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Memantine treatment reduces the incidence of flaccid paralysis in a zika virus mouse model of temporary paralysis with similarities to Guillain-Barré syndrome. 美金刚治疗可降低暂时性瘫痪的寨卡病毒小鼠模型弛缓性麻痹的发生率,该模型与吉兰-巴罗综合征相似。
Q2 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2020-01-01 DOI: 10.1177/2040206620950143
Venkatraman Siddharthan, Hong Wang, Alexandre Lr de Oliveira, Xin Dai, John D Morrey

Clinical evidence suggests that Zika virus contributes to Guillain-Barré syndrome that causes temporary paralysis. We utilized a recently described Zika virus mouse model of temporary flaccid paralysis to address the hypothesis that treatment with an N-methyl-D-aspartate receptor antagonist, memantine, can reduce the incidence of paralysis. Aged interferon alpha/beta-receptor knockout mice were used because of their sublethal susceptibility to Zika virus infection. Fifteen to twenty-five percent of mice infected with a Puerto Rico strain of Zika virus develop acute flaccid paralysis beginning at days 8-9 and peaked at days 10-12. Mice recover from paralysis within a week of onset. In two independent studies, twice daily oral administration of memantine at 60 mg/kg/day on days 4 through 9 after viral challenge significantly reduced the incidence of paralysis. No efficacy was observed with treatments from days 9 through 12. Memantine treatment in cell culture or mice did not affect viral titers. These data indicate that early treatment of memantine before onset of paralysis is efficacious, but treatments beyond the onset of paralysis were not efficacious. The effect of this N-methyl-D-aspartate receptor antagonist on the incidence of Zika virus-induced paralysis may provide guidance for investigations on the mechanism of paralysis.

临床证据表明,寨卡病毒会导致吉兰-巴罗综合征,导致暂时性瘫痪。我们利用最近描述的一种暂时性弛缓性麻痹的寨卡病毒小鼠模型来验证用n -甲基- d -天冬氨酸受体拮抗剂美金刚可以减少麻痹发生率的假设。使用老年干扰素α / β受体敲除小鼠是因为它们对寨卡病毒感染具有亚致死易感性。15%到25%感染波多黎各寨卡病毒株的小鼠在第8-9天开始出现急性弛缓性麻痹,在第10-12天达到高峰。小鼠在发病一周内从瘫痪中恢复。在两项独立研究中,病毒攻击后第4至9天每日两次口服美金刚60 mg/kg/天,可显著降低瘫痪的发生率。从第9天到第12天的治疗没有观察到任何疗效。细胞培养或小鼠中美金刚处理不影响病毒滴度。这些数据表明,麻痹发作前的早期治疗美金刚是有效的,但麻痹发作后的治疗无效。该n -甲基- d -天冬氨酸受体拮抗剂对寨卡病毒致瘫痪发生率的影响可能为麻痹机制的研究提供指导。
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引用次数: 2
Relevance of Ebola virus VP35 homo-dimerization on the type I interferon cascade inhibition 埃博拉病毒VP35同源二聚化与I型干扰素级联抑制的相关性
Q2 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2019-11-01 DOI: 10.1177/2040206619889220
Francesco Di Palma, G. Daino, V. K. Ramaswamy, A. Corona, A. Frau, E. Fanunza, A. Vargiu, E. Tramontano, P. Ruggerone
Ebola virus high lethality relies on its ability to efficiently bypass the host innate antiviral response, which senses the viral dsRNA through the RIG-I receptor and induces type I interferon α/β production. In the bypassing action, the Ebola virus protein VP35 plays a pivotal role at multiple levels of the RIG-I cascade, masking the viral 5′-triphosphorylated dsRNA from RIG-I, and interacting with other cascade components. The VP35 type I interferon inhibition is exerted by the C-terminal domain, while the N-terminal domain, containing a coiled-coil region, is primarily required for oligomerization. However, mutations at key VP35 residues L90/93/107A (VP35-3m) in the coiled-coil region were reported to affect oligomerization and reduce type I interferon antagonism, indicating a possible but unclear role of homo-oligomerization on VP35 interaction with the RIG-I pathway components. In this work, we investigated the VP35 dimerization thermodynamics and its contribution to type I interferon antagonism by computational and biological methods. Focusing on the coiled-coil region, we combined coarse-grained and all-atom simulations on wild type VP35 and VP35-3m homo-dimerization. According to our results, wild type VP35 coiled-coil is able to self-assemble into dimers, while VP35-3m coiled-coil shows poor propensity to even dimerize. Free-energy calculations confirmed the key role of L90, L93 and L107 in stabilizing the coiled-coil homo-dimeric structure. In vitro type I interferon antagonism studies, using full-length wild type VP35 and VP35-3m, revealed that VP35 homo-dimerization is an essential preliminary step for dsRNA binding, which appears to be the main factor of the VP35 RIG-I cascade inhibition, while it is not essential to block the other steps.
埃博拉病毒的高致死性依赖于其有效绕过宿主先天抗病毒反应的能力,该反应通过RIG-I受体感应病毒dsRNA并诱导I型干扰素α/β的产生。在绕过作用中,埃博拉病毒蛋白VP35在RIG-I级联的多个水平上发挥关键作用,从RIG-I中屏蔽病毒5′-三磷酸化的dsRNA,并与其他级联组分相互作用。VP35 I型干扰素抑制作用由C端结构域发挥,而含有卷曲螺旋区的N端结构域主要是低聚所必需的。然而,据报道,卷曲螺旋区中关键VP35残基L90/93/107A(VP35-3m)的突变会影响寡聚化并降低I型干扰素的拮抗作用,这表明同源寡聚化对VP35与RIG-I通路成分相互作用的作用可能但尚不清楚。在这项工作中,我们通过计算和生物学方法研究了VP35二聚化热力学及其对I型干扰素拮抗作用的贡献。聚焦于卷曲线圈区域,我们结合了野生型VP35和VP35-3m同源二聚体的粗粒度和全原子模拟。根据我们的结果,野生型VP35-3m卷曲线圈能够自组装成二聚体,而VP35-3m缠绕线圈甚至表现出较差的二聚倾向。自由能计算证实了L90、L93和L107在稳定卷曲线圈同源二聚体结构中的关键作用。使用全长野生型VP35和VP35-3m进行的体外I型干扰素拮抗研究表明,VP35同源二聚体是dsRNA结合的重要初步步骤,这似乎是VP35-RIG-I级联抑制的主要因素,而阻断其他步骤并不重要。
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引用次数: 12
Synthesis and anti-human immunodeficiency virus activity of substituted ( o,o-difluorophenyl)-linked-pyrimidines as potent non-nucleoside reverse transcriptase inhibitors. 作为强效非核苷类逆转录酶抑制剂的取代(o,o-二氟苯基)链嘧啶的合成及其抗人类免疫缺陷病毒活性
Q2 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2019-01-01 DOI: 10.1177/2040206619826265
Lucie Čechová, Milan Dejmek, Ondřej Baszczyňski, David Šaman, Liping Gao, Eric Hu, George Stepan, Petr Jansa, Zlatko Janeba, Petr Šimon

With the worldwide number of human immunodeficiency virus positive patients stagnant and the increasing emergence of viral strains resistant to current treatment, the development of novel anti-human immunodeficiency virus drug candidates is a perpetual quest of medicinal chemists. Herein, we report a novel group of diarylpyrimidines, non-nucleoside reverse transcriptase inhibitors, which represents an important class of current anti-human immunodeficiency virus therapy. Series of diarylpyrimidines containing o, o-difluorophenyl (A-arm), 4-cyanophenylamino (B-arm), and a small substituent (e.g. NH2, OMe) at positions 2, 4, and 6 of the pyrimidine ring were prepared. The A-arm was modified in the para position (F or OMe) and linked to the central pyrimidine core with a variable spacer (CO, O, NH). Antiviral activities of 20 compounds were measured against wild type human immunodeficiency virus-1 and mutant reverse transcriptase strains (K103N, Y181C) using a cytoprotection assay. To the most promising structural motives belong the o, o-difluoro- p-methoxy A-arm in position 4, and the amino group in position 6 of pyrimidine. Single digit nanomolar activities with no significant toxicity (CC50 > 17,000 nM) were found for compounds 35 (EC50 = 2 nM), 37 (EC50 = 3 nM), and 13 (EC50 = 4 nM) having O, NH, and CO linkers, respectively.

随着世界范围内人类免疫缺陷病毒阳性患者的数量停滞不前,以及越来越多的病毒株对现有治疗产生耐药性,开发新的抗人类免疫缺陷病毒候选药物是药物化学家永恒的追求。在此,我们报告了一组新的二芳基嘧啶,非核苷逆转录酶抑制剂,它代表了当前抗人类免疫缺陷病毒治疗的重要类别。制备了一系列含有o, o-二氟苯基(a臂)、4-氰苯胺(b臂)和嘧啶环2、4和6位上的小取代基(如NH2、OMe)的二芳基嘧啶。a臂在对位(F或OMe)上进行了修饰,并通过可变间隔(CO, O, NH)连接到中心嘧啶核。采用细胞保护实验测定了20种化合物对野生型人类免疫缺陷病毒-1和突变型逆转录酶菌株(K103N, Y181C)的抗病毒活性。最有希望的结构动机是位于4位的o, o-二氟-对甲氧基a臂和嘧啶的6位氨基。化合物35 (EC50 = 2 nM)、37 (EC50 = 3 nM)和13 (EC50 = 4 nM)分别具有O、nhh和CO连接体,其单位数纳米摩尔活性无显著毒性(CC50 > 17,000 nM)。
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引用次数: 4
Mozobil® (Plerixafor, AMD3100), 10 years after its approval by the US Food and Drug Administration. Mozobil®(Plerixafor, AMD3100),获得美国食品和药物管理局批准10年后。
Q2 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2019-01-01 DOI: 10.1177/2040206619829382
Erik De Clercq

AMD3100 (plerixafor, Mozobil®) was first identified as an anti-HIV agent specifically active against the T4-lymphotropic HIV strains, as it selectively blocked the CXCR4 receptor. Through interference with the interaction of CXCR4 with its natural ligand, SDF-1 (also named CXCL12), it also mobilized the CD34+stem cells from the bone marrow into the peripheral blood stream. In December 2008, AMD3100 was formally approved by the US FDA for autologous transplantation in patients with Non-Hodgkin's Lymphoma or multiple myeloma. It may be beneficially used in various other malignant diseases as well as hereditary immunological disorders such as WHIM syndrome, and physiopathological processes such as hepatopulmonary syndrome.

AMD3100 (plerixafor, Mozobil®)最初被确定为一种抗HIV药物,可选择性阻断CXCR4受体,对t4淋巴细胞性HIV毒株具有特异性活性。通过干扰CXCR4与其天然配体SDF-1(也称为CXCL12)的相互作用,它还将骨髓中的CD34+干细胞动员到外周血中。2008年12月,AMD3100被美国FDA正式批准用于非霍奇金淋巴瘤或多发性骨髓瘤患者的自体移植。它可以有益地用于各种其他恶性疾病以及遗传性免疫疾病,如WHIM综合征,以及肝肺综合征等生理病理过程。
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引用次数: 86
A medium-throughput screen for inhibitors of human metapneumovirus. 中等通量筛选人偏肺病毒抑制剂。
Q2 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2019-01-01 DOI: 10.1177/2040206619830197
Jennifer C Becker, Sharon J Tollefson, David Weaver, John V Williams

Human metapneumovirus, a paramyxovirus discovered in 2001, is a major cause of lower respiratory infection in adults and children worldwide. There are no licensed vaccines or drugs for human metapneumovirus. We developed a fluorescent, cell-based medium-throughput screening assay for human metapneumovirus that captures inhibitors of all stages of the viral lifecycle except budding of progeny virus particles from the cell membrane. We optimized and validated the assay and performed a successful medium-throughput screening. A number of hits were identified, several of which were confirmed to inhibit viral replication in secondary assays. This assay offers potential to discover new antivirals for human metapneumovirus and related respiratory viruses. Compounds discovered using the medium-throughput screening may also provide useful probes of viral biology.

人偏肺病毒是2001年发现的一种副粘病毒,是全世界成人和儿童下呼吸道感染的主要病因。目前尚无针对人偏肺病毒的许可疫苗或药物。我们开发了一种基于细胞的荧光中通量筛选人类偏肺病毒的方法,可以捕获病毒生命周期所有阶段的抑制剂,除了从细胞膜上出芽的子代病毒颗粒。我们优化并验证了该方法,并成功进行了中等通量筛选。确定了许多命中点,其中一些在二次分析中被证实可以抑制病毒复制。该试验为发现新的人偏肺病毒和相关呼吸道病毒抗病毒药物提供了潜力。使用中通量筛选发现的化合物也可以提供有用的病毒生物学探针。
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引用次数: 3
Incidence of CXCR4 tropism and CCR5-tropic resistance in treatment-experienced participants receiving maraviroc in the 48-week MOTIVATE 1 and 2 trials. 在48周的MOTIVATE 1和2试验中,接受过马拉韦洛克治疗的参与者中CXCR4向性和ccr5向性耐药的发生率
Q2 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2019-01-01 DOI: 10.1177/2040206619895706
Becky Jubb, Marilyn Lewis, Lynn McFadyen, Paul Simpson, Julie Mori, Phylinda Chan, Barry Weatherley, Elna van der Ryst, Mike Westby, Charles Craig
Maraviroc blocks HIV-1 entry into CD4+ cells by interrupting the interaction between viral gp120 and cell-surface CCR5. Resistance to CCR5 antagonist–mediated inhibition can develop by unmasking pre-existing CXCR4-using virus or through selection of CCR5-tropic resistant virus, characterized by plateaus in maximum percent inhibition <95%. Here, we examine viral escape in maraviroc-treated participants during virologic failure through Week 48 in the MOTIVATE 1 and 2 trials. Resistance was assessed relative to number of active drugs in participants’ optimized background therapy, pharmacokinetic adherence markers, Baseline demographic data, HIV-1 RNA and CD4+ counts. For participants with R5 virus confirmed (post hoc) at Screening, Baseline genotypic weighted optimized background therapy susceptibility scores (gwOBTSS) were assigned where possible. Through Week 48, 219/392 (56%) participants with an assigned gwOBTSS achieved a virologic response. Of those remaining, 48/392 (12%) had CXCR4-using virus; 58/392 (15%) had R5 virus (maraviroc sensitive: n = 35/392, 9%; maraviroc resistant: n = 18/392, 5%; undeterminable: n = 5/392, 1%) and 67/392 (17%) had no failure tropism result. When optimized background therapy provided limited support to maraviroc (gwOBTSS <2), 143/286 (50%) responded to therapy, while 76/106 (72%) participants with gwOBTSS ≥2 responded (p < 0.001). Resistance rates were highest for participants with gwOBTSS <2, accounting for 45/48 (94%) of total CXCR4-using emergence and 18/18 (100%) of total CCR5-tropic resistance. R5 viruses from participants with gwOBTSS ≥2 (n = 10) were exclusively maraviroc sensitive; five of these participants had pharmacokinetic and/or pill-count markers of non-adherence. When co-administered with a fully active background regimen, maraviroc did not readily generate resistance in the clinical setting. Trial registry name: ClinicalTrials.gov (https://clinicaltrials.gov/), NCT00098722 and NCT00098306
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引用次数: 0
Indolylarylsulfones, a fascinating story of highly potent human immunodeficiency virus type 1 non-nucleoside reverse transcriptase inhibitors. 吲哚芳基砜,一个引人入胜的故事,高效的人类免疫缺陷病毒1型非核苷逆转录酶抑制剂。
Q2 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2018-01-01 DOI: 10.1177/2040206617753443
Valeria Famiglini, Romano Silvestri

Indolylarylsulfones are a potent class of human immunodeficiency virus type 1 non-nucleoside reverse transcriptase inhibitors. In this review, the structure activity relationship (SAR) studies to improve the profile of sulfone L-737,126 discovered by Merck AG have been analysed with focus on introduction of the 3',5'-dimethyl groups at the 3-phenylsulfonyl moiety, the 2-hydroxyethyl tail at the indole-2-carboxamide nitrogen, coupling of the carboxamide nitrogen with one or two glycinamide and alaninamide units, a fluorine atom at position 4 of the indole ring and correlation between configuration of the asymmetric centre and linker length. IAS derivatives look like promising drug candidates for the treatment of AIDS and related infections in combination with other antiretroviral agents.

吲哚芳基砜是一类有效的人类免疫缺陷病毒1型非核苷逆转录酶抑制剂。本文综述了为改善默克公司发现的L-737,126砜的结构活性关系(SAR)研究,重点介绍了在3-苯基磺酰基部分引入3′,5′-二甲基,在吲哚-2-羧基酰胺氮上引入2-羟乙基尾,在羧基酰胺氮上偶联一个或两个甘氨酸酰胺和丙氨酸酰胺单元。吲哚环第4位氟原子及不对称中心构型与连接体长度的关系。IAS衍生物看起来是与其他抗逆转录病毒药物联合治疗艾滋病和相关感染的有希望的候选药物。
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引用次数: 14
The effectiveness of antiviral agents with broad-spectrum activity against chikungunya virus varies between host cell lines. 具有广谱活性的抗病毒药物对基孔肯雅病毒的有效性因宿主细胞系而异。
Q2 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2018-01-01 DOI: 10.1177/2040206618807580
Evelyn J Franco, Jaime L Rodriquez, Justin J Pomeroy, Kaley C Hanrahan, Ashley N Brown

Chikungunya virus (CHIKV) is a mosquito-borne virus that has recently emerged in the Western Hemisphere. Approved antiviral therapies or vaccines for the treatment or prevention of CHIKV infections are not available. This study aims to evaluate the antiviral activity of commercially available broad-spectrum antivirals against CHIKV. Due to host cell-specific variability in uptake and intracellular processing of drug, we evaluated the antiviral effects of each agent in three cell lines. Antiviral activities of ribavirin (RBV), interferon-alfa (IFN-α) and favipiravir (FAV) were assessed in CHIKV-infected Vero, HUH-7, and A549 cells. CHIKV-infected cells were treated with increasing concentrations of each agent for three days and viral burden was quantified by plaque assay on Vero cells. Cytotoxic effects of RBV, FAV and IFN-α were also evaluated. Antiviral activity differed depending on the cell line used for evaluation. RBV had the greatest antiviral effect in HUH-7 cells (EC50 = 2.575 µg/mL); IFN-α was most effective in A549 cells (EC50 = 4.235 IU/mL); and FAV in HUH-7 cells (EC50 = 20.00 μg/mL). The results of our study show FAV and IFN-α are the most promising candidates, as their use led to substantial reductions in viral burden at clinically achievable concentrations in two human-derived cell lines. FAV is an especially attractive candidate for further investigation due to its oral bioavailability. These findings also highlight the importance of cell line selection for preclinical drug trials.

基孔肯雅病毒(CHIKV)是最近在西半球出现的一种蚊媒病毒。目前还没有获得批准的治疗或预防CHIKV感染的抗病毒疗法或疫苗。本研究旨在评价市售广谱抗病毒药物对CHIKV病毒的抗病毒活性。由于宿主细胞在药物摄取和细胞内加工方面的特异性变异性,我们在三种细胞系中评估了每种药物的抗病毒作用。观察利巴韦林(RBV)、干扰素-α (IFN-α)和favipiravir (FAV)在chikv感染的Vero、HUH-7和A549细胞中的抗病毒活性。用增加浓度的每种药物处理感染chikv的细胞3天,并通过在Vero细胞上的斑块测定法定量病毒负荷。同时观察RBV、FAV和IFN-α的细胞毒作用。抗病毒活性取决于用于评估的细胞系。RBV对hh -7细胞的抗病毒作用最大(EC50 = 2.575µg/mL);IFN-α对A549细胞最有效(EC50 = 4.235 IU/mL);HUH-7细胞中FAV含量(EC50 = 20.00 μg/mL)。我们的研究结果显示FAV和IFN-α是最有希望的候选药物,因为它们的使用导致两种人类来源的细胞系在临床可达到的浓度下显著降低病毒负荷。由于其口服生物利用度,FAV是一个特别有吸引力的进一步研究候选者。这些发现也强调了细胞系选择在临床前药物试验中的重要性。
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引用次数: 37
Cyclophilin A as a target in the treatment of cytomegalovirus infections. 嗜环蛋白A作为治疗巨细胞病毒感染的靶点。
Q2 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2018-01-01 DOI: 10.1177/2040206618811413
Ashwaq A Abdullah, Rasedee Abdullah, Zeenathul A Nazariah, Krishnan N Balakrishnan, Faez Firdaus J Abdullah, Jamilu A Bala, Mohd-Azmi Mohd-Lila

Background: Viruses are obligate parasites that depend on the cellular machinery of the host to regenerate and manufacture their proteins. Most antiviral drugs on the market today target viral proteins. However, the more recent strategies involve targeting the host cell proteins or pathways that mediate viral replication. This new approach would be effective for most viruses while minimizing drug resistance and toxicity.

Methods: Cytomegalovirus replication, latency, and immune response are mediated by the intermediate early protein 2, the main protein that determines the effectiveness of drugs in cytomegalovirus inhibition. This review explains how intermediate early protein 2 can modify the action of cyclosporin A, an immunosuppressive, and antiviral drug. It also links all the pathways mediated by cyclosporin A, cytomegalovirus replication, and its encoded proteins.

Results: Intermediate early protein 2 can influence the cellular cyclophilin A pathway, affecting cyclosporin A as a mediator of viral replication or anti-cytomegalovirus drug.

Conclusion: Cyclosporin A has a dual function in cytomegalovirus pathogenesis. It has the immunosuppressive effect that establishes virus replication through the inhibition of T-cell function. It also has an anti-cytomegalovirus effect mediated by intermediate early protein 2. Both of these functions involve cyclophilin A pathway.

背景:病毒是一种专性寄生虫,依靠宿主的细胞机制再生和制造蛋白质。目前市场上的大多数抗病毒药物都针对病毒蛋白。然而,最近的策略涉及靶向宿主细胞蛋白质或介导病毒复制的途径。这种新方法将对大多数病毒有效,同时最大限度地减少耐药性和毒性。方法:巨细胞病毒的复制、潜伏期和免疫反应由中间早期蛋白2介导,该蛋白是决定药物抑制巨细胞病毒有效性的主要蛋白。这篇综述解释了中间早期蛋白2如何改变免疫抑制和抗病毒药物环孢菌素A的作用。它还连接了环孢菌素A、巨细胞病毒复制及其编码蛋白介导的所有途径。结果:中间早期蛋白2可影响细胞亲环素A通路,影响环孢素A作为病毒复制介质或抗巨细胞病毒药物的作用。结论:环孢菌素A在巨细胞病毒发病机制中具有双重作用。它具有免疫抑制作用,通过抑制T细胞功能来建立病毒复制。它还具有由中间早期蛋白2介导的抗巨细胞病毒作用。这两种功能都涉及亲环蛋白A通路。
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引用次数: 0
Frequent cross-resistance to rilpivirine among subtype C HIV-1 from first-line antiretroviral therapy failures in South Africa. 在南非,由于一线抗逆转录病毒治疗失败,丙型HIV-1亚型经常对利匹韦林产生交叉耐药。
Q2 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2018-01-01 DOI: 10.1177/2040206618762985
Kerri J Penrose, Chanson J Brumme, Maritsa Scoulos-Hanson, Kristen Hamanishi, Kelley Gordon, Raquel V Viana, Carole L Wallis, P Richard Harrigan, John W Mellors, Urvi M Parikh

Background Rilpivirine (TMC278LA) is a promising drug for pre-exposure prophylaxis of HIV-1 because of its sub-nanomolar potency and long-acting formulation; however, increasing transmission of non-nucleoside reverse transcriptase inhibitor-resistant HIV-1 with potential cross-resistance to rilpivirine could reduce its preventive efficacy. This study investigated rilpivirine cross-resistance among recombinant subtype C HIV-1 derived from 100 individuals failing on first-line non-nucleoside reverse transcriptase inhibitor-containing antiretroviral therapy in South Africa whose samples were sent for routine HIV-1 drug resistance testing to Lancet Laboratories (Johannesburg, South Africa). Methods Plasma samples were selected from individuals with HIV-1 RNA > 10,000 copies/ml and ≥1 non-nucleoside reverse transcriptase inhibitor-resistance mutation in reverse transcriptase. Recombinant HIV-1LAI-containing bulk-cloned full-length reverse transcriptase sequences from plasma were assayed for susceptibility to nevirapine (NVP), efavirenz (EFV) and rilpivirine in TZM-bl cells. Fold-change (FC) decreases in drug susceptibility were calculated against a mean IC50 from 12 subtype C HIV-1 samples from treatment-naïve individuals in South Africa. Cross-resistance was evaluated based on biological cutoffs established for rilpivirine (2.5-FC) and the effect of mutation combinations on rilpivirine phenotype. Results Of the 100 samples from individuals on failing antiretroviral therapy, 69 had 2.5- to 75-fold decreased susceptibility to rilpivirine and 11 had >75-fold resistance. Rilpivirine resistance was strongly associated with K103N especially in combination with other rilpivirine-associated mutations. Conclusion The frequently observed cross-resistance of HIV-1 suggests that the preventive efficacy of TMC278LA pre-exposure prophylaxis could be compromised by transmission of HIV-1 from individuals with failure of first-line non-nucleoside reverse transcriptase inhibitor-containing antiretroviral therapy.

利匹韦林(TMC278LA)是一种很有前景的HIV-1暴露前预防药物,因为它具有亚纳摩尔的效力和长效配方;然而,非核苷类逆转录酶抑制剂耐药HIV-1的传播增加以及对利匹韦林的潜在交叉耐药可能降低其预防效果。这项研究调查了南非100名接受一线非核苷逆转录酶抑制剂抗逆转录病毒治疗失败的重组C型HIV-1患者对利匹韦林的交叉耐药性,这些患者的样本被送到柳叶刀实验室(南非约翰内斯堡)进行常规HIV-1耐药性检测。方法选取HIV-1 RNA > 10000拷贝/ml、逆转录酶非核苷类抑制剂-耐药突变≥1例患者的血浆样本。从血浆中大量克隆含有重组hiv - 1lai的全长逆转录酶序列,检测TZM-bl细胞对奈韦拉平(NVP)、依非韦伦(EFV)和利匹韦林的敏感性。根据来自南非treatment-naïve个体的12个C亚型HIV-1样本的平均IC50计算了药物敏感性的折叠变化(FC)降低。交叉抗性的评估是基于对利匹韦林(2.5-FC)建立的生物截止点和突变组合对利匹韦林表型的影响。结果在接受抗逆转录病毒治疗失败的100个样本中,69个样本对利匹韦林的易感性降低了2.5- 75倍,11个样本的耐药性降低了>75倍。利匹韦林耐药与K103N密切相关,特别是与其他利匹韦林相关突变联合。结论HIV-1交叉耐药的频繁出现表明TMC278LA暴露前预防的预防效果可能会因一线非核苷类逆转录酶抑制剂抗逆转录病毒治疗失败而降低。
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引用次数: 6
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Antiviral Chemistry and Chemotherapy
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