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Journal of Virology, October 2002, p. 10015-10019, Vol. 76, No. 19
0022-538X/02/$04.00+0 DOI: 10.1128/JVI.76.19.10015-10019.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
Crystal Structures of Zidovudine- or Lamivudine-Resistant Human Immunodeficiency Virus Type 1 Reverse Transcriptases Containing Mutations at Codons 41, 184, and 215
P. P. Chamberlain,1,2 J. Ren,1 C. E. Nichols,1,2 L. Douglas,1 J. Lennerstrand,3,
B. A. Larder,3 D. I. Stuart,1,2 and D. K. Stammers1,2*
Division of Structural Biology, The Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford OX3 7BN,1
Oxford Centre for Molecular Sciences, Oxford OX1 3QT,2
Visible Genetics, Cambridge CB4 0GA, United Kingdom3
Received 25 March 2002/
Accepted 30 June 2002

ABSTRACT
Six structures of human immunodeficiency virus type 1 (HIV-1)
reverse transcriptase (RT) containing combinations of resistance
mutations for zidovudine (AZT) (M41L and T215Y) or lamivudine
(M184V) have been determined as inhibitor complexes. Minimal
conformational changes in the polymerase or nonnucleoside RT
inhibitor sites compared to the mutant RTMC (D67N, K70R, T215F,
and K219N) are observed, indicating that such changes may occur
only with certain combinations of mutations. Model building
M41L and T215Y into HIV-1 RT-DNA and docking in ATP that is
utilized in the pyrophosphorolysis reaction for AZT resistance
indicates that some conformational rearrangement appears necessary
in RT for ATP to interact simultaneously with the M41L and T215Y
mutations.

TEXT
Codon 215 mutations in combination with M41L in reverse transcriptase
(RT) confer high-level zidovudine (AZT) resistance on human
immunodeficiency virus (HIV) (
9,
11). M184V gives resistance
to lamivudine (3TC) (
20,
23) and restores AZT sensitivity to
codon 41 and 215 mutations (
12). X-ray crystallographic results
indicate that residues 41 and 215 in HIV-1 RT are distal to
the deoxynucleoside triphosphate binding site (
6,
7,
10,
16),
and ideas as to how AZT resistance is induced include template
rearrangement (
3) and conformational changes propagated from
residues 215 and 219 for the mutant RTMC (D67N, K70R, T215F,
and K219N) (
17). Biochemical studies have shown a mechanism
of AZT resistance involving AZTMP removal from the blocked primer
strand in a pyrophosphate- or ATP-dependent pyrophosphorolysis
reaction enhanced by RTMC and other mutant RTs (
1,
2,
13,
14).
Model building studies suggest that T215Y might promote ATP
binding, the presumed physiological acceptor for the pyrophosphorolysis
reaction (
2). To investigate further the effects of AZT and
3TC drug resistance mutations on the conformational states of
HIV-1 RT, structures of a series of six AZT- and/or 3TC-resistant
RTs mainly containing combinations of M41L, T215Y, and M184V
mutations were determined in the absence of oligonucleotide
or deoxynucleoside triphosphate substrates to assess whether
underlying baseline structural rearrangements are induced by
these mutations in a way analogous to that previously observed
for RTMC.
Site-directed mutants were introduced into the HIV-1 HXB2-D RT coding region by using ExSite or QuikChange kits (Stratagene). Expression, purification, and crystallization of RT (as complexes with nevirapine or the nevirapine analogue 1051U91) were performed as described previously (5, 22, 24). Six RT mutants were purified and crystallized, and structures were determined for five of these (Table 1), whereas the sixth mutant, RT+M41L, gave disordered crystals unsuitable for data collection. X-ray data were collected at synchrotron sources (Table 1), and DENZO and SCALEPACK were used for data processing (15). The orientation and translation of HIV-1 RT in the unit cell were determined by using rigid-body refinement with XPLOR, and refinement was done with XPLOR or CNS (4) as described previously (18). For data sets too small for full refinement, tight positional restraints were applied. Table 1 gives statistics on X-ray data quality and refinement statistics. Coordinates and structure factors have been deposited in the Protein Data Bank (PDB) for immediate release (see Table 1 for PDB codes). O (8) was used for mutating side chains in the RT-DNA complex (PDB code 1rtd) (6) and docking in ATP.
Omit maps show electron density for the mutated side chains
in p66 (Fig.
1). Y215 is clearly defined (Fig.
1b, d, g, and h),
while for L41 the density is less clear within p66 (Fig.
1c and e) than in p51; nevertheless, its conformation could
be determined. In the RTMQ+M184V structure the 67 and 70 side
chains are disordered.
Electron density for the M184V mutation is clear in all cases
(Fig.
1a and f) compared to the previously reported RT+M184I
structure which had the mutated residue disordered in the unliganded
structure but defined in the binary complex with DNA (
19).
Comparison of the structures of this present set of mutant RTs with wild-type RT-nevirapine complexes shows only minor conformational changes in the protein (Fig. 2a). Structural differences at the ß9-ß10 loop region appear related to the various crystal forms, and such effects can be separated from differences in inhibitor binding or drug resistance mutations. These results are distinct from the previously determined structure of an AZT-resistant RT containing a different set of mutations (RTMC: D67N, K70R, T215F, and K219N), where significant movement of the polymerase active site and the Y181 side chain is observed (17). The RTMF-1051U91 structure is essentially identical to that with nevirapine, indicating that the conformational variation compared to RTMC could not be ascribed to these different inhibitors (Fig. 2b). There are differences between the particular AZT resistance mutations for RTMC and those for RTMF or RTMN. RTMC has, in addition to the change at codon 215, mutations at 67, 70, and 219, and none of the latter are present in RTMF or RTMN. It was determined from the earlier structural studies that the observed conformational changes that propagated toward the active site and the nonnucleoside RT inhibitor (NNRTI)-binding site apparently originated from residues 215 and 219 (17), and it is possible that the 219 mutation in combination with T215F (in place of T215Y in RTMN) could give rise to the conformational rearrangement in the RTMC active and NNRTI sites. RTMN is from a mutant virus that shows high-level AZT resistance, and yet the polymerase active site has essentially the same conformation as does wild-type RT, hence indicating a lack of correlation between resistance phenotype and the active site conformational state of substrate-free RT. RTs containing the M184V mutation either in the absence or in the presence of AZT resistance mutations have similar conformational states. The reversal effect of M184V on AZT resistance may in any case be mediated by more direct effects, since residue 184 is positioned close to the termination site on the blocked primer. However, drug resistance mutation-dependent conformational changes might occur in higher-order complexes involving bound substrates or other ligands.
The side chain conformations of the mutated 41 and 215 residues
from the structures determined here were modeled into the ternary
complex of RT-template-primer-dTTP (
6) followed by the docking
of ATP, based on the mode predicted from the nature of the pyrophosphorolysis
reaction (
2,
21). This showed that ATP cannot simultaneously
contact the mutated side chains of residues 215 and 41 (Fig.
3). Contacts with the Y215 side chain could be made via parallel
aromatic ring stacking of the adenine base of ATP, forming a
number of van der Waals contacts as has been noted previously
(
2,
21). Structural mechanisms whereby the mutation of M41L
could lead to increased ATP binding are less clear. M41 is located
some distance from Y215 and is somewhat buried, making direct
interaction with ATP unlikely. The M41L mutation introduces
a branched side chain that potentially might disrupt this buried
region; however, structures of RTMN and RTMN+M184V reveal that
this change is accommodated without significant rearrangement
of the protein. It thus seems more likely that a conformational
rearrangement occurs either within the catalytic complex or
on binding of ATP rather than that there are two distinct ATP
binding positions, each of which is strengthened by the mutations
at either residue 41 or residue 215. The former model would
be consistent with the synergistic effect of the combination
of M41L and T215Y on AZT drug resistance. The putative further
conformational change could lead to an indirect effect on ATP
binding via intervening side chains, such as that formed by
contact between residues 116 and 41, or main chain elements
rather than repositioning the mutated 41 and 215 side chains
to simultaneously interact with ATP. Further work is required
to test such possibilities, in particular determination of a
range of HIV-1 RT mutant-DNA structures including complexes
with ATP.

ACKNOWLEDGMENTS
We thank the staff of synchrotron facilities at SRS, Daresbury,
United Kingdom; ESRF, Grenoble, France; and the Photon Factory,
Tsukuba, Japan.
D.I.S. is a member of the TARA project. The UK MRC provided long-term funding of the RT work with grants to D.K.S. and D.I.S. D.K.S. acknowledges the support of the EU via grant QLKT-2000-00291.

FOOTNOTES
* Corresponding author. Mailing address: Division of Structural Biology, The Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, United Kingdom. Phone: 44-1865-287-565. Fax: 44-1865-287-547. E-mail:
daves{at}strubi.ox.ac.uk.

Present address: Division of Clinical Virology, Karolinska Institute F68, Huddinge University Hospital, S-141 86 Huddinge, Sweden. 

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Journal of Virology, October 2002, p. 10015-10019, Vol. 76, No. 19
0022-538X/02/$04.00+0 DOI: 10.1128/JVI.76.19.10015-10019.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
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