复发性和新的进化途径在体外驱动HIV-1 lenacapavir耐药性,具有多样化的表型后果
Luke L Orris1, Mohammad Adnan Siddiqui1, Junyi Tang1
1Aaron Diamond AIDS Research Center, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Nature communications
|March 7, 2026
概括
人类免疫缺陷病毒1型 (HIV-1) 可以通过突变对莱纳卡帕维尔 (LEN) 囊抑制剂产生耐药性. 新的抗药性途径增强了病毒的健康状况,并可能为未来的药物开发提供信息.
科学领域:
- 病毒学 病毒学
- 药物发现 药物发现 药物发现
- 分子生物学分子生物学
背景情况:
- 人类免疫缺陷病毒1型 (HIV-1) 囊是抗病毒治疗的验证临床点,特别是小分子抑制剂莱纳卡帕维尔 (LEN).
- 艾滋病毒-1已经证明了通过特定的囊突变,主要是在药物结合口袋内,对LEN产生耐药性的能力,这引发了对治疗持久性的担忧.
研究的目的:
- 调查HIV-1在选择性压力下对lenacapavir (LEN) 产生抗性的进化能力.
- 确定新的抗药性途径,并了解它们对病毒健康和囊功能的影响.
主要方法:
- 利用加速进化的方法来产生和研究LEN抗性HIV-1变种.
- 分析了囊突变,它们的位置 (药物结合口袋,六合体间接口),以及它们对病毒复制,核入口和药物依赖的影响.
主要成果:
- 在LEN结合口袋内确定了具有高突变耐受性的两个关键位置,从而产生了多样化的抗性配置.
- 观察到低级和高级耐药性突变 (例如M66I) 之间的协同相互作用,恢复了核入口并增强了病毒适应性.
- 在六合体间接口发现了远程电荷逆转替代物,这些替代物调节了体的稳定性并抵消了LEN的影响.
- 描述了一种高度耐药的E213K变种,该变种表现出依赖LEN的传染性颗粒产生.
结论:
- 艾滋病毒-1具有显著的适应潜力,可以通过直接结合的口袋突变和囊稳定性的全调节来克服LEN抑制.
- 新兴的抗药性途径,包括药物依赖的复制,突出显示了病毒进化和抗病毒压力之间的复杂相互作用.
- 这些发现支持对HIV-1耐药性的持续监测,并为设计下一代囊抑制剂提供关键见解,以保持长期的治疗疗效.
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