- Klíčová slova
- inhibitory HIV kapsidy,
- MeSH
- fixní kombinace léků MeSH
- humanizované monoklonální protilátky MeSH
- inhibitory HIV fúze aplikace a dávkování farmakologie terapeutické užití MeSH
- inhibitory HIV-integrasy aplikace a dávkování farmakologie terapeutické užití MeSH
- inhibitory reverzní transkriptasy aplikace a dávkování farmakologie terapeutické užití MeSH
- látky proti HIV * aplikace a dávkování farmakologie terapeutické užití MeSH
- lidé MeSH
- rilpivirin aplikace a dávkování farmakologie terapeutické užití MeSH
- vysoce aktivní antiretrovirová terapie metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Nucleos(t)ide analogues entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are recommended as first-line monotherapies for chronic hepatitis B (CHB). Multiple HBV genotypes/subgenotypes have been described, but their impact on treatment response remains largely elusive. We investigated the effectiveness of ETV/TDF on HBV/D-subgenotypes, D1/D2/D3/D5, studied the structural/functional differences in subgenotype-specific reverse transcriptase (RT) domains of viral polymerase, and identified novel molecules with robust inhibitory activity on various D-subgenotypes. Transfection of Huh7 cells with full-length D1/D2/D3/D5 and in vitro TDF/ETV susceptibility assays demonstrated that D1/D2 had greater susceptibility to TDF/ETV while D3/D5 exhibited poorer response. Additionally, HBV load was substantially reduced in TDF-treated CHB patients carrying D1/D2 but minimally reduced in D3/D5-infected patients. Comparison of RT sequences of D-subgenotypes led to identification of unique subgenotype-specific residues, and molecular modeling/docking/simulation studies depicted differential bindings of TDF/ETV to the active site of their respective RTs. Replacement of signature residues in D3/D5 HBV clones with corresponding amino acids seen in D1/D2 improved their susceptibility to TDF/ETV. Using high throughput virtual screening, we identified N(9)-[3-fluoro-2-(phosphonomethoxy)propyl] (FPMP) derivatives of purine bases, including N6-substituted (S)-FPMP derivative of 2,6-diaminopurine (DAP) (OB-123-VK), as potential binders of RT of different D-subgenotypes. We synthesized (S)-FPMPG prodrugs (FK-381-FEE/FK-381-SEE/FK-382) and tested their effectiveness along with OB-123-VK. Both OB-123-VK and FK-381-FEE exerted similar antiviral activities against all D-subgenotypes, although FK-381-FEE was more potent. Our study highlighted the natural variation in therapeutic response of D1/D2/D3/D5 and emphasized the need for HBV subgenotype determination before treatment. Novel molecules described here could benefit future design/discovery of pan-D-subgenotypic inhibitors. IMPORTANCE Current treatment of chronic hepatitis B relies heavily on nucleotide/nucleoside analogs in particular, tenofovir disoproxil fumarate (TDF) and entecavir (ETV) to keep HBV replication under control and prevent end-stage liver diseases. However, it was unclear whether the therapeutic effects of TDF/ETV differ among patients infected with different HBV genotypes and subgenotypes. HBV genotype D is the most widespread of all HBV genotypes and multiple D-subgenotypes have been described. We here report that different subgenotypes of HBV genotype-D exhibit variable response toward TDF and ETV and this could be attributed to naturally occurring amino acid changes in the reverse transcriptase domain of the subgenotype-specific polymerase. Further, we identified novel molecules and also synthesized prodrugs that are equally effective on different D-subgenotypes and could facilitate management of HBV/D-infected patients irrespective of D-subgenotype.
- MeSH
- antivirové látky chemie farmakologie terapeutické užití MeSH
- chronická hepatitida B farmakoterapie virologie MeSH
- genotyp MeSH
- guanin analogy a deriváty chemie farmakologie terapeutické užití MeSH
- inhibitory reverzní transkriptasy chemie farmakologie terapeutické užití MeSH
- lidé MeSH
- mutace MeSH
- organofosfonáty chemie farmakologie MeSH
- prekurzory léčiv MeSH
- proteinové domény MeSH
- racionální návrh léčiv * MeSH
- reverzní transkriptasa chemie genetika MeSH
- tenofovir chemie farmakologie terapeutické užití MeSH
- virová léková rezistence účinky léků genetika MeSH
- virová nálož účinky léků MeSH
- virus hepatitidy B účinky léků enzymologie genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Efavirenz (EFV) is a non-nucleoside reverse transcriptase inhibitor used in first-line combination antiretroviral therapy (cART). It is usually administered with nucleoside reverse transcriptase inhibitors (NRTI), many of which are substrates of OCT uptake solute carriers (SLC22A) and MATE (SLC47A), P-gp (MDR1, ABCB1), BCRP (ABCG2), or MRP2 (ABCC2) efflux transporters. The aim of this study was to evaluate the inhibitory potential of efavirenz towards these transporters and investigate its effects on the pharmacokinetics and tissue distribution of a known Oct/Mate substrate, lamivudine, in rats. Accumulation and transport assays showed that efavirenz inhibits the uptake of metformin by OCT1-, OCT2- and MATE1-expressing MDCK cells and reduces transcellular transport of lamivudine across OCT1/OCT2- and MATE1-expressing MDCK monolayers. Only negligible inhibition of MATE2-K was observed in HEK-MATE2-K cells. Efavirenz also reduced the efflux of calcein from MDCK-MRP2 cells, but had a rather weak inhibitory effect on Hoechst 33342 accumulation in MDCK-MDR1 and MDCK-BCRP cells. An in vivo pharmacokinetic interaction study in male Wistar rats revealed that intravenous injection of efavirenz or the control Oct/Mate inhibitor cimetidine significantly reduced the recovery of lamivudine in urine and greatly increased lamivudine retention in the renal tissue. Co-administration with efavirenz or cimetidine also increased the AUC0-∞ value and reduced total body clearance of lamivudine. These data suggest that efavirenz is a potent inhibitor of OCT/Oct and MATE/Mate transporters. Consequently, it can engage in drug-drug interactions that reduce renal excretion of co-administered substrates and enhance their retention in the kidneys, potentially compromising therapeutic safety.
- MeSH
- benzoxaziny farmakologie MeSH
- buňky MDCK MeSH
- cimetidin farmakologie MeSH
- eliminace ledvinami MeSH
- HEK293 buňky MeSH
- inhibitory reverzní transkriptasy farmakokinetika farmakologie moč MeSH
- krysa rodu rattus MeSH
- lamivudin farmakokinetika farmakologie moč MeSH
- ledviny metabolismus MeSH
- lidé MeSH
- metformin metabolismus farmakologie MeSH
- plocha pod křivkou MeSH
- poločas MeSH
- potkani Wistar MeSH
- proteiny přenášející organické kationty antagonisté a inhibitory metabolismus MeSH
- proteiny spojené s mnohočetnou rezistencí k lékům antagonisté a inhibitory metabolismus MeSH
- psi MeSH
- ROC křivka MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- lidé MeSH
- mužské pohlaví MeSH
- psi MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Rilpivirine (TMC278) is a highly potent nonnucleoside reverse transcriptase inhibitor (NNRTI) representing an effective component of combination antiretroviral therapy (cART) in the treatment of HIV-positive patients. Many antiretroviral drugs commonly used in cART are substrates of ATP-binding cassette (ABC) and/or solute carrier (SLC) drug transporters and, therefore, are prone to pharmacokinetic drug-drug interactions (DDIs). The aim of our study was to evaluate rilpivirine interactions with abacavir and lamivudine on selected ABC and SLC transporters in vitro and assess its importance for pharmacokinetics in vivo Using accumulation assays in MDCK cells overexpressing selected ABC or SLC drug transporters, we revealed rilpivirine as a potent inhibitor of MDR1 and BCRP, but not MRP2, OCT1, OCT2, or MATE1. Subsequent transport experiments across monolayers of MDCKII-MDR1, MDCKII-BCRP, and Caco-2 cells demonstrated that rilpivirine inhibits MDR1- and BCRP-mediated efflux of abacavir and increases its transmembrane transport. In vivo experiments in male Wistar rats confirmed inhibition of MDR1/BCRP in the small intestine, leading to a significant increase in oral bioavailability of abacavir. In conclusion, rilpivirine inhibits MDR1 and BCRP transporters and may affect pharmacokinetic behavior of concomitantly administered substrates of these transporters, such as abacavir.
- MeSH
- ABC transportér z rodiny G, člen 2 metabolismus MeSH
- biologický transport fyziologie MeSH
- buněčné linie MeSH
- buňky MDCK MeSH
- Caco-2 buňky MeSH
- dideoxynukleosidy metabolismus farmakologie MeSH
- inhibitory reverzní transkriptasy metabolismus farmakologie MeSH
- intestinální absorpce fyziologie MeSH
- krysa rodu rattus MeSH
- lamivudin metabolismus farmakologie MeSH
- lékové interakce fyziologie MeSH
- lidé MeSH
- membránové transportní proteiny metabolismus MeSH
- nádorové buněčné linie MeSH
- P-glykoprotein metabolismus MeSH
- potkani Wistar MeSH
- psi MeSH
- rilpivirin metabolismus farmakologie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- lidé MeSH
- mužské pohlaví MeSH
- psi MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
To understand the persistence of latently HIV-1 infected cells in virally suppressed infected patients, a number of in vitro models of HIV latency have been developed. In an attempt to mimic the in vivo situation as closely as possible, several models use primary cells and replication-competent viruses in combination with antiretroviral compounds to prevent ongoing replication. Latency is subsequently measured by HIV RNA and/or protein production after cellular activation. To discriminate between pre- and post-integration latency, integrase inhibitors are routinely used, preventing novel integrations upon cellular activation. Here, we show that this choice of antiretrovirals may still cause a bias of pre-integration latency in these models, as unintegrated HIV DNA can form and directly contribute to the levels of HIV RNA and protein production. We further show that the addition of reverse transcriptase inhibitors effectively suppresses the levels of episomal HIV DNA (as measured by 2-LTR circles) and decreases the levels of HIV transcription. Consequently, we show that latency levels described in models that only use integrase inhibitors may be overestimated. The inclusion of additional control conditions, such as 2-LTR quantification and the addition of reverse transcriptase inhibitors, is crucial to fully elucidate the actual levels of post-integration latency.
- MeSH
- aktivace lymfocytů MeSH
- benzoxaziny farmakologie MeSH
- biologické modely MeSH
- CD4-pozitivní T-lymfocyty imunologie virologie MeSH
- DNA virů antagonisté a inhibitory biosyntéza genetika MeSH
- HIV infekce farmakoterapie imunologie virologie MeSH
- HIV-1 účinky léků fyziologie MeSH
- inhibitory HIV-integrasy farmakologie MeSH
- inhibitory HIV-proteasy farmakologie MeSH
- inhibitory reverzní transkriptasy farmakologie MeSH
- integrace viru účinky léků MeSH
- latence viru účinky léků MeSH
- lidé MeSH
- nevirapin farmakologie MeSH
- primární buněčná kultura MeSH
- raltegravirum kalicum farmakologie MeSH
- replikace viru účinky léků MeSH
- reportérové geny MeSH
- ritonavir farmakologie MeSH
- virové proteiny antagonisté a inhibitory biosyntéza genetika MeSH
- zelené fluorescenční proteiny genetika metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001. METHODS: Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)-infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0. RESULTS: The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%-9.5%) in 2008-2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones. CONCLUSIONS: Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected.
- MeSH
- dospělí MeSH
- HIV infekce farmakoterapie virologie MeSH
- HIV-1 účinky léků genetika MeSH
- inhibitory HIV-proteasy farmakologie MeSH
- inhibitory reverzní transkriptasy farmakologie MeSH
- látky proti HIV farmakologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mikrobiální testy citlivosti MeSH
- mutace MeSH
- prevalence MeSH
- virová léková rezistence genetika MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
INTRODUCTION: All HIV positive pregnant women should receive combination antiretroviral therapy (cART) to prevent mother-to-child transmission (MTCT) of the virus. It has recently been shown that fetal exposure of nucleoside reverse transcriptase inhibitors (NRTIs) tenofovir disoproxil fumarate (TDF) and abacavir is decreased by placental ABC transporters p-glycoprotein (ABCB1) and BCRP (ABCG2). The aim of this study was to evaluate transporter-mediated drug-drug interactions (DDI) between etravirine (TMC125), a novel non-nucleoside reverse transcriptase inhibitor used in cART, and the NRTIs and to assess the relevance of such DDI for transplacental pharmacokinetics of TDF and abacavir. METHODS: In vitro accumulation assays and transport experiments on ABCB1 and ABCG2 overexpressing MDCKII monolayers were employed. Furthermore, the effect of etravirine on the transplacental passage of TDF and abacavir was assessed using in situ dually perfused rat placenta. RESULTS: We confirmed significant inhibition of ABCG2 but not ABCB1 by etravirine in hoechst accumulation assays. In transport studies on MDCKII-ABCG2 monolayers etravirine completely abolished the ABCG2-mediated transfer of [3H]-TDF. Similar effect was observed in [3H]-abacavir albeit at markedly lower etravirine concentration. Using dually perfused rat placenta, etravirine co-administration resulted in reduced fetal-to-maternal passage of TDF but not abacavir. DISCUSSION: Etravirine is able to affect transplacental passage of TDF but not that of abacavir through interactions on ABCG2. These results should be considered when introducing etravirine into TDF-containing cART in pregnancy.
- MeSH
- ABC transportér z rodiny G, člen 2 metabolismus MeSH
- buněčné linie MeSH
- inhibitory reverzní transkriptasy farmakologie MeSH
- krysa rodu rattus MeSH
- látky proti HIV farmakologie MeSH
- lidé MeSH
- P-glykoprotein metabolismus MeSH
- placenta účinky léků metabolismus MeSH
- potkani Wistar MeSH
- pyridaziny farmakologie MeSH
- těhotenství MeSH
- tenofovir farmakologie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
To elucidate the structure-geometry-activity relationship in diarylpyrimidine family (DAPYs) containing carbonyl linker between the central pyrimidine core and phenyl type B-arm, a series of (2,6-difluorophenyl)(2-(phenylamino)pyrimidin-4-yl)methanones was designed, prepared and tested for their anti-HIV-1 activity. The carbonyl linker bearing B phenyl arm was successfully attached at both C-2 and C-4 positions of the central pyrimidine ring using a new synthetic approach. Further modifications of target compounds are present at C-5 position of the pyrimidine ring. In vitro anti-HIV-1 activity study performed on a series of 22 compounds confirmed the crucial importance of both conformational rigidity between phenyl B arm and the pyrimidine core linked through the carbonyl bridge, as well as presence of fluoro substituents in ortho-positions of phenyl B moiety. The most potent derivative of the series, compound 17, having almost perpendicular angle within the two planes made from the B aromatic arm and the pyrimidine ring, exhibited low nanomolar anti-HIV-1 activity (EC50 = 4 nM) with no significant toxicity (CC50 > 57.1 μM).
- MeSH
- HIV reverzní transkriptasa antagonisté a inhibitory chemie metabolismus MeSH
- HIV-1 účinky léků enzymologie MeSH
- inhibitory reverzní transkriptasy chemie metabolismus farmakologie MeSH
- konformace proteinů MeSH
- pyrimidiny chemie metabolismus farmakologie MeSH
- racionální návrh léčiv * MeSH
- simulace molekulového dockingu MeSH
- Publikační typ
- časopisecké články MeSH
Heterocyclic compounds execute a very important role in drug design and discovery. This article provides the basic milestones of the research for pyrroloaryl and pyrroloheteroaryl based components targeting HIV viral replication cycle. Anti-HIV activity is elaborated for several classes of pyrrolo-compounds as pyrrolopyridines, pyrrolopyrimidines, pyrrolopyridazines, pyrrolobenzodiazepinones, pyrrolobenzothiazepines, pyrrolobenzoxazepinones, pyrrolophenanthridines, pyrroloquinoxalines, pyrrolotriazines, pyrroloquinolines, pyrrolopyrazinones, pyrrolothiatriazines, arylthiopyrroles and pyrrolopyrazolones targeting two essential HIV enzymes, reverse transcriptase and integrase as well as attachment/fusion of HIV virons to the host CD-4 cell. Such attempts were resulted in a discovery of highly potent anti-HIV agents suitable for clinical trials, for example, BMS-378806, BMS-585248, BMS-626529, BMS-663068, BMS-488043 and BMS-663749, etc. as anti-HIV attachment agents, triciribine, QX432, BI-1 and BI-2 as HIV RT inhibitors which are in preclinical or clinical development. Mechanism of action of compounds presented in this article towards the suppression of HIV attachment/fusion as well as against the activities of HIV enzymes reverse transcriptase and integrase has been discussed. Relationships of new compounds' molecular framework and HIV viral target has been overviewed in order to facilitate further construction of promising anti-HIV agents in future drug discovery process.
- MeSH
- HIV infekce farmakoterapie virologie MeSH
- HIV-integrasa metabolismus MeSH
- HIV účinky léků enzymologie fyziologie MeSH
- inhibitory HIV fúze chemie farmakologie MeSH
- inhibitory HIV-integrasy chemie farmakologie MeSH
- inhibitory reverzní transkriptasy chemie farmakologie MeSH
- látky proti HIV chemie farmakologie MeSH
- lidé MeSH
- objevování léků MeSH
- pyrroly chemie farmakologie MeSH
- replikace viru účinky léků MeSH
- reverzní transkriptasa metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
x
x
- Klíčová slova
- studie START, plazmatická virémie,
- MeSH
- adherence k farmakoterapii MeSH
- antiretrovirové látky * farmakologie terapeutické užití MeSH
- CD4-pozitivní T-lymfocyty MeSH
- fixní kombinace léků MeSH
- HIV infekce * farmakoterapie virologie MeSH
- HIV séropozitivita farmakoterapie MeSH
- HIV-integrasa farmakologie terapeutické užití MeSH
- HIV genetika účinky léků MeSH
- inhibitory HIV fúze farmakologie terapeutické užití MeSH
- inhibitory HIV-integrasy farmakologie terapeutické užití MeSH
- inhibitory HIV-proteasy farmakologie terapeutické užití MeSH
- inhibitory reverzní transkriptasy farmakologie terapeutické užití MeSH
- kombinovaná farmakoterapie MeSH
- látky proti HIV farmakologie terapeutické užití MeSH
- lidé MeSH
- multicentrické studie jako téma MeSH
- počet CD4 lymfocytů MeSH
- randomizované kontrolované studie jako téma MeSH
- RNA virová krev MeSH
- viremie MeSH
- virová nálož MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH