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Journal of Virology, January 2005, p. 764-770, Vol. 79, No. 2
0022-538X/05/$08.00+0 doi:10.1128/JVI.79.2.764-770.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Laboratory of Virus Immunology,1 Laboratory of Biochemistry, Institute for Virus Research,2 Graduate School of Pharmaceutical Science, Kyoto University, Kyoto, Japan3
Received 24 May 2004/ Accepted 27 August 2004
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The emergence of T-20-resistant HIV-1 was first reported in clinical patients receiving T-20 monotherapy in a phase I clinical trial (28) and subsequently in combined regimens employed in phase II and III trials of T-20 (23, 25). The T-20 susceptibility of recombinant HIV-1 containing the identified substitutions was examined in vitro and considered to be moderately resistant (5.4- to 6.3-fold) (28). However, the detailed mechanism of resistance of these variants still remains to be elucidated. On the other hand, Rimsky et al. revealed that three continuous amino acids in the N-HR (GIV at positions 36 to 38 of gp41) were crucial for the inhibition of HIV-1 entry by T-20 and for efficient association between N-HR and T-20 in vitro (26). Fikkert et al. also reported that HIV-1 variants resistant to T-20 contained substitutions in gp41, L33S and N43K, and a deletion of 5 amino acids, FNSTW (
FNSTW), in the V4 region of gp120 (9). L33S and N43K contributed to T-20 resistance, whereas the 5-amino-acid deletion alone had little effect on T-20 sensitivity. These results suggest that substitutions in the N-HR directly affect T-20 binding. Although the baseline sensitivity of HIV-1 to T-20 is defined by amino acid substitutions in gp41, coreceptor specificity is influenced by substitutions in the V3 loop in gp120, affects the fusion kinetics, and modulates T-20 sensitivity (4, 5).
To elucidate the mechanism of resistance to the peptide fusion inhibitors, we generated and characterized HIV-1 variants resistant to C34, a gp41 C-HR-derived peptide (2, 22) (Fig. 1A). During the selection of C34-resistant variants, we observed a 5-amino-acid deletion in the gp120 V4 region and a total of seven amino acid substitutions in gp41. Among the deletion and the substitutions, I37K and N126K play a key role in the resistance to C-HR-derived peptides, including T-20. Other deletions or substitutions were considered to enhance C34 resistance and/or improve the impaired replication kinetics. A30V and D36G maintained the Rev-responsive element (RRE) structure destabilized by I37T and I37K, respectively. Thus, these results reveal that the deletions or substitutions conferring resistance are restricted by both gp41 and RRE functions, suggesting that HIV-1 fusion is one of the most ideal targets for chemotherapy.
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FIG. 1. Schematic view of HIV-1 gp41 (A) and induction of C34-resistant HIV-1 (B). The locations of the fusion peptide (FP), N-terminal heptad repeat region (N-HR), C-terminal heptad repeat region (C-HR), transmembrane domain (TM), various gp41-derived peptides, and the Rev-responsive element (RRE) coding region are shown (A). The residue numbers of each peptide correspond to their positions in gp41. The bold underlined letters in the boxes indicate the novel mutations that have been reported in T-20-resistant HIV-1 variants (T-20r) in vitro (9, 26) and that have been observed in C34-resistant HIV-1 variants (C34r). (B) HIV-1NL4-3 was passaged in the presence of increasing concentrations of C34 in MT-2 cells. The dose-escalating selection was carried out for a total of 93 passages, with compound concentrations ranging from 0.0001 to 20 µM. At the indicated passages, proviral DNAs from the lysates of infected cells were sequenced, and the EC50s of the HIV-1 variants were determined with the MAGI assay.
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Antiviral agents. The peptides used were N36, derived from the N-HR of gp41, and C34 and T-20, derived from the C-HR of gp41. The peptides were synthesized as described previously (24) and are depicted in Fig. 1A. 2',3'-Dideoxycytidine (ddC) was purchased from Sigma (St. Louis, Mo.).
Determination of drug susceptibility of HIV-1. The peptide sensitivity of infectious clones was determined by the MAGI assay with some modifications (14, 21). Briefly, the target cells (HeLa-CD4-LTR-ß-gal; 104 cells/well) were plated in 96-well flat microtiter culture plates. On the following day, the cells were inoculated with the HIV-1 clones (60 MAGI U/well, giving 60 blue cells after 48 h of incubation) and cultured in the presence of various concentrations of drugs in fresh medium. Forty-eight hours after viral exposure, all the blue cells stained with X-Gal (5-bromo-4-chloro-3-indolyl-ß-D-galactopyranoside) were counted in each well. The activity of test compounds was determined as the concentration that blocked HIV-1 replication by 50% (50% effective concentration [EC50]).
Construction of recombinant HIV-1 clones. Recombinant infectious HIV-1 clones carrying various mutations in gp120 and/or gp41 were generated by using pNL4-3. Briefly, the desired mutations were introduced into the NheI-BamHI region (1,220 bp) of pSLgp41WT, which encoded nucleotides 7250 to 8469 of pNL4-3, by an oligonucleotide-based mutagenesis method (29). NheI-BamHI fragments were inserted into pNL4-3, generating various molecular clones with the desired mutations. Each molecular clone was transfected into Cos-7 cells (105 cells/six-well culture plate). After 48 h, MT-2 cells (106 cells/well) were added and cocultured with the Cos-7 cells for an additional 24 h. When an extensive cytopathic effect (CPE) was observed, the supernatants were harvested and stored at 80°C until use.
Generation of HIV-1 variants resistant to C34. MT-2 cells were exposed to HIV-1WT and cultured in the presence of C34 at an initial concentration of 0.0001 µM. Cultures were incubated at 37°C until an extensive CPE was observed. The culture supernatants were used for further passages in MT-2 cells in the presence of twofold increasing concentrations of C34 when massive CPEs were seen in the earlier periods. Such dose-escalating culture was performed until resistant variants were obtained. This selection was carried out for a total of 93 passages. At the indicated passages (Fig. 1B), the sequence of the env region was determined by direct sequencing of the proviral DNA extracted from the infected MT-2 cells.
Viral replication kinetics assay. MT-2 cells (105 cells/5 ml) were infected with each virus preparation (500 MAGI U) for 4 h. The infected cells were then washed and cultured in a final volume of 5 ml. The culture supernatants (100 µl) were harvested on days 1, 2, 4, 6, and 8 after infection, and the p24 antigen amounts were determined.
For competitive HIV-1 replication assays (CHRA), two titrated infectious clones to be examined were mixed and added to MT-2 cells (105 cells/3 ml) as described previously (15) with some modifications. To ensure that the two infectious clones being compared were of approximately equal infectivity, a fixed amount (500 MAGI U) of one infectious clone was mixed with three different amounts (250, 500, and 1,000 MAGI U) of the other infectious clone. On day 1, one third of the infected MT-2 cells were harvested and washed twice with phosphate-buffered saline, and the cellular DNA was extracted. The purified DNA was subjected to nested PCR and then direct DNA sequencing. The HIV-1 coculture which best approximated a 50:50 mixture on day 1 was further propagated. Every 6 to 7 days, the cell-free supernatant of the virus coculture (1 ml) was transmitted to new uninfected MT-2 cells. The cells harvested at the end of each passage were subjected to direct sequencing, and the viral population change was determined.
Binding assay. Each peptide (40 µM) was mixed with 10 mM phosphate-buffered saline-140 mM NaCl, pH 7.4, in an Aviv model 202 DS spectrometer equipped with a thermoelectric temperature controller. The thermal stability was assessed by monitoring the change in the circular dichroism signal at 222 nm. The midpoint of the thermal unfolding transition (melting temperature [Tm]) of each complex was determined as described previously (24).
Gel shift assay. RNA of the RRE region and recombinant Rev were prepared as described previously (10) with some modifications. Briefly, the RRE region of the variants (nucleotides 7748 to 8009 of pNL4-3) was introduced into pBlueScript (Stratagene, La Jolla, Calif.). In vitro RNA transcription was performed with T7 RNA polymerase and [32P]UTP. Recombinant Rev was generated by use of the pGEX-6P-1/BL21 expression system (Amersham Biosciences, Piscataway, N.J.). The RNA and Rev were mixed at 25°C for 20 min in binding buffer (50 mM Tris-HCl, pH 7.5, 150 mM KCl, 1 mM dithiothreitol, 8% glycerol, 50 µg of tRNA/ml, and 100 µg of bovine serum albumin/ml) and subjected to native acrylamide gel electrophoresis.
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FNSTW) was observed together with the four substitutions (
FNSTW/D36G/I37K/N126K/L204I) (Fig. 1B). In addition to the env region, we also examined the Tat- and Rev-encoding regions but did not observe any substitutions. These results suggest that, in order to develop a higher resistance to C34, HIV-1 acquires not only multiple substitutions in gp41 but also the 5-amino-acid deletion in gp120.
Susceptibility of the different env recombinant viruses to fusion inhibitors.
To clarify which substitutions among the identified changes were responsible for C34 resistance, we first generated infectious HIV-1 clones containing the deletion (
FNSTW) in gp120 or the single amino acid substitutions (A30V, D36G, I37T, I37K, Q39H, N126K, or L204I) in gp41 that were observed during the selection procedure (Fig. 1B). We also evaluated the activities of the gp41-derived peptides N36, T-20, and C34 and a reverse transcriptase inhibitor used as a control, ddC, against these strains with the MAGI assay (Table 1).
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TABLE 1. Antiviral activity of HIV-1 gp41-derived peptides against gp120 and/or gp41 recombinant virusesa
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FNSTW, HIV-1A30V, HIV-1Q39H, and HIV-1L204I showed weak resistance to C34 compared with HIV-1WT (less than fivefold). Interestingly, D36G, observed in the majority of HIV-1 strains (16), conferred an increased T-20 susceptibility to HIV-1 (10-fold), in agreement with previous reports (20, 26), whereas D36G did not contribute C34 resistance by itself (0.8-fold). Although I37T has also been reported as one of the T-20 resistance mutations in vitro, its detailed mechanism of resistance remains unknown (20, 26). In our experiments, I37T conferred T-20 and C34 resistance to HIV-1 (13- and 11-fold, respectively), and I38K also conferred both T-20 and C34 resistance (212- and 13-fold, respectively). HIV-1N126K showed moderate resistance to C34 (6.8-fold). Neither the deletion in gp120 nor any of the substitutions in gp41 conferred resistance to N36 or ddC (Table 1).
Although the I37 substitutions appeared to be primarily responsible for C34 resistance, the C34 resistance levels of the I37 substitution variants were not comparable to that of the selected virus at P-93 (EC50, 0.78 µM). Therefore, we generated infectious HIV-1 clones containing the identified substitutions combined with I37T or I37K and determined their susceptibilities to the peptides (Table 1). The combination of I37K and N126K enhanced C34 resistance (13- to 28-fold), whereas HIV-1I37T, HIV-1I37T/N126K, and HIV-1A30V/I37T/N126K showed comparable resistance levels to C34. Moreover, I37K/N126K combined with D36G (D36G/I37K/N126K) enhanced C34 resistance (72-fold), although the L204I substitution combined with D36G/I37K/N126K decreased the levels of resistance to both T-20 and C34 (10- and 54-fold, respectively). A clone containing the deletion in gp120 and four substitutions in gp41, HIV-1
FNSTW/D36G/I37K/N126K/L204I, showed the highest resistance to C34 (83-fold) and cross-resistance to T-20 (64-fold). These results indicate that the I37K substitution is mainly responsible for C34 resistance, whereas the other substitutions enhance the resistance or improve the impaired viral replication kinetics.
Next, we generated a T-20-resistant molecular clone which had been previously reported (26), HIV-1D36S/V38M, and evaluated the susceptibility to N36, T-20, and C34. HIV-1D36S/V38M showed moderate resistance to both T-20 and C34 (5.1- and 7.7-fold, respectively) (Table 1). We also generated HIV-1 variants that contained each of the single substitutions, HIV-1D36S and HIV-1V38M. HIV-1D36S did not contribute to the resistance, although HIV-1V38M showed cross-resistance to T-20 and C34 (26- and 15-fold, respectively). Combined with the finding that I37K is the major mutation for resistance to C34, this region, positions 37 and 38 of gp41, appears to be involved in resistance to both T-20 and C34, while changes at position 36 appear to be largely restricted in their effects to T-20.
Peptide binding affinity. To clarify the effect of the substitutions on the interaction of N-HR and C-HR, the binding affinity of the peptides in vitro was examined with the synthesized peptides (Table 2). The affinity between N36D36G/I37K and C34 was unstable even at 37°C, indicating that the peptide inhibitor C34 hardly bound to N36D36G/I37K. However, it is still unclear whether it is a direct effect of the N-HR mutations decreasing the affinity of C34 binding or an indirect effect of the N-HR mutations destabilizing the N-HR trimer formation. In contrast, C34N126K, with the substitution responsible for the resistance, showed enhanced binding affinity not only to N36 but also to N36D36G/I37K. Thus, there are two implications of mutations in gp41 for conferring C34 resistance: the decreased affinity of C34 for N36D36G/I37K and the increased affinity of C34N126K for both N36WT and N36D36G/I37K. In other words, the D36G and I37K substitutions in the N-HR interfere with the binding of the peptide inhibitors, such as T-20 and C34, and N126K in the C-HR enhances the intra-gp41 binding of N-HR and C-HR compared with the peptide inhibitors.
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TABLE 2. Binding affinity of wild and mutated peptidesa
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FIG. 2. Replication kinetics of the resistant variants. The replication kinetics determined by p24 antigen production and the CHRA are summarized. The data are depicted as the resistance (x axis) and replication (y axis) compared with those of HIV-1WT. Variants observed (continuous arrows) and not observed (dashed arrows) in the selection are shown in the order of their emergence.
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FIG. 3. Putative secondary structure of the RRE and locations of the nucleotides corresponding to the substitutions. The IIA, IIB, and IIC stems and the effects of the nucleotide substitutions are shown (A). A30V (GCC to GTC) to D36 (GAT) and A30 (GCC) to D36G (GAT to GGT) are located complementary to each other in the stem IIB (underlined). The effects of the nucleotide substitutions on the Rev-RRE interaction were examined by gel shift assays (B). The RRE of HIV-1I37T and HIV-1I37K displayed two signals. The amounts of Rev used were 0, 20, 40, 80, 160, 240, and 320 nM (left to right).
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During the selection of the C34-resistant variants, the substitutions were introduced in the following order: a substitution (N126K) associated with susceptibility to C34 was introduced first, followed by a substitution (A30V) associated with replication. L204I also improved the replication kinetics of HIV-1D36G/I37K/N126K. It is likely that substitutions that are associated with resistance usually impair the replication kinetics, resulting in selection of HIV-1 variants containing substitutions that improve the replication disadvantages. This hypothesis has been proved with analyses of replication kinetics of T-20-resistant variants described previously (20). Moreover, such substitution patterns have previously been observed in multi-dideoxynucleoside-resistant variants (15, 21). However, the mechanism of replication improvement in multi-dideoxynucleoside-resistant variants remains unknown. In this study, I37 is one of the key amino acids for C34 resistance, and it is located in an important region for the Rev-RRE interaction (13). The significance of the secondary mutations, A30V and D36G, for improvement of the RRE structural stability impaired by I37T or I37K is thought to be that they maintain both gp41 and RRE functions. In contrast to the C34 resistance mutations, nucleotides encoding some T-20 resistance mutations, L33S and N43K (9), are located in a single-stranded bulge region of the stem IIC loop top (UUA to UCA) (Fig. 3A) and in the bulge region of stem III, indicating that the structural changes to the RRE would be minimal, while other T-20 resistance mutations (20), such as G36D, G36S, I37K, and possibly V38A and V38 M, appear to alter the stability of the RRE stem IIC structure and to impair the replication kinetics. To date, the Rev-RRE interaction has mainly been examined for stem IIB, since Rev directly binds to it (10, 13). Although the functions of stems IIA and IIC remain to be defined, it is possible that the secondary mutations in stem IIC influence the Rev-RRE interaction, since we have shown that the secondary mutations were introduced simultaneously with the primary mutations and improved replication. These results also indicate that the conformation of the RRE is essential for the Rev-RRE interaction and not just the nucleotide sequence of the RRE itself.
NL4-3 gp41 contains four N-glycan attachment sites, N-X-S/T, located at N100-A-S, N105-K-S, N114-M-T, and N126-Y-T. These four sites are highly conserved in various HIV strains (11, 16). Mutational analysis revealed that each substitution of the N glycosylation sites had a modest effect on HIV replication, whereas some combined substitutions severely impaired replication (11). Although the effect of N126-glycan on binding of the N-HR and C-HR remains unknown, it would be possible that N126-glycan plays some roles for C34 resistance. Different effects of N126K substitution on susceptibility to T-20 and C34 (1.9- and 6.8-fold, respectively) were observed (Table 1). This result might be accounted for by the finding that N126 locates at 1 (outside) from the N terminus of T-20, whereas it locates inside (+10) of C34 (Fig. 1A).
It has been reported that a tyrosine-based sorting signal in the gp41 cytoplasmic domain, Y201-X-X-L, was involved in trafficking and targeting to the plasma membrane of the gp41 (3). The motif is highly conserved among various HIV strains (16, 19). Although the role of Y201 for infectivity has been studied in detail (3, 19), that of L204 remains to be defined. In the present study, we showed that the L204I substitution enhanced viral replication, suggesting that L204, as well as Y201, plays an important role for viral replication.
pNL4-3 was established as a molecular clone of wild-type HIV-1 (1) and is widely used in HIV research. However, it represents only one of the wild-type HIV-1 variants. In fact, even in the absence of C34, we still observed several substitutions in NL4-3 that were identified in the C34 selection, e.g., A30V and Q39H. These substitutions are also observed in some treatment-naïve clinical isolates (16). It is well known that HIV reverse transcriptase makes several nucleotides miss incorporation during the reverse transcription, suggesting that each HIV isolate, even in the wild-type population, contains several substitutions in the integrated DNA genome. D36 is identified only in pNL4-3-derived clones, although the G36/I37/V38 motif is well conserved, not only in HIV-1 but also in HIV-2 and simian immunodeficiency virus strains (16). Furthermore, the 5-amino-acid deletion in gp120 was reported not only in a fusion inhibitor, T-20 (9), but also in CD4-gp120-binding inhibitors DS5000 (8) and AR177 (Zintevir) (7), CXCR4 antagonists, bicyclams JM2763 and SID791 (6), and SDF-1
-resistant variants (27). In these reports, pNL4-3-derived viruses were also used for the selection of the resistant variants. Only pNL4-3 has the 5-amino-acid tandem sequence FNSTWFNSTW in the gp120 V4 region. Therefore, this deletion is thought to be specific for HIV-1NL4-3, although the 5-amino-acid deletion conferred weak C34 resistance. These results indicate that we should be careful before concluding that such substitutions are involved in the resistance or replication kinetics.
In conclusion, HIV acquires resistance against C34 by mutations in both N-HR and C-HR. However, mutations in N-HR are restricted by Rev-RRE and/or gp120-gp41 interactions, suggesting that HIV-1 fusion is one of the most attractive targets for blocking HIV infection.
This work was supported in part by a grant for the Promotion of AIDS Research from the Ministry of Health and Welfare of Japan (M.M.), a grant for Research for Health Sciences Focusing on Drug Innovation from the Japan Health Sciences Foundation (E.K.), and a grant from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (E.K.). D.N. is supported by the 21st Century COE Program of the Ministry of Education, Culture, Sports, Science, and Technology.
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contains mutations in the envelope gp120 but does not show a switch in coreceptor use. J. Virol. 72:4032-4037.
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