Download MendeleyAllosteric Crosstalk between Inhibitor Binding Sites Drives Enhanced Islatravir Susceptibility in F227C HIV-1 Reverse Transcriptase.
Hecksel, C.W., Walker, S.N., Raheem, I., Asante-Appiah, E., Calero, G., Diamond, T.L., Gabelli, S.B., Gomez-Llorente, Y., Hayes, R.P., Tummala, S., Vergara, S., Klein, D.J.(2026) ACS Infect Dis 12: 3179-3190
- PubMed: 42725963 Search on PubMed
- DOI: https://doi.org/10.1021/acsinfecdis.6c00431
- Primary Citation Related Structures:
36BT, 36CP, 36CW, 36DK, 36DN - PubMed Abstract:
Doravirine (DOR) and islatravir (ISL) are inhibitors of human immunodeficiency virus type 1 (HIV-1) replication that block the viral reverse transcriptase (RT) by distinct mechanisms. The combination has demonstrated efficacy in Phase 3 clinical studies in both virologically suppressed and treatment-naïve people living with HIV-1 and has the potential to mitigate the emergence of resistance-associated mutations through complementary virological profiles. RT bearing a single point mutation, F227C, is associated with resistance to DOR, yet is hypersusceptible to ISL. Here, we report cryoEM structures of islatravir triphosphate (ISL-TP) bound to wild-type (WT) RT and F227C RT. Comparison with the corresponding ISL-TP and dATP-bound WT RT structures reveals that the F227C mutation induces an unexpected conformational change in a loop of the palm domain that is positioned to gate substrate access, providing a structural basis for ISL hypersusceptibility.
- Department of Protein & Structural Chemistry, Merck & Co., Inc., West Point, Pennsylvania19486, United States.
Organizational Affiliation:
