临床试验阶段的抗人免疫缺陷病毒化学药物研究进展

综述和分析了目前国内外正在进行的抗HIV化学药物临床试验的进展情况,这些药物包括进入抑制剂、逆转录酶抑制剂、整合酶抑制剂、蛋白酶抑制剂、成熟抑制剂、锌指抑制剂等。     

两个抗艾滋病新药Maraviroc和Raltegravir的Ⅲ期临床试验结果被公布

目前抗艾滋病药的作用机制包括抑制HIV复制所需的酶——蛋白酶和逆转录酶的抑制剂、阻止艾滋病病毒进入和感染免疫细胞的CCR5抑制剂、通过阻断病毒与宿主细胞膜的融合而阻断HIV繁殖的膜融合抑制剂，如罗氏公司的恩夫韦地（enfuvirtide，Fuzeon）以及整合酶（integrase）抑制剂。     

HIV化学治疗的最新进展

分两部分介绍了抗HIV的化学治疗药物的新进展,一是作用于现有病毒靶位的属于逆转录酶抑制剂和蛋白酶抑制剂的新化合物,另一部分是作用于病毒新靶位的化合物如HIV整合酶抑制剂、核糖核酸酶-H抑制剂以及病毒进入抑制剂。主要从化学结构、对耐药性病毒的抑制作用、作用机制和临床效果等几个方面介绍了解决HIV耐药性问题的新化合物。     

艾滋病抗病毒治疗进展

抗HIV药物的研发和应用为临床控制疾病的进展发挥了重要的作用。回顾了临床常用的抗HIV药物的研发历史,综述了目前应用于临床的逆转录酶抑制剂、蛋白酶抑制剂、病毒入胞抑制剂和整合酶抑制剂及其新产品的作用和机制,以及对HIV治疗的新思路和药物预防策略。     

具抗HIV作用的天然逆转录酶抑制剂、蛋白酶抑制剂和整合酶抑制剂

综述了目前开发的促进 HIV 复制的逆转录酶抑制剂、HIV 蛋白酶抑制剂和 HIV 整合酶抑制剂等3类抗 AIDS 药物的研究状况。     

五类抗艾滋病药物的研究分析

艾滋病是威胁人类健康的重大疾病,目前各国均积极投入抗艾滋病药物的研发与生产。本文详细分析了五类抗艾滋病药物的研究进展,包括核苷类逆转录酶抑制剂（NRTIs）、非核苷类逆转录酶抑制剂（NNRIs）、蛋白酶抑制剂（PIs）、进入抑制剂（entry inhibitors）、整合酶抑制剂（integrase inhibitors）的抗病机理、上市品种及副作用等情况。     

抗艾滋病药物的现状与展望

艾滋病（AIDs）的肆意传播对人类生存和发展提出了严峻挑战，迫切需要开发出新的药物来遏制AIDS的泛滥。笔者全面综述了已上市的五大类抗AIDS药物，包括核苷类逆转录酶抑制剂（NRTIs）、非核苷类逆转录酶抑制剂（NNRTIs）、蛋白酶抑制剂（PIs）、进入抑制剂（entry inhibitors）、整合酶抑制剂（integrase inhibitors）的作用机制、特点及ADR情况，并探讨了一些有可能成为新的抗AIDS药物的研究进展，以期为AIDS的药物治疗提供参考。     

HIV-1侵入抑制剂的研究进展

人类免疫缺陷病毒(HIV)-1侵入抑制剂能抑制HIV进入靶细胞,在最初环节抑制病毒的传播。具有高活性、较好药物代谢性质的肽及肽类似物不断被发现,并成为抗HIV药物研究的热点。根据HIV-1进入靶细胞的3个步骤可将侵入抑制剂分为黏附抑制剂、辅助受体结合抑制剂和融合抑制剂,并对其研发策略和研究进展进行综述。     

新型抗艾滋病药物——HIV进入抑制剂的研究进展

HIV与靶细胞融合的过程是药物干预的重要环节。融合过程主要由H IV包被蛋白表面亚基gp120和跨膜亚基gp41介导。H IV gp120与靶细胞上的CD4分子和辅助受体(趋化因子受体CCR5或CXCR4等)结合,导致gp41的构型发生改变,启动病毒包膜与靶细胞膜的融合。在融合过程中,病毒和靶细胞上的这些蛋白和受体均可作为药物的作用靶点,寻找抑制H IV进入靶细胞的药物用来治疗H IV感染和艾滋病。作用于gp41的肽类药物T-20已被美国FDA批准上市,表明继逆转录酶抑制剂和蛋白酶抑制剂后,H IV进入抑制剂作为第3类抗H IV药物开始在临床上应用。作为一种新机制的抗H IV药物,H IV进入抑制剂单独或与逆转录酶抑制剂和蛋白酶抑制剂联合应用,将有助于提高药物的疗效,降低毒副作用,并可望挽救对现有抗H IV药物耐药的艾滋病病人的生命。该文综述了近年来H IV进入抑制剂的研究进展。     

抗耐药性逆转录病毒药物研究的新进展

最近1种抗HIV-1感染疫苗的失败提示了抗逆转录病毒疗法对治疗HIV-1感染患者的重要性。迄今为止,2种病毒蛋白酶（逆转录酶和蛋白酶）的抑制剂对于HIV-1感染患者的存活有着显著影响。由于当前使用的抗逆转录病毒药物耐药性的发展,迫切需要新的能作用于病毒复制不同环节的抑制剂。本文综述了最近抗逆转录病毒药物的发现进展,并着重探讨了病毒进入、病毒DNA与宿主细胞基因组整合和病毒颗粒成熟等病毒复制阶段新抑制剂的发展。     

Small molecule HIV entry inhibitors: Part II. Attachment and fusion inhibitors: 2004-2010

INTRODUCTION: The first US FDA approved HIV entry inhibitor drug Enfuvirdine belongs to the fusion inhibitor category. Earlier efforts in this area were focused on peptides and monoclonal antibodies; recently, the focus has shifted towards the development of small molecule HIV attachment and fusion inhibitors. They can be used for prophylactic purposes and also hold potential for the development of HIV microbicides. AREAS COVERED: In a previous paper ('Small molecule HIV entry inhibitors: Part I'), we reviewed patents and patent applications for small molecule chemokine receptor antagonists from major pharmaceutical companies. In this paper, the development of small molecule HIV attachment and fusion inhibitors is discussed in detail. It covers patents and patent applications for small molecule HIV attachment and fusion inhibitors published between 2004 and 2010 and related literature with a focus on recent developments based on lead generation and lead modification. EXPERT OPINION: To augment the potency of currently available antiretroviral drug combinations and to fight drug-resistant virus variants, more effective drugs which target additional steps in the viral replication cycle are urgently needed. HIV attachment and fusion processes are such targets. Inhibitors of these targets will provide additional options for the treatment of HIV drug-resistant strains. Small molecule HIV attachment inhibitors such as BMS-378806 and analogs from Bristol Myers Squibb, N-aryl piperidine derivatives from Propharmacon, and NBD-556 and NBD-557 from New York Blood Center may have potential as vaginal microbicidal agents and can be an economical alternative to monoclonal antibodies.     

Inhibiting HIV-1 entry with fusion inhibitors

In recent years, tremendous progress has been made in understanding the HIV-1 entry process in which the viral and cellular membranes are fused, resulting in the subsequent delivery of the viral genome into the host cell. The mechanistic insight gained from these studies has led to the formulation of exciting new approaches for therapeutic intervention. One of the first and clinically most advanced drugs to emerge from this effort is the fusion inhibitor T20. T20 acts by freezing a transient structural intermediate of the HIV-1 fusion process, thus blocking an essential step in viral entry. With phase III clinical trials already well underway, the success of T20 indicates that targeting of the viral entry process will soon be an important component of antiretroviral therapy. This review addresses this rapidly developing area of HIV research, with a focus on the mechanistic role of fusion inhibitors targeted to the HIV-1 gp41 transmembrane glycoprotein. We will review the results of recent clinical trials with T20 and discuss possible mechanisms of viral escape through the evolution of drug-resistant HIV-1 variants. We will also discuss ongoing research on fusion inhibitor susceptibility testing and the development of new improved fusion inhibitors.