Acta Pharmaceutica Sinica B
|
2026, 16(2): 728-745
• Reviews •
Anti-influenza drugs targeting trimeric RNA polymerase complex: From development to clinics
Full
Yingjun Li1,2, Jianfang Zhang2, Fengming He2, Cuiting Cao2, Yangqing Zhan2, Nanshan Zhong1,3,2, Zifeng Yang1,3,2
Affiliations
1 China-Portugal Artificial Intelligence and Public Health Technologies Joint Laboratory, Guangdong-Hong Kong-Macao Joint Laboratory of Respiratory Infectious Diseases, Guangdong Provincial Key Laboratory of Respiratory Disease Research, Guangzhou Medical University, Guangzhou 510180, China;
2 State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Joint International Research Laboratory of Respiratory Health, Guangdong Basic Research Center of Excellence for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510163, China;
3 Guangzhou National Laboratory, Guangzhou 510000, China
doi: 10.1016/j.apsb.2025.11.033
Outline
The rapid evolution of influenza viruses, driven by high mutation rates and cross-species transmission, underscores the importance of discovering antivirals with novel mechanisms of action and distinct resistance profiles. The influenza virus RNA polymerase, a highly conserved heterotrimeric complex, comprises polymerase basic protein 1 (PB1), polymerase basic protein 2 (PB2), and polymerase acidic protein (PA) in influenza A and B viruses, or polymerase 3 protein (P3) in influenza C and D viruses. This complex is essential for viral genome replication and transcription, rendering it a critical target for antiviral intervention. Over the past two decades, research on influenza polymerase (FluPol) has advanced from fundamental studies to drug development and clinical application. By 2025, six FluPol-targeting drugs have received regulatory approval: the PA inhibitors baloxavir marboxil, suraxavir marboxil, seloxavir marboxil, and pixavir marboxil; the PB1 inhibitor favipiravir; and the PB2 inhibitor onradivir, with several additional candidates progressing to clinical research. This review summarizes the structure and function of influenza polymerase and the mechanisms of action of different inhibitors, highlighting the discovery and clinical effectiveness of the newly approved FluPol-targeting drugs. It addresses the potential of FluPol inhibitors against highly pathogenic avian influenza and the challenges posed by resistance mutations.
Influenza
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RNA polymerase
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Antiviral drug
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Polymerase basic protein 1
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Polymerase basic protein 2
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Polymerase acidic protein
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Approved drug
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Replication and transcription
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Drug resistance
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Structure-based drug design
Yingjun Li, Jianfang Zhang, Fengming He, Cuiting Cao, Yangqing Zhan, Nanshan Zhong, Zifeng Yang.
Anti-influenza drugs targeting trimeric RNA polymerase complex: From development to clinics[J].
Acta Pharmaceutica Sinica B,
2026
, 16
(2)
: 728
-745
.
DOI: 10.1016/j.apsb.2025.11.033
Year 2026 volume 16 Issue 2
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Article Info
doi: 10.1016/j.apsb.2025.11.033
- Receive Date:2025-08-26
- Online Date:2026-09-17