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Berke JM, Tan Y, Sauviller S, Wu DT, Zhang K, Conceição-Neto N, Blázquez Moreno A, Kong D, Kukolj G, Li C, Zhu R, Nájera I, Pauwels F. Class A capsid assembly modulator apoptotic elimination of hepatocytes with high HBV core antigen level in vivo is dependent on de novo core protein translation. J Virol 2024; 98:e0150223. [PMID: 38315015 PMCID: PMC10949496 DOI: 10.1128/jvi.01502-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/19/2023] [Indexed: 02/07/2024] Open
Abstract
Capsid assembly is critical in the hepatitis B virus (HBV) life cycle, mediated by the viral core protein. Capsid assembly is the target for new anti-viral therapeutics known as capsid assembly modulators (CAMs) of which the CAM-aberrant (CAM-A) class induces aberrant shaped core protein structures and leads to hepatocyte cell death. This study aimed to identify the mechanism of action of CAM-A modulators leading to HBV-infected hepatocyte elimination where CAM-A-mediated hepatitis B surface antigen (HBsAg) reduction was evaluated in a stable HBV replicating cell line and in AAV-HBV-transduced C57BL/6, C57BL/6 SCID, and HBV-infected chimeric mice with humanized livers. Results showed that in vivo treatment with CAM-A modulators induced pronounced reductions in hepatitis B e antigen (HBeAg) and HBsAg, associated with a transient alanine amino transferase (ALT) increase. Both HBsAg and HBeAg reductions and ALT increase were delayed in C57BL/6 SCID and chimeric mice, suggesting that adaptive immune responses may indirectly contribute. However, CD8+ T cell depletion in transduced wild-type mice did not impact antigen reduction, indicating that CD8+ T cell responses are not essential. Transient ALT elevation in AAV-HBV-transduced mice coincided with a transient increase in endoplasmic reticulum stress and apoptosis markers, followed by detection of a proliferation marker. Microarray data revealed antigen presentation pathway (major histocompatibility complex class I molecules) upregulation, overlapping with the apoptosis. Combination treatment with HBV-specific siRNA demonstrated that CAM-A-mediated HBsAg reduction is dependent on de novo core protein translation. To conclude, CAM-A treatment eradicates HBV-infected hepatocytes with high core protein levels through the induction of apoptosis, which can be a promising approach as part of a regimen to achieve functional cure. IMPORTANCE Treatment with hepatitis B virus (HBV) capsid assembly modulators that induce the formation of aberrant HBV core protein structures (CAM-A) leads to programmed cell death, apoptosis, of HBV-infected hepatocytes and subsequent reduction of HBV antigens, which differentiates CAM-A from other CAMs. The effect is dependent on the de novo synthesis and high levels of core protein.
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Affiliation(s)
- Jan Martin Berke
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg, Beerse, Belgium
| | - Ying Tan
- Infectious Diseases Discovery, Janssen Research and Development, Jinchuang Mansion, Pudong, Shanghai, China
| | - Sarah Sauviller
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg, Beerse, Belgium
| | - Dai-tze Wu
- Infectious Diseases Discovery, Janssen Research and Development, Jinchuang Mansion, Pudong, Shanghai, China
| | - Ke Zhang
- Infectious Diseases Discovery, Janssen Research and Development, Jinchuang Mansion, Pudong, Shanghai, China
| | - Nádia Conceição-Neto
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg, Beerse, Belgium
| | - Alfonso Blázquez Moreno
- Infectious Diseases Biomarkers, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg, Beerse, Belgium
| | - Desheng Kong
- Infectious Diseases Discovery, Janssen Research and Development, Jinchuang Mansion, Pudong, Shanghai, China
| | - George Kukolj
- Infectious Diseases Discovery, Janssen Research and Development, Brisbane, California, USA
| | - Chris Li
- Infectious Diseases Discovery, Janssen Research and Development, Brisbane, California, USA
| | - Ren Zhu
- Infectious Diseases Discovery, Janssen Research and Development, Jinchuang Mansion, Pudong, Shanghai, China
| | - Isabel Nájera
- Infectious Diseases Discovery, Janssen Research and Development, Brisbane, California, USA
| | - Frederik Pauwels
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg, Beerse, Belgium
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Conceição-Neto N, Pierson W, Vacca M, Beyens M, De Clerck B, Aerts L, Voeten B, De Pooter D, Verschueren L, Dockx K, Vandenberk M, De Troyer E, Verwilt K, Van Hove C, Verslegers M, Bosseler L, Crabbe M, Krishna V, Nájera I, Van Gulck E. Sustained Liver HBsAg Loss and Clonal T- and B-Cell Expansion upon Therapeutic DNA Vaccination Require Low HBsAg Levels. Vaccines (Basel) 2023; 11:1825. [PMID: 38140229 PMCID: PMC10747285 DOI: 10.3390/vaccines11121825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Suppression of HBV DNA, inhibition of HBV surface (HBsAg) production and therapeutic vaccination to reverse HBV-specific T-cell exhaustion in chronic HBV patients are likely required to achieve a functional cure. In the AAV-HBV mouse model, therapeutic vaccination can be effective in clearing HBV when HBsAg levels are low. Using a single-cell approach, we investigated the liver immune environment with different levels of HBsAg and sustained HBsAg loss through treatment with a GalNAc-HBV-siRNA followed by therapeutic vaccination. METHODS AAV-HBV-transduced C57BL/6 mice were treated with GalNAc-HBV-siRNA to lower HBsAg levels and then vaccinated using a DNA vaccine. We used single-cell RNA and V(D)J sequencing to understand liver immune microenvironment changes. RESULTS GalNAc-HBV-siRNA, followed by therapeutic vaccination, achieved sustained HBsAg loss in all mice. This was accompanied by CD4 follicular helper T-cell induction, polyclonal activation of CD8 T cells and clonal expansion of plasma cells that were responsible for antibody production. CONCLUSIONS This study provides novel insights into liver immune changes at the single-cell level, highlighting the correlation between induced reduction of HBsAg levels and clonal expansion of CD4, CD8 T cells and plasma cells in the liver upon HBV siRNA and subsequent therapeutic vaccination.
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Affiliation(s)
- Nádia Conceição-Neto
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (N.C.-N.); (M.V.); (B.D.C.); (L.A.); (D.D.P.); (L.V.)
| | - Wim Pierson
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (N.C.-N.); (M.V.); (B.D.C.); (L.A.); (D.D.P.); (L.V.)
| | - Maurizio Vacca
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (N.C.-N.); (M.V.); (B.D.C.); (L.A.); (D.D.P.); (L.V.)
| | - Matthias Beyens
- Discovery Therapeutics and Molecular Pharmacology, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (M.B.); (K.V.); (C.V.H.)
| | - Ben De Clerck
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (N.C.-N.); (M.V.); (B.D.C.); (L.A.); (D.D.P.); (L.V.)
| | - Liese Aerts
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (N.C.-N.); (M.V.); (B.D.C.); (L.A.); (D.D.P.); (L.V.)
| | - Birgit Voeten
- Charles River Laboratories, Turnhoutseweg 30, 2340 Beerse, Belgium (K.D.); (M.V.)
| | - Dorien De Pooter
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (N.C.-N.); (M.V.); (B.D.C.); (L.A.); (D.D.P.); (L.V.)
| | - Lore Verschueren
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (N.C.-N.); (M.V.); (B.D.C.); (L.A.); (D.D.P.); (L.V.)
| | - Koen Dockx
- Charles River Laboratories, Turnhoutseweg 30, 2340 Beerse, Belgium (K.D.); (M.V.)
| | - Mathias Vandenberk
- Charles River Laboratories, Turnhoutseweg 30, 2340 Beerse, Belgium (K.D.); (M.V.)
| | - Ewoud De Troyer
- SDS Discovery Statistics, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (E.D.T.); (M.C.)
| | - Kato Verwilt
- Discovery Therapeutics and Molecular Pharmacology, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (M.B.); (K.V.); (C.V.H.)
| | - Carl Van Hove
- Discovery Therapeutics and Molecular Pharmacology, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (M.B.); (K.V.); (C.V.H.)
| | - Mieke Verslegers
- Preclinical Sciences and Translational Safety (PSTS) Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (M.V.); (L.B.)
| | - Leslie Bosseler
- Preclinical Sciences and Translational Safety (PSTS) Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (M.V.); (L.B.)
| | - Marjolein Crabbe
- SDS Discovery Statistics, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (E.D.T.); (M.C.)
| | - Vinod Krishna
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, 1400 McKean Road, Spring House, PA 19002, USA;
| | - Isabel Nájera
- Infectious Diseases and Vaccines, Janssen Research and Development, 1600 Sierra Point Parkway, South San Francisco, CA 94005, USA;
| | - Ellen Van Gulck
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg 30, 2340 Beerse, Belgium; (N.C.-N.); (M.V.); (B.D.C.); (L.A.); (D.D.P.); (L.V.)
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Jensen DM, Brunda M, Elston R, Gane EJ, George J, Glavini K, Hammond JM, Le Pogam S, Nájera I, Passe S, Piekarska A, Rodriguez I, Zeuzem S, Chu T. Interferon-free regimens containing setrobuvir for patients with genotype 1 chronic hepatitis C: a randomized, multicenter study. Liver Int 2016; 36:505-14. [PMID: 26519669 DOI: 10.1111/liv.12997] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 10/20/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND & AIMS Setrobuvir is a direct-acting antiviral (DAA) non-nucleoside inhibitor of hepatitis C virus (HCV) polymerase. This study examined interferon-free combinations containing setrobuvir, a ritonavir-boosted protease inhibitor (danoprevir/r) and ribavirin, with/without the nucleoside inhibitor mericitabine in HCV genotype (G)1 patients. METHODS Non-cirrhotic treatment-naïve patients (N = 110) were randomized to five groups. Three groups received a 14-day mericitabine/ribavirin lead-in followed by treatment with 3 DAAs (setrobuvir, danoprevir/r, mericitabine) plus ribavirin for 12 weeks (Group A: G1a; D: G1b) or 24 weeks (B: G1a), and two groups received 2 DAAs (setrobuvir, danoprevir/r) plus ribavirin for 12 weeks (E: G1b) or 24 weeks (C: G1a). Efficacy was defined as sustained virological response (HCV RNA <25 IU/ml after 12 weeks' follow-up, SVR12). RESULTS Two groups met predefined futility criteria for breakthrough (C) or relapse (A) and were discontinued. SVR12 rates were 42.9% (3/7) and 74.1% (20/27) in G1a patients in Groups A and B, respectively, and 95.7% (22/23) and 68.2% (15/22) in G1b patients in Groups D and E respectively. All G1a patients assigned to 24 weeks of treatment who experienced a decrease in HCV RNA of ≥2.3 log10 IU by the end of the lead-in period (n = 28) achieved SVR12. Overall, treatment was well tolerated and most adverse events were mild to moderate. No major safety signals were identified. CONCLUSIONS An interferon-free setrobuvir-based regimen (3 DAAs plus ribavirin) is safe and effective in treatment-naïve G1 patients.
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Affiliation(s)
| | | | | | | | - Jacob George
- Storr Liver Unit, Westmead Hospital and University of Sydney, Westmead, NSW, Australia
| | - Katerina Glavini
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Janet M Hammond
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | | | - Isabel Nájera
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | | | - Anna Piekarska
- Department of Infectious Diseases and Hepatology, Medical University of Łódź, Łódź, Poland
| | | | - Stefan Zeuzem
- Medizinische Klinik I, Johann-Wolfgang-Goethe University Hospital, Frankfurt, Germany
| | - Tom Chu
- Roche Innovation Center, New York, NY, USA
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Wedemeyer H, Forns X, Hézode C, Lee SS, Scalori A, Voulgari A, Le Pogam S, Nájera I, Thommes JA. Mericitabine and Either Boceprevir or Telaprevir in Combination with Peginterferon Alfa-2a plus Ribavirin for Patients with Chronic Hepatitis C Genotype 1 Infection and Prior Null Response: The Randomized DYNAMO 1 and DYNAMO 2 Studies. PLoS One 2016; 11:e0145409. [PMID: 26752189 PMCID: PMC4713467 DOI: 10.1371/journal.pone.0145409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 12/01/2015] [Indexed: 12/15/2022] Open
Abstract
UNLABELLED Most patients with chronic hepatitis C virus (HCV) genotype 1 infection who have had a previous null response (<2-log10 reduction in HCV RNA by treatment week 12) to peginterferon/ribavirin (PegIFN/RBV) do not achieve a sustained virological response (SVR) when re-treated with a first-generation HCV protease inhibitor (PI) administered in combination with PegIFN/RBV. We studied the incremental benefits associated with adding mericitabine (nucleoside analog inhibitor of HCV polymerase) to PI plus PegIFN alfa-2a/RBV-based therapy in two double-blind randomized multicenter phase 2 trials (with boceprevir in DYNAMO 1, and with telaprevir in DYNAMO 2). The primary endpoint in both trials was SVR, defined as HCV RNA <25 IU/mL 12 weeks after the end of treatment (SVR12). Overall, the addition of mericitabine to PI plus PegIFN alfa-2a/RBV therapy resulted in SVR12 rates of 60-70% in DYNAMO 1 and of 71-96% in DYNAMO 2. SVR12 rates were similar in patients infected with HCV genotype 1a and 1b in both trials. The placebo control arms in both studies were stopped because of high rates of virological failure. Numerically lower relapse rates were associated with longer treatment with mericitabine (24 versus 12 weeks), telaprevir-containing regimens, and regimens that included 48 weeks of PegIFN alfa-2a/RBV therapy. No mericitabine resistance mutations were identified in any patient in either trial. The addition of mericitabine did not add to the safety burden associated with either telaprevir or boceprevir-based regimens. These studies demonstrate increased SVR rates and reduced relapse rates in difficult-to-treat patients when a nucleoside polymerase inhibitor with intermediate antiviral potency is added to regimens containing a first-generation PI. TRIAL REGISTRATION ClinicalTrials.gov NCT01482403 and ClinicalTrials.gov NCT01482390.
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Affiliation(s)
- Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology at Hannover Medical School, Hannover, Germany
| | - Xavier Forns
- Liver Unit, Hospital Clinic, IDIBAPS and CIBEREHD, Barcelona, Spain
| | - Christophe Hézode
- Department of Hepatology and Gastroenterology, Hôpital Henri Mondor, INSERM U955, Université Paris-Est, Créteil, France
| | | | - Astrid Scalori
- Global Product Development Immunology, Respiratory, Roche Products Ltd, Welwyn, United Kingdom
| | - Athina Voulgari
- Global Product Development Clinical Science, Roche Products Ltd, Welwyn, United Kingdom
| | - Sophie Le Pogam
- Clinical Development-Infectious Diseases, Genentech Inc., South San Francisco, California, United States of America
| | - Isabel Nájera
- Roche Pharma and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - James A. Thommes
- Product Development Immunology, Genentech Inc., South San Francisco, California, United States of America
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Feld JJ, Jacobson IM, Jensen DM, Foster GR, Pol S, Tam E, Jablkowski M, Berak H, Vierling JM, Yoshida EM, Perez-Gomez HR, Scalori A, Hooper GJ, Tavel JA, Navarro MT, Shahdad S, Kulkarni R, Le Pogam S, Nájera I, Eng S, Lim CY, Shulman NS, Yetzer ES. Randomized study of danoprevir/ritonavir-based therapy for HCV genotype 1 patients with prior partial or null responses to peginterferon/ribavirin. J Hepatol 2015; 62:294-302. [PMID: 25239078 DOI: 10.1016/j.jhep.2014.09.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 08/06/2014] [Accepted: 09/10/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND & AIMS Chronic hepatitis C treatment for prior non-responders to peginterferon (PegIFN)/ribavirin remains suboptimal. The MATTERHORN study evaluated regimens containing ritonavir-boosted danoprevir (danoprevir/r) in prior PegIFN alfa/ribavirin non-responders. METHODS Prior partial responders (N=152) were randomized to 24 weeks of twice-daily danoprevir/r 100/100mg, mericitabine 1000 mg and ribavirin 1000/1200 mg (IFN-free); danoprevir/r plus PegIFN alfa-2a/ribavirin (triple); or danoprevir/r, mericitabine and PegIFN alfa-2a/ribavirin (Quad). Prior null responders (N=229) were randomized to 24 weeks of IFN-free therapy, or quad alone (Quad 24) or quad plus 24-weeks of PegIFN alfa-2a/ribavirin (Quad 48). The primary endpoint was sustained virological response (HCV RNA <25 IU/ml) 24 weeks after end-of-treatment (SVR24). Due to high relapse rates, genotype (G) 1a patients in IFN-free arms were offered additional PegIFN alfa-2a/ribavirin. RESULTS Among prior partial responders, SVR24 rates were 46.2%, 51.0%, and 86.0%, in the IFN-free, Triple and Quad arms, respectively; among prior null responders, SVR24 rates were 45.5%, 80.5%, and 83.8% respectively. Relapse rates were lower and SVR24 rates higher in G1b-infected than G1a-infected patients. SVR24 rates in G1a and G1b patients randomized to Quad were 75.0% and 96.2%, respectively, in the partial Quad arm, and 68.1% and 100%, respectively, in the null Quad 24 arm. Treatment failure was associated with resistance to danoprevir, but not to mericitabine, and was more common in G1a infected patients. Treatment was well-tolerated. CONCLUSIONS Danoprevir/r, mericitabine plus PegIFN alfa-2a/ribavirin was well-tolerated and produced high overall SVR24 rates in prior partial and null responders to PegIFN alfa/ribavirin. In contrast, IFN-free regimens were associated with unacceptably high relapse rates.
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Affiliation(s)
- Jordan J Feld
- Toronto Centre for Liver Disease, McLaughlin-Rotman Centre for Global Health, Toronto, ON, Canada.
| | - Ira M Jacobson
- Center for the Study of Hepatitis C, Weill Cornell Medical College, New York, NY, USA
| | - Donald M Jensen
- Center for Liver Diseases, University of Chicago Hospitals, Chicago, IL, USA
| | - Graham R Foster
- Queen Mary, University of London, Institute of Cellular and Molecular Sciences, London, UK
| | - Stanislas Pol
- Hôpital Cochin, Université Paris Descartes and INSERM U1610, Paris, France
| | | | | | - Hanna Berak
- Hospital of Infectious Diseases, Warsaw, Poland
| | | | | | - Héctor R Perez-Gomez
- Hospital Civil de Guadalajara, Instituto de Patologia Infecciosa, Universidad de Guadalajara, Guadalajara, Mexico
| | | | | | | | | | | | | | | | | | - Simon Eng
- Genentech, South San Francisco, CA, USA
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Everson G, Cooper C, Hézode C, Shiffman ML, Yoshida E, Beltran-Jaramillo T, Andreone P, Bruno S, Ferenci P, Zeuzem S, Brunda M, Le Pogam S, Nájera I, Zhou J, Navarro MT, Voulgari A, Shulman NS, Yetzer ES. DAUPHINE: a randomized phase II study of danoprevir/ritonavir plus peginterferon alpha-2a/ribavirin in HCV genotypes 1 or 4. Liver Int 2015; 35:108-19. [PMID: 24517252 DOI: 10.1111/liv.12471] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 01/11/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Danoprevir is a hepatitis C virus (HCV) protease inhibitor with activity against genotypes (G)1/G4, which is maintained at lower doses by ritonavir-boosting. We report results of a large, randomized, active-controlled phase IIb study of ritonavir-boosted danoprevir (danoprevir/r) plus peginterferon alpha-2a/ribavirin (P/R) in treatment-naive patients with HCV G1/4 infection. METHODS Treatment-naive patients with HCV G1/4 infection were randomized to twice-daily danoprevir/r 200/100 mg (A, n = 92); 100/100 mg (B, n = 93); or 50/100 mg (C, n = 94) plus P/R for 24 weeks; twice-daily danoprevir/r 100/100 mg (D, n = 94) plus P/R for 12 or 24 weeks; or P/R alone (E, n = 44) for 48 weeks. Patients in the response-guided therapy arm (D) with an extended rapid virological response (eRVR2: HCV RNA <15 IU/ml during Weeks 2-10) stopped all therapy at Week 12; non-eRVR2 patients continued all treatment to Week 24. The primary efficacy endpoint was sustained the virological response (SVR24: HCV RNA <15 IU/ml after 24 weeks of untreated follow-up). RESULTS SVR24 rates in Arms A, B, C, D and E were 89.1%, 78.5%, 66.0%, 69.1% and 36.4%, respectively, in the overall population; 83.6%, 69.6%, 60.3%, 59.2% and 38.5% in G1a-infected patients, 96.6%, 93.1%, 73.1%, 78.4% and 28.6% in G1b-infected patients and 100%, 87.5%, 100%, 100% and 66.7% in G4-infected patients. Danoprevir/r plus P/R was generally well tolerated compared with P/R alone. There was a higher incidence of serious adverse events in danoprevir-treatment arms, but most were associated with P/R. CONCLUSIONS The combination of danoprevir/r plus P/R is efficacious in treatment-naïve patients with HCV genotype 1 or 4 infection.
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Gane EJ, Pockros PJ, Zeuzem S, Marcellin P, Shikhman A, Bernaards C, Zhou J, Yetzer ES, Ballester R, Dwyer C, Tong X, Nájera I, Bertasso A, Hammond J, Kindrick A, Morcos PN, Smith P, Stancic S, Shulman NS. Mericitabine and ritonavir-boosted danoprevir with or without ribavirin in treatment-naive HCV genotype 1 patients: INFORM-SVR study. Liver Int 2015; 35:79-89. [PMID: 24814388 DOI: 10.1111/liv.12588] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 04/30/2014] [Indexed: 02/13/2023]
Abstract
BACKGROUND & AIMS Safety and tolerability of peginterferon-based hepatitis C virus (HCV) infection therapy remains suboptimal, even when direct-acting antiviral agents are added. This study assessed the efficacy, safety and tolerability of mericitabine combined with ritonavir-boosted danoprevir (danoprevir/r) ± ribavirin for up to 24 weeks in treatment-naïve HCV genotype (G)1 infected patients. METHODS Patients received twice daily mericitabine (1000 mg) and danoprevir/r (100 mg/100 mg) plus either ribavirin (1000/1200 mg/day; Arm A) or placebo (Arm B) for 12 or 24 weeks. Patients with HCV RNA <43 IU/ml between Weeks 2 and 8 and HCV RNA <15 IU/ml at Week 10 were rerandomized (1:1) at Week 12 to discontinue/continue assigned regimens until Week 24. Because of unacceptable relapse rates in both 12-week arms and in ribavirin-free Arm B, treatment was extended to 24 weeks and patients in Arm B received peginterferon alfa-2a/ribavirin. The primary outcome was sustained virological response 24 weeks after end of treatment (SVR24). RESULTS In Arm A, the SVR24 rate in patients receiving 24 weeks of therapy was 37.9% (25/66); 63.6% (14/22) in G1b and 25.0% (11/44) in G1a patients. Virologic breakthrough and relapse were associated with danoprevir-resistant virus in most cases. The mericitabine-resistance mutation (NS5BS282T) was detected in two patients bearing dual resistant virus NS3 R155K/NS5B S282T and dual resistance mutation L159F/L320F in one patient. Treatment was safe and well tolerated. CONCLUSIONS Mericitabine, danoprevir/r plus ribavirin for 24 weeks were safe and well tolerated. However, SVR rates were poor, achieving rates of only 25.0% in G1a and 63.6% in G1b patients.
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8
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Meistermann H, Gao J, Golling S, Lamerz J, Le Pogam S, Tzouros M, Sankabathula S, Gruenbaum L, Nájera I, Langen H, Klumpp K, Augustin A. A novel immuno-competitive capture mass spectrometry strategy for protein-protein interaction profiling reveals that LATS kinases regulate HCV replication through NS5A phosphorylation. Mol Cell Proteomics 2014; 13:3040-8. [PMID: 25044019 DOI: 10.1074/mcp.m113.028977] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Mapping protein-protein interactions is essential to fully characterize the biological function of a protein and improve our understanding of diseases. Affinity purification coupled to mass spectrometry (AP-MS) using selective antibodies against a target protein has been commonly applied to study protein complexes. However, one major limitation is a lack of specificity as a substantial part of the proposed binders is due to nonspecific interactions. Here, we describe an innovative immuno-competitive capture mass spectrometry (ICC-MS) method to allow systematic investigation of protein-protein interactions. ICC-MS markedly increases the specificity of classical immunoprecipitation (IP) by introducing a competition step between free and capturing antibody prior to IP. Instead of comparing only one experimental sample with a control, the methodology generates a 12-concentration antibody competition profile. Label-free quantitation followed by a robust statistical analysis of the data is then used to extract the cellular interactome of a protein of interest and to filter out background proteins. We applied this new approach to specifically map the interactome of hepatitis C virus (HCV) nonstructural protein 5A (NS5A) in a cellular HCV replication system and uncovered eight new NS5A-interacting protein candidates along with two previously validated binding partners. Follow-up biological validation experiments revealed that large tumor suppressor homolog 1 and 2 (LATS1 and LATS2, respectively), two closely related human protein kinases, are novel host kinases responsible for NS5A phosphorylation at a highly conserved position required for optimal HCV genome replication. These results are the first illustration of the value of ICC-MS for the analysis of endogenous protein complexes to identify biologically relevant protein-protein interactions with high specificity.
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Affiliation(s)
- Hélène Meistermann
- From the ‡Pharma Research and Early Development Department, F. Hoffmann-La Roche Ltd, Basel 4070, Switzerland and
| | - Junjun Gao
- the ¶Pharma Research and Early Development Department, F. Hoffmann-La Roche Ltd, Nutley, NJ, 07110-1199
| | - Sabrina Golling
- From the ‡Pharma Research and Early Development Department, F. Hoffmann-La Roche Ltd, Basel 4070, Switzerland and
| | - Jens Lamerz
- From the ‡Pharma Research and Early Development Department, F. Hoffmann-La Roche Ltd, Basel 4070, Switzerland and
| | - Sophie Le Pogam
- the ¶Pharma Research and Early Development Department, F. Hoffmann-La Roche Ltd, Nutley, NJ, 07110-1199
| | - Manuel Tzouros
- From the ‡Pharma Research and Early Development Department, F. Hoffmann-La Roche Ltd, Basel 4070, Switzerland and
| | - Sailaja Sankabathula
- the ¶Pharma Research and Early Development Department, F. Hoffmann-La Roche Ltd, Nutley, NJ, 07110-1199
| | - Lore Gruenbaum
- the ¶Pharma Research and Early Development Department, F. Hoffmann-La Roche Ltd, Nutley, NJ, 07110-1199
| | - Isabel Nájera
- the ¶Pharma Research and Early Development Department, F. Hoffmann-La Roche Ltd, Nutley, NJ, 07110-1199
| | - Hanno Langen
- From the ‡Pharma Research and Early Development Department, F. Hoffmann-La Roche Ltd, Basel 4070, Switzerland and
| | - Klaus Klumpp
- the ¶Pharma Research and Early Development Department, F. Hoffmann-La Roche Ltd, Nutley, NJ, 07110-1199
| | - Angélique Augustin
- From the ‡Pharma Research and Early Development Department, F. Hoffmann-La Roche Ltd, Basel 4070, Switzerland and
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9
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Talamas FX, Abbot SC, Anand S, Brameld KA, Carter DS, Chen J, Davis D, de Vicente J, Fung AD, Gong L, Harris SF, Inbar P, Labadie SS, Lee EK, Lemoine R, Le Pogam S, Leveque V, Li J, McIntosh J, Nájera I, Park J, Railkar A, Rajyaguru S, Sangi M, Schoenfeld RC, Staben LR, Tan Y, Taygerly JP, Villaseñor AG, Weller PE. Discovery of N-[4-[6-tert-butyl-5-methoxy-8-(6-methoxy-2-oxo-1H-pyridin-3-yl)-3-quinolyl]phenyl]methanesulfonamide (RG7109), a potent inhibitor of the hepatitis C virus NS5B polymerase. J Med Chem 2014; 57:1914-31. [PMID: 24195700 PMCID: PMC3954946 DOI: 10.1021/jm401329s] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In the past few years, there have been many advances in the efforts to cure patients with hepatitis C virus (HCV). The ultimate goal of these efforts is to develop a combination therapy consisting of only direct-antiviral agents (DAAs). In this paper, we discuss our efforts that led to the identification of a bicyclic template with potent activity against the NS5B polymerase, a critical enzyme on the life cycle of HCV. In continuation of our exploration to improve the stilbene series, the 3,5,6,8-tetrasubstituted quinoline core was identified as replacement of the stilbene moiety. 6-Methoxy-2(1H)-pyridone was identified among several heterocyclic headgroups to have the best potency. Solubility of the template was improved by replacing a planar aryl linker with a saturated pyrrolidine. Profiling of the most promising compounds led to the identification of quinoline 41 (RG7109), which was selected for advancement to clinical development.
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Affiliation(s)
- Francisco X. Talamas
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Sarah C. Abbot
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Shalini Anand
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Ken A. Brameld
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - David S. Carter
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Jun Chen
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Dana Davis
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Javier de Vicente
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Amy D. Fung
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Leyi Gong
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Seth F. Harris
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Petra Inbar
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Sharada S. Labadie
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Eun K. Lee
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Remy Lemoine
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Sophie Le Pogam
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Vincent Leveque
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Jim Li
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Joel McIntosh
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Isabel Nájera
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Jaehyeon Park
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Aruna Railkar
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Sonal Rajyaguru
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Michael Sangi
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Ryan C. Schoenfeld
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Leanna R. Staben
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Yunchou Tan
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Joshua P. Taygerly
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Armando G. Villaseñor
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
| | - Paul E. Weller
- Hoffmann-La Roche Inc., Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States
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10
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Tong X, Le Pogam S, Li L, Haines K, Piso K, Baronas V, Yan JM, So SS, Klumpp K, Nájera I. In vivo emergence of a novel mutant L159F/L320F in the NS5B polymerase confers low-level resistance to the HCV polymerase inhibitors mericitabine and sofosbuvir. J Infect Dis 2013; 209:668-75. [PMID: 24154738 DOI: 10.1093/infdis/jit562] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Resistance to mericitabine (prodrug of HCV NS5B polymerase inhibitor PSI-6130) is rare and conferred by the NS5B S282T mutation. METHODS Serum HCV RNA from patients who experienced viral breakthrough, partial response, or nonresponse in 2 clinical trials in which patients received mericitabine plus peginterferon alfa-2a (40KD)/ribavirin were analyzed by population and clonal sequence analysis as well as phenotypic assay for assessment of in vivo mericitabine resistance. RESULTS Among 405 patients treated with mericitabine plus peginterferon alfa-2a/ribavirin in PROPEL and JUMP-C, virologic breakthrough or nonresponse were not observed; 12 patients experienced a partial response. The NS5B S282T resistance mutation was not observed in any patient. A number of treatment-associated NS5B changes were observed and characterized. A novel double mutant (L159F/L320F) with impaired replication capacity was detected in one HCV genotype 1b-infected patient. Introduction of double mutant L159F/L320F into genotype 1a (H77) and 1b (Con-1) replicons, respectively, increased the EC50 for mericitabine by 3.1- and 5.5-fold and the EC90 by 3.1- and 8.9-fold. The double mutant also decreased susceptibility to sofosbuvir (GS-7977) and GS-938 but not setrobuvir, relative to wild-type. CONCLUSIONS A novel and replication-deficient double mutation (L159F/L320F) confers low-level resistance to mericitabine and cross-resistance to both sofosbuvir and GS-938. CLINICAL TRIALS REGISTRATION NCT00869661, NCT01057667.
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Affiliation(s)
- Xiao Tong
- Hoffmann-La Roche Inc, Nutley, New Jersey
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11
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Marcellin P, Cooper C, Balart L, Larrey D, Box T, Yoshida E, Lawitz E, Buggisch P, Ferenci P, Weltman M, Labriola-Tompkins E, Le Pogam S, Nájera I, Thomas D, Hooper G, Shulman NS, Zhang Y, Navarro MT, Lim CY, Brunda M, Terrault NA, Yetzer ES. Randomized controlled trial of danoprevir plus peginterferon alfa-2a and ribavirin in treatment-naïve patients with hepatitis C virus genotype 1 infection. Gastroenterology 2013; 145:790-800.e3. [PMID: 23811112 DOI: 10.1053/j.gastro.2013.06.051] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 06/20/2013] [Accepted: 06/20/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS The combination of a hepatitis C virus (HCV) protease inhibitor, peginterferon, and ribavirin is the standard of care for patients with HCV genotype 1 infection. We report the efficacy and safety of response-guided therapy with danoprevir (a potent second-generation protease inhibitor), peginterferon alfa-2a (40 KD), and ribavirin in these patients. METHODS Treatment-naïve patients (N = 237) were randomly assigned to groups given 12 weeks of danoprevir (300 mg every 8 hours; 600 mg every 12 hours, and 900 mg every 12 hours) or placebo plus peginterferon alfa-2a and ribavirin, followed by peginterferon alfa-2a and ribavirin. Patients given danoprevir who had an extended rapid virologic response (eRVR4-20: HCV RNA <15 IU/mL during weeks 4-20) stopped therapy at week 24; those without an eRVR4-20 continued therapy to 48 weeks. Patients who were given placebo received 48 weeks of peginterferon alfa-2a and ribavirin. The primary efficacy end point was sustained virologic response (SVR: HCV RNA <15 IU/mL after 24 weeks without treatment). RESULTS Rates of SVR were higher among patients given danoprevir 300 mg (68%), 600 mg (85%), and 900 mg (76%) than placebo (42%) (95% confidence interval: 26%-59%). Seventy-nine percent of patients given danoprevir 600 mg had an eRVR4-20; among these, 96% had an SVR. Serious adverse events were reported in 7% to 8% of patients given danoprevir and 19% given placebo. Four patients given danoprevir (1 patient in the 600-mg group and 3 in the 900-mg group) had reversible, grade 4 increases in alanine aminotransferase, which led to early discontinuation of the 900-mg arm of the study. CONCLUSIONS The combination of danoprevir, peginterferon alfa-2a, and ribavirin leads to high rates of SVR in patients with HCV genotype 1 infection, but high doses of danoprevir can lead to grade 4 increases in alanine aminotransferase. Studies of lower doses of danoprevir with ritonavir, to reduce overall danoprevir exposure while maintaining potent antiviral activity, are underway; Clinicaltrials.gov number, NCT00963885.
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12
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Talamas FX, Ao-Ieong G, Brameld KA, Chin E, de Vicente J, Dunn JP, Ghate M, Giannetti AM, Harris SF, Labadie SS, Leveque V, Li J, Lui AST, McCaleb KL, Nájera I, Schoenfeld RC, Wang B, Wong A. De novo fragment design: a medicinal chemistry approach to fragment-based lead generation. J Med Chem 2013; 56:3115-9. [PMID: 23509929 DOI: 10.1021/jm4002605] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The use of fragments with low binding affinity for their targets as starting points has received much attention recently. Screening of fragment libraries has been the most common method to find attractive starting points. Herein, we describe a unique, alternative approach to generating fragment leads. A binding model was developed and a set of guidelines were then selected to use this model to design fragments, enabling our discovery of a novel fragment with high LE.
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Affiliation(s)
- Francisco X Talamas
- Hoffmann-La Roche Inc, Pharma Research & Early Development, 340 Kingsland Street, Nutley, New Jersey 07110, United States.
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13
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Lim SR, Qin X, Susser S, Nicholas JB, Lange C, Herrmann E, Hong J, Arfsten A, Hooi L, Bradford W, Nájera I, Smith P, Zeuzem S, Kossen K, Sarrazin C, Seiwert SD. Virologic escape during danoprevir (ITMN-191/RG7227) monotherapy is hepatitis C virus subtype dependent and associated with R155K substitution. Antimicrob Agents Chemother 2012; 56:271-9. [PMID: 22064535 PMCID: PMC3256012 DOI: 10.1128/aac.05636-11] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 10/26/2011] [Indexed: 01/03/2023] Open
Abstract
Danoprevir is a hepatitis C virus (HCV) NS3/4A protease inhibitor that promotes multi-log(10) reductions in HCV RNA when administered as a 14-day monotherapy to patients with genotype 1 chronic HCV. Of these patients, 14/37 experienced a continuous decline in HCV RNA, 13/37 a plateau, and 10/37 a rebound. The rebound and continuous-decline groups experienced similar median declines in HCV RNA through day 7, but their results diverged notably at day 14. Plateau group patients experienced a lesser, but sustained, median HCV RNA decline. Baseline danoprevir susceptibility was similar across response groups but was reduced significantly at day 14 in the rebound group. Viral rebound in genotype 1b was uncommon (found in 2/23 patients). Population-based sequence analysis of NS3 and NS4A identified treatment-emergent substitutions at four amino acid positions in the protease domain of NS3 (positions 71, 155, 168, and 170), but only two (155 and 168) were in close proximity to the danoprevir binding site and carried substitutions that impacted danoprevir potency. R155K was the predominant route to reduced danoprevir susceptibility and was observed in virus isolated from all 10 rebound, 2/13 plateau, and 1/14 continuous-decline patients. Virus in one rebound patient additionally carried partial R155Q and D168E substitutions. Treatment-emergent substitutions in plateau patients were less frequently observed and more variable. Single-rebound patients carried virus with R155Q, D168V, or D168T. Clonal sequence analysis and drug susceptibility testing indicated that only a single patient displayed multiple resistance pathways. These data indicate the ascendant importance of R155K for viral escape during danoprevir treatment and may have implications for the clinical use of this agent.
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14
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Gane EJ, Rouzier R, Stedman C, Wiercinska-Drapalo A, Horban A, Chang L, Zhang Y, Sampeur P, Nájera I, Smith P, Shulman NS, Tran JQ. Antiviral activity, safety, and pharmacokinetics of danoprevir/ritonavir plus PEG-IFN α-2a/RBV in hepatitis C patients. J Hepatol 2011; 55:972-9. [PMID: 21354234 DOI: 10.1016/j.jhep.2011.01.046] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 12/22/2010] [Accepted: 01/30/2011] [Indexed: 12/31/2022]
Abstract
BACKGROUND & AIMS Danoprevir (RG7227; ITMN-191) is a potent inhibitor of the HCV NS3/4A serine protease. The aims of this double-blind, placebo-controlled, multiple-ascending dose phase Ib study were to evaluate safety, tolerability, antiviral activity, resistance, and pharmacokinetics of once- and twice-daily danoprevir in the presence of low-dose ritonavir (danoprevir/r) and in combination with peginterferon alfa-2a (40KD)/ribavirin in treatment-naive HCV genotype 1 patients. METHODS Thirty eligible patients were enrolled into three cohorts and treated with danoprevir/r or placebo/r all in combination with peginterferon alfa-2a (40KD)/ribavirin for 15 days. Cohort 1 received danoprevir/r at 100/100mg twice daily; Cohort 2 200/100mg once daily; and Cohort 3 200/100mg twice daily. RESULTS The median reductions in HCV RNA from baseline after 14 days of treatment (day 15) were -5.1, -4.8, and -4.6 log(10)IU/ml in Cohorts 1, 2, and 3, respectively, and -2.7 log(10) in placebo/r and peginterferon alfa-2a (40KD)/ribavirin recipients. Viral breakthrough was not observed in any patient. On day 15, HCV RNA was undetectable (<15IU/ml) in 6/9 (67%), 4/8 (50%), and 8/8 (100%) patients in Cohorts 1, 2, and 3, respectively. When co-administered with low dose ritonavir, danoprevir concentrations reached a steady state between 6 to 10 days of dosing. Danoprevir exposures increased more than dose proportionally between 100/100mg and 200/100mg. Danoprevir/r plus peginterferon alfa-2a (40KD)/ribavirin was well-tolerated with no safety-related discontinuations. CONCLUSIONS Danoprevir/r plus peginterferon alfa-2a (40KD)/ribavirin provides profound and robust reductions in serum HCV RNA, at substantially lower systemic exposures compared to those observed with higher doses of danoprevir in the absence of ritonavir. These results support further studies of danoprevir/r.
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15
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Le Pogam S, Seshaadri A, Ewing A, Kang H, Kosaka A, Yan JM, Berrey M, Symonds B, De La Rosa A, Cammack N, Nájera I. RG7128 alone or in combination with pegylated interferon-α2a and ribavirin prevents hepatitis C virus (HCV) Replication and selection of resistant variants in HCV-infected patients. J Infect Dis 2010; 202:1510-9. [PMID: 20942646 DOI: 10.1086/656774] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION RG7128 (prodrug of PSI-6130) shows potent antiviral efficacy in patients infected with hepatitis C virus (HCV) genotypes 1, 2, or 3, with mean viral load decreases of 2.7 and 5 log(10) IU/mL, respectively, associated with 1500-mg doses twice daily after monotherapy for 2 weeks and with 1000-mg and 1500-mg doses twice daily after treatment in combination with the standard of care (SOC) for 4 weeks. RESULTS From 32 patients treated with RG7128 monotherapy for 2 weeks, marginal viral load rebound was observed in 3 HCV genotype 1-infected patients, whereas partial response was observed in 2 genotype 1-infected patients. From 85 patients receiving RG7128 in combination with SOC, 1 HCV genotype 1-infected patient experienced a viral rebound, and 2 genotype 3-infected patients experienced a transient rebound. Five genotype 1-infected patients had an HCV load of >1000 IU/mL at the end of 4-week treatment. No viral resistance was observed, per NS5B sequencing and phenotypic studies. PSI-6130 resistance substitution S282T needs to be present at levels of ≥90% within a patient's quasispecies to confer low-level resistance. No evidence of S282T was found by population or clonal sequence analyses. CONCLUSIONS The requirement for a predominant S282T mutant quasispecies, its low replication capacity, and the low-level resistance it confers probably contribute to the lack of RG7128 resistance observed in HCV-infected patients.
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16
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Chua PK, McCown MF, Rajyaguru S, Kular S, Varma R, Symons J, Chiu SS, Cammack N, Nájera I. Modulation of alpha interferon anti-hepatitis C virus activity by ISG15. J Gen Virol 2009; 90:2929-2939. [DOI: 10.1099/vir.0.013128-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
ISG15 has recently been reported to possess antiviral properties against viruses, both in vivo and in vitro. Knock-down of ISG15 gene expression by small interfering RNA followed by alpha interferon (IFN-α) treatment in Huh-7 cells resulted in an increased phenotypic sensitivity to IFN-α, as determined by measuring hepatitis C virus (HCV) RNA replication inhibition in stably transfected HCV replicon cells and in cells infected with genotype 1a HCVcc (infectious HCV). This IFN-α-specific effect, which was not observed with IFN-γ, correlated with an increase in expression of the IFN-α-inducible genes IFI6, IFITM3, OAS1 and MX1, whereas the expression of the non-IFN-α-inducible genes PTBP-1 and JAK1 remained unchanged. It has previously been reported that, unlike ISG15 knock-down, increased sensitivity to IFN-α after knock-down of USP18 occurs through the prolonged phosphorylation of STAT-1. Combination knock-down of ISG15 and USP18 resulted in a moderate increase in IFN-α-inducible gene expression compared with single ISG15 or USP18 knock-down. Furthermore, the phenotype of increased gene expression after ISG15 knock-down and IFN-α treatment was also observed in non-hepatic cell lines A549 and HeLa. Taken together, these results reveal a novel function for ISG15 in the regulation of the IFN-α pathway and its antiviral effect.
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Affiliation(s)
- Pong Kian Chua
- Roche Palo Alto LLC, 3431 Hillview Avenue, Palo Alto, CA 94304, USA
| | | | - Sonal Rajyaguru
- Roche Palo Alto LLC, 3431 Hillview Avenue, Palo Alto, CA 94304, USA
| | - Simran Kular
- Roche Palo Alto LLC, 3431 Hillview Avenue, Palo Alto, CA 94304, USA
| | - Ram Varma
- Roche Palo Alto LLC, 3431 Hillview Avenue, Palo Alto, CA 94304, USA
| | - Julian Symons
- Roche Palo Alto LLC, 3431 Hillview Avenue, Palo Alto, CA 94304, USA
| | - Sophie S. Chiu
- Roche Palo Alto LLC, 3431 Hillview Avenue, Palo Alto, CA 94304, USA
| | - Nick Cammack
- Roche Palo Alto LLC, 3431 Hillview Avenue, Palo Alto, CA 94304, USA
| | - Isabel Nájera
- Roche Palo Alto LLC, 3431 Hillview Avenue, Palo Alto, CA 94304, USA
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17
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Hang JQ, Yang Y, Harris SF, Leveque V, Whittington HJ, Rajyaguru S, Ao-Ieong G, McCown MF, Wong A, Giannetti AM, Le Pogam S, Talamás F, Cammack N, Nájera I, Klumpp K. Slow binding inhibition and mechanism of resistance of non-nucleoside polymerase inhibitors of hepatitis C virus. J Biol Chem 2009; 284:15517-29. [PMID: 19246450 DOI: 10.1074/jbc.m808889200] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The binding affinity of four palm and thumb site representative non-nucleoside inhibitors (NNIs) of HCV polymerase NS5B to wild-type and resistant NS5B polymerase proteins was determined, and the influence of RNA binding on NNI binding affinity was investigated. NNIs with high binding affinity potently inhibited HCV RNA polymerase activity and replicon replication. Among the compounds tested, HCV-796 showed slow binding kinetics to NS5B. The binding affinity of HCV-796 to NS5B increased 27-fold over a 3-h incubation period with an equilibrium Kd of 71 +/- 2 nm. Slow binding kinetics of HCV-796 was driven by slow dissociation from NS5B with a k(off) of 4.9 +/- 0.5 x 10(-4) s(-1). NS5B bound a long, 378-nucleotide HCV RNA oligonucleotide with high affinity (Kd = 6.9 +/- 0.3 nm), whereas the binding affinity was significantly lower for a short, 21-nucleotide RNA (Kd = 155.1 +/- 16.2 nm). The formation of the NS5B-HCV RNA complex did not affect the slow binding kinetics profile and only slightly reduced NS5B binding affinity of HCV-796. The magnitude of reduction of NNI binding affinity for the NS5B proteins with various resistance mutations in the palm and thumb binding sites correlated well with resistance -fold shifts in NS5B polymerase activity and replicon assays. Co-crystal structures of NS5B-Con1 and NS5B-BK with HCV-796 revealed a deep hydrophobic binding pocket at the palm region of NS5B. HCV-796 interaction with the induced binding pocket on NS5B is consistent with slow binding kinetics and loss of binding affinity with mutations at amino acid position 316.
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Affiliation(s)
- Julie Qi Hang
- Roche Palo Alto LLC, Palo Alto, California 94304, USA
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Maffuz A, Barroso-Bravo S, Nájera I, Zarco G, Alvarado-Cabrero I, Rodríguez-Cuevas SA. Tumor size as predictor of microinvasion, invasion, and axillary metastasis in ductal carcinoma in situ. J Exp Clin Cancer Res 2006; 25:223-7. [PMID: 16918134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Ductal carcinoma in situ (DCIS) represents a small number of cases in countries with inadequate breast cancer screening programs, and in the majority of cases is diagnosed as a palpable lump. It has been proposed that DCIS with palpable lump > or = 2.5 cm can be associated with microinvasion or invasive carcinoma and risk of axillary metastasis. The purpose of the present study is to evaluate incidence of microinvasion, invasion, and the role of lymphatic mapping and sentinel lymph node biopsy in DCIS > or = 2.5 cm. We conducted a retrospective analysis of patients with histologically proven incisional, excisional, or core biopsy of DCIS lump > or = 2.5 cm at a tertiary-care hospital. All patients underwent lymphatic mapping with sentinel lymph node biopsy.A total of 24 patients were included with average tumor size of 4 cm (range, 2.5-6 cm); 29% had microinvasive and 12.5% had invasive disease, three patients (12.5%) had positive sentinel lymph node, all had micrometastasis, and no metastasis were found in non-sentinel lymph nodes. Incidence of microinvasion and invasion were directly related with tumor size (10% for DCIS tumor size of 2.5-3.5 cm, 57% for 3.6-4.5 cm, and 71% for tumors between 4.5 and 6 cm). In addition, axillary metastasis incidence had a direct relationship with tumor size. (0% in 2.5-3.5-cm tumor size, 14% for 3.6-4.5 cm, and 28% in DCIS between 4.6 and 6.0 cm). The present study shows high incidence of microinvasion and invasion in DCIS diagnosed in tumors > or = 2.5 cm and supports the importance of axillary evaluation in patients with tumors >3.5 cm by means of lymphatic mapping and sentinel lymph node biopsy.
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Affiliation(s)
- A Maffuz
- Breast Tumor Department, Hospital de Oncologia, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
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Le Pogam S, Kang H, Harris SF, Leveque V, Giannetti AM, Ali S, Jiang WR, Rajyaguru S, Tavares G, Oshiro C, Hendricks T, Klumpp K, Symons J, Browner MF, Cammack N, Nájera I. Selection and characterization of replicon variants dually resistant to thumb- and palm-binding nonnucleoside polymerase inhibitors of the hepatitis C virus. J Virol 2006; 80:6146-54. [PMID: 16731953 PMCID: PMC1472602 DOI: 10.1128/jvi.02628-05] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Multiple nonnucleoside inhibitor binding sites have been identified within the hepatitis C virus (HCV) polymerase, including in the palm and thumb domains. After a single treatment with a thumb site inhibitor (thiophene-2-carboxylic acid NNI-1), resistant HCV replicon variants emerged that contained mutations at residues Leu419, Met423, and Ile482 in the polymerase thumb domain. Binding studies using wild-type (WT) and mutant enzymes and structure-based modeling showed that the mechanism of resistance is through the reduced binding of the inhibitor to the mutant enzymes. Combined treatment with a thumb- and a palm-binding polymerase inhibitor had a dramatic impact on the number of replicon colonies able to replicate in the presence of both inhibitors. A more exact characterization through molecular cloning showed that 97.7% of replicons contained amino acid substitutions that conferred resistance to either of the inhibitors. Of those, 65% contained simultaneously multiple amino acid substitutions that conferred resistance to both inhibitors. Double-mutant replicons Met414Leu and Met423Thr were predominantly selected, which showed reduced replication capacity compared to the WT replicon. These findings demonstrate the selection of replicon variants dually resistant to two NS5B polymerase inhibitors binding to different sites of the enzyme. Additionally, these findings provide initial insights into the in vitro mutational threshold of the HCV NS5B polymerase and the potential impact of viral fitness on the selection of multiple-resistant mutants.
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Le Pogam S, Jiang WR, Leveque V, Rajyaguru S, Ma H, Kang H, Jiang S, Singer M, Ali S, Klumpp K, Smith D, Symons J, Cammack N, Nájera I. In vitro selected Con1 subgenomic replicons resistant to 2'-C-methyl-cytidine or to R1479 show lack of cross resistance. Virology 2006; 351:349-59. [PMID: 16713611 DOI: 10.1016/j.virol.2006.03.045] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2005] [Revised: 01/27/2006] [Accepted: 03/29/2006] [Indexed: 02/05/2023]
Abstract
The HCV polymerase is an attractive target for the development of new and specific anti-HCV drugs. Herein, the characterization of the inhibitory effect of 2'-C-Methyl-Cytidine shows that it is a potent inhibitor of both genotype 1b and 1a HCV replicon replication, both of laboratory-optimized as well as of NS5B clinical isolates-chimera replicons. The corresponding 5'-triphosphate derivative is a potent inhibitor of native HCV replicase isolated from replicon cells and of the recombinant genotype 1b and 1a HCV polymerase-mediated RNA synthesis. Resistance to 2'-C-Methyl-Cytidine was mapped to amino acid substitution S282T in the NS5B coding region. Cross-resistance was observed to 2'-C-Methyl-Adenosine but not to interferon alpha-2a, to non-nucleoside HCV polymerase inhibitors or to R1479, a new and potent nucleoside inhibitor of NS5B polymerase. In vitro studies mapped resistance to R1479 to amino acid substitutions S96T and S96T/N142T of the NS5B polymerase. These mutations did not confer resistance to 2-C-Methyl-Cytidine, thus confirming the lack of cross-resistance between these two HCV inhibitors. These data will allow the optimization of new polymerase inhibitors and their use in combination therapy.
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Affiliation(s)
- Sophie Le Pogam
- Roche Palo Alto LLC, S3-1, 3431 Hillview Avenue, Palo Alto, CA 94304, USA
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21
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Klumpp K, Lévêque V, Le Pogam S, Ma H, Jiang WR, Kang H, Granycome C, Singer M, Laxton C, Hang JQ, Sarma K, Smith DB, Heindl D, Hobbs CJ, Merrett JH, Symons J, Cammack N, Martin JA, Devos R, Nájera I. The novel nucleoside analog R1479 (4'-azidocytidine) is a potent inhibitor of NS5B-dependent RNA synthesis and hepatitis C virus replication in cell culture. J Biol Chem 2005; 281:3793-9. [PMID: 16316989 DOI: 10.1074/jbc.m510195200] [Citation(s) in RCA: 180] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Hepatitis C virus (HCV) polymerase activity is essential for HCV replication. Targeted screening of nucleoside analogs identified R1479 (4'-azidocytidine) as a specific inhibitor of HCV replication in the HCV subgenomic replicon system (IC(50) = 1.28 microM) with similar potency compared with 2'-C-methylcytidine (IC(50) = 1.13 microM). R1479 showed no effect on cell viability or proliferation of HCV replicon or Huh-7 cells at concentrations up to 2 mM. HCV replicon RNA could be fully cleared from replicon cells after prolonged incubation with R1479. The corresponding 5'-triphosphate derivative (R1479-TP) is a potent inhibitor of native HCV replicase isolated from replicon cells and of recombinant HCV polymerase (NS5B)-mediated RNA synthesis activity. R1479-TP inhibited RNA synthesis as a CTP-competitive inhibitor with a K(i) of 40 nM. On an HCV RNA-derived template substrate (complementary internal ribosome entry site), R1479-TP showed similar potency of NS5B inhibition compared with 3'-dCTP. R1479-TP was incorporated into nascent RNA by HCV polymerase and reduced further elongation with similar efficiency compared with 3'-dCTP under the reaction conditions. The S282T point mutation in the coding sequence of NS5B confers resistance to inhibition by 2'-C-MeATP and other 2'-methyl-nucleotides. In contrast, the S282T mutation did not confer cross-resistance to R1479.
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Harrigan PR, Stone C, Griffin P, Nájera I, Bloor S, Kemp S, Tisdale M, Larder B. Resistance profile of the human immunodeficiency virus type 1 reverse transcriptase inhibitor abacavir (1592U89) after monotherapy and combination therapy. CNA2001 Investigative Group. J Infect Dis 2000; 181:912-20. [PMID: 10720512 DOI: 10.1086/315317] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Abacavir (1592U89) is a nucleoside inhibitor of human immunodeficiency virus (HIV) type 1 reverse transcriptase (RT). Resistance to abacavir was studied with abacavir alone and with abacavir in combination with other nucleoside analogues in cell culture, in virus isolates from zidovudine/lamivudine clinical trials, and in the first dose-escalating 12-week clinical trial (CNA2001) to evaluate abacavir clinical potency. Abacavir alone in vitro selected for mutations at HIV RT codons K65R, L74V, Y115F, and M184V. However, abacavir combined with zidovudine selected against virus with the M184V mutation. Abacavir therapy in vivo resulted in large decreases in HIV load (>1 log), even in 1 subject who had the M184V mutation at baseline. A total of 51% of subjects showed new mutations at any of codons K65R, L74V, and M184V after abacavir monotherapy, compared with 11% who received zidovudine/abacavir. Small changes (2- to 4-fold) in abacavir susceptibility were detected. On stopping therapy, reselection of the pretherapy sequence occurred within 4 weeks.
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Affiliation(s)
- P R Harrigan
- Clinical Virology, GlaxoWellcome Research and Development, Stevenage, United Kingdom
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23
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Harrigan PR, Kinghorn I, Bloor S, Kemp SD, Nájera I, Kohli A, Larder BA. Significance of amino acid variation at human immunodeficiency virus type 1 reverse transcriptase residue 210 for zidovudine susceptibility. J Virol 1996; 70:5930-4. [PMID: 8709214 PMCID: PMC190612 DOI: 10.1128/jvi.70.9.5930-5934.1996] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Amino acid variation at reverse transcriptase (RT) codon 210 (generally Leu-210 to Trp [L210W], TTG-->TGG) is occasionally detected after the initiation of azidothymidine (AZT) therapy. The impact of this variation on AZT resistance and viral replication was addressed by four different approaches. The frequency and genetic background of the L210W mutation in vivo were assessed by analyzing sera of AZT-naive and AZT-experienced patients by RT-PCR and DNA sequencing. The degree of AZT resistance (50% infective concentration [IC50]) of recombinant viruses constructed by using the RT of 21 clinical isolates was stratified by the presence or absence of the 210 mutation. The AZT IC50S of a panel of mutant viruses (with or without W-210) constructed by site-directed mutagenesis in an HXB2 background were assayed by using a HeLa CD4 plaque reduction assay. Finally, the effect of the 210 mutation on viral replication was assessed by replication competition of an AZT-resistant virus, RTMN (L-41/Y-215), and RTMN with the W-210 mutation in the presence and in the absence of AZT. In AZT-naive patients, tryptophan at RT residue 210 was rare. After AZT exposure, W-210 appeared in a minority of those patients, most commonly in association with L-41 and Y-215. The presence of W-210 increased the AZTIC50 by two- to fourfold, as determined by both the recombinant virus assay and site-directed mutagenesis. A significant replication advantage in favor of the wild-type L-210 over W-210 was observed, although the selection against the 210 mutant was two- to threefold lower when the viruses were grown in the presence of 5 microM AZT. In summary, the L210W mutation appears to be of marginal significance, conferring approximately two- to fourfold-reduced sensitivity to AZT compared with similar AZT-resistant genomes with L-210. The selection pressure against W-210 may account for the modest proportion of patients in which W-210 appears in vivo.
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Affiliation(s)
- P R Harrigan
- Glaxo Wellcome Research and Development, Stevenage, United Kingdom
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Quiñones-Mateu ME, Holguín A, Dopazo J, Nájera I, Domingo E. Point mutant frequencies in the pol gene of human immunodeficiency virus type 1 are two- to threefold lower than those of env. AIDS Res Hum Retroviruses 1996; 12:1117-28. [PMID: 8844016 DOI: 10.1089/aid.1996.12.1117] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Nucleotide sequences have been determined for the HIV-1 genomic regions encoding codons 41-108 and 181-219 of reverse transcriptase (RT) (pol gene), and codons 198-331 of gp120 (the C2V3 domains; env gene). Eighty-one HIV-1 samples from patients treated or untreated with RT inhibitors were used to sequence pol and 28 HIV-1 samples were used to sequence env. Several individual quasispecies have also been analyzed. All HIV-1 isolates belonged to subtype B. Point mutant frequencies and nucleotide diversities for pol were at most two- to threefold lower than env, with the proportion of nonsynonymous mutations ranging from 33 to 67%. A new variability index that takes into account the type of amino acid substitution as well as genetic distances between the compared sequences is introduced, and its main features for sequence comparisons emphasized. Extension of the calculations to gag, pol, and env sequences contained in the current HIV-1 database confirmed the high mutant frequencies for all HIV-1 genomic regions. The results indicate that although env is more tolerant to insertions and deletions than pol, point mutant frequencies for HIV-1 regions encoding nonstructural proteins are only two- to threefold lower than for regions encoding structural proteins. This implies the occurrence of frequent changes in HIV-1 phenotypes that are dependent on amino acid substitutions in viral enzymes.
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Affiliation(s)
- M E Quiñones-Mateu
- Centro de Biología Molecular Severo Ochoa (CSIC-UAM), Universidad Autónoma de Madrid, Spain
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25
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Nájera I, Holguín A, Quiñones-Mateu ME, Muñoz-Fernández MA, Nájera R, López-Galíndez C, Domingo E. Pol gene quasispecies of human immunodeficiency virus: mutations associated with drug resistance in virus from patients undergoing no drug therapy. J Virol 1995; 69:23-31. [PMID: 7983713 PMCID: PMC188544 DOI: 10.1128/jvi.69.1.23-31.1995] [Citation(s) in RCA: 193] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The nucleotide sequences of two pol gene regions (codons 41 to 108 and 181 to 219 of reverse transcriptase) of 60 human immunodeficiency virus type 1 genomes obtained directly from primary lymphocytes from infected individuals are reported. In addition, the mutant spectra of several quasispecies have been sampled by repetitive sequencing of molecular clones representing the same pol genomic regions. Average mutation frequencies ranged from 1.6 x 10(-2) to 3.4 x 10(-2) substitutions per nucleotide for independent samples (relative to their consensus nucleotide sequence) and from 3.6 x 10(-3) to 1.1 x 10(-2) substitutions per nucleotide for individual quasispecies distributions. Several mutations leading to amino acid substitutions related to loss of sensitivity to reverse transcriptase inhibitors have been identified in samples from patients not subjected to antiretroviral therapy. Mutation frequencies in the codons previously identified as involved in resistance to reverse transcriptase inhibitors were very similar to the average mutation frequencies in the pol region analyzed. Thus, the finding of mutations related to drug resistance (even in the absence of positive selection by the corresponding drugs) is the expected consequence of the statistical distribution of mutations along the pol gene. The presence of such critical amino acid replacements in human immunodeficiency virus type 1 populations underscores the importance of viral quasispecies as reservoirs of phenotypic virus variants and has a number of implications for AIDS control.
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Affiliation(s)
- I Nájera
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas-UAM, Universidad Autónoma de Madrid, Spain
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Nájera I, Richman DD, Olivares I, Rojas JM, Peinado MA, Perucho M, Nájera R, López-Galíndez C. Natural occurrence of drug resistance mutations in the reverse transcriptase of human immunodeficiency virus type 1 isolates. AIDS Res Hum Retroviruses 1994; 10:1479-88. [PMID: 7534096 DOI: 10.1089/aid.1994.10.1479] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Reverse transcriptase-associated amino acid substitutions related to ddC, d4T, and nevirapine resistance have been found in isolates of human immunodeficiency virus type 1 (HIV-1) from patients treated with AZT only. Sequence analysis of 23 isolates documented the presence of 4 unexpected mutations at amino acid residues related to drug resistance. Two isolates contained an aspartic residue in codon 69 associated with ddC resistance, and another a change in codon 75 associated with resistance to d4T. The Y-to-C alteration in codon 181 associated with nevirapine resistance was observed in another isolate after serial passage in cell culture in the absence of drug. Changes in substitution patterns were also noted after serial passage of four AZT resistant isolates in cell culture without inhibitors. One of the strains showed changes in codons 67 and 70 to wild-type residues. Clonal analysis showed that this alteration occurred by the selection during cell culture passage of the wild-type genotype, which was present as a minority subpopulation in the initially resistant virus stock, rather than to genetic reversion. In summary, we present evidence documenting the presence of mutations associated with drug resistance in the absence of drug treatment and supporting the role played by gentic variability in the emergence of HIV-1 antiviral resistance.
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Affiliation(s)
- I Nájera
- Centro Nacional de Biologia Celular y Retrovirus, Instituto de Salud Carlos III, Madrid, Spain
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Rojas JM, Dopazo J, Nájera I, Sánchez-Palomino S, Olivares I, Martin MJ, Bernal A, García Saiz A, Nájera R, López-Galíndez C. Molecular epidemiology of HIV-1 in Madrid. Virus Res 1994; 31:331-42. [PMID: 7545926 DOI: 10.1016/0168-1702(94)90026-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Thirteen HIV-1 isolates from patients of different risk groups in Madrid (Spain) have been analyzed at the genetic level. Two distinct lineages of subtype B have been detected among the HIV-1 circulating in this area: one was related to SF-2/RF strains, whereas the other consists of a more heterogeneous group related to reference strain III-B. Variants of each lineage appeared to circulate preferentially within a risk group: III-B among intravenous drug users, and RF/SF-2 among male homosexuals.
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Affiliation(s)
- J M Rojas
- Centro de Biología Celular y Retrovirus, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
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