The Resistance Part III:
Chemical Innovations and New Approaches
By Jason Socrates Bardi
"Perhaps
the eye of a scrutinizing observer might have discovered a barely perceptible
fissure, which, extending from the roof of the building in front, made
its way down the wall in a zigzag direction"
Edgar
Allen Poe, The Fall of the House of Usher, 1839.
Human immunodeficiency virus (HIV) plays a simple game of overwhelming
numbers.
The game is analogous to what would take place in an honest casino that
has been infiltrated by thousands of crooked gamblers who are trying to
break the bank. The gamblers constantly try different strategies of cheating,
until eventually the house loses.
Imagine that the casino tries to control these losses by hiring private
detectives who walk around the casino floor and grab any crooked gamblers
they see, incapacitating them and preventing them from cheating. But the
crooked gamblers soon learn how to outwit the house detectives by disguising
their faces so that they are no longer recognized.
The same thing happens with HIV.
The virus replicates prolifically in the body, and has such a high frequency
of mutation that it can rapidly evolve resistance to the drugs that are
used to treat it. A scientific consortium led by Professor Arthur Olson
of The Scripps Research Institute (TSRI) was created to counter this HIV
drug resistance.
Funded by a program project grant, the consortium combines the efforts
of dozens of investigators, postdoctoral fellows, graduate students, and
other researchers at TSRI and several other institutions. It seeks to
establish a drug design cycle aimed at developing, testing, and refining
novel approaches to making specific inhibitors that will disable resistant
mutants of HIV protease, and it combines molecular and cellular biology,
computational and structural approaches, and chemistry.
Two of the projects focus on the design and synthesis of compounds that
inhibit HIV protease and drug-resistant strains of HIV protease. One of
these two projects is led by TSRI Chemistry Professor Chi-Huey Wong.
A New Strategy
Against the wall in Wong's office is a shelf lined with volumes of chemistry
and biology texts. Outside and down the hall is a reading room that has
stacks of some of the leading journals in his field. Also in this reading
room are several networked computers.
And yet when Wong and his colleagues began thinking of ways to combat
HIV drug resistance several years ago, the answers were not to be found
in any of these sources.
"We needed to have a new strategy," recalls Wong.
Wong is doing synthetic chemistry work for the project and coming up
with new ways of targeting the virus, including using technology of his
own design to identify unique spots in the viral mRNA that are highly
conserved, even in the mutant strains. He has found that one good target
is the RNA frameshift region of the virus.
Frameshifting, in biology, is something that takes place during the
translation of the nucleotides into protein amino acids. It happens when
a ribosome that is translating the RNA into protein shifts slightly, moving
up or down the RNA sequence by a nucleotide or so. But this seemingly
slight change can have a radical change on the amino acid sequence of
the protein that is being translatedit may result in a completely
different protein.
For instance, a sequence that originally is read: (UGG) (GCA) (UGU)
(UGA) (CGU)... might be frameshifted into a sequence that would now be
read: (...U) (GGG) (CAU) (GUU) (GAC)...
In HIV, the frameshift region is where the gag and pol regions of the
viral RNA meet, and is highly conserved because frameshifting is necessary
for the expression of the POL polyprotein, which contains the all-important
viral enzymes, the reverse transcriptase, the integrase, and the protease.
The virus cannot tolerate mutations to this region of RNA because mutations
would block the frameshift and knock out the all-important viral enzymes.
Wong reasoned when he began this work that by designing an inhibitor
that targets this non-mutating RNA, he could potentially have a compound
that would be broadly effective against a wide variety of mutant HIV strains.
In order to achieve this, he turned to the aminoglycosides.
One-Pot Synthesis
Aminoglycosides are compounds that interact with interact with RNA,
and there are already drugs of this class on the marketlike the
antibiotic streptomycin, which targets specific pieces of RNA.
These drugs all target the RNA of one portion of the bacterial ribosome,
known as the "30S subunit." The aminoglycosides bind to this RNA and prevent
the ribosome from accurately translating protein. Wong reasoned that he
might be able to use these compounds as scaffolds upon which to design
a chemical that would specifically target the HIV mRNA frameshift region.
The basic technique that Wong uses is one he designed a few years ago
for the synthesis of oligosaccharides in general, called programmable
one-pot synthesis. This technique basically involves placing a large number
of specific chemical building blocks into a reaction vessel and then making
sequential chemical reactions in the soup. The final products depend entirely
on the particular reaction scheme followed.
The one-pot technique, as Wong calls it, allows him to quickly assemble
many types of carbohydrate structuresin just minutes or hours, depending
on how complicated the chemistry is. Wong even developed software that
he uses to streamline the process. "The computer will tell you which building
blocks to use and you simply add them in sequence," he explains.
Depending on the type of building blocks used and the size of the final
structures, the pool of compounds made in this way can be quite large.
For instance, placing 300 building blocks in a pot and randomly combining
them into tetramers will yield over eight billion compounds.
Once the oligosaccharides are made, these carbohydrate "libraries" can
be used for any number of biological studies. One of Wong's main uses
for the libraries is screening against various types of biological targets
to look for interactions.
For instance, he created an array of several hundred aminoglycosides
and screened for molecules that target HIV RNA by taking a 20- to 40-base
piece of the viral RNA attached to a "biotin" molecule, which allows the
bound aminoglycosides to be detected.
While this technology is promising, warns Wong, any potential drug that
could be produced by this method still has to overcome the obstacle of
cell permeability.
"If any [aminoglycoside compound] is going to be useful, it has to get
into a cell," he says. While aminoglycosides are useful antibiotics already,
they cannot get into human cells as easily as they can get into bacterial
cells.
The eventual solution, says Wong, might be to develop a "prodrug" form
of the compound, which would be converted to an active form after it enters
a cell or to employ some "shuttle" molecules that can transport the drugs
into the cells.
For now, he is at the beginning of this research. The structure of the
program project grant is helpful because it allows him to use the structural
and biochemical data that the other investigators on the project produce
to help him come up with the molecular design of the molecules he is going
to synthesize.
"Then you can go back to the biology and see if the chemistry works,"
says Wong. "An environment like Scripps is very good for a chemist. Through
collaboration, you can solve a lot of interesting problems."
Click Chemistry
Together with TSRI Assistant Professor Valery Fokin, Professor K. Barry
Sharpless, who is the W.M. Keck Professor of Chemistry, and Associate
Professor M.G. Finn lead the second of the two chemically oriented projects
on the grant.
"Our role is to develop and synthesize molecules that could potentially
be inhibitors of HIV protease, and, using chemical tools, to learn more
about the mutations of the protease," says Fokin. The technique they use
is in situ click chemistry.
Click chemistry, a modular protocol for organic synthesis that Sharpless
developed, is a powerful and original approach to drug design. In short,
it relies on using energetic yet stable building blocks that will react
with each other in a highly efficient and irreversible spring-loaded reaction.
In its in situ variant, click chemistry uses the target enzyme
itself to bring these building blocks together and to direct the formation
of the desired inhibitor.
The idea is to use the HIV protease itself to design its own inhibitor
by providing it with various building blocks. Only those building blocks
that can form an inhibitor will be selected by the enzyme to "click" together.
This technique has great potential to cut through a frenzy of possible
inhibitors to demonstrate the best.
"We want to let the enzyme teach us what inhibitors [it prefers]," says
Finn. "Those, in general, should be the better inhibitors."
The idea seems almost fantastic, but Sharpless and his colleagues have
already had success with in situ click chemistry.
A few years ago, they published a paper in the scientific journal Angewandte
Chemie describing the use of this technique to make a powerful inhibitor
to acetylcholinesterase, a brain enzyme that breaks down acetylcholine,
the neurotransmitter that propagates nerve signals. Inhibitors of acetylcholinesterase
are used to treat the dementia associated with Alzheimer's disease, increasing
the amount of acetylcholine in the brain, in turn enhancing brain activity.
They have since expanded on this work using this method in several other
systems.
As part of the program project grant, Sharpless and Finn want to see
if they can apply the techniques of click chemistry to designing inhibitors
of HIV protease.
"That enzyme," says Finn, "should, in principle, be amenable to the
same kind of [click chemistry] strategy as acetylcholinesterase."
The strategy, Finn explains, is best applied to enzymes that have regions
of protein-protein interfaces, such as proteins like HIV, where a dimer
is formed by two identical protease monomers. Acetylcholinesterase itself
is not a dimer, but it does have two binding regions adjacent to each
other.
These protein-protein interfaces often have multiple potential binding
sites for small molecules, and the trick with in situ click chemistry
is to find classes of compounds that will bind tightly enough in the two
faces of HIV that their proximity will allow their natural reactivity
to take over.
Looking for a Short Cut
Employing the enzyme to make its own inhibitor could provide a great
short cut. For instance, to take a simple case where inhibitors are made
by combining two chemical structuressay one of 10 "A" structures
and one of 10 "B" structuresthen the possible number of structures
multiplies.
With 10 possible "A" structures and 10 possible "B" structures, there
would be 100 possible compounds. But with 100 possible "A" structures
and 100 possible "B" structures, there would be 10,000 possible compounds.
"We don't have to make and screen all those," says Fokin. "We just have
to allow the enzyme to select which ones fit best."
Inside the enzyme's binding pocket, the components should click together
into a potent inhibitor of HIV protease, and once Sharpless, Fokin, and
Finn recover the inhibitor, they can determine its structure and produce
it in much larger quantities so that their colleagues on the program project
grant can study the interaction of this inhibitor with the protease in
structural and tissue culture experiments.
As the cycle continues, the way that the TSRI researchers envision it,
other members of the project will provide mutant and wild type protease,
and the Sharpless, Fokin and Finn laboratories will then repeat the process.
Dynamic Therapy
At the moment, this project is still in the early stages.
Together with the computational team, Sharpless, Finn, and Fokin are
deciding on the best building blocks to start with. The Sharpless group
has also been developing a benign copper catalyst and a methodology for
copper-catalyzed "stitching" of azide and alkyne building blocks that
will allow them to make a variety of the inhibitor analogs they are interested
in. In addition to generating libraries of the analogs, the technique
could also be used to produce large amounts of click inhibitors for further
studies.
"Everything changed when we discovered the copper-catalyzed process
for the synthesis of triazoles," says Fokin. "It makes the whole process
go a lot smoother."
Another intriguing question they are asking is whether they can possibly
apply the technique of in situ click chemistry in vivo.
In vivo means literally "in life," which in biology is generally understood
to apply to experiments that take place in a living organism. In this
case, in vivo in situ click chemistry suggests the development
of a new type of cocktailone that is made inside the target enzymes
inside a living organism.
The idea is to give a cocktail of building blocks to a patient from
which the final structure of the best inhibitor will be made. Only those
building blocks that are effective against the protease enzymes encoded
by the particular strain of HIV that infects that one patient would react
and make inhibitors. Another intriguing alternative is to provide a pharmacist
with a collection of building blocks, or "pre-drugs", which can be dispensed
to each patient based on the specific information about the mutation.
"We asked, 'Can we actually apply click chemistry to treatment?'" says
Fokin. "'Can we use our bodies to decide what kind of inhibitors to make?'"
The idea is that the therapy would be flexible enough so that it would
work no matter which strains of HIV infect a person. By giving patients
the subunits, the particular drug needed at that moment would be selected
by whichever strain of HIV infected them.
While these ideas are tantalizing, they are a long way from becoming
a reality. The investigators are still doing the first in situ studies
with HIV, and any eventual in vivo studies would have to be done
in cells first and then in model systems, before extensive human trials
for safety and efficacy could even begin.
Still, says Fokin, the concept as they envisioned it offers a new way
to approach what is now the long-standing problem of HIV drug resistance.
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