Characterization of resistance to a potent D-peptide HIV entry inhibitor.
Smith, A.R., Weinstock, M.T., Siglin, A.E., Whitby, F.G., Francis, J.N., Hill, C.P., Eckert, D.M., Root, M.J., Kay, M.S.(2019) Retrovirology 16: 28-28
- PubMed: 31640718 
- DOI: https://doi.org/10.1186/s12977-019-0489-7
- Primary Citation of Related Structures:  
6PSA - PubMed Abstract: 
PIE12-trimer is a highly potent D-peptide HIV-1 entry inhibitor that broadly targets group M isolates. It specifically binds the three identical conserved hydrophobic pockets at the base of the gp41 N-trimer with sub-femtomolar affinity. This extremely high affinity for the transiently exposed gp41 trimer provides a reserve of binding energy (resistance capacitor) to prevent the viral resistance pathway of stepwise accumulation of modest affinity-disrupting mutations. Such modest mutations would not affect PIE12-trimer potency and therefore not confer a selective advantage. Viral passaging in the presence of escalating PIE12-trimer concentrations ultimately selected for PIE12-trimer resistant populations, but required an extremely extended timeframe (> 1 year) in comparison to other entry inhibitors. Eventually, HIV developed resistance to PIE12-trimer by mutating Q577 in the gp41 pocket.
Organizational Affiliation: 
Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT, 84112, USA.