Pathophysiology Nodes

6
6 shared nodes are defined in this module.

Cell Types

0
No cell types are annotated for this module.

Biological Processes

5
Viral Gene Expression GO:0019080 Gene Ontology (GO) Relation: this mechanism module involves this biological process This mechanism module involves Viral Gene Expression (GO:0019080). GO:0019080 is a biological process from the Gene Ontology. Viral Protein Processing GO:0019082 Gene Ontology (GO) Relation: this mechanism module involves this biological process This mechanism module involves Viral Protein Processing (GO:0019082). GO:0019082 is a biological process from the Gene Ontology. Viral RNA Genome Replication GO:0039694 Gene Ontology (GO) Relation: this mechanism module involves this biological process This mechanism module involves Viral RNA Genome Replication (GO:0039694). GO:0039694 is a biological process from the Gene Ontology. Virion Assembly GO:0019068 Gene Ontology (GO) Relation: this mechanism module involves this biological process This mechanism module involves Virion Assembly (GO:0019068). GO:0019068 is a biological process from the Gene Ontology. Negative Regulation of Viral Process GO:0048525 Gene Ontology (GO) Relation: this mechanism module involves this biological process This mechanism module involves Negative Regulation of Viral Process (GO:0048525). GO:0048525 is a biological process from the Gene Ontology.
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Notes

This pathogen-process-centric module models biological steps rather than individual drugs. Disorder nodes reference exact anchors with conforms_to, and protease-inhibitor treatments point to the conforming virus-specific processing node with target_mechanisms. Key conformance / treatment target: "Virus-Encoded Protease-Dependent Polyprotein Processing". The two outputs are deliberately distinct. COVID-19 and Acute_Hepatitis_C_Virus_Infection conform through "Replication-Complex Formation and Viral RNA Replication"; an HIV conformer would instead use "Protease-Driven Structural Virion Maturation" and may continue to "Production of Immature, Non-Infectious Virions". As a high-precision operational curation boundary, a qualifying branch must model synthesis of a viral polyprotein precursor, cleavage at defined junctions by a virus-encoded protease, and exactly the applicable productive output: nonstructural replicase function and viral RNA replication, or Gag/Gag-Pol structural maturation. Conformance to the central virus-encoded processing node is mandatory. Protease-resistance and immature-particle nodes are optional, context-specific extensions and are not sufficient by themselves. Host-protease entry or priming (including TMPRSS2 and furin), host CYP3A boosting, protease-mediated immune evasion without the polyprotein-processing trunk, replication or viremia alone, immature particles alone, and non-protease antiviral targets do not qualify. Ritonavir is itself an HIV protease inhibitor, but in modern regimens it is used almost exclusively as a pharmacokinetic enhancer. In nirmatrelvir/ritonavir it inhibits host CYP3A rather than the viral protease; that boosting role is therefore described separately from viral target inhibition and resistance. See projects/ANTIVIRAL.md.

Used By Disorder Entries

2

Pathograph

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Pathograph: causal mechanism network for Viral Protease Inhibition Module Interactive directed graph showing how this shared module's pathophysiology nodes connect.

Pathophysiology

6
Synthesis of the Viral Polyprotein Precursor
trigger
The viral genome is expressed as one or more polyprotein precursors. These precursors contain structural proteins, replicative enzymes, or both, and must be cleaved into individual functional products. Examples include HIV Gag and Gag-Pol, the HCV polyprotein, and the SARS-CoV-2 replicase polyproteins pp1a and pp1ab.
Viral Gene Expression GO:0019080 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves Viral Gene Expression (GO:0019080). GO:0019080 is a biological process from the Gene Ontology.
Virus-Encoded Protease-Dependent Polyprotein Processing
therapeutic vulnerability
A virus-encoded peptidase cleaves the polyprotein precursor at defined sites. This shared druggable step is instantiated by HIV protease cleavage of Gag and Gag-Pol, HCV NS3/4A cleavage within the nonstructural region, and SARS-CoV-2 Mpro (3CLpro/nsp5) cleavage of pp1a and pp1ab. Active-site or substrate-cleft protease inhibitors prevent the applicable cleavage events. The products and downstream phenotype are branch-specific rather than interchangeable across these virus families.
Viral Protein Processing GO:0019082 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves Viral Protein Processing (GO:0019082). GO:0019082 is a biological process from the Gene Ontology.
Replication-Complex Formation and Viral RNA Replication
effector
In the replicase branch, proteolytic processing releases viral nonstructural proteins that form or support the replication machinery. SARS-CoV-2 pp1a/pp1ab processing releases products including the RNA polymerase and helicase, and HCV NS3/4A processing of the nonstructural region is essential for viral replication. Inhibition of the upstream protease prevents this functional replicase output; it is not represented as production of an immature particle.
Viral RNA Genome Replication GO:0039694 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves Viral RNA Genome Replication (GO:0039694). GO:0039694 is a biological process from the Gene Ontology.
Protease-Driven Structural Virion Maturation
effector
In the structural-maturation branch exemplified by HIV-1, protease-mediated Gag and Gag-Pol cleavage reorganizes the immature particle and produces the mature capsid and other functional virion components. This branch is not used for SARS-CoV-2 Mpro or HCV NS3/4A conformances.
Virion Assembly GO:0019068 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves Virion Assembly (GO:0019068). GO:0019068 is a biological process from the Gene Ontology.
Production of Immature, Non-Infectious Virions
consequence
In the HIV structural-maturation branch, inhibiting viral protease prevents complete Gag and Gag-Pol cleavage. Particles can be released but retain immature architecture and are non-infectious. This consequence is scoped to the structural branch and is not asserted as the phenotype of HCV NS3/4A or SARS-CoV-2 Mpro inhibition.
Negative Regulation of Viral Process GO:0048525 Gene Ontology (GO) Relation: this pathophysiological event involves this biological process This pathophysiological event involves Negative Regulation of Viral Process (GO:0048525). GO:0048525 is a biological process from the Gene Ontology.
Protease-Inhibitor Resistance
adaptive escape
Viral proteases can acquire substitutions that reduce inhibitor affinity while preserving enough catalytic activity for polyprotein processing. HCV NS3/4A resistance-associated substitutions at positions including R155, A156, and D168 illustrate this adaptive escape. Host-drug metabolism and pharmacokinetic boosting are intentionally excluded from this node: ritonavir or cobicistat enhancement changes inhibitor exposure, whereas resistance is a heritable viral target change selected under drug pressure.