ABSTRACT
Remdesivir 1 is an phosphoramidate prodrug that releases the monophosphate of nucleoside GS-441524 (2) into lung cells, thereby forming the bioactive triphosphate 2-NTP. 2-NTP, an analog of ATP, inhibits the SARS-CoV-2 RNA-dependent RNA polymerase replication and transcription of viral RNA. Strong clinical results for 1 have prompted interest in oral approaches to generate 2-NTP. Here, we describe the discovery of a 5'-isobutyryl ester prodrug of 2 (GS-5245, Obeldesivir, 3) that has low cellular cytotoxicity and 3-7-fold improved oral delivery of 2 in monkeys. Prodrug 3 is cleaved presystemically to provide high systemic exposures of 2 that overcome its less efficient metabolism to 2-NTP, leading to strong SARS-CoV-2 antiviral efficacy in an African green monkey infection model. Exposure-based SARS-CoV-2 efficacy relationships resulted in an estimated clinical dose of 350-400 mg twice daily. Importantly, all SARS-CoV-2 variants remain susceptible to 2, which supports development of 3 as a promising COVID-19 treatment.
Subject(s)
COVID-19 , Prodrugs , Chlorocebus aethiops , Humans , Animals , SARS-CoV-2 , COVID-19 Drug Treatment , Nucleosides , Prodrugs/pharmacology , Prodrugs/therapeutic use , RNA, Viral , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , FuransSubject(s)
Brain/diagnostic imaging , Confusion/etiology , Dexamethasone/therapeutic use , Fever/etiology , Meningoencephalitis/complications , Confusion/diagnosis , Diagnosis, Differential , Electroencephalography , Female , Fever/diagnosis , Glucocorticoids/therapeutic use , Humans , Magnetic Resonance Imaging , Meningoencephalitis/diagnosis , Meningoencephalitis/drug therapy , Middle Aged , Tomography, X-Ray ComputedABSTRACT
There is an ever-increasing interest in synthetic methods that not only enable peptide macrocyclization, but also facilitate downstream application of the synthesized molecules. We have found that aziridine amides are stereoelectronically attenuated in a macrocyclic environment such that non-specific interactions with biological nucleophiles are reduced or even shut down. The electrophilic reactivity, revealed at high pH, enables peptide sequencing by mass spectrometry, which will further broaden the utility of aziridine amide-containing libraries of macrocycles.
Subject(s)
Amides/chemistry , Electrons , Peptides, Cyclic/chemistry , Sequence Analysis, Protein , Aziridines/chemistry , Hydrolysis , Ketones/chemistry , Mass SpectrometryABSTRACT
The factors determining diastereoselectivity observed in the multicomponent conversion of amino acids, aziridine aldehyde dimers, and isocyanides into chiral piperazinones have been investigated. Amino acid-dependent selectivity for either trans- or cis-substituted piperazinone products has been achieved. An experimentally determined diastereoselectivity model for the three-component reaction driven by aziridine aldehyde dimers has predictive value for different substrate classes. Moreover, this model is useful in reconciling the previously reported observations in multicomponent reactions between isocyanides, α-amino acids, and monofunctional aldehydes.
