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Journal of Virology, January 2007, p. 362-373, Vol. 81, No. 1
0022-538X/07/$08.00+0 doi:10.1128/JVI.01404-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Rega Institute for Medical Research, K.U. Leuven, B-3000 Leuven, Belgium,1 Department of Biomedical Sciences and Biotechnology, University of Brescia, I-25123 Brescia, Italy,2 Biotechnology Research Center, Toyama Prefectural University, Kurokawa 5180, Kosugi, Imizu-shi, Toyama 939-0398, Japan,3 Keck School of Medicine, University of Southern California, Los Angeles, California4
Received 5 July 2006/ Accepted 6 October 2006
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In the course of screening for new antibiotics active against fungi, an actinomycete strain (Actinomadura hibisca) was found to produce pradimicin A (PRM-A), which shows activity against systemic fungal infections (26). PRM-A has a unique structure containing the following moieties: the amino acid D-alanine, the carbohydrates D-xylose and 4,6-dideoxy-4-methylamino-D-galactose, and a substituted 5,6-dihydrobenzo[a]naphtacenequinone (Fig. 1). Interestingly, PRM-A was also shown to be inhibitory to HIV-1 (36, 37). The biological effect of PRM-A had been ascribed to binding to mannose residues (37, 38). This proposed mechanism of antiviral action of PRM-A is in agreement with the observation that the antibiotic binds to terminal D-mannopyranoside and Ca2+ to yield a ternary complex (40; for more-detailed information on the mechanisms of the antifungal activity and molecular interactions of PRM-A, see references 18, 19, 25, and 45).
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FIG. 1. Structural formula of pradimicin A.
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Cells. Human T-lymphocytic CEM and Sup T1 cells were cultivated in RPMI 1640 medium supplemented with 10% fetal bovine serum (FBS) (BioWittaker Europe, Verviers, Belgium), 2 mM L-glutamine, and 0.075 M NaHCO3. C8166 cells were grown and maintained in RPMI 1640 medium supplemented with 10% heat-inactivated fetal calf serum, 2 mM L-glutamine, 0.1% sodium bicarbonate, and 20 µg gentamicin per ml.
Viruses. HIV-1(IIIB) was provided by R. C. Gallo and M. Popovic (at that time of the National Cancer Institute, National Institutes of Health, Bethesda, MD). The HIV-1/NL4-3.GFP11 strain that expresses an enhanced version of green fluorescent protein (GFP) (35) as a replacement for Nef has been described previously (41). For this molecular clone, the expression of GFP in infected cells is a measurement of virus production (11). For all tests described, HIV-1/NL4-3.GFP11 was obtained from the transfection of 293T cells. One milliliter of virus-containing 293T cell supernatant was used to infect 8 x 106 MT-4 cells in 40 ml of culture medium. Three days after being infected, the supernatant was collected and used as the virus input in our assays.
Generation of VSV-G-pseudotyped HIV-1.
The vesicular stomatitis virus glycoprotein (VSV-G)-pseudotyped HIV-1(with env deleted) was generated by transient cotransfection of recombinant pHIV-1/NL4-3-
E-GFP with env deleted (48) (a kind gift of R. Siliciano, Johns Hopkins University, Baltimore MD) and pVSV-G in 293T cells, using calcium phosphate. The supernatants containing VSV-G-pseudotyped HIV-1 were collected 60 h after transfection. The cell debris was removed from the supernatant by centrifugation (450 x g for 10 min), and the supernatants were used for infection experiments or stored at 80°C.
Production of GFP-labeled HIV-1 virions. Fluorescent virions were produced by transient cotransfection of pHIV-1/NL4-3 (48) and pGFP-Vpr, a plasmid expressing the GFP-Vpr fusion protein (a kind gift from G. N. Pavlakis, National Cancer Institute, Frederick MD). The supernatants holding GFP-Vpr-containing HIV-1 were collected 60 h after transfection. The cell debris was removed from the supernatant by centrifugation (450 x g for 10 min), and the supernatants were used for infection experiments or stored at 80°C.
Antiretrovirus assays. The methodology of the anti-HIV assays has been described previously. Briefly, CEM cells (4.5 x 105 cells/ml) were suspended in fresh culture media and infected with HIV-1 at 100 50% cell culture infective dose per ml of cell suspension in the presence of appropriate dilutions of the test compounds. After 4 to 5 days of incubation at 37°C, giant cell formation was recorded microscopically in the CEM cell cultures. The 50% effective concentration (EC50) corresponds to the compound concentrations required to prevent syncytium formation by 50% in the virus-infected CEM cell cultures. Several test compounds were also tested against HIV-1 in CEM cell culture media containing 2, 5, 10, 20, or 40% FBS.
In the cocultivation assays, 5 x 104 persistently HIV-1-infected HUT-78 cells (designated HUT-78/HIV-1) were mixed with 5 x 104 Sup T1 cells, along with appropriate concentrations of the test compounds. After 16 to 20 h, marked syncytium formation was noted in the control cell cultures, and the number of syncytia was determined under a microscope.
Antiviral activity of test compounds against HIV-1 clade isolates in PBMCs. Primary clinical isolates representing different HIV-1 clades and an HIV-2 isolate (see Table 2) were all kindly provided by L. Lathey of BBI Biotech Research Laboratories, Inc., Gaithersburg, MD, and their coreceptor (R5 or X4) use was determined (33). Antiviral testing of these isolates in peripheral blood mononuclear cells (PBMCs) was done as previously described (6). Briefly, PBMCs from healthy donors were stimulated with phytohemagglutinin (PHA) at 2 µg/ml (Sigma, Bornem, Belgium) for 3 days at 37°C. The PHA-stimulated blasts were then seeded at 0.5 x 106 cells per well into a 48-well plate containing various concentrations of the compound in cell culture medium (RPMI 1640) containing 10% fetal calf serum and interleukin-2 (25 U/ml, R&D Systems Europe, Abingdon, United Kingdom). The virus stocks were added at a final dose of 250 pg of p24 or p27/ml. The cell supernatant was collected at day 12, and the HIV-1 core antigen (Ag) in the culture supernatant was analyzed by a p24 Ag enzyme-linked immunosorbent assay kit (Perkin Elmer, Boston, MA). For HIV-2 p27 Ag detection, the INNOTEST from Innogenetics (Temse, Belgium) was used.
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TABLE 2. Inhibitory activity of CBAs on anti-HIV-1 activity in CEM cell cultures in the presence of different concentrations of serum
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Selection and isolation of PRM-A-resistant HIV-1 strains. The procedure followed for the selection of drug-resistant virus mutants was essentially as recently described (5, 6). Briefly, HIV-1(IIIB) was added to CEM cell cultures in 48-well plates in the presence of PRM-A at a concentration equal to one- to twofold the EC50. For the generation of drug-resistant virus mutants, an increased drug concentration was administered when the previous cell culture became fully cytopathogenic. The drug resistance selection schedule is depicted in Fig. 2. Ten virus isolates from four independent series of drug resistance selections were taken at different time points during the drug resistance selection process.
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FIG. 2. Time-of-drug-addition experiment. C8166 cells were infected with HIV-1/NL4-3.GFP11, and test compounds were added at different times after infection. Virus-associated GFP expression was measured by flow cytometry at 30 h postinfection. Depending on the target of the drug action, addition of the compounds could be delayed for a certain number of hours without loss of antiviral activity. The later the drug target occurs in the virus infection process, the longer the drug addition can be delayed before antiviral activity is lost.
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Antibody staining and flow cytometry. Human T-lymphoid MT-4 and CEM cells were washed once with phosphate-buffered saline (PBS) containing 2% FBS and preincubated with the CBAs GNA, HHA, and PRM-A or the specific CXCR4 antagonist AMD3100 at the indicated concentrations for 30 min at room temperature. After being centrifugated and washed with PBS containing 2% FBS, the cells were incubated for 30 min on ice with a panel of different anti-human CXCR4 monoclonal antibodies (i.e., clones 12G5, 2B11 [BD Pharmingen)], and 44717.111 [R&D Systems Europe]), all phycoerythrin [PE] conjugated) and anti-human CD4 MAbs [i.e., clones SK3(Leu3a) and L120(CD4 v4), both PE-conjugated (BD Pharmingen), and OKT4 and OKT4A, both fluorescein isothiocyanate (FITC)-conjugated (Ortho Diagnostic Systems, Raritan, NJ)] in PBS containing 2% FBS. Thereafter, the cells were washed twice with PBS, fixed in 1% paraformaldehyde in PBS and analyzed on a FACSCalibur flow cytometer equipped with CellQuest software (Becton Dickinson, San Jose, CA). As a negative control for a specific background staining, the cells were stained in parallel with Simultest isotype control MAb (Becton Dickinson).
Evaluation of the immunosuppressive activity of PRM-A. The immunosuppressive activity of PRM-A was evaluated in PHA-stimulated PBMCs and in mixed leukocyte cultures (MLC) with mitomycin-C-treated PBMCs from donor number 1 as stimulators and untreated PBMCs from another donor (donor number 2) as responders. The PBMCs were stimulated with PHA (2 µg/ml (Sigma), and 105 PBMCs/well were set up in triplicate in a 96-well microtiter plate in the presence of a dilution series of PRM-A. For the MLC cocultures, 105 PBMCs from each donor were set up in triplicate in a 96-well microtiter plate in the presence of a dilution series of PRM-A. At day 3 for PHA-stimulated PBMCs and day 5 for the MLC, 0.4 µCi of [3H]thymidine (Amersham Pharmacia, Buckinghamshire, United Kingdom) with a radiospecific activity of 5 Ci/mmol was added to each well. The plates were harvested 12 h later, and [3H]thymidine incorporation, which is a measure of lymphocyte proliferation, was measured in a scintillation counter (Canberra-Packard, Zellik, Belgium) and expressed as counts per minute.
Surface plasmon resonance binding assay.
A BIAcore X apparatus (BIAcore Inc, Piscataway, NJ) was used. Surface plasmon resonance (SPR) was exploited to measure changes in the refractive index caused by the ability of PRM-A and HHA to bind to gp120 immobilized to a BIAcore sensor chip. Seven and a half micrograms per milliliter of recombinant gp120 protein (HIV-1 MN strain), produced and purified from baculovirus (Immunodiagnostics Inc., Woburn, MA), was allowed to react with a flow cell of a CM3 sensor chip that was previously activated with 50 µl of a mixture of 0.2 M N-ethyl-N'-(3-dimethylaminopropyl)carbodiimide hydrochloride and 0.05 M N-hydroxysuccinimide. These experimental conditions allowed the immobilization of 3,000 resonance units (RU;
0.025 pmol of gp120) (14, 15). Similar results were obtained for the immobilization of bovine serum albumin (BSA), used as a negative control and for Blanco subtraction. Increasing concentrations of PRM-A or HHA in HBS buffer (10 mM HEPES, 150 mM NaCl, 3 mM EDTA, 0.005% surfactant P20 [pH 7.4]) were then injected over the GST-Tat or BSA surfaces for 4 min (to allow their association with immobilized proteins) and then washed until dissociation was observed. For PRM-A only, the injections were also made in HBS with EDTA omitted and 10 mM Ca2+ added. After every run, the sensor chip was regenerated with an injection of 10 mM glycine buffer (pH 1.5). The SPR signal was expressed in terms of RU.
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0.07 µM). Whereas the antiviral activity of PRM-A could be reversed by 10-fold in the presence of mannan, with the plant lectins it lost antiviral activity by 50- to 100-fold. In contrast, DS-5000 was not affected in its antiviral potential by mannan (Table 1). |
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TABLE 1. Inhibitory activity of CBAs on anti-HIV-1 activity in CEM cell cultures
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PRM-A efficiently prevented giant cell formation between persistently HIV-1(IIIB)-infected HUT-78/HIV-1 and uninfected Sup T1 cells at an EC50 of 3.4 µg/ml, that is, at a drug concentration that is equally effective in preventing cytopathic effects induced by HIV in CEM cell cultures (Table 1). In contrast, the peptidic CBAs such as GNA and HHA and the polyanionic compound DS-5000 lost
10-fold of their inhibitory potential in the cocultivation assay compared with that for the infection assay with free virus (Table 1).
PRM-A was also endowed with a consistent suppressive activity against a wide variety of X4- and R5-tropic HIV-1 clade isolates in PBMCs (Table 3). In contrast, the mannose-specific plant lectins showed much higher variability in their virus-suppressive potential (i.e., 1.2 µg/ml [group O] to
100 µg/ml [clade C]).
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TABLE 3. Inhibitory activity of CBAs on HIV strains and clinical HIV-1 clade isolates in PBMC cultures
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To further investigate the effect of PRM-A on the HIV-1 entry process, VSV-G-pseudotyped (env-deficient) GFP-encoding HIV-1 was exposed to C8166 cells in the absence (control) or presence of different concentrations of the test compounds (Fig. 3). Forty-eight hours postinfection, the supernatants were analyzed for GFP production. The reverse transcriptase inhibitors UC-781 and nevirapine dose dependently suppressed GFP expression by the pseudotyped virus-infected cells, while the CXCR4 antagonist AMD3100, HHA, and PRM-A completely lost their inhibitory effect, pointing to the specific interaction of the HIV-1 envelope with susceptible cells as the target of antiviral intervention of PRM-A and HHA (Fig. 3).
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FIG. 3. Effect of test compounds against VSV-G-pseudotyped HIV-1. C8166 cells were infected with GFP-encoding, env-deleted HIV-1 pseudotyped with envelope VSV-G and treated with different compounds at different concentrations. The letters on the x axis represent different concentrations of the respective compounds (in µg/ml, for AMD3100, A = 0, B = 0.008, C = 0.04, D = 0.2, E = 1, and F = 5; for PRM-A, A = 0, B = 0.08, C = 0.4, D = 2, E = 10, and F = 50; for HHA, A = 0, B = 0.16, C = 0.8, D = 4, E = 20, and F = 100; for UC781, A = 0, B = 0.0016, C = 0.008, D = 0.04, E = 0.2, and F = 1; for nevirapine, A = 0, B = 0.0008, C = 0.004, D = 0.02, E = 0.1, and F = 0.5). The infected cells were assayed for GFP expression at 48 h postinfection. One hundred percent of GFP expression for each compound was defined as that for the control culture without the compound added.
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FIG. 4. Flow cytometric analysis of human C8166 cells incubated with GFP-Vpr-labeled HIV-1 virions. C8166 cells were incubated in the presence or absence of different compounds for 30 min at 37°C. (Panels 1 and 2) Medium (control); (panel 3) 100 µg/ml DS5000; (panels 4, 5, and 6) different concentrations of PRM-A. The cells were then inoculated with GFP-Vpr-labeled HIV-1 (15 ng of p24) for 6 h at 37°C. The cells were subsequently washed with PBS, fixed with 3% paraformaldehyde, and analyzed by flow cytometry for GFP fluorescence. The toxicity of the compounds was assessed by comparing the forward- versus the side-scatter dot plots. Cell debris was excluded from the analysis by gating on forward- versus side-scatter dot plots. The percentage of GFP-positive cells (R2) is indicated in the upper right hand corner of each panel.
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FIG. 5. Four independent selection pathways for PRM-A-resistant HIV-1 strains. The drug concentrations were increased when a marked viral cytopathic effect was observed in the cell cultures. The time points at which virus isolates were propagated are indicated by arrows and a designation that corresponds with the virus strains depicted in Table 3.
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TABLE 4. Genotypic characterization of gp120 of mutant HIV-1(IIIB) strains that emerged under escalating PRM-A exposure in CEM cell cultures
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FIG. 6. Mapping of the deleted glycosylation sites in gp120 of HIV-1 strains isolated under escalating PRM-A concentrations in CEM cell cultures. HIV-1 (HXB-2) gp120 contains 24 numbered N-glycosylation sites (circles) (21, 23). The N-glycosylation sites that were found to be deleted in the ten PRM-A-exposed virus strains are in red. The N-glycosylation sites that were not found to be mutated are in green. The N-glycosylation site that was created during the drug selection process (series-1) is indicated in blue.
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TABLE 5. Inhibitory activity of CBAs to pradimicin A-exposed HIV-1(IIIB) isolates in CEM cell culturesa
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PRM-A and HHA were also investigated for their binding capacity for HIV-1 gp120, using the BIAcore technology. When tested in HBS buffer, HHA interacted with gp120 immobilized on the BIAcore sensor chip (Fig. 7A), while PRM-A did not show any binding capacity (Fig. 7C). However, the gp120 binding capacity of PRM-A became evident when EDTA was omitted and Ca2+ (10 mM) was added to the HBS buffer (Fig. 7C). The same buffer only slightly increased the binding of HHA to gp120 (less than 20%) without altering the binding parameters (data not shown). When tested in the appropriate buffers (unmodified HBS for HHA and HBS without EDTA and containing 10 mM Ca2+ for PRM-A), HHA and PRM-A showed a similar binding capacity (800 to 960 RU bound at the end of the injection phase). The specificity of the interactions was demonstrated by the lack of significant binding for the compounds when tested at the maximal doses on a BSA-coated sensor chip (Fig. 7A and C). In a second series of experiments, increasing concentrations of the two compounds were injected over the gp120 surface to evaluate the binding parameters. HHA, once bound, hardly detached from the gp120 surface, even when the dissociation phase was prolonged to 2,200 s (Fig. 7B), that is, at experimental conditions in which PRM-A almost completely dissociated (Fig. 7D). Accordingly, the dissociation rate of PRM-A is significantly higher than that of the plant lectin (Table 6). The dissociation constant (KD) for the interaction of HHA with gp120 was in the low nanomolar range, while that calculated for PRM-A proved significantly higher, being equal to
2.7 µM (Table 6). Interestingly, while the molar ratio of gp120 versus the drug could be calculated to be approximately 1:1.5 for HHA, a value of 1:33 was found for PRM-A (Table 6).
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FIG. 7. Interaction of HHA and PRM-A with gp120. In the first series of experiments, HHA (A) was injected at 5 nM in HBS over BIAcore sensor chips containing p120 (upper sensor grams) or BSA (lower sensor grams). PRM-A (C) was injected at 700 nM in HBS over gp120 (dotted sensor gram) or BSA (hacked sensor gram) surfaces. Alternatively, PRM-A was injected into HBS without EDTA but in the presence of 10 mM Ca2+ over gp120 (upper straight sensor gram) or BSA (lower straight sensor gram) surfaces (C). The solid black lines represent the experimental data. The gray lines represent the fit (A and C). In a second series of experiments, HHA (B) and PRM-A (D) were injected into the appropriate buffers at increasing concentrations over the gp120 surface (HHA at 0.3, 0.75, 0.5, 1.3, and 5 nM; PRM-A at 100, 150, 200, 350, 500, and 700 nM). In panels B and D, the sensor grams shown are those obtained after blank subtraction.
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TABLE 6. Binding parameters of the interactions of HHA and PRM-A to gp120 immobilized to a BIAcore sensor chipa
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Although virus infection/replication could be completely blocked by PRM-A, the drug seems to enhance virus interactions with its target cells in a dose-dependent manner (Fig. 4). In this respect, the enhancing effects of PRM-A were more pronounced than those of the mannose-specific HHA (data not shown). Since DS-5000 clearly showed the opposite effect (Fig. 4), we hypothesize that CBAs such as plant lectins, as well as the nonpeptidic low-molecular-weight PRM-A, may be endowed with a cross-linking ability that creates a network of cross-linked and immobilized surface glycoproteins between the virus particle gp120 envelope and the target cell membrane. Given the evidence of the presence of two PRM-A molecules in the ternary complex that have mannose oligomers and Ca2+ and a total of two mannose binding sites for each PRM-A molecule, this cross-linking hypothesis may be viable. PRM-A may then inhibit virus entry by cross-linking glycans, affecting their mobility and preventing the virus particle gp120 from adopting the conformations necessary for efficient virus-cell fusion. This proposed mechanism of action, however, has still to be proven. However, such a cross-linking activity on surface glycoproteins has also been proposed for the antiviral action of the
-defensin retrocyclin 2 (a multivalent lectin), which inhibits influenza virus infection by blocking membrane fusion mediated by the viral hemagglutinin (22). It was also shown that human ß-defensin 3 and mannan-binding C-type lectin block viral fusion by creating a protective barricade of immobilized surface glycoproteins. This general binding mechanism may explain the broad-spectrum antiviral activity of many multivalent lectins of the immune system (22).
The KD of PRM-A/gp120 interaction (in the presence of Ca2+) was markedly higher than that of the mannose-specific plant lectin HHA. This correlates with our observation that PRM-A is 5- to 10-fold less inhibitory to HIV in cell culture than the HHA plant lectin. However, PRM-A has a much lower variability of antiviral activity against a broad variety of X4- and R5-tropic HIV-1 clades than the plant lectins HHA and GNA. Whereas the plant lectins HHA and GNA are reported to recognize
(1-3) and/or
(1-6) mannose oligomers (43), it has been suggested that PRM-A predominantly recognizes
(1-2) mannose residues (38) that are predominantly present on high-mannose-type glycans of HIV-1 gp120. Cyanovirin N, which also selectively recognizes
(1-2) mannose residues (8), is also more consistently active against all different HIV-1 clades than HHA and GNA (7).
Since CBAs, in particular PRM-A, may simultaneously bind to multiple sites on HIV gp120, this drug differs from the currently available anti-HIV drugs that stoichiometrically bind to their target molecules (at an obligatory 1:1 ratio). Indeed, one reverse transcriptase or protease or gp41 molecule can bind to only one interacting drug molecule (nonnucleoside reverse transcriptase inhibitor, protease inhibitor, or fusion inhibitor) at the same moment. As a consequence, one or a few mutations that appear in a target, like reverse transcriptase, protease, or gp41, usually result in a marked degree of drug resistance. Instead, the data obtained from the BIAcore studies revealed a molar ratio for gp120 to drug of 1:33 (Table 6), which means that a high number of PRM-A molecules may bind to one gp120 molecule. Data in the literature has revealed a stoichiometry ratio of 1:5 for the
1,2-mannose-specific cyanovirin (24), which is still higher than the 1:1.5 ratio found for HHA (Table 6). These striking differences in stoichiometry may be directly correlated with the size of the drug molecules: 50,000 D for HHA, 11,000 D for cyanovirin, and 838 D for PRM-A. Obviously, the smaller the size of the molecule, the easier the carbohydrates on gp120 can be reached by the CBAs without steric hindrance. Therefore, the multiple binding sites on gp120 for CBAs make these drugs much less susceptible to sensitivity loss by the deletion of a few glycosylation sites in gp120, resulting in a high genetic barrier for the CBAs. Moreover, in particular for high-molecular-weight CBAs such as HHA, one single glycan deletion in HIV gp120 may immediately make space for an efficient interaction of one of the other (remaining) glycans with the CBA. As a consequence, multiple glycans need concomitantly to be deleted before CBAs will show a decreased antiviral efficacy. These properties are indeed observed in our drug resistance selection experiments. Interestingly, whereas PRM-A also seems to be able to induce apoptosis-like cell death in Saccharomyces cerevisiae, a mutant that lacks a putative N-glycosylation site in the extracellular domain of a surface protein of the yeast became resistant to the PRM-A derivative (18), showing a molecular mechanism of resistance development (deletion of glycosylation sites) comparable to that found in our studies for HIV.
The very slow (and moderate) resistance development of HIV-1 against the plant lectins (5, 6) and PRM-A (this study) is in full agreement with the mechanisms of action and interaction of PRM-A with its target molecule. Given the uniqueness of the drug resistance profile (i.e., glycan deletions in HIV gp120) of the CBAs, in casu PRM-A, mutant HIV strains that emerge under CBA pressure are not expected to loose their susceptibilities to other anti-HIV drugs, including the variety of available entry inhibitors as also shown in our drug-susceptibility studies. Instead, HIV-1 strains resistant to other drug targets such as RT, protease, and gp41 are not expected to loose susceptibility to CBAs, including PRM-A. However, it was previously shown that mannose (i.e., HHA, GNA, and cyanovirin)- and GlcNAc (i.e., UDA)-specific plant lectins also select for glycan deletions in the HIV-1 gp120 (5-7, 47). Such deletions predominantly occurred at similar glycosylation sites, as observed for PRM-A. Consequently, PRM-A also showed decreased antiviral activity against such GNA-, HHA-, and UDA-resistant virus strains (data not shown) and vice versa: GNA, HHA, and UDA partially lost antiviral activity against the PRM-A-resistant virus strains (Table 5). Although no glycan deletions have been observed so far in gp41 under PRM-A pressure, it cannot be excluded that such mutations might appear at higher concentrations (with a more-soluble PRM-A derivative) or longer selection times for compensatory purposes.
The antiviral properties of PRM-A and the mutational pattern the virus follows in an attempt to escape PRM-A drug pressure led us to consider that the application of CBAs may represent a novel therapeutic approach to HIV treatment that is entirely different in concept from currently existing therapeutic approaches. Indeed, exposure of HIV to CBAs such as PRM-A may put the virus in a dilemma: it must either eventually be eliminated from its host by continual suppression by the CBA, or it must escape the drug pressure by progressively deleting the glycosylation sites in its envelope, thereby becoming highly susceptible to neutralization and elimination by the immune system (2). The proposed therapeutic concept may display a thus far unprecedented concerted action between drug chemotherapy and the immune system. Indeed, besides a direct antiviral activity of the CBAs, CBA-induced deletions of gp120 glycans may have the potential to trigger the immune system against previously hidden highly immunogenic and antigenic epitopes on gp120, resulting in "therapeutic self-vaccination" (2). The observation that a number of known monoclonal neutralizing antibodies (i.e., B12, NEA-9205, and F105) did not display a more pronounced inhibitory effect and in some cases even displayed a decreased antiviral efficacy against the PRM-A-exposed mutant HIV-1 strains is not necessarily against this hypothesis. In fact, these antibodies have been generated against the wild-type virus but not the mutated virus (with glycan deleted) and thus may never have encountered the epitopes that became uncovered after the glycan deletions appeared in the gp120 envelope. Although a dual mechanism of antiviral action with involvement of the immune system has to be shown in the in vivo setting, the earlier findings of Reitter et al. (29) may be highly relevant in this context. It was indeed demonstrated that infection of monkeys with mutant SIV strains that contain as few as two deleted glycosylation sites in their envelope glycoproteins induced a much stronger production of neutralizing antibodies (to the uncovered, exposed, immunogenic envelope epitopes) and eventually resulted in markedly lower viral levels in the plasma (up to three orders of magnitude lower) (29). It now seems imperative to examine CBAs such as PRM-A in SIV-infected monkeys to determine whether a similar phenomenon would occur. Also, other viruses with a glycosylated envelope, such as para- and orthomyxoviruses (i.e., influenza virus), flaviviruses (i.e., hepatitis C virus), and coronaviruses (i.e., severe acute respiratory syndrome coronavirus), may be susceptible to the inhibitory activity of CBAs as well, putting the proposed therapeutic concept in a broader (antiviral) context.
Although general in vivo toxicity should be a realistic concern with the CBA therapeutic concept, it should be mentioned that in previous studies intravenous injection of plant lectins (i.e., HHA, GNA, and UDA) into mice did not result in acute animal toxicity (4, 6). Also, a PRM-A derivative was shown to have in vivo antifungal activity in the treatment of experimental pulmonary aspergillosis in persistently neutropenic rabbits. In this study, the drug was well tolerated at all dosing schedules (up to 150 mg/kg/day) and no toxicity was noted (16). Moreover, it was shown that the PRM-A derivative can bind only to terminal D-mannopyranosides of glycans (40), which are abundantly present on the HIV gp120 envelope, whereas normal animal cells show no binding of the drug, probably because D-mannopyranoside terminals which are necessary for PRM-A binding are very scarce on the cell surface (4, 40). Interestingly, large doses of PRM-A derivative have been administered to animals in the past with minimal toxicity (45), and one (more-soluble) compound derivative (BMS 181184) has already been subjected to phase I/II clinical trials to investigate its antifungal activity. In the clinical study, hepatic transaminase was significantly induced in the majority of volunteers (17). It would be important to reveal whether this side effect is entirely the result of, or not related to, the carbohydrate-binding property of the compound.
In conclusion, nonpeptidic CBAs such as PRM-A represent a novel therapeutic concept for HIV therapy. PRM-A represents the first nonpeptidic (low-molecular-weight) drug with an interesting anti-HIV activity, unique mutational pattern and resistance profile, and high genetic barrier. Moreover, the drug's lead may have the potential to act in vivo through a dual mechanism of action involving a "direct" antiviral activity (entry inhibition) and the triggering of the immune system against previously hidden immunogenic epitopes on HIV gp120 ("self-vaccination"). Therefore, CBAs in general, and the nonpeptidic PRM-A lead compound and its derivatives in particular, should be given prompt consideration for further (pre)clinical development as a potential new conceptual generation of anti-HIV agents.
We are grateful to Ann Absillis, Lizette van Berckelaer, Yoeri Schrooten, Sandra Claes, Rebecca Provinciael, and Eric Fonteyn for excellent technical assistance, Mathy Froeyen for valuable help in drawing Fig. 6, and Christiane Callebaut for dedicated editorial help.
Published ahead of print on 18 October 2006. ![]()
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-glucosidase inhibitor N-butyldeoxynojirimycin inhibits human immunodeficiency virus entry at the level of post-CD4 binding. J. Virol. 69:5791-5797.[Abstract]
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2 mannose residues on the outer face of gp120. J. Virol. 76:7306-7321.This article has been cited by other articles:
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