Zhang Zhijun, Walker Michelle, Xu Wen, Shim Jae Hoon, Girardet Jean-Luc, Hamatake Robert K, Hong Zhi
Drug Discovery, Valeant Research & Development, Costa Mesa, CA 92626, USA.
Antimicrob Agents Chemother. 2006 Aug;50(8):2772-81. doi: 10.1128/AAC.00127-06.
Mutations in and around the catalytic site of the reverse transcriptase (RT) of human immunodeficiency virus type 1 (HIV-1) are associated with resistance to nucleoside RT inhibitors (NRTIs), whereas changes in the hydrophobic pocket of the RT are attributed to nonnucleoside RT inhibitor (NNRTI) resistance. In this study, we report a novel series of nonnucleoside inhibitors of HIV-1, exemplified by VRX-329747 and VRX-413638, which inhibit both NNRTI- and NRTI-resistant HIV-1 isolates. Enzymatic studies indicated that these compounds are HIV-1 RT inhibitors. Surprisingly, however, following prolonged (6 months) tissue culture selection, this series of nonnucleoside inhibitors did not select NNRTI-resistant mutations in HIV-1 RT. Rather, four mutations (M41L, A62T/V, V118I, and M184V) known to cause resistance to NRTIs and two additional novel mutations (S68N and G112S) adjacent to the catalytic site of the enzyme were selected. Although the M184V mutation appears to be the initial mutation to establish resistance, this mutation alone confers only a two- to fourfold decrease in susceptibility to VRX-329747 and VRX-413638. At least two additional mutations must accumulate for significant resistance. Moreover, while VRX-329747-selected viruses are resistant to lamivudine and emtricitabine due to the M184V mutation, they remain susceptible to zidovudine, stavudine, dideoxyinosine, abacavir, tenofovir, and efavirenz. These results directly demonstrate that VRX-329747 and VRX-413638 are novel nonnucleoside inhibitors of HIV-1 RT with the potential to augment current therapies.
1型人类免疫缺陷病毒(HIV-1)逆转录酶(RT)催化位点及其周围的突变与对核苷类逆转录酶抑制剂(NRTIs)的耐药性相关,而RT疏水口袋的变化则归因于非核苷类逆转录酶抑制剂(NNRTIs)耐药。在本研究中,我们报告了一系列新型HIV-1非核苷类抑制剂,以VRX-329747和VRX-413638为代表,它们对NNRTI耐药和NRTI耐药的HIV-1分离株均有抑制作用。酶学研究表明,这些化合物是HIV-1 RT抑制剂。然而,令人惊讶的是,经过长时间(6个月)的组织培养筛选后,这一系列非核苷类抑制剂并未在HIV-1 RT中选择出NNRTI耐药突变。相反,选择出了四个已知会导致对NRTIs耐药的突变(M41L、A62T/V、V118I和M184V)以及两个与酶催化位点相邻的额外新型突变(S68N和G112S)。尽管M184V突变似乎是产生耐药性的初始突变,但仅该突变使对VRX-329747和VRX-413638的敏感性仅降低两到四倍。至少还必须积累另外两个突变才能产生显著耐药性。此外,虽然由于M184V突变,VRX-329747选择的病毒对拉米夫定和恩曲他滨耐药,但它们对齐多夫定、司他夫定、去羟肌苷、阿巴卡韦、替诺福韦和依非韦伦仍敏感。这些结果直接表明,VRX-329747和VRX-413638是HIV-1 RT的新型非核苷类抑制剂,具有增强当前治疗方法的潜力。