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Kuiper BD, Keusch BJ, Dewdney TG, Chordia P, Ross K, Brunzelle JS, Kovari IA, MacArthur R, Salimnia H, Kovari LC. The L33F darunavir resistance mutation acts as a molecular anchor reducing the flexibility of the HIV-1 protease 30s and 80s loops. Biochem Biophys Rep 2015; 2:160-165. [PMID: 29124158 PMCID: PMC5668655 DOI: 10.1016/j.bbrep.2015.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/09/2015] [Accepted: 06/10/2015] [Indexed: 11/06/2022] Open
Abstract
HIV-1 protease (PR) is a 99 amino acid protein responsible for proteolytic processing of the viral polyprotein - an essential step in the HIV-1 life cycle. Drug resistance mutations in PR that are selected during antiretroviral therapy lead to reduced efficacy of protease inhibitors (PI) including darunavir (DRV). To identify the structural mechanisms associated with the DRV resistance mutation L33F, we performed X-ray crystallographic studies with a multi-drug resistant HIV-1 protease isolate that contains the L33F mutation (MDR769 L33F). In contrast to other PR L33F DRV complexes, the structure of MDR769 L33F complexed with DRV reported here displays the protease flaps in an open conformation. The L33F mutation increases noncovalent interactions in the hydrophobic pocket of the PR compared to the wild-type (WT) structure. As a result, L33F appears to act as a molecular anchor, reducing the flexibility of the 30s loop (residues 29-35) and the 80s loop (residues 79-84). Molecular anchoring of the 30s and 80s loops leaves an open S1/S1' subsite and distorts the conserved hydrogen-bonding network of DRV. These findings are consistent with previous reports despite structural differences with regards to flap conformation.
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Affiliation(s)
- Benjamin D. Kuiper
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Bradley J. Keusch
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Tamaria G. Dewdney
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Poorvi Chordia
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI, USA
| | - Kyla Ross
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Joseph S. Brunzelle
- Life Sciences Collaborative Access Team and Department of Molecular Pharmacology and Biological Chemistry, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Iulia A. Kovari
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Rodger MacArthur
- Department of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI, USA
| | - Hossein Salimnia
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ladislau C. Kovari
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, MI, USA
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Chordia P, Dewdney TG, Keusch B, Kuiper BD, Ross K, Kovari IA, MacArthur R, Salimnia H, Kovari LC. The role of mutations at codons 32, 47, 54, and 90 in HIV-1 protease flap dynamics. Discoveries (Craiova) 2014; 2:e27. [PMID: 32309558 PMCID: PMC6941557 DOI: 10.15190/d.2014.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Treatment of Human Immunodeficiency Virus remains challenging due to the emergence of drug resistant strains under the selective pressure produced by standard anti-retroviral therapy. To explore the structural mechanisms of drug resistance, we performed 40 ns molecular dynamics simulations on three multi-drug resistant HIV-1 protease clinical isolates from patients attending an infectious diseases clinic in Detroit, MI. We identify a novel structural role for the I47V, V32I, I54M and L90M major resistance mutations in flap opening and closure of MDR-PR isolates. Our studies suggest I47V is involved in flap opening and the interaction between I47V and V32I tethers the flaps to the active site. Also, I54M and L90M may be responsible for asymmetric movement of the protease flaps. These findings can be utilized to improve drug design strategies against MDR HIV-1 PR variants.
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Affiliation(s)
- Poorvi Chordia
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Infectious Diseases, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Tamaria G Dewdney
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Bradley Keusch
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Benjamin D Kuiper
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Kyla Ross
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Iulia A Kovari
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Rodger MacArthur
- Department of Infectious Diseases, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Hossein Salimnia
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Ladislau C Kovari
- Department of Biochemistry and Molecular Biology, Wayne State University School of Medicine, Detroit, Michigan, USA
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Phung BC, Yeni P. Darunavir: an effective protease inhibitor for HIV-infected patients. Expert Rev Anti Infect Ther 2014; 9:631-43. [DOI: 10.1586/eri.11.48] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Drug resistance mutations in HIV-infected patients in the Spanish drug resistance database failing tipranavir and darunavir therapy. Antimicrob Agents Chemother 2010; 54:3018-20. [PMID: 20479204 DOI: 10.1128/aac.00160-10] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The presence of resistance mutations in patients failing tipranavir or darunavir was examined at the national drug resistance database of the Spanish AIDS Research Network. Although mutations emerging during tipranavir and darunavir failures differed considerably, cross-resistance was found in up to half of the patients tested. Interestingly, mutation 54L, which is associated with tipranavir hypersusceptibility, was selected in half of the darunavir failures. Thus, resistance testing seems mandatory to ensure the benefit of the sequential use of these drugs.
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Factors predictive of successful darunavir/ritonavir-based therapy in highly antiretroviral-experienced HIV-1-infected patients (the DARWEST study). J Clin Virol 2010; 47:248-52. [DOI: 10.1016/j.jcv.2009.12.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2009] [Revised: 12/22/2009] [Accepted: 12/23/2009] [Indexed: 11/18/2022]
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Abstract
Even as pediatric rollout programs are struggling to meet global need, increasing numbers of children are failing first-line antiretroviral therapy in low- and middle-income countries. Without better access to viral load monitoring, second-line antiretrovirals and research to guide optimal regimen selection, it will be difficult to ensure that HIV-infected children will survive into adulthood. Data available on pediatric drug resistance demonstrate that failure occurs early in childhood. Studies of salvage drug options have been promising, but are primarily conducted in adults. Evidence-based approaches to regimen selection, pediatric antiretroviral formulations and expanded access to novel drugs are now required to prepare for the future.
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Affiliation(s)
- Annette H Sohn
- TREAT Asia/amfAR – The Foundation for AIDS Research, Bangkok, Thailand
| | - Jintanat Ananworanich
- The Southeast Asia Research Collaboration with Hawaii (SEARCH), Bangkok, Thailand
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Bangkok, Thailand
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Neely M, Kovacs A. Managing treatment-experienced pediatric and adolescent HIV patients: role of darunavir. Ther Clin Risk Manag 2009; 5:595-615. [PMID: 19707276 PMCID: PMC2724190 DOI: 10.2147/tcrm.s4595] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Darunavir is currently the most recently approved HIV-1 protease inhibitor. It is approved for twice-daily dosing with ritonavir in treatment-experienced patients as young as 6 years of age and is available in numerous pill strengths. Emergence of darunavir-specific mutations is generally slow; therefore it can retain activity against viral strains that are resistant to other protease inhibitors, including tipranavir. Darunavir pharmacokinetics, clinical efficacy, resistance mutations and pharmacodynamics, and adverse effects are reviewed here. Substantial data support its use as a potent, well-tolerated option for salvage therapy in highly treatment-experienced children and adolescents.
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Affiliation(s)
- Michael Neely
- University of Southern California, Keck School of Medicine, Department of Pediatrics, Division of infectious Diseases, Los Angeles, CA, USA
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