrombin, and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease (Mpro) share a considerable similarity, as judged by the superimposition of their 3D structures (Supplementary Figure S1; Biembengut and De Souza, 2020). Although structural similarities between FXa and thrombin with Mpro have been
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