Certain viruses have the ability to subvert the mammalian immune response, including interference in the chemokine system. Poxviruses produce the chemokine binding protein vCCI (viral CC chemokine inhibitor; also called 35K), which tightly binds to CC chemokines. To facilitate the study of vCCI, we first provide a protocol to produce folded vCCI from Escherichia coli (E. coli.) It is shown here that vCCI binds with unusually high affinity to viral Macrophage Inflammatory Protein-II (vMIP-II), a chemokine analog produced by the virus, human herpesvirus 8 (HHV-8). Fluorescence anisotropy was used to investigate the vCCI:vMIP-II complex and shows that vCCI binds to vMIP-II with a higher affinity than most other chemokines, having a Kd of 0.06 ± 0.006 nM. Nuclear magnetic resonance (NMR) chemical shift perturbation experiments indicate that key amino acids used for binding in the complex are similar to those found in previous work. Molecular dynamics were then used to compare the vCCI:vMIP-II complex with the known vCCI:Macrophage Inflammatory Protein-1β/CC-Chemokine Ligand 4 (MIP-1β/CCL4) complex. The simulations show key interactions, such as those between E143 and D75 in vCCI/35K and R18 in vMIP-II. Further, in a comparison of 1 μs molecular dynamics (MD) trajectories, vMIP-II shows more overall surface binding to vCCI than does the chemokine MIP-1β. vMIP-II maintains unique contacts at its N-terminus to vCCI that are not made by MIP-1β, and vMIP-II also makes more contacts with the vCCI flexible acidic loop (located between the second and third beta strands) than does MIP-1β. These studies provide evidence for the basis of the tight vCCI:vMIP-II interaction while elucidating the vCCI:MIP-1β interaction, and allow insight into the structure of proteins that are capable of broadly subverting the mammalian immune system.
Background and Purpose: Patients with severe obstructive sleep apnea (OSA) have an almost 4-fold higher odds of resistant hypertension than those with less severe OSA. Obstructive sleep apnea screening practices in primary care are deficient. Additional study is needed regarding the value of OSA screening in hypertensive adults who present to the primary care clinic. Methods: This was a convenience sample of adults with hypertension from a rural primary care clinic in Iowa. Staff identified patients who met the inclusion criteria for the project. The STOP-Bang Questionnaire was used to screen the patients for OSA. Providers subsequently used discretion as to ordering polysomnography (PSG). Conclusions: Thirty-two patients were screened over a 3-month time period. All of the men included in the study scored either high or intermediate risk for OSA. Forty percent of the study participants scored high risk for OSA, with 33% of those participants referred for PSG. At project conclusion, three participants had undergone PSG testing, and all were diagnosed with sleep apnea. Implications for Practice: To ensure timely diagnosis and treatment of OSA, primary care providers should consider screening all hypertensive adults for OSA. With compulsory screening and subsequent identification and treatment of patients with OSA, nurse practitioner providers can pave the way in reducing mortality and morbidity associated with OSA, as well as resistant hypertension.
Human immunodeficiency virus (HIV) infection continues to pose a major infectious disease threat worldwide. It is characterized by the depletion of CD4 + T cells, persistent immune activation, and increased susceptibility to secondary infections. Advances in the development of antiretroviral drugs and combination antiretroviral therapy have resulted in a remarkable reduction in HIV-associated morbidity and mortality. Antiretroviral therapy (ART) leads to effective suppression of HIV replication with partial recovery of host immune system and has successfully transformed HIV infection from a fatal disease to a chronic condition. Additionally, antiretroviral drugs have shown promise for prevention in HIV pre-exposure prophylaxis and treatment as prevention. However, ART is unable to cure HIV. Other limitations include drug-drug interactions, drug resistance, cytotoxic side effects, cost, and adherence. Alternative treatment options are being investigated to overcome these challenges including discovery of new molecules with increased anti-viral activity and development of easily administrable drug formulations. In light of the difficulties associated with current HIV treatment measures, and in the continuing absence of a cure, the prevention of new infections has also arisen as a prominent goal among efforts to curtail the worldwide HIV pandemic. In this review, the authors summarize currently available anti-HIV drugs and their combinations for treatment, new molecules under clinical development and prevention methods, and discuss drug delivery formats as well as associated challenges and alternative approaches for the future.
Inflammation plays a major role in many pathologies including asthma, arthritis, atherosclerosis and traumatic brain injury. As such, controlling inflammation is an important goal. While many biological pathways are involved in inflammation, an appealing target is the chemokine pathway. Chemokines are small immune system proteins that mediate chemotaxis of leukocytes bearing cognate chemokine receptors to the site of infection or inflammation. Many viruses have evolved strategies to counter the chemokine system, including the production of chemokine binding proteins. In particular, poxviruses encode vCCI (viral CC chemokine Inhibitor; also called p35), a protein that binds members of the CC class of chemokines. vCCI has been shown to bind many CC chemokines with high affinity and as such vCCI could be a potent tool as part of an anti‐inflammation strategy. The mechanistic details of how vCCI is able to bind dozens of CC chemokines with nanomolar (or sub‐nanomolar) affinity is still being elucidated. Structures of vCCI alone and in complex have revealed a beta sandwich composed of two beta sheets that binds chemokines using one face of the sandwich in conjunction with a long, highly acidic loop after the second beta strand. Experimental work shows that this highly negatively charged loop in vCCI can act as a lid on the bound chemokine and interacts with positive charges on the chemokine. A particularly puzzling vCCI‐chemokine interaction is in the area at the edge of the negatively charged loop in vCCI, where a conserved tyrosine (Y80) is close to K48 of the chemokine. It was hypothesized that mutating Y80 to Ala in vCCI would allow more room for the chemokine to bind, but experimentally the opposite has been shown to be the case: the Y80A variant in vCCI has a greatly decreased ability to bind chemokines. We report a collaborative effort to understand the role of Y80 and the action of the acidic loop in vCCI to bind chemokines. Molecular dynamics simulations suggest that rather than being a hindrance to the function of the loop, the role of Y80 is actually to prop the loop in the “open” conformation so that the chemokine can bind. When Y80 is replaced with Ala in simulations, the loop closes and blocks the chemokine binding site. This intriguing and unexpected hypothesis from in silico work has been tested experimentally using NMR, isothermal titration calorimetry and other biophysical techniques. We therefore report a collaborative set of experiments that includes computation and experimentation to aid in the understanding of the vCCI:chemokine interaction Support or Funding Information Support provided by UC Merced summer graduate funding.
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