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The vaccinia virus p37 protein (F13L, also called VP37) is a viral envelope protein required for the formation and egress of extracellular virus particles in orthopoxvirus infections, including smallpox and monkeypox. Tecovirimat (ST-246) specifically targets the p37 protein, disrupting its interaction with host proteins Rab9 and TIP47, thereby blocking viral envelopment and release from infected cells. This mode of action is highly specific for orthopoxviruses, and tecovirimat is orally bioavailable, with demonstrated efficacy and safety in animal models and human trials. Resistance mutations can occur at the VP37 dimer interface. No notable off-target cytotoxicity has been observed in laboratory studies.
Inhibition of p37/F13L protein, blocking formation of extracellular enveloped virus particles and preventing viral egress from infected cells
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