Department of Hematology, Rheumatology, and Infectious Disease, Kumamoto University Hospitalgrid.411152.2, Kumamoto, Kumamoto, Japan.
Experimental Retrovirology Section, HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Antimicrob Agents Chemother. 2022 Feb 15;66(2):e0171521. doi: 10.1128/AAC.01715-21. Epub 2022 Jan 3.
To date, there are no specific treatment regimens for HIV-1-related central nervous system (CNS) complications, such as HIV-1-associated neurocognitive disorders (HAND). Here, we report that two newly generated CNS-targeting HIV-1 protease (PR) inhibitors (PIs), GRL-08513 and GRL-08613, which have a P1-3,5--fluorophenyl or P1--monofluorophenyl ring and P2-tetrahydropyrano-tetrahydrofuran (-THF) with a sulfonamide isostere, are potent against wild-type HIV-1 strains and multiple clinically isolated HIV-1 strains (50% effective concentration [EC]: 0.0001 to ∼0.0032 μM). As assessed with HIV-1 variants that had been selected to propagate at a 5 μM concentration of each HIV-1 PI (atazanavir, lopinavir, or amprenavir), GRL-08513 and GRL-08613 efficiently inhibited the replication of these highly PI-resistant variants (EC: 0.003 to ∼0.006 μM). GRL-08513 and GRL-08613 also maintained their antiviral activities against HIV-2 as well as severely multidrug-resistant clinical HIV-1 variants. Additionally, when we assessed with the blood-brain barrier (BBB) reconstruction system, GRL-08513 and GRL-08613 showed the most promising properties of CNS penetration among the evaluated compounds, including the majority of FDA-approved combination antiretroviral therapy (cART) drugs. In the crystallographic analysis of compound-PR complexes, it was demonstrated that the -THF rings at the P2 moiety of GRL-08513 and GRL-08613 form robust hydrogen bond interactions with the active site of HIV-1 PR. Furthermore, both the P1-3,5--fluorophenyl- and P1--monofluorophenyl rings sustain greater contact surfaces and form stronger van der Waals interactions with PR than is the case with darunavir-PR complex. Taken together, these results strongly suggest that GRL-08513 and GRL-08613 have favorable features for patients infected with wild-type/multidrug-resistant HIV-1 strains and might serve as candidates for a preventive and/or therapeutic agent for HAND and other CNS complications.
迄今为止,针对 HIV-1 相关中枢神经系统 (CNS) 并发症(如 HIV-1 相关神经认知障碍 [HAND])尚无特定的治疗方案。在这里,我们报告两种新生成的针对 CNS 的 HIV-1 蛋白酶 (PR) 抑制剂 (PIs),GRL-08513 和 GRL-08613,它们具有 P1-3,5-氟苯基或 P1-单氟苯基环和 P2-四氢吡喃-四氢呋喃 (-THF) 带有磺酰胺等排体,对野生型 HIV-1 株和多种临床分离的 HIV-1 株均具有很强的抑制作用(50%有效浓度 [EC]:0.0001 至约 0.0032 μM)。用每种 HIV-1 PI(阿扎那韦、洛匹那韦或安普那韦)浓度为 5 μM 选择繁殖的 HIV-1 变体进行评估,GRL-08513 和 GRL-08613 能够有效地抑制这些高度对 PI 耐药的变体的复制(EC:0.003 至约 0.006 μM)。GRL-08513 和 GRL-08613 对 HIV-2 以及严重耐多药的临床 HIV-1 变体也保持了抗病毒活性。此外,当我们用血脑屏障 (BBB) 重建系统进行评估时,GRL-08513 和 GRL-08613 在评估的化合物中显示出最有希望穿透 CNS 的特性,包括大多数 FDA 批准的联合抗逆转录病毒疗法 (cART) 药物。在化合物-PR 复合物的晶体分析中,证明 GRL-08513 和 GRL-08613 的 P2 部分的 -THF 环与 HIV-1 PR 的活性位点形成了牢固的氢键相互作用。此外,与 darunavir-PR 复合物相比,P1-3,5-氟苯基和 P1-单氟苯基环维持更大的接触表面并与 PR 形成更强的范德华相互作用。总之,这些结果强烈表明,GRL-08513 和 GRL-08613 具有针对感染野生型/多药耐药 HIV-1 株的患者的有利特征,可能成为 HAND 和其他 CNS 并发症的预防和/或治疗药物的候选物。