
| 10.1038/s41594-021-00651-0
http://scihub22266oqcxt.onion/10.1038/s41594-021-00651-0
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Nat+Struct+Mol+Biol 2021 ; 28 (9): 740-746 Nephropedia Template TP
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Mechanism of molnupiravir-induced SARS-CoV-2 mutagenesis #MMPMID34381216Kabinger F; Stiller C; Schmitzova J; Dienemann C; Kokic G; Hillen HS; Hobartner C; Cramer PNat Struct Mol Biol 2021[Sep]; 28 (9): 740-746 PMID34381216show ga
Molnupiravir is an orally available antiviral drug candidate currently in phase III trials for the treatment of patients with COVID-19. Molnupiravir increases the frequency of viral RNA mutations and impairs SARS-CoV-2 replication in animal models and in humans. Here, we establish the molecular mechanisms underlying molnupiravir-induced RNA mutagenesis by the viral RNA-dependent RNA polymerase (RdRp). Biochemical assays show that the RdRp uses the active form of molnupiravir, beta-D-N(4)-hydroxycytidine (NHC) triphosphate, as a substrate instead of cytidine triphosphate or uridine triphosphate. When the RdRp uses the resulting RNA as a template, NHC directs incorporation of either G or A, leading to mutated RNA products. Structural analysis of RdRp-RNA complexes that contain mutagenesis products shows that NHC can form stable base pairs with either G or A in the RdRp active center, explaining how the polymerase escapes proofreading and synthesizes mutated RNA. This two-step mutagenesis mechanism probably applies to various viral polymerases and can explain the broad-spectrum antiviral activity of molnupiravir.|Animals[MESH]|Antiviral Agents/chemistry/metabolism/pharmacology[MESH]|Base Sequence[MESH]|COVID-19 Drug Treatment[MESH]|COVID-19/*prevention & control/virology[MESH]|Cytidine/*analogs & derivatives/chemistry/metabolism/pharmacology[MESH]|Humans[MESH]|Hydroxylamines/chemistry/*metabolism/pharmacology[MESH]|Models, Molecular[MESH]|Molecular Structure[MESH]|Mutagenesis/drug effects/*genetics[MESH]|Mutation/drug effects/genetics[MESH]|Nucleic Acid Conformation[MESH]|Protein Binding/drug effects[MESH]|Protein Conformation[MESH]|RNA, Viral/chemistry/*genetics/metabolism[MESH]|RNA-Dependent RNA Polymerase/chemistry/genetics/metabolism[MESH]|SARS-CoV-2/drug effects/*genetics/physiology[MESH]
  
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