Article(id=1198624474548499017, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1198624466902287155, articleNumber=null, orderNo=null, doi=10.16438/j.0513-4870.2022-1116, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1665936000000, receivedDateStr=2022-10-17, revisedDate=1670515200000, revisedDateStr=2022-12-09, acceptedDate=null, acceptedDateStr=null, onlineDate=1763703944098, onlineDateStr=2025-11-21, pubDate=1681228800000, pubDateStr=2023-04-12, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1763703944098, onlineIssueDateStr=2025-11-21, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1763703944098, creator=13701087609, updateTime=1763703944098, updator=13701087609, issue=Issue{id=1198624466902287155, tenantId=1146029695717560320, journalId=1189982191388893191, year='2023', volume='58', issue='4', pageStart='1', pageEnd='1092', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1763703942275, creator=13701087609, updateTime=1763704125380, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1198625234971619912, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1198624466902287155, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1198625234971619913, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1198624466902287155, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=909, endPage=918, ext={EN=ArticleExt(id=1198624474846294635, articleId=1198624474548499017, tenantId=1146029695717560320, journalId=1189982191388893191, language=EN, title=Research progress on the development of human neutrophil elastase inhibitors, columnId=null, journalTitle=Acta Pharmaceutica Sinica, columnName=null, runingTitle=null, highlight=null, articleAbstract=

Human neutrophil elastase (hNE) is a serine proteolytic enzyme mainly distributed in neutrophils. When the balance between anti-hNE protein and hNE is broken, excessive release of hNE can cause the occurrence of various diseases. Therefore, inhibition of hNE is a promising therapeutic strategy. In this paper, the structure, action mechanism, physiological function of hNE and the development of hNE inhibitors were briefly summarized, in order to provide information for the related research.

, correspAuthors=Hua-qing CUI, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2023 Acta Pharmaceutica Sinica. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Zhong-wei WANG, Hui WEN, Yu-chen WANG, Hua-qing CUI), CN=ArticleExt(id=1198624480709931011, articleId=1198624474548499017, tenantId=1146029695717560320, journalId=1189982191388893191, language=CN, title=人中性粒细胞弹性蛋白酶抑制剂的研究进展, columnId=1190335349655180086, journalTitle=药学学报, columnName=综述, runingTitle=null, highlight=null, articleAbstract=

人中性粒细胞弹性蛋白酶(human neutrophil elastase, hNE) 是一种丝氨酸蛋白水解酶, 主要分布于中性粒细胞中。当体内抗hNE蛋白与hNE的平衡被打破, 过量释放的hNE会导致相关疾病的发生, 因此抑制hNE是一种很有前途的疾病治疗策略。本文简要介绍了hNE的结构、作用机制、生理功能及hNE抑制剂的研发现状, 以期能为相关研究提供参考。

, correspAuthors=崔华清, authorNote=null, correspAuthorsNote=
*崔华清, Tel: 86-10-63165248, E-mail:
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Substituted 4-pyridones and their use as inhibitors of neutrophil elastase activity: US, 9340507 B2 [P]. 2016-05-17., articleTitle=null, refAbstract=null)], funds=[Fund(id=1198702048796573816, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, awardId=2021-I2M-1-028, language=CN, fundingSource=中国医学科学院医学与健康科技创新工程(2021-I2M-1-028), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1198702039258726703, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, xref=null, ext=[AuthorCompanyExt(id=1198702039267115314, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, companyId=1198702039258726703, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Beijing Key Laboratory of Active Substance Discovery and Druggability Evaluation, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China), AuthorCompanyExt(id=1198702039275503921, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, companyId=1198702039258726703, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=中国医学科学院、北京协和医学院药物研究所, 活性物质发现与适药化研究北京市重点实验室, 北京 100050)])], figs=[ArticleFig(id=1198702043654357694, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, language=EN, label=null, caption=null, figureFileSmall=tL+d214YkO0GPbb0FvRbqg==, figureFileBig=2yg6r14T2VTUL5zEQCvZZQ==, tableContent=null), ArticleFig(id=1198702043763409607, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, language=CN, label=Figure 1, caption= (A) The structure of MDL101146 (peptide hNE inhibitor). P<sub>1</sub>, P<sub>2</sub> are substrate residues that interact with S<sub>1</sub> and S<sub>2</sub> of human neutrophil elastase (hNE). (B) The binding mode of MDL101146 with hNE (PDB code: 1B0F). 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(1) Sivelestat acetylates Ser195; (2) Concomitant hydrolysis again frees up Ser195 , figureFileSmall=EqohLhIkA6M1d3rRtqhokQ==, figureFileBig=8+BM1+c+QxyPhhR2TkMG1Q==, tableContent=null), ArticleFig(id=1198702045281747784, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, language=EN, label=null, caption=null, figureFileSmall=xIZ2rrZUmH41/sZ+AIYWKw==, figureFileBig=9n8FHX109CqOuVdUTXLtPQ==, tableContent=null), ArticleFig(id=1198702045420159826, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, language=CN, label=Figure 6, caption= The general structure of 4<i>H</i>-3, 1-benzoxazin-4-ones<sup>[<a href="javascript:;" class="mag_content_a" onclick="piaofuRef(this,'b53')" rid="b53">53</a>]</sup> , figureFileSmall=xIZ2rrZUmH41/sZ+AIYWKw==, figureFileBig=9n8FHX109CqOuVdUTXLtPQ==, tableContent=null), ArticleFig(id=1198702045579543389, tenantId=1146029695717560320, journalId=1189982191388893191, 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caption= The general structure of <i>N</i>-benzoylindazole<sup>[<a href="javascript:;" class="mag_content_a" onclick="piaofuRef(this,'b56')" rid="b56">56</a>]</sup> , figureFileSmall=cvFMSqEfdKsDPNcbSLtwZA==, figureFileBig=J1VzeM/ywtjOA8RxeEgGLw==, tableContent=null), ArticleFig(id=1198702046078665620, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, language=EN, label=null, caption=null, figureFileSmall=Pu/Xi0g0dw53ua514kyqEg==, figureFileBig=lIM/WvY11x3y/D+dF+sK2g==, tableContent=null), ArticleFig(id=1198702046246437793, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, language=CN, label=Figure 9, caption= The structures of <i>N</i>-benzoylindazole hNE inhibitors<sup>[<a href="javascript:;" class="mag_content_a" onclick="piaofuRef(this,'b56')" rid="b56">56</a>]</sup> , figureFileSmall=Pu/Xi0g0dw53ua514kyqEg==, figureFileBig=lIM/WvY11x3y/D+dF+sK2g==, tableContent=null), 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figureFileBig=BjPnHFaFsINj764VsNJXUA==, tableContent=null), ArticleFig(id=1198702047261459436, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, language=EN, label=null, caption=null, figureFileSmall=I0IGNcmAkm0mJH8aKFNL5Q==, figureFileBig=UhwfVRL8D6tYV9zTQMe6wg==, tableContent=null), ArticleFig(id=1198702047412454396, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, language=CN, label=Figure 13, caption= The structures of SuFExable hNE inhibitors<sup>[<a href="javascript:;" class="mag_content_a" onclick="piaofuRef(this,'b68')" rid="b68">68</a>]</sup> , figureFileSmall=I0IGNcmAkm0mJH8aKFNL5Q==, figureFileBig=UhwfVRL8D6tYV9zTQMe6wg==, tableContent=null), ArticleFig(id=1198702047534088199, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, language=EN, label=null, caption=null, figureFileSmall=tvwKE7tZOn6d+7+YAkRSPg==, figureFileBig=J68m8eWZCoEJz7ucUgCdVQ==, 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onclick="piaofuRef(this,'b70')" rid="b70">70</a>, <a href="javascript:;" class="mag_content_a" onclick="piaofuRef(this,'b71')" rid="b71">71</a>]</sup> , figureFileSmall=xU6g2+uSWfmSg0SH2zamzA==, figureFileBig=wVtYfmIcemlMNPd4+GhZ1Q==, tableContent=null), ArticleFig(id=1198702048142262332, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, language=EN, label=null, caption=null, figureFileSmall=v8VHijEcJpVjyOUnDVch0A==, figureFileBig=2DOKQ8ElPijjUxd9jMElHw==, tableContent=null), ArticleFig(id=1198702048301645898, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198624474548499017, language=CN, label=Figure 16, caption= (A1) The structure of dihydropyrimidone (DHPI) hNE inhibitor; (A2) The binding mode of DHPI with hNE (PDB code: 3Q77). 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人中性粒细胞弹性蛋白酶抑制剂的研究进展
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王中伟 , 文辉 , 王雨辰 , 崔华清 *
药学学报 | 综述 2023,58(4): 909-918
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药学学报 | 综述 2023, 58(4): 909-918
人中性粒细胞弹性蛋白酶抑制剂的研究进展
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王中伟, 文辉, 王雨辰, 崔华清*
作者信息
  • 中国医学科学院、北京协和医学院药物研究所, 活性物质发现与适药化研究北京市重点实验室, 北京 100050

通讯作者:

*崔华清, Tel: 86-10-63165248, E-mail:
Research progress on the development of human neutrophil elastase inhibitors
Zhong-wei WANG, Hui WEN, Yu-chen WANG, Hua-qing CUI*
Affiliations
  • Beijing Key Laboratory of Active Substance Discovery and Druggability Evaluation, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
出版时间: 2023-04-12 doi: 10.16438/j.0513-4870.2022-1116
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人中性粒细胞弹性蛋白酶(human neutrophil elastase, hNE) 是一种丝氨酸蛋白水解酶, 主要分布于中性粒细胞中。当体内抗hNE蛋白与hNE的平衡被打破, 过量释放的hNE会导致相关疾病的发生, 因此抑制hNE是一种很有前途的疾病治疗策略。本文简要介绍了hNE的结构、作用机制、生理功能及hNE抑制剂的研发现状, 以期能为相关研究提供参考。

中性粒细胞弹性蛋白酶  /  中性粒细胞弹性蛋白酶作用机制  /  中性粒细胞弹性蛋白酶生理功能  /  中性粒细胞弹性蛋白酶抑制剂

Human neutrophil elastase (hNE) is a serine proteolytic enzyme mainly distributed in neutrophils. When the balance between anti-hNE protein and hNE is broken, excessive release of hNE can cause the occurrence of various diseases. Therefore, inhibition of hNE is a promising therapeutic strategy. In this paper, the structure, action mechanism, physiological function of hNE and the development of hNE inhibitors were briefly summarized, in order to provide information for the related research.

human neutrophil elastase  /  human neutrophil elastase mechanism  /  human neutrophil elastase physiological effect  /  human neutrophil elastase inhibitor
王中伟, 文辉, 王雨辰, 崔华清. 人中性粒细胞弹性蛋白酶抑制剂的研究进展. 药学学报, 2023 , 58 (4) : 909 -918 . DOI: 10.16438/j.0513-4870.2022-1116
Zhong-wei WANG, Hui WEN, Yu-chen WANG, Hua-qing CUI. Research progress on the development of human neutrophil elastase inhibitors[J]. Acta Pharmaceutica Sinica, 2023 , 58 (4) : 909 -918 . DOI: 10.16438/j.0513-4870.2022-1116
2019年末全球暴发由新型冠状病毒COVID-19引起的肺炎, 新冠肺炎给全球的经济生产和社会生活造成严重影响[1-3]。新冠肺炎重症患者最具典型的症状为小气道黏液增多, 呼吸困难, 30%以上的重症患者出现急性呼吸窘迫综合症(ARDS) 的临床并发症[1-3]。值得一提的是, 研究发现人中性粒细胞弹性蛋白酶(human neutrophil elastase, hNE) 小分子抑制剂能够有效缓解各类ARDS动物模型的症状[4-6]。在过去的30多年里, 不同研究机构报道了不同的hNE抑制剂。虽然多个hNE抑制剂进入临床研究, 但仅西维来司他(sivelestat) 于2002年在日本被批准用于临床治疗ARDS。新冠肺炎期间, 国家药监局也应急批准了注射用西维来司他钠作为新冠治疗药物。
hNE (EC 3.4.21.37) 是一种丝氨酸蛋白酶, 主要分布在中性粒细胞的嗜天青颗粒中, 在肥大细胞、成纤维细胞、嗜酸性粒细胞、单核细胞和角质形成细胞中也有分布[7, 8]。hNE在中性粒细胞中的浓度超过5 mmol·L-1, 单个细胞中的hNE总量大约为3 pg[9]。正常生理条件下, 这些高浓度的hNE在嗜天青颗粒中被严格调控[10]
hNE是一种含有218个氨基酸残基的多肽链糖蛋白, 包括两条由天冬酰胺连接的糖侧链和四对二硫键[11]。hNE含有19个精氨酸残基, 其中18个在蛋白质表面形成精氨酸簇[12], 使蛋白质等电点偏碱性, pI约为10~11[10]。一级结构与组织蛋白酶G (cathepsin G, CG) 和蛋白酶3 (proteinase 3, PR3) 具有同源性, 3种蛋白酶都属于丝氨酸蛋白酶家族[10]
1986年文献[13]已经报道了hNE的晶体结构, 由两个同源β-桶组成, 每个桶由6个反平行的β-折叠和一个位于C-端的α-螺旋构成[14]。hNE的活性位点由两部分构成: 催化位点与结合位点[15]。催化位点由His57、Asp102和Ser195构成, 这三个氨基酸残基位于两个β-桶的交界处[14]。而结合位点是在催化位点以外hNE与底物发生非共价相互作用的位点, 在hNE结构上对应的位点被称为S1、S2等, 而在底物上相对应的残基被称为P1、P2[15] (图 1)。S1和S2位点是两个较深的结合口袋, 位于hNE活性位点的结合裂缝处。相较于S2位点, S1位点和P1残基之间的相互作用更为重要, 通过修饰S1位点的结合基团, 可以改变底物或抑制剂对hNE的选择性[15]
hNE的His57、Asp102和Ser195通过氢键相互作用形成催化三联体, 然后通过酰化和去酰化过程对底物肽段进行水解[11]。首先, 在酰化反应中, Asp102羧基上的电子通过His57传递给Ser195, 致使Ser195羟基上的氧原子具有很强的亲核性[12], 这种具有强亲核作用的氧原子可以进攻底物肽键中的羰基碳, 与底物形成第一个四面体中间体。这个四面体中间体的氧负离子通过与主链Gly193和Ser195的NH相互作用而稳定[16]。然后, 在酸性介质His57-H+的辅助下, 该四面体中间体脱去R2-NH2, 生成酰基酶中间体[16]。接着, 酰基酶中间体发生去酰化反应。该过程与酰化反应过程相似, Asp102羧基上的电子通过His57传递给水的氧原子, 致使氧原子带有一定的亲核性, 并进攻酰基酶中间体的羰基碳, 形成第二个四面体中间体[16]。该中间体进一步分解, 产生羧酸产物R1COOH, hNE的催化三联体也得以恢复, 整个hNE催化水解过程结束。hNE中的关键催化基团是Ser195的羟基[15]。从hNE的活性作用机制来看, 如果设计的化合物能与Ser195形成四面体加合物, 可以竞争性地抑制hNE对底物肽段的水解活性。hNE的水解机制见图 2[17]
hNE能降解多种细胞外基质蛋白, 如弹性蛋白、蛋白聚糖、层粘连蛋白和纤连蛋白等[18-20]。在正常生理过程中, hNE可以通过降解这些组织结构蛋白, 来降解或修复受损组织, 以维持组织稳态。
在正常生理状态下, hNE蛋白的水解活性受到多种内源性抑制剂的严格调控, 如α1抗胰蛋白酶、elafin和分泌性白细胞蛋白酶抑制剂等[21]。然而, 在病理状态下, 内源性抗蛋白酶与hNE的平衡被打破, hNE活性不受控制, 导致体内氧化剂暴露量增加, 抗氧化能力降低[22, 23]。hNE的过度释放与富集, 可破坏正常的肺组织结构[24], 导致肺气肿。同时也会诱导微血管通透性增加, 黏液分泌过多[25, 26], 导致慢性支气管炎。此外, 过量释放的hNE也会导致一些严重的心肺系统疾病[5], 如慢性阻塞性肺疾病(COPD)[27]、囊性纤维化(CF)、急性呼吸窘迫综合征(ARDS)、支气管扩张(BE)、急性肺损伤(ALI)、特发性肺纤维化(IPF) 和肺动脉高血压(PAH) 等[28, 29]
正常生理条件下, hNE还可以通过降解细菌的结构蛋白[30], 帮助中性粒细胞在炎症部位募集, 降低细菌感染, 参与炎症调节[31]。有研究报道, hNE还可以选择性地杀死癌细胞[32], 并且hNE可以抑制多种原发性肿瘤的生长, 还可以增加细胞毒性CD8+ T细胞, 从而减弱转移性肿瘤的生长[32]。相关研究表明, 对hNE的进一步研究可能有助于开发新的抗癌疗法。鉴于hNE作为疾病治疗靶标的广泛适用性, 许多制药公司和科研单位正在研发有潜力的hNE抑制剂, 来治疗相关疾病。
过去的30多年里, 研究者报道了多种不同结构类型的hNE抑制剂[33]。通过查阅现有的文献和专利, 本文将这些hNE抑制剂分为大分子和小分子hNE抑制剂分别进行介绍。大分子hNE抑制剂以内源性抑制剂为主, 小分子hNE抑制剂则多是通过理性设计得到的一些化合物。
大分子hNE抑制剂主要是一类内源性hNE抑制剂, 与hNE具有互补的三级结构。它们在调节免疫应答中发挥重要作用。大分子hNE抑制剂包括α1蛋白酶抑制剂(alfa1-proteinase inhibitor, α1-PI)、α1抗胰蛋白酶(alfa1-anti-tripsin, AAT)、分泌性白细胞蛋白酶抑制剂(secretory leukocyte protease inhibitor, SLPI)、elafin、α1-抗胰凝乳蛋白酶(α1-anti-chymiotrypsin, ACT)、α2-巨球蛋白和单核细胞中性粒细胞弹性蛋白酶抑制剂(MNEI或Serpin B1)[21]等。
肝脏中产生的内源性α1抗胰蛋白酶(AAT) 是一种重要的中性粒细胞弹性蛋白酶抑制剂。AAT抑制hNE的活性, 从而保护组织免受hNE的损伤[34]。在COPD患者体内, AAT水平升高以平衡hNE活性的增加, 减少炎症[29]。Elafin和SLPI也是在炎症部位产生的内源性hNE抑制剂[35]。Elafin通过竞争性结合机制抑制hNE, 从而发挥组织保护作用[36]。hNE和elafin水平之间的失衡与ARDS死亡率相关[37]。SLPI是一种由中性粒细胞、肥大细胞、上皮细胞和巨噬细胞产生的hNE抑制剂[38]。SLPI通过抑制丝氨酸蛋白酶, 减弱单核细胞/巨噬细胞对LPS的反应, 从而预防细菌、真菌和病毒感染来控制炎症[34, 38]。Serpin B1是一种最有效的hNE抑制剂, 由中性粒细胞和巨噬细胞产生。Serpin B1一般不分泌到细胞外, 而是主要保留在细胞质和初级颗粒中[39]。有研究表明, 缺乏Serpin B1的中性粒细胞出现加速死亡的过程[39]
与大分子hNE抑制剂相比, 小分子抑制剂具有多种优势, 包括较好的口服生物利用度、降低的免疫原性[40]。此外, 通过修饰小分子抑制剂的结构能够改善其药代动力学特性, 从而得到更可靠的临床候选药物[41]。下面总结了一些典型的小分子hNE抑制剂, 主要包括以下几类。
多肽是一类研究较早的hNE抑制剂, 同时为后来的小分子抑制剂的设计与合成奠定了重要的基础[42]。这类抑制剂具有类似的骨架结构(图 3), 结构修饰主要集中在R1和R2两部分[42, 43]。多肽类抑制剂在体外酶水平上的抑制活性较好, 但体内药代动力学特性不佳[43, 44], 导致其难以进入临床研究, 主要原因是多肽类抑制剂的结构上含有多个肽键, 进入体内后会被水解代谢, 而不能发挥相应的抑制作用。
研究进展较好的是POL6014 (图 4), 它是由苏黎世大学与Polyphor公司利用蛋白质表位模拟物(protein epitope mimmetics, PEM) 研发的一种大环肽模拟物[45]。POL6014是一种选择性好、具有口服活性的hNE小分子肽类抑制剂。POL6014目前处于临床Ⅱ期试验, 用于治疗囊性纤维化[46, 47]
Sivelestat (ONO-5046, Elaspol®100) 由日本小野制药公司研发, 是一种已经上市的hNE小分子抑制剂, 在日本等国家批准用于治疗ALI和ARDS[48, 49]。Sivelestat具有高度的hNE抑制特异性, 不会影响体内其他蛋白酶的功能[50], 其中抑制hNE的IC50为44 nmol·L-1, Ki为200 nmol·L-1 [48]。2002年, Sivelestat与hNE之间的相互作用通过LC/ESI-MS技术确定, sivelestat抑制hNE的作用机制见图 5[51]。Sivelestat在ALI/ARDS中的保护作用已在多种肺损伤模型中验证[52]。相关研究报道, 基于sivelestat对新冠肺炎并发症的有利作用, sivelestat有希望治疗COVID-19引发的ALI/ARDS[52]
苯并噁嗪酮类[53] (图 6) hNE小分子抑制剂在hNE酶催化过程中形成酰基酶中间体。Allen Krantz和Robin W. Spencert的研究团队合成并筛选了大量苯并噁嗪酮类化合物对hNE的抑制活性[53], 他们总结了苯并噁嗪酮类化合物抑制hNE的构效关系: 在R2位有吸电子基团和R5有烷基取代, 对hNE的抑制作用显著增强, 但在R6位有取代基对活性不利[53]
苯并噁嗪酮类化合物KRP-109[54] (图 7) 是一个活性较突出的hNE特异性抑制剂。研究发现, 在肺炎链球菌诱导的重症肺炎小鼠模型中, 使用KRP-109治疗的小鼠比对照组小鼠具有更高的存活率[54]。研究结果也表明, KRP-109可减少小鼠模型中的肺部炎症, KRP-109有望用于治疗重症肺炎[54]
Letizia Crocetti和Maria Paola Giovannoni的团队发现了一类含有N-benzoylindazole (N-苯甲酰基吲唑类) 母核结构的高效hNE抑制剂[55, 56] (图 8), 这些化合物对于hNE抑制的IC50值在低纳摩尔范围内。这些化合物对hNE的选择性比其他丝氨酸蛋白酶更强, 且在缓冲溶液中具有良好的化学稳定性[56]。在N-苯甲酰基吲唑的R1位引入各种取代基, 筛选得到了有效的抑制剂7 (IC50为12 nmol·L-1) (图 9)。对R基团进行修饰, 得到了该系列中最有效的化合物3-CN取代衍生物8 (IC50为7 nmol·L-1) (图 9)。这类化合物构效关系表明, 在N-1位保持苯甲酰取代基是活性所必需的, 并且可以通过在吲唑环上引入取代基来提高药效[56]
硼酸boronicacids (BAs) 广泛用于设计生物活性化合物和功能性生物材料。20世纪80年代初, 重氮硼烷化合物作为一类很有发展前景的抗菌剂出现, 其通过在烟酰胺核糖羟基和硼原子之间形成共价键来靶向烯酰还原酶[57, 58]
Pedro M. P. Gois团队研究了B-N杂环家族对于丝氨酸蛋白酶的抑制活性。具体设计中, 以芳香硼基杂环形式稳定重氮硼烷化合物[59]。通过体外活性筛选发现一系列的重氮硼烷化合物在低微摩尔范围内可以有效地抑制hNE (图 10)[59]。研究发现这类化合物对hNE具有良好的选择性, 对其他5种密切相关的丝氨酸蛋白酶没有抑制效果[59]。这类重氮硼烷化合物在pH值为7.4的磷酸盐缓冲液和人血浆中非常稳定[59]。这有利于进一步开发重氮硼烷化合物作为选择性的hNE抑制剂。
Claudia Vergelli团队报道了一类异噁唑酮的hNE抑制剂(图 11)[60]。具体研究中, 他们设计合成了不同系列的小分子化合物: 一类是R3位和R4位均带有烷基基团; 另一类是R3位带有烷基基团、R4位无取代的衍生物(图 11)[60]。研究团队[55, 56, 61]也探讨了不同取代基对于抑制活性的影响, 其中活性最好的化合物13 (图 12) 的hNE抑制活性IC50为20 nmol·L-1, 化合物13在缓冲液的化学稳定性t1/2为8.9 h[60]。化学稳定性研究表明, 异噁唑酮类化合物比N-苯甲酰基吲唑类化合物[56]更稳定, t1/2值从3.1 h延长到19.3 h, 这两类化合物都属于竞争性的hNE抑制剂[60]
基于以上报道进一步设计优化, 合成了一系列基于异噁唑酮类母核结构12的R3位非取代且在R4位苯环上具有不同取代基的衍生物。其中, 抑制活性最强的是化合物14 (IC50为16 nmol·L-1) 和化合物15 (IC50为11 nmol·L-1) (图 12)[62]
硫氟交换(sulfur fluoride exchange, SuFEx) 反应是2014年首次引入的点击化学[63], 应用于化学生物学[64, 65]和药物化学[66, 67]等领域。2022年的诺贝尔化学奖得主Sharpless研究团队[68]曾经报道了一类硫氟交换SuFEx的化合物可以作为hNE的共价抑制剂。研究团队筛选SuFEx化合物库, 发现了选择性的hNE抑制剂: 1, 2-苯二磺酰氟[68] (化合物16, 图 13)。然后对化合物16进行优化, 得到了活性更好的化合物17 (图 13), IC50为0.24 μmol·L-1。相比于同源性蛋白酶CG, 化合物17对hNE具有更高的选择性[68]。硫氟交换衍生物也有望成为一类高选择性的hNE共价抑制剂[68]
2021年, Rami A. Al-Horani研究团队报道了一类磺化非糖肝素模拟物可以作为hNE的抑制剂[69]。研究中得到多个化合物可以抑制hNE, 其中抑制活性最佳的是化合物18 (图 14), IC50为220 nmol·L-1 [69]。化合物18作为一种有效的、选择性的hNE抑制剂, 有望成为治疗hNE相关疾病的潜在药物, 其原因有以下几点[69]: ①它是一种均相分子, 不具有易被硫酸酯酶、脱氧核糖核酸酶或肝素酶酶解的官能团; ②可采用一些策略将其设计为前体药物, 以提高其口服生物利用度; ③磺酸根离子(阴离子性质) 的存在, 使得它不太可能透过血脑屏障或胎盘, 提高了它的安全性; ④该分子没有显示出类似肝素对人类血浆凝血时间的影响, 故无出血并发症; ⑤它不影响多种细胞系的增殖, 提示有较高的安全性; ⑥化合物18也能抑制组织蛋白酶G, 提示其具有双重抗炎作用[69]
拜耳公司研发了以二氢嘧啶酮为母核的hNE小分子抑制剂BAY 85-8501 (图 15), 目前正在进行治疗肺部疾病的Ⅱ期临床试验[28, 70]。BAY 85-8501对hNE具有极佳的抑制活性(IC50为0.065 nmol·L-1), 且对hNE具有高度的选择性和特异性。BAY 85-8501与其他小分子抑制剂相比, 显示出较长的半衰期, 低清除率和较好的代谢稳定性[70]。二氢嘧啶酮结构与hNE的结合是基于诱导契合的结合模式(图 16), 其与hNE的S1和S2口袋紧密作用。BAY 85-8501上对氰基苯环上的甲磺酰基(图 15), 在关键氰基苯基-嘧啶酮轴处提高旋转势垒, 将结合构象锁定在理想的生物活性构象中, 从而提高抑制活性、选择性和稳定性[70]
拜耳公司以临床候选化合物BAY 85-8501为基础, 在嘧啶环右侧加上新的环状体系, 形成咪唑嘧啶、三唑嘧啶和四唑嘧啶等结构, 如化合物20 (图 15), 以确保化合物还有更多的结构部分与hNE蛋白接触[71]。在嘧啶环左侧加上哒嗪环, 得到了化合物BAY-8040 (IC50为28 nmol·L-1) (图 15), 具有较好的药效和体内药代动力学[71]。在肺动脉高压大鼠模型中, BAY-8040减少了慢性炎症, 从而减缓甚至逆转了肺动脉的组织重构[71]。在使用BAY-8040干预后, 观察到心肺参数(如氧饱和度和心排血量) 有统计学上显著的影响[71]
阿斯利康公司多年来一直进行hNE抑制剂的研究, 公司研发的代表性化合物alvelestat (AZ9668) (图 17) 是一种可逆hNE抑制剂, 具有2-吡啶酮骨架。吡啶酮hNE抑制剂与hNE的结合模式, 如图 16所示。Alvelestat在COPD患者和健康志愿者的临床Ⅰ期试验中初步证实了alvelestat具有非常好的安全性和耐受性[72]。目前alvelestat在囊性纤维化患者(CF)、支气管扩张患者(BE) 和慢性阻塞性肺疾病患者(COPD) 中开展临床Ⅱ期试验[73-75]
勃林格殷格翰公司也研发了多种2-吡啶酮骨架结构的hNE抑制剂[76], 用于预防和治疗胃肠道和肺部疾病、过敏性疾病和其他自身免疫疾病。这些化合物具有良好的代谢稳定性和口服渗透性。化合物23 (图 17)[76]是勃林格殷格翰公司研发的hNE抑制剂。
本文简单介绍了hNE的生物学活性, 对现有的hNE抑制剂及相关研究进展进行了综述。相较于大分子hNE抑制剂, 小分子hNE抑制剂可以通过结构修饰, 优化其物理和药代动力学特性, 成为成药性更佳的临床候选药物。但现有的小分子抑制剂也存在一些不足之处, 例如苯并噁嗪酮类抑制剂对其他种类丝氨酸蛋白酶未表现出较好的选择性。二氢嘧啶酮衍生物与吡啶酮衍生物类抑制剂的合成步骤复杂。一些抑制剂的生物利用度低, 稳定性较差, 化合物的半衰期较短, 因此难以进入实际应用。目前处于临床试验的hNE抑制剂较少, 且已经批准上市的sivelestat临床效果差强人意。hNE抑制剂的临床需求仍远未得到满足, 因此值得深入研究和开发具有不同骨架结构的hNE抑制剂。
作者贡献: 王中伟撰写论文初稿, 文辉、王雨辰、崔华清修改论文并定稿。
利益冲突: 本文无相关利益冲突。
  • 中国医学科学院医学与健康科技创新工程(2021-I2M-1-028)
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doi: 10.16438/j.0513-4870.2022-1116
  • 接收时间:2022-10-17
  • 首发时间:2025-11-21
  • 出版时间:2023-04-12
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  • 收稿日期:2022-10-17
  • 修回日期:2022-12-09
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中国医学科学院医学与健康科技创新工程(2021-I2M-1-028)
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    中国医学科学院、北京协和医学院药物研究所, 活性物质发现与适药化研究北京市重点实验室, 北京 100050

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*崔华清, Tel: 86-10-63165248, E-mail:
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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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