一类新型的抗病毒药物:病毒进入抑制剂

艾滋病是严重威胁人类健康的病毒性传染病.目前临床上抗人类免疫缺陷病毒(HIV)感染的药物主要是针对反转录酶和蛋白酶.反转录酶抑制剂和蛋白酶抑制剂的联合使用能显著降低HIV感染者的发病率和病死率,然而不良反应较大,价格昂贵,而且耐药的问题日益突出.近来一类新型抗HIV药物相继问世,其中T-20已经被美国食品药品管理局(FDA)批准正式在临床使用,此外几十种同类药物已经进入临床试验.     

RANTES衍生物与HIV-1进入抑制剂

HIV-1-1进入抑制剂的研究是近年来艾滋病药物研发领域的新热点,其中最受关注的是以CCR5为靶点的新药研发。CCR5是病毒进入细胞的主要辅助受体,在HIV-1进入宿主细胞过程中起着非常重要的作用。作为CCR5的天然配体,CC类的趋化因子RANTES、MIP-1α和MIP-1β都是极具潜力的HIV-1抑制剂,特别是有关对RANTES的定向设计的研究尤为引人关注,其目的是设计出一种既有很强的抗病毒能力而又不引发炎症反应的HIV-1拮抗剂。就RANTES衍生物应用于抑制HIV进入细胞方面的研究进行了综述。     

获得性免疫缺陷综合征抗病毒治疗药物研究进展

获得性免疫缺陷综合征,即艾滋病,是由人类免疫缺陷病毒(HIV)感染造成的一种严重免疫缺陷,并发一系列机会性感染及肿瘤,严重者可导致死亡的综合征。目前,艾滋病已成为严重威胁世界人民健康的公共卫生问题。30年来,全球科学家和医学家对其病毒学、免疫学等方面进行了大量研究,希望能够寻找出预防、治疗该疾病的方法,但并未取得突破性进展。根据抗HIV药物作用靶点的不同,可将抗HIV药物分为六大类,即核苷类反转录酶抑制剂、非核苷类反转录酶抑制剂、蛋白酶抑制剂、融合抑制剂、入胞抑制剂或辅受体拮抗剂、整合酶抑制剂。治疗药物虽然不能完全治愈艾滋病,但可以抑制HIV的复制,降低病毒载量,延缓病情发展,改善症状,延长患者的生存时间。     

广谱趋化因子受体结合物-vMIP-II的体内抗SIV功能研究

病毒巨噬细胞炎症蛋白II(vMIP-II)是一种广谱趋化因子受体拮抗剂,它所拮抗的趋化因子受体被认为是不同的人免疫缺陷病毒株(Human immunodeficiency virus,HIV)进入靶细胞的辅受体。虽然理论上vMIP-II是一个广谱的HIV抑制剂,但vMIP-II的抗HIV感染作用却少有报道,特别是体内研究。本研究利用一个有效的SIV-mac251感染食蟹猴模型来评价vMIP-II的体内抗HIV感染作用,结果显示vMIP-II能够有效地并呈剂量依赖性地降低食蟹猴血浆病毒载量,同时对宿主免疫功能具有保护作用。这些结果表明vMIP-II是一种有效的抗HIV物质,可以作为一类新型的抗HIV先导药物,也为研发靶向病毒进入的新药提供了进一步的理论支持。     

广谱趋化因子受体结合物-vMIP-Ⅱ的体内抗SIV功能研究

病毒巨噬细胞炎症蛋白Ⅱ(vMIP-Ⅱ)是一种广谱趋化因子受体拮抗剂,它所拮抗的趋化因子受体被认为是不同的人免疫缺陷病毒株(Human immunodeficiency virus,HIV)进入靶细胞的辅受体.虽然理论上vMIP-Ⅱ是一个广谱的HIV抑制剂,但vMIP-Ⅱ的抗HIV感染作用却少有报道,特别是体内研究.本研究利用一个有效的SIV-mac251感染食蟹猴模型来评价vMIP-Ⅱ的体内抗HIV感染作用,结果显示vMIP-Ⅱ能够有效地并呈剂量依赖性地降低食蟹猴血浆病毒载量,同时对宿主免疫功能具有保护作用.这些结果表明vMIP-Ⅱ是一种有效的抗HIV物质,可以作为一类新型的抗HIV先导药物,也为研发靶向病毒进入的新药提供了进一步的理论支持.     

广谱趋化因子受体结合物-vMIP—Ⅱ的体内抗SIV功能研究

病毒巨噬细胞炎症蛋白Ⅱ（vMIP-Ⅱ）是一种广谱趋化因子受体拮抗剂,它所拮抗的趋化因子受体被认为是不同的人免疫缺陷病毒株（Human immunodeficiency virus,HIV）进入靶细胞的辅受体。虽然理论上vMIP—Ⅱ是一个广谱的HIV抑制剂,但vMIP—Ⅱ的抗HIV感染作用却少有报道,特别是体内研究。本研究利用一个有效的SIV—mac251感染食蟹猴模型来评价vMIP-Ⅱ的体内抗HIV感染作用,结果显示vMIP-Ⅱ能够有效地并呈剂量依赖性地降低食蟹猴血浆病毒载量,同时对宿主免疫功能具有保护作用。这些结果表明vMIP—Ⅱ是一种有效的抗HIV物质,可以作为一类新型的抗HIV先导药物,也为研发靶向病毒进入的新药提供了进一步的理论支持。     

艾滋病治疗药物-HIV抑制剂作用机制及研究进展

艾滋病（AIDS）是由人类免疫缺陷病毒（HIV）感染而引起的慢性进行性致死性传染病,又称获得性免疫缺陷综合症,目前无有效治愈的方法,严重危害着人类的健康。现今,艾滋病治疗药物主要包括逆转录酶抑制剂、蛋白酶抑制剂、进入抑制剂、整合酶抑制剂四大类化学药物和一些中草药制剂。抗HIV药物虽然不能完全治愈艾滋病,但可以控制艾滋病病情的发展,延长患者的无病生存期,提高患者的生活质量。本文就艾滋病发病机制、HIV抑制药物的抗病机制、副作用及其研究进展做一综述。     

艾滋病治疗药物--HIV 抑制剂作用机制及研究进展

艾滋病(AIDS)是由人类免疫缺陷病毒(HIV)感染而引起的慢性进行性致死性传染病,又称获得性免疫缺陷综合症,目前无有效治愈的方法,严重危害着人类的健康。现今,艾滋病治疗药物主要包括逆转录酶抑制剂、蛋白酶抑制剂、进入抑制剂、整合酶抑制剂四大类化学药物和一些中草药制剂。抗HIV药物虽然不能完全治愈艾滋病,但可以控制艾滋病病情的发展,延长患者的无病生存期,提高患者的生活质量。本文就艾滋病发病机制、HIV抑制药物的抗病机制、副作用及其研究进展做一综述。     

一种拮抗HIV-1并靶向DC的融合基因的设计及表达鉴定

艾滋病病毒 (Human immunodeficiency virus,HIV) 通过与靶细胞膜的融合感染宿主细胞,研究表明阻断HIV与受体靶分子的结合可以阻止HIV进入宿主细胞,抑制HIV病毒的感染。设计合成了一个包含CD4和CCR5与HIV-1结合的主要功能结构区,及Flt3-L和Mip-3α分子的融合基因,构建了2个融合基因的真核表达载体pABK-CKR5-CD4/Flt3L-Mip3α (pABK-HIV-MF) 和pABK-CKR5-CD4 (pABK-HIV-MT),在人胚肾293细胞中进行了表达。RT-PCR、细胞免疫荧光技术、ELISA和Western blotting检测结果表明融合基因在真核细胞中获得了正确的表达,这为进一步研究其对于HIV-1的拮抗并靶向树突状细胞 (DC) 清除研究奠定了基础。     

人免疫缺陷病毒假病毒药物筛选模型的构建及其应用

目的:构建人免疫缺陷病毒(HIV)假病毒模型,用多种HIV逆转录酶和蛋白酶抑制剂作用于该模型,以检测其是否能有效用于HIV抑制药物的筛选。方法:通过载体改造获得最终慢病毒载体puc18-NL4-3-LUC-stop,其中含有萤光素酶基因,将该载体与包膜质粒VSV-G共转染293FT细胞,包装产生HIV假病毒,在假病毒包装和病毒感染293FT细胞的过程中加入蛋白酶和逆转录酶抑制剂,通过检测感染细胞中萤光素酶的表达来检测该模型的有效性,并利用此模型检测药物的抗病毒效果。结果:将HIV逆转录酶和蛋白酶抑制剂作用于该假病毒模型时发现萤光素酶的表达得到很大程度的抑制。结论:建立了HIV假病毒药物筛选模型,该模型以萤光素酶基因作为报告基因,快速灵敏,在抗HIV药物筛选中有一定的应用价值。     

Novel Antiviral Agents Targeting HIV Entry and Transmission

Studies of the mechanism of HIV entry and transmission have identified multiple new targets for drug development. A range of inhibitors have demonstrated potent antiretroviral activity by interfering with CD4-gp120 interaction,coreceptor binding or viral-cell fusion in preclinical and clinical studies. One of these agents,fusion inhibitor enfuvirtide,is already in clinical use. Here we review the progress in the development of specific entry inhibitors as novel therapeutics. The potential of entry inhibitors as topical microbicides to block HIV transmission is also discussed.     

A covalent inhibitor targeting an intermediate conformation of the fusogenic subunit of the HIV-1 envelope complex

Peptide inhibitors corresponding to sequences in the six helix bundle structure of the fusogenic portion (gp41) of the HIV envelope glycoprotein have been successfully implemented in preventing HIV entry. These peptides bind to regions in HIV gp41 transiently exposed during the fusion reaction. In an effort to improve upon these entry inhibitors, we have successfully designed and tested peptide analogs composed of chemical spacers and reactive moieties positioned strategically to facilitate covalent attachment. Using a temperature-arrested state prime wash in vitro assay we show evidence for the trapping of a pre-six helix bundle fusion intermediate by a covalent reaction with the specific anti-HIV-1 peptide. This is the first demonstration of the trapping of an intermediate conformation of a viral envelope glycoprotein during the fusion process that occurs in live cells. The permanent specific attachment of the covalent inhibitor is projected to improve the pharmacokinetics of administration in vivo and thereby improve the long-term sustainability of peptide entry inhibitor therapy and help to expand its applicability beyond salvage therapy.     

Novel antiviral agents targeting HIV entry and transmission

Studies of the mechanism of HIV entry and transmission have identified multiple new targets for drug development. A range of inhibitors have demonstrated potent antiretroviral activity by interfering with CD4-gp120 interaction, coreceptor binding or viral-cell fusion in preclinical and clinical studies. One of these agents, fusion inhibitor enfuvirtide, is already in clinical use. Here we review the progress in the development of specific entry inhibitors as novel therapeutics. The potential of entry inhibitors as topical microbicides to block HIV transmission is also discussed. Foundation items: NIH (AI065413 and AI041346) and the 973 Program (2006CB504200) for financial support.     

Compensatory link between fusion and endocytosis of human immunodeficiency virus type 1 in human CD4 T lymphocytes

Virions of the type 1 human immunodeficiency virus (HIV-1) can enter target cells by fusion or endocytosis, with sharply different functional consequences. Fusion promotes productive infection of the target cell, while endocytosis generally leads to virion inactivation in acidified endosomes or degradation in lysosomes. Virion fusion and endocytosis occur equally in T cells, but these pathways have been regarded as independent because endocytosis of HIV virions requires neither CD4 nor CCR5/CXCR4 engagement in HeLa-CD4 cells. Using flow cytometric techniques to assess the binding and entry of green fluorescent protein (GFP)-Vpr-labeled HIV virions into primary peripheral blood mononuclear cells, we have found that HIV fusion and endocytosis are restricted to the CD4-expressing subset of cells and that both pathways commonly require the initial binding of HIV virions to surface CD4 receptors. Blockade of CXCR4-tropic HIV virion fusion with AMD3100, a CXCR4-specific entry inhibitor, increased virion entry via the endocytic pathway. Similarly, inhibition of endosome acidification with bafilomycin A1, concanamycin A, or NH(4)Cl enhanced entry via the fusion pathway. Although fusion remained dependent on CD4 and chemokine receptor binding, the endosome inhibitors did not alter surface expression of CD4 and CXCR4. These results suggest that fusion in the presence of the endosome inhibitors likely occurs within nonacidified endosomes. However, the ability of these inhibitors to impair vesicle trafficking from early to late endosomes in some cells could also increase the recycling of these virion-containing endosomes to the cell surface, where fusion occurs. In summary, our results reveal an unexpected, CD4-mediated reciprocal relationship between the pathways governing HIV virion fusion and endocytosis.     

Survival of the Fittest: Positive Selection of CD4+ T Cells Expressing a Membrane-Bound Fusion Inhibitor Following HIV-1 Infection

Although a variety of genetic strategies have been developed to inhibit HIV replication, few direct comparisons of the efficacy of these inhibitors have been carried out. Moreover, most studies have not examined whether genetic inhibitors are able to induce a survival advantage that results in an expansion of genetically-modified cells following HIV infection. We evaluated the efficacy of three leading genetic strategies to inhibit HIV replication: 1) an HIV-1 tat/rev-specific small hairpin (sh) RNA; 2) an RNA antisense gene specific for the HIV-1 envelope; and 3) a viral entry inhibitor, maC46. In stably transduced cell lines selected such that >95% of cells expressed the genetic inhibitor, the RNA antisense envelope and viral entry inhibitor maC46 provided the strongest inhibition of HIV-1 replication. However, when mixed populations of transduced and untransduced cells were challenged with HIV-1, the maC46 fusion inhibitor resulted in highly efficient positive selection of transduced cells, an effect that was evident even in mixed populations containing as few as 1% maC46-expressing cells. The selective advantage of the maC46 fusion inhibitor was also observed in HIV-1-infected cultures of primary T lymphocytes as well as in HIV-1-infected humanized mice. These results demonstrate robust inhibition of HIV replication with the fusion inhibitor maC46 and the antisense Env inhibitor, and importantly, a survival advantage of cells expressing the maC46 fusion inhibitor both in vitro and in vivo. Evaluation of the ability of genetic inhibitors of HIV-1 replication to confer a survival advantage on genetically-modified cells provides unique information not provided by standard techniques that may be important in the in vivo efficacy of these genes.     

Identification of the Niemann-Pick C1-like 1 cholesterol absorption receptor as a new hepatitis C virus entry factor

Hepatitis C virus (HCV) is a leading cause of liver disease worldwide. With ～170 million individuals infected and current interferon-based treatment having toxic side effects and marginal efficacy, more effective antivirals are crucially needed. Although HCV protease inhibitors were just approved by the US Food and Drug Administration (FDA), optimal HCV therapy, analogous to HIV therapy, will probably require a combination of antivirals targeting multiple aspects of the viral lifecycle. Viral entry represents a potential multifaceted target for antiviral intervention; however, to date, FDA-approved inhibitors of HCV cell entry are unavailable. Here we show that the cellular Niemann-Pick C1-like 1 (NPC1L1) cholesterol uptake receptor is an HCV entry factor amendable to therapeutic intervention. Specifically, NPC1L1 expression is necessary for HCV infection, as silencing or antibody-mediated blocking of NPC1L1 impairs cell culture-derived HCV (HCVcc) infection initiation. In addition, the clinically available FDA-approved NPC1L1 antagonist ezetimibe potently blocks HCV uptake in vitro via a virion cholesterol-dependent step before virion-cell membrane fusion. Moreover, ezetimibe inhibits infection by all major HCV genotypes in vitro and in vivo delays the establishment of HCV genotype 1b infection in mice with human liver grafts. Thus, we have not only identified NPC1L1 as an HCV cell entry factor but also discovered a new antiviral target and potential therapeutic agent.     

Enfuvirtide resistance mutations: impact on human immunodeficiency virus envelope function, entry inhibitor sensitivity, and virus neutralization

Enfuvirtide (ENF/T-20/Fuzeon), the first human immunodeficiency virus (HIV) entry inhibitor to be licensed, targets a structural intermediate of the entry process. ENF binds the HR1 domain in gp41 after Env has bound CD4, preventing conformational changes needed for membrane fusion. Mutations in HR1 that confer ENF resistance can arise following ENF therapy. ENF resistance mutations were introduced into an R5- and X4-tropic Env to examine their impact on fusion, infection, and sensitivity to different classes of entry inhibitors and neutralizing antibodies. HR1 mutations could reduce infection and fusion efficiency and also delay fusion kinetics, likely accounting for their negative impact on viral fitness. HR1 mutations had minimal effect on virus sensitivity to other classes of entry inhibitors, including those targeting CD4 binding (BMS-806 and a CD4-specific monoclonal antibody [MAb]), coreceptor binding (CXCR4 inhibitor AMD3100 and CCR5 inhibitor TAK-779), or fusion (T-1249), indicating that ENF-resistant viruses can remain sensitive to other entry inhibitors in vivo. Some HR1 mutations conferred increased sensitivity to a subset of neutralizing MAbs that likely target fusion intermediates or with epitopes preferentially exposed following receptor interactions (17b, 48D, 2F5, 4E10, and IgGb12), as well as sera from some HIV-positive individuals. Mechanistically, enhanced neutralization correlated with reduced fusion kinetics, indicating that, in addition to steric constraints, kinetics may also limit virus neutralization by some antibodies. Therefore, escape from ENF comes at a cost to viral fitness and may confer enhanced sensitivity to humoral immunity due to prolonged exposure of epitopes that are not readily accessible in the native Env trimer. Resistance to other entry inhibitors was not observed.     

Section: bioprocessing and biological engineering gene fragment polymerization for increased yield of recombinant HIV fusion inhibitor enfuvirtide

Fuzeon (Enfuvirtide, T20) is the first fusion inhibitor approved by the FDA of the USA for the treatment of HIV/AIDS in combination with other anti-retroviral drugs. Enfuvirtide is a synthetic peptide that blocks the entry of HIV into healthy host CD₄ cells, which requires very high (90 mg twice daily) therapeutic doses. To increase the yield of Enfuvirtide, a gene polymerization strategy was introduced and recombinant T20 (rT20) was expressed in Escherichia coli as a five copy repeat polypeptide with a histidine-tag. The five copy rT20 was purified by Ni-affinity chromatography and cleaved to single rT20 units by cyanogen bromide. Finally, single rT20 units were purified by reversed phase chromatography giving a yield (400 mg/l) with a purity >95 %, which exhibited specific biological activity similar to Fuzeon.     

Development of HIV fusion inhibitors.

In the past 25 years, the worldwide AIDS epidemic has grown such that roughly 38 million people were estimated to be living with the disease worldwide at the end of 2003. The introduction of antiretroviral-based therapies, beginning in 1987, has enabled many to live with HIV as a chronic, rather than terminal, disease. However, the emergence and spread of drug-resistant strains highlights the continued need for new therapies with novel modes of action. In 2003, the FDA and EMEA approved enfuvirtide (Fuzeon), a 36 amino acid peptide derived from the natural gp41 HR2 sequence, as the first HIV fusion inhibitor. T-1249, a 39 amino acid fusion inhibitor, is active against viruses that develop resistance to enfuvirtide. The development of FIs and the processes to manufacture enfuvirtide and T-1249 on an unprecedented scale for peptide therapeutics are presented. Synthetic routes based on a combination of solid phase peptide synthesis and solution phase fragment condensation as well as the analytical controls necessary to insure a robust process are discussed.     

Multiple Cationic Amphiphiles Induce a Niemann-Pick C Phenotype and Inhibit Ebola Virus Entry and Infection

Ebola virus (EBOV) is an enveloped RNA virus that causes hemorrhagic fever in humans and non-human primates. Infection requires internalization from the cell surface and trafficking to a late endocytic compartment, where viral fusion occurs, providing a conduit for the viral genome to enter the cytoplasm and initiate replication. In a concurrent study, we identified clomiphene as a potent inhibitor of EBOV entry. Here, we screened eleven inhibitors that target the same biosynthetic pathway as clomiphene. From this screen we identified six compounds, including U18666A, that block EBOV infection (IC₅₀ 1.6 to 8.0 µM) at a late stage of entry. Intriguingly, all six are cationic amphiphiles that share additional chemical features. U18666A induces phenotypes, including cholesterol accumulation in endosomes, associated with defects in Niemann–Pick C1 protein (NPC1), a late endosomal and lysosomal protein required for EBOV entry. We tested and found that all six EBOV entry inhibitors from our screen induced cholesterol accumulation. We further showed that higher concentrations of cationic amphiphiles are required to inhibit EBOV entry into cells that overexpress NPC1 than parental cells, supporting the contention that they inhibit EBOV entry in an NPC1-dependent manner. A previously reported inhibitor, compound 3.47, inhibits EBOV entry by blocking binding of the EBOV glycoprotein to NPC1. None of the cationic amphiphiles tested had this effect. Hence, multiple cationic amphiphiles (including several FDA approved agents) inhibit EBOV entry in an NPC1-dependent fashion, but by a mechanism distinct from that of compound 3.47. Our findings suggest that there are minimally two ways of perturbing NPC1-dependent pathways that can block EBOV entry, increasing the attractiveness of NPC1 as an anti-filoviral therapeutic target.