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Review

Emerging and state of the art hemagglutinin-targeted influenza virus inhibitors.

, , ORCID Icon &
Pages 715-728
Received 01 Mar 2020
Accepted 24 Nov 2020
Accepted author version posted online: 17 Dec 2020
Published online: 24 Dec 2020
 

ABSTRACT

Introduction: Seasonal influenza vaccination, together with FDA-approved neuraminidase (NA) and polymerase acidic (PA) inhibitors, is the most effective way for prophylaxis and treatment of influenza infections. However, the low efficacy of prevailing vaccines to newly emerging influenza strains and increasing resistance to available drugs drives intense research to explore more effective inhibitors. Hemagglutinin (HA), one of the major surface proteins of influenza strains, represents an attractive therapeutic target to develop such new inhibitors.

Areas covered: This review summarizes the current progress of HA-based influenza virus inhibitors and their mechanisms of action, which may facilitate further research in developing novel antiviral inhibitors for controlling influenza infections.

Expert opinion: HA-mediated entry of influenza virus is an essential step for successful infection of the host, which makes HA a promising target for the development of antiviral drugs. Recent progress in delineating the crystal structures of HA, especially HA-inhibitors complexes, has revealed a number of key residues and conserved binding pockets within HA. This has opened up important insights for developing HA-based antiviral inhibitors that have a high resistance barrier and broad-spectrum activities.

Article highlights

  • Prevailing a small arsenal of antiviral drugs and the rapid emergence of drug-resistant strains demand the development of new broad-spectrum antiviral inhibitors.

  • Recent advances in understanding the structural basis of HA and HA-inhibitor complexes led to the identification of key residues and conserved regions facilitating structure-based drug designs.

  • Neutralizing antibodies and polypeptides recognizing conserved sites present in HA have broad-spectrum antiviral activity and are currently under clinical development.

  • Recombinant sialidase DAS181 and a small-molecule drug, arbidol, are currently under clinical development and have potent antiviral activity with high resistance barrier properties.

  • The latest discovery of novel-conserved sites in HA trimeric interface provides important insights into designing universal antiviral inhibitors.

This box summarizes the key points contained in the article.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was funded by the National Natural Science Foundation of China [81728007], the Major scientific and technological projects of Guangdong Province [2019B020202002], the Chinese Academy of Traditional Chinese Medicine [ZZ13-035-02], and the Evidence-based capacity building project of Traditional Chinese Medicine [2019XZZX-LG04] awarded to S. Liu.

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