Enhanced Exposure of Human Immunodeficiency Virus Type 1 Primary Isolate Neutralization Epitopes through Binding of CD4 Mimetic Compounds

N-(4-Chlorophenyl)-N′-(2,2,6,6-tetramethyl-piperidin-4-yl)-oxalamide (NBD-556) is a low-molecular-weight compound that reportedly blocks the interaction between human immunodeficiency virus type 1 (HIV-1) gp120 and its receptor CD4. We investigated whether the enhancement of binding of anti-gp120 monoclonal antibodies (MAbs) toward envelope (Env) protein with NBD-556 are similar to those of soluble CD4 (sCD4) by comparing the binding profiles of the individual MAbs to Env-expressing cell surfaces. In flow cytometric analyses, the binding profiles of anti-CD4-induced epitope (CD4i) MAbs toward NBD-556-pretreated Env-expressing cell surfaces were similar to the binding profiles toward sCD4-pretreated cell surfaces. To investigate the binding position of NBD-556 on gp120, we induced HIV-1 variants that were resistant to NBD-556 and sCD4 in vitro. At passage 21 in the presence of 50 μM NBD-556, two amino acid substitutions (S375N in C3 and A433T in C4) were identified. On the other hand, in the selection with sCD4, seven mutations (E211G, P212L, V255E, N280K, S375N, G380R, and G431E) appeared during the passages. The profiles of the mutations after the selections with NBD-556 and sCD4 were very similar in their three-dimensional positions. Moreover, combinations of NBD-556 with anti-gp120 MAbs showed highly synergistic interactions against HIV-1. We further found that after enhancing the neutralizing activity by adding NBD-556, the contemporaneous virus became highly sensitive to antibodies in the patient''s plasma. These findings suggest that small compounds such as NBDs may enhance the neutralizing activities of CD4i and anti-V3 antibodies in vivo.Human immunodeficiency virus type 1 (HIV-1) replicates continuously in the face of a strong antibody (Ab) response, although Abs effectively control many viral infections (3). Neutralizing Abs (NAbs) are directed against the HIV-1 envelope (Env) protein, which is a heterodimer comprising an extensively glycosylated CD4-binding subunit (gp120) and an associated transmembrane protein (gp41). Env proteins are present on the virion surface as “spikes” composed of trimers of three gp120-gp41 complexes (20, 21, 29). These spikes resist neutralization through epitope occlusion within the oligomer, extensive glycosylation, extension of variable loops from the surface of the complex, and steric and conformational blocking of receptor binding sites (16, 18, 20).Ab access to conserved regions is further limited because viral entry is a stepwise process involving conformational changes that lead to only transient exposure of conserved domains such as the coreceptor binding site (4, 5). However, some early strains of HIV-1 appear to be highly susceptible to neutralization by Abs (1, 10). For instance, subtype A HIV-1 envelopes from the early stage of infection exhibit a broad range of neutralization sensitivities to both autologous and heterologous plasma (1), suggesting that at least a subset of the envelopes have some preserved and/or exposed neutralization epitopes. It is well known that the potential for neutralizing properties of particular Abs is enhanced after binding of soluble CD4 (sCD4), especially NAbs against CD4-induced epitopes (CD4i Abs) (27) and some anti-V3 Abs (22). CD4i Abs are detected in plasma samples from many patients at an early stage of HIV-1 infection (9). Consequently, we hypothesize that small compounds such as sCD4 can enhance the neutralizing activities of CD4i Abs and some anti-V3 Abs not only in vitro but also in vivo.In a previous report, two low-molecular-weight compounds that presumably interfere with viral entry of HIV-1 into cells were described (35). These two N-phenyl-N′-(2,2,6,6-tetramethyl-piperidin-4-yl)-oxalamide analogs, NBD-556 and NBD-557, comprise a novel class of HIV-1 entry inhibitors that block the interaction between gp120 and CD4. These compounds were found to be equally potent inhibitors of both X4 and R5 viruses in CXCR4- and CCR5-expressing cell lines, respectively (35). Schön et al. (25) also reported that NBD-556 binds to gp120 in a process characterized by a large favorable change in enthalpy that is partially compensated for by a large unfavorable entropy change, representing a thermodynamic signature similar to that observed for binding of sCD4 to gp120. In a recent study, Madani et al. (23) reported the following findings: (i) NBD-556 binds within the Phe43 cavity, a highly conserved and functionally important pocket formed as gp120 assumes the CD4-bound conformation; (ii) the NBD-556 phenyl ring projects into the Phe43 cavity; (iii) the enhancement of CD4-independent infection by NBD-556 requires the induction of conformational changes in gp120; and (iv) increased affinities of NBD-556 analogs toward gp120 improve the antiviral potency during infection of CD4-expressing cells. The latter two studies demonstrated that low-molecular-weight compounds such as NBDs can induce conformational changes in the HIV-1 gp120 glycoprotein similar to those observed upon sCD4 binding (23, 25). The authors of these studies concluded that their data supported the importance of gp120 residues near the Phe43 cavity in binding to NBD-556 and lent credence to the docked binding mode.In the present study, we investigated the binding position of NBD-556 on gp120 by inducing HIV-1 variants that were resistant to NBD-556 by exposing HIV-1_IIIB to increasing concentrations of the compound in vitro. We also induced sCD4-resistant HIV-1_IIIB variants and compared the profile of the sCD4-resistant mutations to that of the NBD-556-resistant mutations. We subsequently examined the virological properties of pseudotyped HIV-1 clones carrying the NBD-556 and sCD4 resistance-associated env gene mutations. Our findings provide a foundation for understanding the interaction of NBD-556 with the CD4-binding site of HIV-1 gp120. We also evaluated the anti-HIV-1 interactions between plasma NAbs and NBD-556 in vitro and considered the possibility of using the data as a key to opening the shield covering the conserved epitopes targeted by NAbs.(This study was presented in part at the 15th Conference on Retroviruses and Opportunistic Infection, Boston, MA, 3 to 6 February 2008 [Abstract 736].)