Discussions

Indinavir (Crixivan for SARS-CoV-2 antiviral) is a drug used as an HIV protease inhibitor. It works by binding to HIV protease active sites and inhibiting post-translational processing, leading to the formation of immature non-infectious virus particles and interruption of viral transmission. At concentrations of 25 to 100 nmol/L, Indinavir inhibited 95% of HIV replication in vitro, and in combination with other antiretroviral drugs, it has shown cumulative or synergistic antiviral effects in cell cultures in most studies. However, due to amino acid substitutions of HIV proteases, cross-resistance occurs across the entire class of protease inhibitors. In actual clinical trials, indinavir-resistant HIV clinical isolates selected during indinavir treatment have demonstrated a high degree of cross-resistance to other protease inhibitors.

In addition, there are significant differences in plasma concentrations of indinavir in patients receiving the same dose of medication. Patients with no HIV RNA detected in plasma had significantly higher drug concentrations than those with HIV RNA detected in plasma. The concentration relationship between this drug dose and antiviral effect provides good material for us to quantify the effect of heterogeneity of treatment response. Starting from this aspect, we can continue to study the pharmacological mechanism of indinavir on other viruses, especially coronavirus.

Three primary anti-virus techniques are currently in use: 1) direct anti-viral effects, 2) blocking virus entry and replication at the cellular level by focusing on virus-related activities, and 3) boosting host immune response. Creative Biolabs has paid close attention to the pharmacological research and development of antiviral protease inhibitors in order to screen out possible protease inhibitor medications that are effective for SARS-CoV-2. We can assist clients in determining and assessing if Indinavir has the potential to be an efficient and targeted antiviral agent against this SARS-CoV-2 outbreak by examining the crystal structures of currently available commercial medications. Additionally, we can assist clients with in vivo and in vitro testing to determine the indinavir's true efficacy.