Examples of currently approved molecular therapeutics. (A) Examples of small-molecule drugs, most of which are under 500 Da and less than 1 nm in size, shown as ball-and-stick models with transparent molecular surfaces. Clockwise from top left, Cambridge structural database (CSD) crystal structures COTZAN03, JEMJOA01, BZPENK01, and APUYOA are shown. (B) Examples of peptide macrocycle drugs, of which only 20 are approved for clinical use. Molecules are shown as ball-and-stick models (with apolar hydrogen atoms omitted for clarity) and transparent molecular surfaces. Clockwise from top left, CSD structures YICMUS and DEKSAN, and PDB structures 5L3 F (chain C) and 2VDN (chain C) are shown. (C) Examples of protein drugs, shown as ribbons and molecular surfaces. Clockwise from top, PDB structures 1 CG2 (chains A and B), 1BML (chains C and D), and 5HYS (chains C and D). Insets: small-molecule and peptide macrocycle drugs from panels A and B, respectively, shown to scale.

Examples of currently approved molecular therapeutics. (A) Examples of small-molecule drugs, most of which are under 500 Da and less than 1 nm in size, shown as ball-and-stick models with transparent molecular surfaces. Clockwise from top left, Cambridge structural database (CSD) crystal structures COTZAN03, JEMJOA01, BZPENK01, and APUYOA are shown. (B) Examples of peptide macrocycle drugs, of which only 20 are approved for clinical use. Molecules are shown as ball-and-stick models (with apolar hydrogen atoms omitted for clarity) and transparent molecular surfaces. Clockwise from top left, CSD structures YICMUS and DEKSAN, and PDB structures 5L3 F (chain C) and 2VDN (chain C) are shown. (C) Examples of protein drugs, shown as ribbons and molecular surfaces. Clockwise from top, PDB structures 1 CG2 (chains A and B), 1BML (chains C and D), and 5HYS (chains C and D). Insets: small-molecule and peptide macrocycle drugs from panels A and B, respectively, shown to scale.

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Drug discovery is a laborious process with rising cost per new drug. Peptide macrocycles are promising therapeutics, though conformational flexibility can reduce target affinity and specificity. Recent computational advancements address this problem by enabling rational design of rigidly folded peptide macrocycles. Areas Covered: This review summar...

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... of the rest are either cellular therapies or protein therapeutics with masses over 10 kDa. Examples of small-molecule drugs are shown in Figure 1A: here, acetaminophen (paracetamol) is a common analgesic, diphenhydramine is a widely used antihistamine, penicillin G is a lactam antibiotic, and darunavir is an HIV protease inhibitor. While small molecules are easier to mass produce, more shelf-stable, easier to administer, frequently orally bioavailable, sometimes cell permeable, and often able to evade the human immune system, their small size limits the surface area that they can present for target recognition. ...
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... under 45 kDa are also rapidly cleared by the kidneys, limiting serum half-life [30]. Unlike small molecules, protein therapeutics ( Figure 1C) can present much larger surfaces for very specifically recognizing a target, resulting in high-affinity binding and excellent specificity, and producing high therapeutic indices. Shown are glucarpidase, an enzyme able to remove excess methotrexate from the blood of patients with impaired kidney function, streptokinase, which enzymatically dissolves blood clots, and the Fab fragment of omalizumab, a monoclonal antibody used to treat asthma. ...
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... they represent a small fraction of known drugs, some of the most potent and versatile therapeutics are intermediate-or mesoscale macrocycles, often built from amino acids or amino acid-like building-blocks. Figure 1B shows octreotide, a synthetic analogue of the natural hormone somatostatin which is used to treat tumors producing growth hormone, cyclosporine A, a potent immunosuppressant, polymyxin B1, an antibiotic that targets Gram-negative bacteria, and eptifibatide, a powerful anticoagulant. Currently, there are 20 peptide macrocycle drugs in use in the clinic (Table 1), most of which were discovered or invented prior to 1990 [27,. ...

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... peptides, they primarily thrive in the realm of smaller, simpler molecules, neglecting the specific challenges of peptide synthesis (Mulligan, 2020). Macrocyclic peptides are usually synthesized through the one-by-one incorporation of natural or non-natural amino acids, and are followed by reactions to cyclize peptides (Qian et al., 2015). ...
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... Although rarely mentioned in publications, computational tools have demonstrated successful applications in facilitating the macrocyclization process 16,17 . Wagner et al. 18 and Sindhikara et al. 19 utilized geometrically constrained linker database searching and linker connection strategy to generate macrocycles from acyclic ligands. ...
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... Therefore, attention was turned to the binding mode of β-lactamase antibiotics to NDM-1. For example, some macrocyclic peptides have been constructed from a mixture of L-and D-amino acids (D-type structures tend to have stronger affinity) [53]. The design of another group is similar to that of Mulligan in that it uses a portion of the natural product largazole as the "anchor" for cyclic peptide design, targeting the cancer target histone deacetylase [54]. ...
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... The energetics of this desolvation process will have an enthalpic component, due to breaking of hydrogen bonds to water, and an entropic component due to changes to the ordered solvation shell. A membrane permeating macrocycle is deemed to have "chameleonicity" 11,12 when differing conformational ensembles exist in the bulk water and membrane interior phases. The "puckering" of a molecule to shield polar/charged groups from the membrane interior is said to drive membrane permeation for flexible macrocycles ( Figure 1A). ...
... The LPE is a function of the decadienewater distribution coefficient at pH 7.4 (logD 7.4 ) , the calculated octanol-water partition coefficient (clogP), and scaling factors to standardize the LPE across different chemical scaffolds and clogP metrics. Naylor et al. proposed that the LPE is more useful for modeling permeability, especially for compounds that are "chameleonic" 11,12 in nature. ...
... In contrast to PSA_w, Es_w, ALOGP, and nHBD, the latter three features T (N...N), T(N...O), and piPC02 are novel features for inclusion in a permeability model. These structural features encode compound flexibility and, likely, capture the ability of the macrocycle to adopt multiple environment-dependent conformational states while transitioning reversibly from water to the membrane (Figure 1), i.e., to behave in a 'chameleonic' 11,12 manner. We would suggest that while PSA_w, Es_w, ALOGP, and nHBD encode the enthalpic contributions to the free energy of membrane permeation, T (N...N), T(N...O), and piPC02 likely model (partially) the entropic contributions to membrane permeation. ...
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... Hit refinement to produce leads for preclinical, animal, and clinical evaluation can also be guided by computation to further increase the likelihood of leads succeeding. The ultimate effect is to shift failures to earlier, less expensive stages of the pipeline and to allow more successes in later stages, allowing more drugs to be brought to the clinic with less cost in time, effort, or resources recently, computational tools have been developed to facilitate the rational design of peptide macrocycles able to bind to target proteins of therapeutic interest (Mulligan 2020). ...
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... Cyclic peptides have been widely used as potential therapeutics [38][39][40] and scaffolded antigens, [41][42][43] since they are in the "beyond-rule-of-five" chemical space 44 and have many protein characteristics. 45 Computational methods have been developed to design well-structured cyclic peptides that preferentially populate a single conformation, [45][46][47][48][49][50] which have led to several applications. ...
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... The main focus of this chapter is small peptides (those with fewer than 15 amino acids) that are cyclic; i.e. their N-and C-terminal residues are connected via an amide bond, disulfide bond, thioether bond, or other covalent connection ( Figure 1B). These constrained peptides are a promising class of therapeutics, complementary to antibodies and small molecules, for binding currently undruggable protein targets (9)(10)(11)(12)(13). ...
... This section describes the overall workflow for design of peptides using Rosetta, with some details about each step (Figure 3). For detailed instructions on how to run these methods, the readers are referred to references cited (13,32,44,57,58,86,102). It should be noted that while this section is focused on using Rosetta for peptide design, many of the steps are similar in other computational pipelines, and the differences are often in the implementations and in algorithmic details. ...
... However, studies of miniproteins designed through this method, in particular their synthesis, can be more high-cost and time-consuming than those designed through the first approach. 12,106 These methodologies could be in some cases combined and/or supported by rational/ manual selection of modifications. ...
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