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TitleMechanisms of HIV-1 integrase resistance to dolutegravir and potent inhibition of drug-resistant variants.
Journal, issue, pagesSci Adv, Vol. 9, Issue 29, Page eadg5953, Year 2023
Publish dateJul 21, 2023
AuthorsMin Li / Dario Oliveira Passos / Zelin Shan / Steven J Smith / Qinfang Sun / Avik Biswas / Indrani Choudhuri / Timothy S Strutzenberg / Allan Haldane / Nanjie Deng / Zhaoyang Li / Xue Zhi Zhao / Lorenzo Briganti / Mamuka Kvaratskhelia / Terrence R Burke / Ronald M Levy / Stephen H Hughes / Robert Craigie / Dmitry Lyumkis /
PubMed AbstractHIV-1 infection depends on the integration of viral DNA into host chromatin. Integration is mediated by the viral enzyme integrase and is blocked by integrase strand transfer inhibitors (INSTIs), ...HIV-1 infection depends on the integration of viral DNA into host chromatin. Integration is mediated by the viral enzyme integrase and is blocked by integrase strand transfer inhibitors (INSTIs), first-line antiretroviral therapeutics widely used in the clinic. Resistance to even the best INSTIs is a problem, and the mechanisms of resistance are poorly understood. Here, we analyze combinations of the mutations E138K, G140A/S, and Q148H/K/R, which confer resistance to INSTIs. The investigational drug 4d more effectively inhibited the mutants compared with the approved drug Dolutegravir (DTG). We present 11 new cryo-EM structures of drug-resistant HIV-1 intasomes bound to DTG or 4d, with better than 3-Å resolution. These structures, complemented with free energy simulations, virology, and enzymology, explain the mechanisms of DTG resistance involving E138K + G140A/S + Q148H/K/R and show why 4d maintains potency better than DTG. These data establish a foundation for further development of INSTIs that potently inhibit resistant forms in integrase.
External linksSci Adv / PubMed:37478179
MethodsEM (single particle)
Resolution2.2 - 3.0 Å
Structure data

EMDB-29307, PDB-8fn7:
Structure of WT HIV-1 intasome bound to Dolutegravir
Method: EM (single particle) / Resolution: 2.8 Å

EMDB-29309, PDB-8fnd:
Structure of E138K HIV-1 intasome with Dolutegravir bound
Method: EM (single particle) / Resolution: 3.0 Å

EMDB-29312, PDB-8fng:
Structure of E138K HIV-1 intasome with Dolutegravir bound
Method: EM (single particle) / Resolution: 2.2 Å

EMDB-29313, PDB-8fnh:
Structure of Q148K HIV-1 intasome with Dolutegravir bound
Method: EM (single particle) / Resolution: 2.5 Å

EMDB-29315, PDB-8fnj:
Structure of E138K/G140A HIV-1 intasome with Dolutegravir bound
Method: EM (single particle) / Resolution: 2.4 Å

EMDB-29317, PDB-8fnl:
Structure of E138K/Q148K HIV-1 intasome with Dolutegravir bound
Method: EM (single particle) / Resolution: 2.8 Å

EMDB-29318, PDB-8fnm:
Structure of G140A/Q148K HIV-1 intasome with Dolutegravir bound
Method: EM (single particle) / Resolution: 2.8 Å

EMDB-29319, PDB-8fnn:
Structure of E138K/G140A/Q148K HIV-1 intasome with Dolutegravir bound
Method: EM (single particle) / Resolution: 2.7 Å

EMDB-29320, PDB-8fno:
Structure of E138K/G140A/Q148R HIV-1 intasome with Dolutegravir bound
Method: EM (single particle) / Resolution: 2.5 Å

EMDB-29321, PDB-8fnp:
Structure of E138K/G140S/Q148H HIV-1 intasome with Dolutegravir bound
Method: EM (single particle) / Resolution: 2.2 Å

EMDB-29322, PDB-8fnq:
Structure of E138K/G140A/Q148K HIV-1 intasome with 4d bound
Method: EM (single particle) / Resolution: 2.8 Å

Chemicals

ChemComp-MG:
Unknown entry

ChemComp-ZN:
Unknown entry

ChemComp-DLU:
(4R,12aS)-N-(2,4-difluorobenzyl)-7-hydroxy-4-methyl-6,8-dioxo-3,4,6,8,12,12a-hexahydro-2H-pyrido[1',2':4,5]pyrazino[2,1-b][1,3]oxazine-9-carboxamide / medication, antiretroviral*YM / Dolutegravir

ChemComp-HOH:
WATER / Water

ChemComp-OZ1:
4-amino-N-[(2,4-difluorophenyl)methyl]-1-hydroxy-6-(6-hydroxyhexyl)-2-oxo-1,2-dihydro-1,8-naphthyridine-3-carboxamide

Source
  • human immunodeficiency virus 1
  • human immunodeficiency virus
  • homo sapiens (human)
KeywordsVIRAL PROTEIN/DNA/INHIBITOR / Integrase / Nucleoprotein complex / Inhibitor / Drug resistance / VIRAL PROTEIN-DNA-INHIBITOR complex

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