Aug 2026· Journal of Medicinal Chemistry· Vol 69 17, pp.
20734-20760
· 0 citations· 49 references
Medicine
TL;DR
QX-31 serves as a valuable chemical tool, demonstrating that covalent targeting of this conformational regulatory domain is a viable therapeutic strategy for fibrotic diseases.
Abstract
Targeting the NLRP3 inflammasome is critical for treating fibrotic diseases; however, current NACHT domain inhibitors face mutational escape and limited isoform specificity. The autoinhibitory leucine-rich repeat (LRR) domain represents an underexplored pharmacological target. Here, we report QX-31, a novel covalent probe selectively engaging the LRR domain. QX-31 covalently binds to Cysteine 838, stabilizing NLRP3 in an inactive conformation and preventing inflammasome assembly with high selectivity over AIM2 and NLRC4. Furthermore, QX-31 reverses maladaptive immunometabolic reprogramming within the renal microenvironment by blunting the PI3K/AKT/HIF-1α axis, suppressing aberrant glycolysis and glutaminolysis. Evaluated in human kidney organoids and murine models of renal injury (UUO and IRI), QX-31 demonstrated potent antifibrotic efficacy comparable to reference drugs, alongside a favorable safety profile. Collectively, QX-31 serves as a valuable chemical tool, demonstrating that covalent targeting of this conformational regulatory domain is a viable therapeutic strategy for fibrotic diseases.
This review summarizes recent advances in NLRP3 inflammasome inhibitors reported from mid-2023 to the beginning of 2026, with emphasis on clinical development status, patent landscapes, and structural classifications.
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