c R4.0, a synthetic CCL5/RANTES-derived peptide, exerts potent anti-HIV-1 activity via its nonactivating interaction with CCR5, the major HIV-1 coreceptor. CCR5 chronic activation may promote undesirable inflammatory effects and enhance viral infection; thus, receptor antagonism is a necessary requisite. HIV-1 gp120, CCL5, and maraviroc dock on CCR5 by sharing two receptor sites: the N terminus and the second extracellular loop. In combination studies, R4.0, CCL5, and maraviroc exhibited concomitant interactions with CCR5 and promoted synergic inhibition of HIV-1 in acute-infection assays. Furthermore, various degrees of additive/synergic HIV-1 inhibition were observed when R4.0 was tested in combination with drugs and lead compounds directed toward different viral targets (gp120, gp41, reverse transcriptase, and protease). In combination with tenofovir, R4.0 provides cross-clade synergic inhibition of primary HIV-1 isolates. Remarkably, an in vitro-generated maraviroc-resistant R5 HIV-1 strain was inhibited by R4.0 comparably to the wild-type strain, suggesting the presence of viral resistance barriers similar to those reported for CCL5. Overall, R4.0 appears to be a promising lead peptide with potential for combination in anti-HIV-1 therapy and in microbicide development to prevent sexual HIV-1 transmission.
More than 34 million people worldwide are presently living with human immunodeficiency virus type 1 (HIV-1) (1), the causative agent of the AIDS, a pandemic that has killed more than 25 million people in 3 decades. Despite the highly active antiretroviral therapy (HAART), three major burdens remain for HIV-1 infection. The HAART has prohibitive costs for the vast majority of HIV-1-infected people, there is no therapeutic route that allows the eradication of the virus after infection (2), and there are no preventive measures that may warrant safety to a significant percentage of the population at risk of infection. Efficacious preventive measures are of the utmost importance and, while a protective HIV-1 vaccine is still a remote perspective, although positive hints are emerging (3, 4), topical anti-HIV-1 microbicides represent a promising alternative, as well as an option complementary to a vaccine (5). Microbicides embrace several formulations and molecular targets, and the concept of combining two or more lead compounds to decrease the insurgence of drug resistance and to increase prevention efficacy is progressively becoming a common trend (6). The HIV-1 coreceptor CCR5, exclusively used in primary infection, represents an important microbicide target since it is present on the surfaces of CD4 ϩ T lymphocytes and macrophages localized in the vaginal, rectal, and foreskin epithelia (7). Any HIV-1 inhibitor targeting CCR5, preferably an antagonist, may therefore be seen as a potential microbicide. Maraviroc (MVC) and certain full-length and short peptide derivatives of CCL5/RANTES may well suit the requirements for the development of an effective HIV-1 microbicide (8-10). CCR5 antagonism (receptor binding...