Structural basis for activation of α-boranophosphate nucleotide analogues targeting drug-resistant reverse transcriptase

AIDS chemotherapy is limited by inadequate intracellular concentrations of the active triphosphate form of nucleoside analogues, leading to incomplete inhibition of viral replication and the appearance of drug-resistant virus. Drug activation by nucleoside diphosphate kinase and inhibition of HIV-1 reverse transcriptase were studied comparatively. We synthesized analogues with a borano (BH₃^-) group on the α-phosphate, and found that they are substrates for both enzymes. X-ray structures of complexes with nucleotide diphosphate kinase provided a structural basis for their activation. The complex with d4T triphosphate displayed an intramolecular CH...O bond contributing to catalysis, and the R(p) diastereoisomer of thymidine α-boranotriphosphate bound like a normal substrate. Using α-(R(p))-boranophosphate derivatives of the clinically relevant compounds AZT and d4T, the presence of the α-borano group improved both phosphorylation by nucleotide diphosphate kinase and inhibition of reverse transcription. Moreover, repair of blocked DNA chains by pyrophosphorolysis was reduced significantly in variant reverse transcriptases bearing substitutions found in drug-resistant viruses. Thus, the α-borano modification of analogues targeting reverse transcriptase may be of generic value in fighting viral drug resistance.