Autophagy facilitates macrophage depots of sustained-release nanoformulated antiretroviral drugs

J Clin Invest. 2017 Mar 1;127(3):857-873. doi: 10.1172/JCI90025. Epub 2017 Jan 30.

Abstract

Long-acting anti-HIV products can substantively change the standard of care for patients with HIV/AIDS. To this end, hydrophobic antiretroviral drugs (ARVs) were recently developed for parenteral administration at monthly or longer intervals. While shorter-acting hydrophilic drugs can be made into nanocarrier-encased prodrugs, the nanocarrier encasement must be boosted to establish long-acting ARV depots. The mixed-lineage kinase 3 (MLK-3) inhibitor URMC-099 provides this function by affecting autophagy. Here, we have shown that URMC-099 facilitates ARV sequestration and its antiretroviral responses by promoting the nuclear translocation of the transcription factor EB (TFEB). In monocyte-derived macrophages, URMC-099 induction of autophagy led to retention of nanoparticles containing the antiretroviral protease inhibitor atazanavir. These nanoparticles were localized within macrophage autophagosomes, leading to a 4-fold enhancement of mitochondrial and cell vitality. In rodents, URMC-099 activation of autophagy led to 50-fold increases in the plasma drug concentration of the viral integrase inhibitor dolutegravir. These data paralleled URMC-099-mediated induction of autophagy and the previously reported antiretroviral responses in HIV-1-infected humanized mice. We conclude that pharmacologic induction of autophagy provides a means to extend the action of a long-acting, slow, effective release of antiretroviral therapy.

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy*
  • Acquired Immunodeficiency Syndrome / metabolism
  • Animals
  • Anti-Retroviral Agents / pharmacology*
  • Atazanavir Sulfate / pharmacology
  • Autophagy / drug effects*
  • Basic Helix-Loop-Helix Leucine Zipper Transcription Factors / metabolism
  • Female
  • HIV-1 / metabolism*
  • Heterocyclic Compounds, 3-Ring / pharmacology
  • Humans
  • Macrophages / metabolism*
  • Male
  • Mice
  • Nanoparticles*
  • Oxazines
  • Piperazines
  • Pyridines / pharmacology
  • Pyridones
  • Pyrroles / pharmacology

Substances

  • Anti-Retroviral Agents
  • Basic Helix-Loop-Helix Leucine Zipper Transcription Factors
  • Heterocyclic Compounds, 3-Ring
  • Oxazines
  • Piperazines
  • Pyridines
  • Pyridones
  • Pyrroles
  • TFEB protein, human
  • URMC-099
  • Atazanavir Sulfate
  • dolutegravir