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Journal of Virology, September 2006, p. 9236-9243, Vol. 80, No. 18
0022-538X/06/$08.00+0 doi:10.1128/JVI.00796-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
Histatin 5-Derived Peptide with Improved Fungicidal Properties Enhances Human Immunodeficiency Virus Type 1 Replication by Promoting Viral Entry
Fedde Groot,1
Rogier W. Sanders,1
Olivier ter Brake,1
Kamran Nazmi,2
Enno C. I. Veerman,2
Jan G. M. Bolscher,2 and
Ben Berkhout1*
Department of Human Retrovirology, Academic Medical Center, University of Amsterdam,1
Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, Free University and University of Amsterdam, Amsterdam, The Netherlands2
Received 19 April 2006/
Accepted 30 June 2006

ABSTRACT
Antimicrobial peptides are found in a number of body compartments
and are secreted at mucosal surfaces, where they form part of
the innate immune system. Many of these small peptides have
a broad spectrum of inhibitory activity against bacteria, fungi,
parasites, and viruses. Generally, the peptide's mode of action
is binding and disruption of membranes due to its amphipathic
properties. Histatin 5 is a salivary peptide that inhibits
Candida albicans, an opportunistic fungus that causes oropharyngeal
candidiasis in a majority of human immunodeficiency virus type
1 (HIV-1)-infected patients progressing towards AIDS. Previously,
we increased the fungicidal properties of histatin 5 by replacing
amino acids in the active domain of histatin 5 (Dh-5) (A. L.
Ruissen, J. Groenink, E. J. Helmerhorst, E. Walgreen-Weterings,
W. vant Hof, E. C. Veerman, and A. V. Nieuw Amerongen,
Biochem. J.
356:361-368, 2001). In the current study, we tested
the anti-HIV-1 activity of Dh-5 and its derivatives. Although
Dh-5 inhibited HIV-1 replication, none of the peptide variants
were more effective in this respect. In contrast, one of the
derivatives, Dhvar2, significantly increased HIV-1 replication
by promoting the envelope-mediated cell entry process. Most
likely, Dhvar2 affects membranes, thereby facilitating fusion
of viral and cellular membranes. This study shows that modification
of antimicrobial peptides in order to improve their activity
against a pathogen may have unpredictable and unwanted side
effects on other pathogens.

INTRODUCTION
Antimicrobial peptides have been identified in all species investigated,
where they form part of the innate and possibly adaptive immune
system. Many of these peptides have a broad spectrum of activity
against bacteria, fungi, parasites, and viruses. Several different
types of antimicrobial peptides have been found in humans (
37,
42). Although very heterogeneous in amino acid sequence, they
share some characteristics, like a low molecular mass (1 to
5 kDa), a positively charged domain of 10 to 25 amino acids,
and the tendency to form amphipathic structures (
28,
37). Generally,
the peptide's mode of action is binding and disruption of membranes,
but some studies indicate that these peptides also act intracellularly
(
12,
13,
31).
Three modes of action of antimicrobial peptides have been described with respect to viruses and human immunodeficiency virus type 1 (HIV-1) in particular: direct virolysis, inhibition of transcription from the long terminal repeat (LTR) promoter, and block of cell entry by binding to cell surface receptors (5, 23, 39, 43). In this study, we investigated the anti-HIV-1 activity of derivatives of histatin 5, an antimicrobial peptide present in human saliva. Histatins form a group of electrophoretically distinct histidine-rich polypeptides with microbicidal activity that are present in human parotid and submandibular gland secretions (35). Histatin 5 is active against the yeast Candida albicans, an opportunistic fungus that causes oropharyngeal candidiasis in a majority of HIV-1-infected patients (6). Internalization of histatin 5 and subsequent targeting of the mitochondria leads to release of vital components and cell death of the yeast (7). To increase the activity of this peptide, amino acids in the active domain (Dh-5) of histatin 5 have been substituted. The resulting peptides (Dhvar2 to Dhvar5; Table 1) have previously been shown to possess increased fungicidal activity, and all but one (Dhvar5) are more amphipathic than Dh-5 (14, 25). In the present study, we tested the anti-HIV-1 activity of Dh-5 and its derivatives. Dh-5 inhibited HIV-1 replication, but none of the derivatives was a more efficient inhibitor. Surprisingly, one of the peptides (Dhvar2) dramatically increased HIV-1 replication by promoting the envelope (Env)-mediated entry process. Dhvar2 probably destabilizes membranes and thereby facilitates fusion of viral and cellular membranes. This study shows that the development of more potent antimicrobial agents against certain pathogens like Candida may have unexpected and dangerous side effects if they are used in the context of other pathogens like HIV-1.

MATERIALS AND METHODS
Peptide synthesis and purification.
The active domain of histatin 5 (Dh-5, KRKFHEKHHSHRGY) and variants
(Dhvar2, KRLFKELLFSLRKY; Dhvar3, KRLFKKLKFSLRKY; Dhvar4, KRLFKKLLFSLRKY;
Dhvar5, LLLFLLKKRKKRKY) were synthesized by F-moc chemistry
with a MilliGen 9050 peptide synthesizer (MilliGen/Biosearch,
Bedford, MA) and purified to at least 95% by reverse-phase high-performance
liquid chromatography (RP-HPLC; Jasco Corporation, Tokyo, Japan).
The authenticity of the peptides was confirmed by ion trap mass
spectrometry with an LCQ Deca XP (Thermo Finnigan, San Jose,
CA). During synthesis, Dh-5 and Dhvar2 were labeled with fluorescein
isothiocyanate (FITC) for FACScan analysis as described previously
(
7). Labeling was achieved by addition of 25 µl FITC (1
mg/ml) in dimethyl sulfoxide to 1 ml of a peptide solution (0.66
mM) in water, adjusted to pH 9.7 with Na
2CO
3. After overnight
incubation at 4°C in the dark, residual FITC was inactivated
by incubation with 50 µl of 1 M NH
4Cl for 2 h. The fluorescein-peptide
conjugates were stored in aliquots at 20°C until
use. LuSIV or SupT1 T cells were incubated for 30 min at 4°C
with labeled peptides at a final concentration of 40 µM.
Cells were then analyzed by a fluorescent-activated cell sorter
(FACS) (FACScan; BD Biosciences, San Jose, CA).
Cells, viruses, and lentiviral vectors.
The PM1 and SupT1 T-cell lines were cultured in RPMI medium 1640 (Life Technologies) supplemented with 10% fetal calf serum (FCS), 2 mM sodium pyruvate, 10 mM HEPES, 2 mM L-glutamine, penicillin (100 U/ml) (Sigma-Aldrich, St. Louis, MO), and streptomycin (100 µg/ml) (Invitrogen, Breda, The Netherlands). The LuSIV cell with an integrated LTR-luciferase reporter construct has been described previously (24). Cells were maintained in the same medium as the PM1 and SupT1 cells but with 300 µg/ml hygromycin B to maintain the luciferase genetic construct. Human embryonic kidney (HEK) 293T adherent cells were grown in Dulbecco's modified Eagle's medium (DMEM) (Invitrogen) supplemented with 10% FCS, 2 mM sodium pyruvate, 10 mM HEPES, 2 mM L-glutamine, penicillin, and streptomycin. HIV-1 was produced by electroporation of PM1 T cells with 5 µg of the molecular clone of T-tropic HIV-1 LAI. The virus-containing supernatant was harvested 5 days posttransfection and was filtered and stored at 80°C. The concentration of virus was determined by CA-p24 enzyme-linked immunosorbent assay (ELISA). The full-length simian immunodeficiency virus (SIV)-mac239 clone (11) was kindly provided by Y. Guan and M. A. Wainberg (McGill University AIDS Centre, Montreal, Canada). The virus was produced by electroporation of CEMx174 cells (26). Lentiviral vectors with CXCR4-using Env of the HIV-1 HXB2 strain or vesicular stomatitis virus glycoprotein (VSV-G) were produced as follows. 293T cells (2.2 x 106) were seeded in a T25 flask the day prior to transfection. The next day, medium was replaced with 2.2 ml medium without antibiotics. Subsequently, 16 µl Lipofectamine 2000 and 1.5 ml Optimem (Invitrogen) was used to transfect lentiviral vector plasmid pRRLcpptpgkgfppreSsin (29) (2.4 µg) with packaging plasmids pSYNGP (1.5 µg) (a kind gift of S. Kingsman; Oxford Biomedia, Oxford, United Kingdom) (16), RSV-rev (0.6 µg), and pVSV-G (0.8 µg) (8, 44) or pSV7D plasmid encoding HXB2 gp160 (0.8 µg). The pSV7D gp160 plasmid was a kind gift of J. Binley (Torrey Pines Institute for Molecular Sciences, La Jolla, CA). Medium was replaced the next day with 4 ml of fresh medium. On day 3, medium was harvested in the morning and replaced with fresh medium. This procedure was repeated in the evening and the next day. Cellular debris from the lentiviral vector-containing medium was removed by low-speed centrifugation, and supernatant was stored at 4°C. On the fourth day, supernatants were pooled and concentrated using an Amicon Ultra concentrator (molecular weight cutoff, 100 kDa; Millipore Corporation, Bedford, MA).
Replication assays.
Single-cycle replication was assayed with LuSIV cells: 4 ng CA-p24 HIV-1 was preincubated at 0, 3.1, 12.5, 50, or 200 µM Dh-5 or Dhvar2 to Dhvar5 in a final volume of 50 µl at 37°C. After 30 min, 50 x 103 LuSIV cells were added (200 µl), and luciferase production was determined 24 h later, as previously described (10). The final concentration of the peptides was 0.6, 2.5, 10, or 40 µM, respectively. Fusion inhibitor T20 was added at different time points before or after infection, as indicated in the text (end concentration, 1, 10, 100, 500, or 1,000 ng/ml). Preincubation of different mixtures of HIV-1, LuSIV, and Dhvar2 was performed as follows. Equal volumes (80 µl) of HIV-1, LuSIV cells, and Dhvar2 were preincubated in pairs at 37°C. All components were mixed after 30 min and cocultured for 24 h, followed by luciferase measurement. Single-cycle replication assays with lentiviral vectors were performed with concentrated supernatant containing the lentiviral vector with HIV-1 Env or VSV-G, which was preincubated with 200 µM Dh-5, Dhvar2, or Dhvar4 in 250 µl. After 30 min, 500 x 103 T cells were added (LuSIV, PM1, or SupT1), followed by coculture for 3 days in a final volume of 1 ml (50 µM final peptide concentration). At day 3, cells were harvested, fixated in 4% paraformaldehyde, and analyzed by FACS for the expression of green fluorescent protein (GFP) (FACScan; BD Biosciences). Replication assay with PM1 cells was initiated with 0.1 or 1 ng CA-p24 HIV-1, which was preincubated with 200 µM Dhvar2 or mock treated for 30 min at 37°C, followed by coculture with 80 x 103 PM1 cells in a final volume of 250 µl (final concentration of Dhvar2, 40 µM). Viral replication was followed by CA-p24 ELISA of the supernatant.
gp120 ELISA.
ELISAs were performed as described previously (21, 22). LAI gp120 (100 ng/ml) was captured onto the solid phase using antibody D7324 to the C5 region (Aalto Bio Reagents, Dublin, Ireland). Bound gp120 was detected with purified immunoglobulin (Ig) from pooled serum of HIV-1-infected individuals (HIVIg), CD4-IgG2 (1), or one of the monoclonal antibodies 17b (with our without soluble CD4 [sCD4] [17]), 2G12 (27, 34), and IgG1b12 (4). Competition experiments were performed at half-maximal binding concentrations of the respective reagents. These were 3 (HIVIg), 0.15 (CD4-IgG2), 0.02 (17b plus sCD4), 0.1 (17b alone), 0.2 (2G12), and 0.02 (IgGb12) µg/ml. LAI gp120, CD4-IgG2, and sCD4 were kindly donated by M. Franti and W. Olson (Progenics Pharmaceuticals, Inc., Tarrytown, NY). 17b and HIVIg were a kind gift of J. Binley (Torrey Pines Institute for Molecular Sciences, La Jolla, CA), and IgG1b12 was provided by D. R. Burton (The Scripps Research Institute, La Jolla, CA). 2G12 from H. Katinger was obtained from the National Institutes of Health AIDS Research and Reference Reagent Program.
Peptide depletion assay.
PM1 T cells were infected with HIV-1, cells were spun down at peak infection (1020 ng CA-p24/ml), and virus-containing supernatant was used to infect fresh PM1 cells. Supernatant with virus (990 ng CA-p24/ml) was harvested 40 h later and spun down in the ultracentrifuge for 2 h at 33,000 x g. Virus was resuspended in phosphate-buffered saline (PBS) (final concentration, 950 ng CA-p24/ml) and incubated with Dh-5 or Dhvar2 (40 µM) for 30 min at 37°C. Alternatively, 2.5 x 106 LuSIV, PM1, or SupT1 cells were incubated in 1 ml PBS with Dh-5 or Dhvar2. Cells and virus were subsequently removed by centrifugation (cells, 400 x g; virus, 33,000 x g), and the remaining concentration of peptide in the supernatant was determined by capillary zone electrophoresis (CZE) and RP-HPLC. CZE separations were conducted on a Biofocus 2000 instrument (Bio-Rad, Hercules, CA) equipped with an uncoated fused silica capillary of 24 cm and 50 µm internal diameter (ID), essentially according to the instructions of the manufacturer. Briefly, the capillary was rinsed for 60 s with the low-pH Bio-Rad CZE phosphate buffer (0.1 M phosphate, supplemented with polymer modifier). Appropriate dilutions of the supernatants were mixed with 10-times-diluted Bio-Rad CZE phosphate buffer, containing 40 µM imidazole as an internal standard. Samples were injected by pressure injection at 20 lb/in2/s. Separation was performed at a voltage of 15 kV (cathode at the detector site) and a temperature of 20°C. On-line UV detection of the samples was accomplished at 200 nm. Run time of the separation was 10 min. RP-HPLC separations were performed by HPLC (Jasco, Tokyo, Japan) on a reversed-phase C18 column (Vydac 218TP54; 24 cm and 4.6 mm ID; 5 µm particle size) developed with a linear gradient of acetonitrile containing 0.1% trifluoroacetic acid. On-line UV detection of the samples was accomplished at 214 nm. Run time of the separation was 20 min. Relative peptide concentrations in the samples were determined based on the relevant peak areas.

RESULTS
Dh-5 inhibits, but derivatives enhance, HIV-1 replication.
Amino acids in the active domain (Dh-5) of salivary peptide
histatin 5 have previously been replaced to increase the fungicidal
activity of this peptide against
Candida albicans (Table
1).
Dhvar2 to Dhvar4 are more amphipathic, while Dhvar5 is less
amphipathic than Dh-5 (
14,
25). Because
Candida is associated
with immune-compromised patients like HIV-1-infected persons
progressing towards AIDS (
6), we wanted to explore the antiviral
properties of Dh-5. We furthermore investigated whether the
variant peptides displayed enhanced antiviral activity, which
was expected due to their increased antifungal properties. We
incubated HIV-1 with these peptides and tested viral infectivity
in a single-cycle replication assay with LuSIV reporter cells.
These reporter cells contain the firefly luciferase gene downstream
of the LTR promoter, resulting in Tat-mediated luciferase expression,
which is a measure of infectivity (
24). Dh-5 was able to reduce
the infectivity of HIV-1, but modification of Dh-5 did not enhance
the anti-HIV-1 properties of this peptide: none of the peptide
variants decreased luciferase production more than Dh-5 (Fig.
1). Surprisingly, the Dhvar2, Dhvar3, and Dhvar4 peptides with
increased amphipathicity stimulated HIV-1 infection. In the
absence of HIV-1, none of these peptides influenced the background
luciferase levels of the LuSIV cells, excluding that the peptides
trigger signaling pathways in the cell that lead to LTR activation
and luciferase production (data not shown). Dhvar2 showed the
highest enhancing effect by increasing luciferase production
10-fold, on average.
Dhvar2 also stimulated HIV-1 replication in T cells over a prolonged
period of time. PM1 T cells were infected with Dhvar2-treated
or mock-incubated HIV-1, and viral replication was followed
by CA-p24 ELISA on the supernatant. The results are very obvious
when a noninfectious dose of HIV-1 was used, in which case Dhvar2
rescued HIV-1 replication (Fig.
2). When a high viral input
was used, we found no stimulation by Dhvar2 in comparison to
the mock-treated sample (results not shown). Cell toxicity was
observed at higher concentrations of Dhvar2 (>60 µM),
which obviously decreased viral replication (data not shown).
Dhvar2 binds to cells.
To elucidate the mechanism by which Dhvar2 enhances HIV-1 infection,
we preincubated the peptide (or medium as a mock treatment)
either with HIV-1 or the LuSIV cells for 30 min at 37°C.
Both treatments yielded the approximately 10-fold enhancement
(Fig.
3). Preincubation of virus and cells prior to addition
of Dhvar2 yielded the same level of stimulation. This experiment
therefore does not identify the target for Dhvar2 stimulation,
but it does show that the peptide has a broad time span in which
it can stimulate HIV-1 infection.
We next investigated whether Dhvar2 (or Dh-5 as a control) affects
the binding of a broad range of reagents to the HIV-1 envelope
(Env) gp120 protein in a gp120 ELISA (Fig.
4A). We focused on
reagents that bind to the CD4 and coreceptor binding sites,
since binding to these sites might provide a plausible mechanism
for stimulation of infectivity by Dhvar2. Purified Ig from HIV-1-infected
individuals (HIVIg) was used as well as several monoclonal antibodies.
2G12 binds to a glycan-dependent epitope on the outer domain
of gp120 (
27), IgGb12 targets the CD4 binding site (
4), and
17b is directed to a CD4-induced site overlapping the coreceptor
binding site (
17). 17b was therefore tested with and without
soluble CD4 (sCD4). Furthermore, we tested CD4-IgG2, which is
a tetrameric CD4-based molecule that is directed to the CD4
binding site (
1). Increasing amounts of peptide were allowed
to compete with these respective reagents for binding to gp120,
which was captured on an ELISA plate. The reagents were used
at the predetermined half-maximal binding concentrations. CD4-IgG2
binding was also performed in the presence of sCD4 to provide
a control for competition efficiency. Although we observed efficient
inhibition of CD4-IgG2 binding to gp120 by sCD4, we did not
observe an effect of Dh-5 or Dhvar2 on binding of the reagents
to gp120 (Fig.
4A). We tested a wide range of concentrations
of the peptides (0, 3.7, 11.1, 33.3, and 100 µM), and
100 µM is twice the concentration that stimulates virus
infectivity. Even this amount of peptide did not influence binding
of the various reagents to gp120, indicating that the peptide's
mode of action does not involve binding to the CD4 or coreceptor
binding sites on gp120.
To further identify the target of Dhvar2, we tested whether
Dhvar2 or Dh-5 could be depleted from a PBS solution by virus
or T cells. High concentrations of virus (950 ng CA-p24/ml)
did not deplete the peptides from the solution by virus centrifugation.
In contrast, T cells (LuSIV, PM1, or SupT1) could deplete both
peptides from the solution (Fig.
4B). The amount of Dh-5 that
remained in solution was, on average, five times higher than
that of Dhvar2, indicating that Dhvar2 binds more efficiently
to T cells than Dh-5. This observation was confirmed with FITC-labeled
peptides that can be detected by FACS analysis. The amount of
FITC-labeled Dhvar2 that bound to LuSIV or SupT1 T cells was,
on average, three times higher than the amount of Dh-5 (Fig.
4C). Combined, these experiments suggest that the target of
Dhvar2 is the T cell rather than the virus.
Stimulation by Dhvar2 is dependent on HIV-1 Env.
To investigate whether the stimulatory properties of Dhvar2 are also applicable to other viruses, we studied whether the peptide could enhance LuSIV infection by CCR5-using SIV-mac239. Although not as efficient as the stimulation observed with CXCR4-using HIV-1, Dhvar2 enhanced SIV infection by a factor of 3.5 (Fig. 5).
To study whether Dhvar2 stimulates viruses that use other entry
mechanisms, we compared a lentiviral vector that is pseudotyped
with either the vesicular stomatitis virus glycoprotein (VSV-G)
or HIV-1 Env. We used a standard lentiviral vector with the
green fluorescent protein (GFP) reporter gene (
29). After entry
of this pseudovirus into the cell and subsequent reverse transcription,
GFP will be produced, which can be detected by FACS 3 days later.
Dhvar2 could elevate the transduction efficiency of the HIV-1
Env-based vector twofold (Fig.
6A, upper row). In contrast,
the percentage of GFP-positive SupT1 T cells was not elevated
by Dhvar2 when the vector was bearing VSV-G (Fig.
6A, second
row). This result clearly demonstrates that the enhancing effect
of Dhvar2 is dependent on the HIV-1 Env protein and excludes
that the peptide affects other steps of the retroviral replication
cycle shared by both vectors, which includes reverse transcription,
integration, transcription, and translation. The FACS results
with SupT1 T cells are quantified in Fig.
6B. Similar results
were obtained when the vector was used to infect LuSIV cells
(Fig.
6B). As a control, we included Dh-5 and Dhvar4. No stimulation
was observed with Dh-5, and a slight stimulation was observed
with Dhvar4.
Dhvar2 promotes HIV-1 Env-mediated entry.
VSV and HIV-1 use different routes of cellular entry: VSV enters
through endocytosis, whereas HIV-1 enters through receptor-mediated
fusion of viral and cellular membranes (
19,
20). The experiment
using VSV-G and HIV-1 Env-pseudotyped lentiviral vectors indicates
that the effect of Dhvar2 is HIV-1 Env dependent (Fig.
6). From
these results, one cannot discriminate between effects on Env-mediated
membrane fusion or postentry steps preceding reverse transcription
(e.g., uncoating). To make this distinction, we employed the
entry inhibitor T20. This peptide stabilizes a transient structural
Env intermediate, thereby blocking subsequent conformational
changes and the fusion of viral and cellular membranes (
2,
9).
We first investigated whether Dhvar2 interferes with the inhibitory
properties of T20 by titrating both peptides on LuSIV cells
that were subsequently infected with HIV-1. Addition of Dhvar2
did not alter the inhibition profile of T20 (Fig.
7A). This
result demonstrates that T20 inhibition is dominant over Dhvar2
stimulation, justifying further usage of T20 in these assays.
We next infected LuSIV cells with HIV-1 and added T20 after
240 min to stop the ongoing infection process. Compared to the
control infection, T20 partially reduced the luciferase production,
demonstrating that a substantial amount of virus, but not all
of it, had already entered the cells within 240 min (Fig.
7B,
left panel). As a control, T20 was added 5 min before HIV-1
infection (
t = 5 min), which totally abolished luciferase
production. When Dhvar2 was added at
t = 255 min, this expectedly
led to a considerable increase in luciferase production. However,
this stimulation was not observed when T20 was supplied 15 min
prior to Dhvar2 addition (Fig.
7B, right panel). If Dhvar2 stimulated
a postentry step, one would expect an increase in luciferase
production despite the presence of T20, because this drug inhibits
new entry events but not virus that has already been fused with
the cell at the time of T20 addition. We therefore conclude
that Dhvar2 promotes the Env-mediated entry step.

DISCUSSION
Vaginal, rectal, or oral transmission of HIV-1 involves crossing
of mucosal tissue, a process that is not yet entirely understood
(
30,
40). One of the complicating factors for the virus is antimicrobial
peptides that are secreted at mucosal surfaces as part of the
innate immune system. Their use as candidate forms of prophylaxis
against HIV-1 has therefore been proposed (
5,
36,
38). There
are several studies on antimicrobial peptides and inhibition
of HIV-1 replication, and their mode of action is diverse, including
disruption of the viral membrane, inhibition of reverse transcription,
or prevention of viral entry (
5,
18,
23,
32,
33,
39,
43). Previously,
we reported that human saliva contains several compounds that
inhibit HIV-1 at different stages of the replication cycle (
3).
We have now investigated the active domain of one salivary peptide
(histatin 5) and derivatives thereof. Amino acids in the active
domain (Dh-5) were substituted, yielding peptide variants (Dhvar2
to Dhvar5) with increased fungicidal activity (
14,
25). We report
that Dh-5 decreases the infectivity of HIV-1 in a single-cycle
replication assay. Unexpectedly, none of the peptide variants
were more potent antivirals. Interestingly, the Dhvar2 variant
significantly stimulated HIV-1 up to 30-fold in the single-cycle
replication assay.
We found that Dhvar2 binds to T cells and that it enhances Env-mediated viral entry. Stimulation was observed with CCR5-using SIV, CXCR4-using HIV-1, and pseudotyped viruses, but not when this pseudovirus was bearing the VSV-G protein. VSV and HIV-1 have different routes of entry: VSV enters a cell through endocytosis, whereas HIV-1 enters through receptor-mediated fusion of viral and cellular membranes (19, 20). In a pulse-chase experiment with the T20 entry inhibitor, we could demonstrate that Dhvar2 acts early at the entry step (Fig. 7B). Membrane interaction is a very general property of antimicrobial peptides (37). Possibly, Dhvar2 facilitates fusion of the viral and cellular membrane due to the fact that this amphipathic peptide inserts in membranes and weakens the structure of the lipid bilayer. We observed a strong correlation between amphipathicity and the stimulatory or inhibitory properties of the different peptides (Table 1). We therefore do not think that Dhvar2 has a specific protein-based receptor on T cells or the virus.
The difference between Dh-5 and the variants is the predicted 3-dimensional
-helical conformation: Dhvar2, Dhvar3, and Dhvar4 have a more pronounced separation between the hydrophilic and hydrophobic amino acids than Dh-5, leading to an optimal amphipathicity in the
-helical conformation (Table 1). While in the context of Candida the derivatives have an increased fungicidal activity, this apparently does not apply to the HIV-1-human cell interaction. At the concentrations used in our study, Dhvar2 seems to affect the membrane such that Env-mediated membrane fusion and subsequent viral entry is promoted. This also applies to Dhvar3 and Dhvar4 to a lesser extent.
Interestingly, one of the Dh-5 variants (Dhvar5) shows sequence similarity to the C terminus of a recently described papillomavirus capsid protein (15). This peptide mediates escape of viral genome degradation by destabilizing the membrane of the endocytic compartment. Remarkably, Dhvar5 is the only Dh-5 variant that did not stimulate HIV-1 infection. Furthermore, Dhvar5 is the only variant that is less amphipathic than Dh-5. These results demonstrate that the stimulatory properties of a peptide on viruses is context dependent and therefore difficult to predict. This papillomavirus study, combined with our results, suggests that minor membrane destabilization may be beneficial to a broad range of viruses.
Recently, another study showed that antimicrobial peptides with comparable bactericidal effects have differential effects on HIV-1 replication. One peptide, cryptdin 3 (Crp3), stimulated HIV-1 in an unidentified step preceding reverse transcription (33). Crp3 is a member of the
-defensin family and has been described to form anion-selective pores in mammalian cell membranes (41). It is therefore possible that the mode of action is comparable to that of Dhvar2. We are the first to show that peptides with minor amino acid substitutions can have an unexpected reverse effect on HIV-1 replication.
Our findings are relevant for the design and clinical application of antimicrobial peptides. Candida albicans is the predominant species of yeast isolated from patients with oral candidiasis, which is a frequent symptom of HIV-1 infection and a criterion for staging and progression of AIDS (6). Treating candidiasis patients with the peptide variants with increased antifungal activity seems tempting but would be unadvisable and potentially dangerous if the patient is HIV-1 infected. In the absence of HIV-1 infection, people who receive treatment for oral candidiasis with the variant peptides should be aware of the increased susceptibility to HIV-1 infection.
In conclusion, our study shows that modification of antimicrobial peptides in order to improve their activity may have unwanted and potentially dangerous side effects on other pathogens. Since these effects are difficult to predict, this should be considered in the development of antimicrobial peptides for clinical application.

ACKNOWLEDGMENTS
This research was funded by grant 7008 from Aids Fonds Netherlands
(B.B.) and a fellowship from the Anton Meelmeijer foundation
and NWO/CW-VENI (R.W.S.).
We thank the following persons for providing us with valuable reagents: J. E. Clements for the LuSIV cells; J. Seppen for the lentiviral vector system; Y. Guan and M. A. Wainberg for the SIV-mac239 clone; J. Binley for the pSV7D plasmids, HIVIg, and 17b antibody; D. R. Burton for the IgG1b12 antibody; M. Franti and W. Olson for LAI gp120, CD4-IgG2, and sCD4; S. Kingsman for the pSYNGP packaging plasmid; and finally, the 2G12 antibody from H. Katinger was obtained from the NIH AIDS Research and Reference Reagent Program, Division of AIDS, NIAID, NIH.

FOOTNOTES
* Corresponding author. Mailing address: Department of Human Retrovirology, Academic Medical Center, Meibergdreef 15, University of Amsterdam, Amsterdam 1105AZ, The Netherlands. Phone: 31-30-5664822. Fax: 31-20-5669064. E-mail:
b.berkhout{at}amc.uva.nl.


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Journal of Virology, September 2006, p. 9236-9243, Vol. 80, No. 18
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