Article
Functional and Structural Characterization of Treatment-Emergent Nirmatrelvir Resistance Mutations at Low Frequencies in the Main Protease (Mpro) Reveals a Unique Evolutionary Route for SARS-CoV-2 to Gain Resistance.
The Journal of infectious diseases - 14 Nov 2025
Deschenes Natalie M, Pérez-Vargas Jimena, Zhong Zoe, Thomas Merrilee, Kenward Calem, Mosimann Wesley A, Worrall Liam J, Waglechner Nicholas, Li Angel XinLiu, Maguire Finlay, Aftanas Patryk, Smith Jason R, Lim Jared, Young Robert N, Cherkasov Artem, Farooqi Lubna, Moinuddin Adnan, Siddiqi Lina, Malik Imaan, Lefebvre Maxime, Paetzel Mark, Strynadka Natalie C J, Jean François, McGeer Allison, Kozak Robert A
Abstract excerpt
BACKGROUND: The main protease (Mpro) is one of the most attractive targets for antiviral drug discovery against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Mutations in Mpro have been linked to resistance against nirmatrelvir-ritonavir (NIR-RIT), an important therapy for SARS-CoV-2 infection. This study aimed to identify low-frequency antiviral resistance mutations in Mpro from NIR-RIT-treated...
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