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Antimicrobial Agents and Chemotherapy, October 2002, p. 3301-3303, Vol. 46, No. 10
0066-4804/02/$04.00+0 DOI: 10.1128/AAC.46.10.3301-3303.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
Inhibition of Human Immunodeficiency Virus Type 1 Isolates by the Integrase Inhibitor L-731,988, a Diketo Acid
Ryan Reinke,1 Deborah J. Lee,1 and W. Edward Robinson Jr.1,2*
Departments of Microbiology and Molecular Genetics,1
Pathology, University of California, Irvine, California 926972
Received 22 April 2002/
Returned for modification 19 June 2002/
Accepted 15 July 2002

ABSTRACT
L-731,988 inhibits human immunodeficiency virus (HIV) replication
through integrase. In this study, approximately 600 nM L-731,988
inhibited the replication of 12 HIV type 1 isolates from multiple
clades, including primary isolates and cloned viruses. These
data suggest that diketo acids or their derivatives may prove
useful on a worldwide basis in treating HIV infection.

TEXT
The human immunodeficiency virus (HIV) genome encodes three
enzymes: protease (PR), reverse transcriptase (RT), and integrase
(IN). Agents targeted at RT and PR inhibit viral replication
within infected individuals (
1,
2,
4). Despite the success of
PR and RT inhibitors, recent evidence suggests that the transmission
of drug-resistant HIV is increasing and that its rate of transmission
can approach 25% (
13), making it clear that new therapeutic
targets must be identified. IN is an enzyme unique to retroviruses
and is required for productive retroviral infection. Given the
latter, as well as the clinical effectiveness of other retroviral
enzyme inhibitors, IN is an attractive therapeutic target. Recently,
the diketo acids were found to curb viral replication through
the inhibition of IN (
6). Amino acid changes that lead to resistance
to diketo acids are located within IN and have been documented
previously for HIV type 1 (HIV-1) (
6). Analysis of the HIV sequence
database shows that changes at 2 of the 3 amino acids conferring
resistance to diketo acids are present within the infected population.
To investigate the role that natural variation has in the susceptibility
of HIV to diketo acids, a series of primary, cloned, and laboratory
HIV-1 isolates were examined for susceptibility to L-731,988
(a diketo acid) (Fig.
1) in both cultured cell lines and peripheral
blood lymphocytes (PBLs).
Laboratory-adapted strains of HIV and the infectious molecular
clone HIV
NL4-3 can replicate in cultured cell lines, unlike
most primary isolates of HIV. Therefore, the susceptibilities
to L-731,988 of laboratory-adapted strains (HIV
LAI and HIV
MVP5180)
and HIV
NL4-3 clones containing different IN genes (HIV
NL4-3:IN7-3,
HIV
NL4-3:INR104, HIV
NL4-3:INR106, and HIV
NL4-3:IN92NG003) were
determined on cultured MT2 cells by using a vital dye assay
(
8,
10,
12).
HIVLAI and HIVNL4-3:IN7-3 are clade B, laboratory-adapted HIV strains that are susceptible to diketo acids (6; R. Reinke et al., unpublished data). Cloned isolates were constructed with HIVNL4-3, which contains two unique restriction sites that allow the native IN to be excised and the IN gene of interest to be cloned in frame into the plasmid vector (7). HIVNL4-3:IN7-3 contains the HIVNL4-3 IN gene and was subjected to the same tissue culture and cloning procedures used for the other viruses (7) to control for changes due to culturing of virus and cloning. HIVNL4-3:INR104 and HIV NL4-3:INR106 contain IN genes derived from the North American clinical isolates described previously (9). HIVNL4-3:IN92NG003 contains an IN gene derived from a near-full-length clone of HIV originally isolated in Nigeria (3), and HIVMVP5180 is a group O isolate from Cameroon (5). Nomenclature used throughout indicates the specific IN gene cloned into HIVNL4-3: HIVNL4-3:INR106 contains the IN gene from clinical isolate R106.
HIV-1 primary isolates (HIV92RW016, HIV92RW009, HIV98IN026, HIV93IN101, HIV92THA005, HIV98CN006) were obtained through the National Institutes of Health AIDS Research and Reference Reagent Program and passaged on phytohemagglutinin-stimulated PBLs with interleukin-2; each virus supernatant was collected when cultures exhibited peak staining with polyclonal anti-HIV serum by an immunofluorescence assay. Supernatants were filtered through 0.45-µm-pore-size filters and assayed for exogenous RT activity. Viral supernatants (36,000 cpm of RT activity) were incubated with 0, 0.5, 1.0, and 5.0 µM L-731,988 for 30 min at 37°C. Following incubation, viral supernatants were added to 1.5 x 106 PBLs containing either 0, 0.5, 1.0, or 5.0 µM L-731,988 in a total volume of 2 ml. All infections were performed in triplicate in 24-well plates. Culture supernatants were monitored by indirect immunofluorescence assay and RT assay (11) every 2 days until RT activity within control infections without L-731,988 peaked. The percent inhibition at each drug concentration was calculated on the basis of the control infections. The 50% effective doses (ED50) were calculated for the viruses when RT values for the control infections were at maximum. ED50 were calculated using the CalcuSyn for Windows software package.
All six viruses tested in the MT2 cell assay were susceptible to the inhibitor, exhibiting only minor differences (two- to threefold) in ED50 (Table 1). ED50 for these isolates ranged from 0.5 to 1.6 µM. Similarly, the ED50 of L-731,988 against the primary isolates ranged from 0.6 to 0.9 µM, with the exception of that for HIV92RW009, which increased about sixfold compared to that for HIVLAI (Table 1). Two assays were utilized in this study to examine the susceptibilities of natural variant IN sequences to L-731,988. Despite the differences between the two assays, the data for a control virus, HIVLAI, correlate between the assays (Table 1) (0.51 to 0.65 µM), demonstrating that the antiviral data from both assays are directly comparable.
The ability of compounds to inhibit primary isolates of HIV
is of paramount importance in their development as drugs. The
data presented here show that a group O isolate, group M primary
viral isolates representing clades A, B, and C, and a clade
A/E recombinant were all susceptible to L-731,988. Compared
to the control HIV
LAI, most of these viruses exhibited a less-than-twofold
difference in susceptibility to L-731,988. In contrast, the
isolate HIV
92RW009, a C/A recombinant, showed an approximately
sixfold decrease in susceptibility to L-731,988. While complete
resistance was not observed, this partial-resistance phenotype
was detected at all drug concentrations tested, as evidenced
by less growth inhibition than with other viruses (Fig.
2).
IN sequence analysis of HIV
92RW009 failed to reveal amino acid
changes matching previously identified resistance mutations
for either the diketo acid or the
L-chicoric acid class of IN
inhibitors (C65, T66, G140, S153, or M154) (
6,
7,
14). These
data suggest that other amino acid changes within the HIV
92RW009 IN may contribute to resistance to diketo acids. Amino acid
changes unique to HIV
92RW009 IN were a valine-to-alanine change
at position 79, a threonine-to-asparagine change at position
124, and a lysine-to-arginine change at position 173. However,
the peak viral RT counts for the HIV
92RW009 cultures were greater
than for other viruses tested. Thus, an increased burst size
may contribute to the resistance phenotype.
To date, three mutations have been associated with resistance
to the diketo acids: T66I, S153Y, and M154I (
6). Two of the
viruses tested contain amino acid changes at positions 153 and
154 of IN. Each virus had other mutations that could account
for the resistance phenotype, but in particular, HIV
MVP5180 contains an S153A change and HIV
NL4-3:INR104 has an M154L change.
HIV
MVP5180 does show an increase in ED
50 of roughly threefold,
nearly identical to that observed by Hazuda et al. (
6) for the
S153Y mutation. Although S153 and M154 have been associated
with resistance to diketo acids, the changes contained within
HIV
MVP5180 and HIV
NL4-3:INR104 do not dramatically affect their
susceptibility to L-731,988, suggesting that mutations occurring
at these positions require additional changes, perhaps at position
66 (
6), or specific amino acid substitutions for a high-resistance
phenotype. Interestingly, S153Y conferred resistance to another
diketo acid, L-708,906, but not to L-731,988 (
6). It should
be noted that if resistance occurs through the synergistic effect
of mutations at positions 66, 153, and 154, as suggested by
Hazuda et al. (
6), the variability at positions 153 and 154
within the natural population may result in a more rapid development
of resistance phenotypes. Nevertheless, 15% amino acid divergence
for HIV
MVP5180 results in only a threefold decrease in susceptibility
to L-731,988. Overall, these data suggest that naturally occurring
genetic variation within the IN gene is not a major obstacle
in the development of the diketo acids for therapeutic use.
Nucleotide sequence accession numbers
The sequences of all IN genes reported herein have been deposited with GenBank. The accession numbers are R104-AF203330, R106-AF203331, 92NG003-U88825, 93IN101-AF500777, 98CN006-AF500778, 98IN026-AF500779, 92RW009-AF500780, 92RW016-AF500781, and 92THA005-AF500782.

ACKNOWLEDGMENTS
This work was supported in part by grants from the Public Health
Service (AI41360) and the Burroughs-Wellcome Fund (99-2609).
W.E.R. is a Burroughs-Wellcome Fund Clinical Scientist in Translational
Research. R.R. (grant AI07319) and D.J.L. (grant GM08620) are
supported in part by training grants.
We are indebted to Brenda R. McDougall for excellent technical assistance. Manfred G. Reinecke (Texas Christian University, Fort Worth) provided L-731,988.

FOOTNOTES
* Corresponding author. Mailing address: Department of Pathology, D440 Med. Sci. I, University of California, Irvine, CA 92697-4800. Phone: (949) 824-3431. Fax: (949) 824-2505. E-mail:
ewrobins{at}uci.edu.


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Antimicrobial Agents and Chemotherapy, October 2002, p. 3301-3303, Vol. 46, No. 10
0066-4804/02/$04.00+0 DOI: 10.1128/AAC.46.10.3301-3303.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
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