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Journal of Virology, November 2004, p. 12062-12065, Vol. 78, No. 21
0022-538X/04/$08.00+0 DOI: 10.1128/JVI.78.21.12062-12065.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Statin Compounds Reduce Human Immunodeficiency Virus Type 1 Replication by Preventing the Interaction between Virion-Associated Host Intercellular Adhesion Molecule 1 and Its Natural Cell Surface Ligand LFA-1
Jean-François Giguère and
Michel J. Tremblay*
Research Center in Infectious Diseases, CHUL Research Center, and Faculty of Medicine, Laval University, Quebec, Canada
Received 27 April 2004/
Accepted 16 June 2004

ABSTRACT
A variety of host factors, including membrane proteins acquired
by human immunodeficiency virus type 1 (HIV-1), play a dominant
role in HIV-1 adsorption onto host cells. Examples include the
integrin intercellular adhesion molecule 1 (ICAM-1), which,
once acquired by HIV-1, promotes virus infectivity via ligation
to LFA-1. We tested the ability of statins to diminish HIV-1
replication, based on the idea that these compounds have been
shown to block ICAM-1-LFA-1 interactions. Our data indicate
that statins diminish HIV-1 attachment to target cells by suppressing
ICAM-1-LFA-1 interactions. The capacity of statins to limit
the initial steps in virus replication could represent an interesting
approach for the treatment of HIV-1 infection.

TEXT
Previous studies have provided evidence that intercellular adhesion
molecule 1 (ICAM-1), when present on the surface of human immunodeficiency
virus type 1 (HIV-1) particles, can enhance virus attachment
through an association with its physiological counterreceptor
LFA-1. This virus-cell interaction augments virus infectivity
severalfold by facilitating binding and entry events (
9), notably
in human lymphoid tissue cultured ex vivo (
3). Therefore, a
strategy aimed at blocking this virus-cell interaction could
represent a new therapy for the treatment of HIV-1 infection.
This idea is supported by the observation that host-encoded
ICAM-1 is acquired by all tested clinical strains of HIV-1 following
production in primary human cells (
2,
3,
5,
6,
11).
Statin compounds, the primary drugs used in the treatment of hypercholesterolemia, act as inhibitors of the rate-limiting enzyme of the cholesterol synthesis pathway, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (7). Interestingly, two members of this family, lovastatin and simvastatin, were recently shown to bind to LFA-1 and to inhibit its normal interaction with ICAM-1 (12, 18). The aim of the present study was to evaluate whether these two compounds can modulate HIV-1 production by affecting the earliest steps in the virus life cycle.
(This work was performed by J.-F.G. as partial fulfillment of a Ph.D. degree in the Microbiology-Immunology Program, Faculty of Medicine, Laval University.)
When an indicator cell line is used as the target, statin compounds reduce infection with ICAM-1-bearing viruses but not with virions lacking the host molecule.
To evaluate the possible anti-HIV-1 efficacy of lovastatin, the LFA-1+ reporter cell line LuSIV (17) was first pretreated with concentrations of 1 to 100 µM lovastatin (Mevinolin or MK-803; A. G. Scientific, Inc., San Diego, Calif.). The cells were next exposed to isogenic NL4-3 virus stocks, either bearing or lacking host ICAM-1, that were produced on 293T cells as described previously (9, 10). As expected, virus infectivity increased upon insertion of ICAM-1 within mature virions (6.5-fold) when infection was allowed to proceed in the absence of lovastatin (Fig. 1A). Interestingly, infection with ICAM-1-bearing viruses was reduced in a dose-dependent manner by lovastatin. The anti-HIV-1 activity of lovastatin seems to be linked to its capacity to inhibit LFA-1-ICAM-1 interactions, since replication of HIV-1 particles lacking ICAM-1 is affected much less by lovastatin. Simvastatin, another statin reported to block LFA-1-ICAM-1 interactions (18), was also tested by the same experimental procedure (simvastatin or MK733; Calbiochem, La Jolla, Calif.). Like lovastatin, simvastatin specifically blocks the infectivity of ICAM-1-bearing viral particles at similar concentrations (i.e., 50 and 100 µM) without affecting replication of NL4-3 devoid of ICAM-1 (Fig. 1B).
LFA-1 can be found in two distinct conformational states, i.e.,
with low or high affinity for ICAM-1. The high-affinity state
has been shown to further enhance the susceptibility of human
cells to infection by ICAM-1-bearing HIV-1 particles (
8,
10).
We thus investigated whether the activation state of LFA-1 on
the target cell surface could affect the anti-HIV-1 potency
of lovastatin. To this end, LuSIV target cells were pretreated
with an LFA-1-activating antibody (i.e., NKI-L16) before the
addition of lovastatin and the studied virus stocks. As depicted
in Fig.
1C, in spite of the higher level of infection with ICAM-1-bearing
virions in cells expressing LFA-1 under an activated state,
lovastatin preserves its capacity to decrease the infectivity
of virions bearing host ICAM-1 on their surfaces.
HIV-1 replication and attachment to primary human cells are diminished by lovastatin via inhibition of ICAM-1-LFA-1 interactions.
The next step was to define whether lovastatin can modulate HIV-1 replication in a more natural cellular reservoir, i.e., primary human cells, such as peripheral blood mononuclear cells (PBMCs). The results show that lovastatin and MEM30, an anti-LFA-1 antibody known to block the interaction between LFA-1 and ICAM-1, decrease the replication of ICAM-1-bearing virions to similar levels (Fig. 2A). Replication of isogenic HIV-1 particles lacking host-encoded ICAM-1 was affected neither by lovastatin nor by MEM30. In order to shed light on the possible effect of lovastatin on the early events in the HIV-1 life cycle, the levels of cell-associated viruses were assessed after 2 h following incubation of PBMCs with the studied NL4-3-based virus preparations. Lovastatin is as efficient as MEM30 in inhibiting attachment of ICAM-1-bearing virions to the surfaces of primary human cells, while neither agent has an effect on the adsorption of viruses lacking ICAM-1 to PBMCs (Fig. 2B). Similar findings were obtained when PBMCs were pretreated with the LFA-1-activating antibody NKI-L16 (data not shown), thus confirming that the ability of lovastatin to block LFA-1-ICAM-1 interactions is not influenced by the conformational state of LFA-1.
Replication of clinical isolates of HIV-1 in primary human cells is affected by treatment with lovastatin.
Previous studies demonstrated that clinical strains of HIV-1
produced in primary human cells do acquire host ICAM-1 (
2,
3,
5,
6,
11). Therefore, to provide physiological relevance to
the present data with statins, two dual-tropic field isolates
of HIV-1 were expanded in PBMCs and used for infectivity studies
of primary human cells. The kinetics of virus production was
monitored by measuring p24 levels in cell-free culture supernatants
at several time points following the initial infection. Replication
of the two HIV-1 clinical variants decreased upon treatment
with lovastatin (Fig.
3). The observed diminution of 92US151-virion
production is comparable for lovastatin and MEM30 (Fig.
3A),
whereas replication of 92RW009 was more severely diminished
by lovastatin than by MEM30 (Fig.
3B).
Different types of inhibitors have been developed to suppress
ICAM-1-LFA-1 interactions, and some of these molecules are currently
parts of clinical trials (e.g., antibodies, peptides, and small
molecules) (reviewed in reference
1). We focused our efforts
on lovastatin, a fungal metabolite that binds to the I domain
of LFA-1 at the I-domain allosteric site. Lovastatin inhibits
ICAM-1-LFA-1 interactions by preventing the conformational change
of LFA-1 to the activated form via allosteric control (
13).
We found that lovastatin diminishes HIV-1 replication by inhibiting
the interaction of virus-associated host ICAM-1 with its normal
counterreceptor LFA-1. We made these observations when using
lovastatin at concentrations higher than 10 µM, different
strains of HIV-1 (laboratory and primary variants), and LFA-1-expressing
lymphoid cells (LuSIV) and primary cells (PBMCs). Our results
are in line with a previous study performed by Weitz-Schmidt
and colleagues, who reported 50% inhibitory concentrations of
25 and 22 µM for lovastatin and simvastatin, respectively,
in an assay measuring the adhesion of LFA-1-positive HUT78 cells
to immobilized ICAM-1 (
18). The propensity of statins to modify
cholesterol synthesis cannot account for the antiviral properties
of statins seen in this study, since infectivity of HIV-1 virions
lacking host ICAM-1 is only slightly affected upon treatment
with these compounds. This is an important issue, considering
the importance of cholesterol and lipid rafts in the virus life
cycle (reviewed in reference
4). Finally, the observation that
the attachment of ICAM-1-bearing viruses, but not that of isogenic
virions devoid of host ICAM-1, is reduced upon addition of statins
provides direct proof that the mechanism of action of statins
is by specifically targeting ICAM-1-LFA-1 interactions. Interestingly,
lovastatin still efficiently reduces HIV-1 infection when target
cells express the activated form of LFA-1. To the best of our
knowledge, this represents the first demonstration that lovastatin
can inhibit the interaction of ICAM-1 with LFA-1 under an active
state. This last finding might be clinically relevant, given
that lymphoid tissues constitute preferred sites for HIV-1 replication
and propagation (reviewed in references
14 to
16) and contain
a high number of cells susceptible to virus infection-expressing
LFA-1 under an activated form, since 25 to 50% of the CD4
+ T
cells found in lymph nodes of HIV-1-infected individuals are
in an activated state (
15).
Although HMG-CoA reductase inhibitors such as statins are efficient at reducing the risk of coronary events and are generally very well tolerated, clinical studies have demonstrated that these drugs show very low systemic bioavailability, due to an extensive first-pass effect at the intestinal and/or hepatic level. The use of lovastatin or simvastatin as an inhibitor of HIV-1 replication is thus very unlikely, given that potentially toxic doses would have to be administered to achieve a plasmatic concentration sufficient to affect virus production. However, it must be noted that Weitz-Schmidt and coworkers recently developed a derivative compound of lovastatin (with a 50% inhibitory concentration of 0.7 µM) that does not inhibit HMG-CoA reductase activity (18). This new compound seems to block ICAM-1-LFA-1 interactions under in vivo conditions, since the migration of neutrophils was abolished upon oral administration in an animal model. It is thus tempting to speculate that newly designed statin compounds might be administered at doses sufficient to reach plasmatic concentrations that could reduce HIV-1 load in infected individuals.

ACKNOWLEDGMENTS
We thank M. Dufour for technical assistance in flow cytometry
studies. We are grateful to S. Méthot for editorial assistance,
and we address special thanks to Caroline Côté
for technical support.
J.-F.G. is the recipient of a Ph.D. fellowship from the "Fonds de la Recherche en Santé du Québec" (Réseau FRSQ SIDA et Maladies Infectieuses), and M.J.T. holds the Canada Research Chair in Human Immuno-Retrovirology (tier 1 level). This study was supported by a grant to M.J.T. from the Canadian Institutes of Health Research HIV/AIDS Research Program (grant HOP-14438).

FOOTNOTES
* Corresponding author. Mailing address: Laboratory of Human Immuno-Retrovirology, Research Center in Infectious Diseases, RC709, CHUL Research Center, 2705 Laurier Blvd., Quebec (QC), Canada G1V 4G2. Phone: (418) 654-2705. Fax: (418) 654-2212. E-mail:
michel.j.tremblay{at}crchul.ulaval.ca.


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Journal of Virology, November 2004, p. 12062-12065, Vol. 78, No. 21
0022-538X/04/$08.00+0 DOI: 10.1128/JVI.78.21.12062-12065.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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