Discovery of Small Molecule Inhibitors of PCSK9 Using Virtual Screening as Potential Therapeutics for Atherosclerosis
Authors
Matthew N. Siciliano

Share
Annotation
High LDL cholesterol can cause heart disease. Current treatments like statins are not always effective, so new therapies are needed. PCSK9 is a protein that reduces the number of LDL receptors in the liver, which keeps cholesterol in the blood, making it a strong target for new drugs. Blocking PCSK9 with small molecules could be a better alternative to current treatments. To find potential inhibitors, I first analyzed the PCSK9 protein to locate possible binding sites using computational methods, which revealed multiple sites that small molecules could target. Then, I created two pharmacophore maps and screened two chemical libraries to find molecules that fit the key interactions. I used molecular docking simulations to estimate how strongly these molecules bind to PCSK9, identifying several with strong predicted binding. Using SwissADME to check drug likeness and absorption properties, we narrowed down the candidates to seven molecules suitable for oral use. Finally, predicted toxicity was analyzed which helped identify the safest and most effective compounds. After comparing binding strength, drug likeness, and toxicity, Z73447142 and Z52103291 are the two most promising drug candidates for PCSK9. These molecules could be further tested using biophysical binding assays and cell-based experiments to confirm their effects, with the goal of eventually developing new oral treatments to lower cholesterol and reduce cardiovascular risk.
Keywords
Authors
Matthew N. Siciliano

Share
References:
Abdulla, A., Shalaby, M., Kumfa, P., Raja, M., Allencherril, J., & Sharifeh, T. A. (2024). Updates on non-statin LDL-lowering therapy. Current Cardiology Reports, 26(4), 221–231. https://doi.org/10.1007/s11886-024-02028-3
Ajoolabady, A., Pratico, D., Mazidi, M., Davies, I. G., Lip, G. Y. H., Seidah, N., Libby, P., Kroemer, G., & Ren, J. (2025). PCSK9 in metabolism and diseases. Metabolism: Clinical and Experimental, 163, 156064. https://doi.org/10.1016/j.metabol.2024.156064
Blanchard, V., Khantalin, I., Ramin-Mangata, S., Chémello, K., Nativel, B., & Lambert, G. (2019). PCSK9: From biology to clinical applications. Pathology, 51(2), 177–183. https://doi.org/10.1016/j.pathol.2018.10.012
Bodapati, A. P., Hanif, A., Okafor, D. K., Katyal, G., Kaur, G., Ashraf, H., & Khan, S. (2023). PCSK9 inhibitors and cardiovascular outcomes: A systematic review with meta-analysis. Cureus, 15(10), e46605. https://doi.org/10.7759/cureus.46605
Chen, B., Shi, X., Cui, Y., Hou, A., & Zhao, P. (2019). A review of PCSK9 inhibitors and their effects on cardiovascular diseases. Current Topics in Medicinal Chemistry, 19(20), 1790–1817. https://doi.org/10.2174/1568026619666190809094203
Coppinger, C., Movahed, M. R., Azemawah, V., Peyton, L., Gregory, J., & Hashemzadeh, M. (2022). A comprehensive review of PCSK9 inhibitors. Journal of Cardiovascular Pharmacology and Therapeutics, 27, 10742484221100107. https://doi.org/10.1177/10742484221100107
Cui, D., Yu, X., Guan, Q., Shen, Y., Liao, J., Liu, Y., & Su, Z. (2025). Cholesterol metabolism: Molecular mechanisms, biological functions, diseases, and therapeutic targets. Molecular Biomedicine, 6(1), 72. https://doi.org/10.1186/s43556-025-00321-3
Farhan, M., Hussein, G. A., Alom, T., Das, A., Durrani, T. A., Hayani, Z. M., Alkassar, A., Oweis, H. A., Nazir, M. H., Dhillon, D. K., Servil, E., & Patel, T. (2025). Evaluating the role of PCSK9 inhibitors in reducing cardiovascular events among statin-intolerant patients: A systematic review and meta-analysis. Annals of Medicine and Surgery, 87(2), 891–899. https://doi.org/10.1097/MS9.0000000000002927
Ferri, N., & Marodin, G. (2024). Emerging oral therapeutic strategies for inhibiting PCSK9. Atherosclerosis Plus, 59, 25–31. https://doi.org/10.1016/j.athplu.2024.11.003
Garwood, C. L., Cabral, K. P., Brown, R., & Dixon, D. L. (2025). Current and emerging PCSK9-directed therapies to reduce LDL-C and ASCVD risk: A state-of-the-art review. Pharmacotherapy, 45(1), 54–65. https://doi.org/10.1002/phar.4635
González-Guerrero, A., Navarrete-Rouco, E., Benaiges, D., Giralt-Steinhauer, E., Marcos, L., Oliveras, A., Recasens, L., & Pedro-Botet, J. (2025). Efficacy and safety of PCSK9 inhibitors in real life. Clínica e Investigación en Arteriosclerosis, 37(5), 500755. https://doi.org/10.1016/j.arteri.2024.500755
Grejtakova, D., Boronova, I., Bernasovska, J., & Bellosta, S. (2025). PCSK9 and lipid metabolism: Genetic variants, current therapies, and cardiovascular outcomes. Cardiovascular Drugs and Therapy, 39(6), 1439–1451. https://doi.org/10.1007/s10557-024-07599-5
Guo, J., Chen, S., Zhang, Y., Liu, J., Jiang, L., Hu, L., Yao, K., Yu, Y., & Chen, X. (2024). Cholesterol metabolism: Physiological regulation and diseases. MedComm, 5(2), e476. https://doi.org/10.1002/mco2.476
Ho, V. Q. T., Tran, N. B., Nguyen, N., Downes, D., Arrighini, G. S., Dandamudi, M., Cardoso, R., & Giorgi, J. (2025). Oral PCSK9 inhibitors as an emerging frontier in lipid management: A meta-analysis. Journal of Clinical Lipidology. https://doi.org/10.1016/j.jacl.2025.09.015
Huh, J., & Kim, H. (2025). Naturally occurring PCSK9 inhibitors: An updated review. Molecules, 30(17), 3582. https://doi.org/10.3390/molecules30173582
Jeswani, B. M., Sharma, S., Rathore, S. S., Nazir, A., Bhatheja, R., & Kapoor, K. (2024). PCSK9 inhibitors: The evolving future. Health Science Reports, 7(11), e70174. https://doi.org/10.1002/hsr2.70174
Kao, G., Chen, C., Zhang, Y., Xu, Y., & Xu, G. (2025). Efficacy and safety of PCSK9 inhibitors in patients with acute coronary syndrome: A systematic review and network meta-analysis. BMC Cardiovascular Disorders, 25(1), 629. https://doi.org/10.1186/s12872-025-05070-3
Katzmann, J. L., & Laufs, U. (2024). PCSK9-directed therapies: An update. Current Opinion in Lipidology, 35(3), 117–125. https://doi.org/10.1097/MOL.0000000000000919
Kuang, J., Hao, L., Zhang, M., & Yang, Z. (2025). Proprotein convertase subtilisin/kexin type 9 (PCSK9): The multifaceted biology, diseases, and pharmaceutical interventions. MedComm, 6(11), e70451. https://doi.org/10.1002/mco2.70451
Li, Y., Xue, K., Hu, R., Hu, X., Guo, R., Guo, H., & Li, G. (2025). A meta-analysis of the regulation of low-density lipoprotein cholesterol and proprotein convertase subtilisin-kexin type 9 with inclisiran. American Journal of Cardiovascular Drugs, 25(2), 191–201. https://doi.org/10.1007/s40256-024-00702-z
Liu, D., Zhang, J., Zhang, X., Jiang, F., Wu, Y., Yang, B., Li, X., Fan, X., Li, H., Sun, Y., Gou, R., & Wang, X. (2024). The efficacy and safety of proprotein convertase subtilisin/kexin type 9 inhibitors combined with statins in patients with hypercholesterolemia: A network meta-analysis. Frontiers in Cardiovascular Medicine, 11, 1454918. https://doi.org/10.3389/fcvm.2024.1454918
Maștaleru, A., Zouri, M., Leon, M. M., Popescu, G., Zouri, N., Tamba, B. I., & Cumpăt, C. M. (2025). Evaluating value beyond efficacy: A meta-analytic assessment of inclisiran's cost-effectiveness in cardiovascular prevention.Healthcare, 13(24), 3287. https://doi.org/10.3390/healthcare13243287
McGuigan, A., & Blair, H. A. (2025). Bempedoic acid: A review in cardiovascular risk reduction in statin-intolerant patients. American Journal of Cardiovascular Drugs, 25(1), 7–16. https://doi.org/10.1007/s40256-024-00714-9
Monami, M., Sesti, G., & Mannucci, E. (2019). PCSK9 inhibitor therapy: A systematic review and meta-analysis of metabolic and cardiovascular outcomes in patients with diabetes. Diabetes, Obesity & Metabolism, 21(4), 903–908. https://doi.org/10.1111/dom.13599
Nicholls, S. J., & Nelson, A. J. (2025). Achieving more optimal lipid control with non-statin lipid lowering therapy.Current Atherosclerosis Reports, 27(1), 32. https://doi.org/10.1007/s11883-025-01280-4
Rajtar-Salwa, R., Bobrowska, B., Socha, S., Dziewierz, A., Siudak, Z., Batko, J., Bartuś, S., & Krawczyk-Ożóg, A. (2024). Efficacy of alirocumab, evolocumab, and inclisiran in patients with hypercholesterolemia at increased cardiovascular risk. Medicina, 60(7), 1124. https://doi.org/10.3390/medicina60071124
Ruhela, N., Singla, A., Trivedi, Y. V., Ahmed, M., Chikatimalla, R., Gupta, S., & Jain, R. (2025). Advancements in lipid-lowering therapy: The role of proprotein convertase subtilisin/kexin type 9 inhibitors and beyond in cardiovascular risk reduction. Coronary Artery Disease, 36(8), 696–706. https://doi.org/10.1097/MCA.0000000000001574
Santulli, G., Kansakar, U., Jankauskas, S. S., & Varzideh, F. (2025). Comparative LDL-C lowering efficacy of nonstatin therapies: Inclisiran is better than ezetimibe, PCSK9 inhibitors, and bempedoic acid. Journal of Cardiovascular Pharmacology, 86(3), 239–241. https://doi.org/10.1097/FJC.0000000000001731
