HIV-Tat Exacerbates the Actions of Atazanavir, Efavirenz, and Ritonavir on Cardiac Ryanodine Receptor (RyR2)

Authors

Imam Abdulrahman Bin Faisal University, Imam Abdulrahman Bin Faisal University
Chengju Tian, University of Nebraska Medical Center
Sean R. Bidasee, University of Nebraska Medical Center
Zachary L. Venn, University of Nebraska Medical Center
Evan Schroder, University of Nebraska Medical Center
Nick Y. Palermo, University of Nebraska Medical CenterFollow
Mohammad AlShabeeb, King Abdullah International Medical Research Center
Benson J. Edagwa, University of Nebraska Medical Center, OmahaFollow
Jason J. Payne, University of Nebraska Medical CenterFollow
Keshoer R. Bidasee, University of Nebraska Medical CenterFollow

Date of this Version

12-23-2022

Citation

Alomar, F.A.; Tian, C.; Bidasee, S.R.; Venn, Z.L.; Schroder, E.; Palermo, N.Y.; AlShabeeb, M.; Edagwa, B.J.; Payne, J.J.; Bidasee, K.R. HIV-Tat Exacerbates the Actions of Atazanavir, Efavirenz, and Ritonavir on Cardiac Ryanodine Receptor (RyR2). Int. J. Mol. Sci. 2023, 24, 274. https://doi.org/10.3390/ ijms24010274

Comments

Open access.

Abstract

The incidence of sudden cardiac death (SCD) in people living with HIV infection (PLWH), especially those with inadequate viral suppression, is high and the reasons for this remain incompletely characterized. The timely opening and closing of type 2 ryanodine receptor (RyR2) is critical for ensuring rhythmic cardiac contraction–relaxation cycles, and the disruption of these processes can elicit Ca²⁺ waves, ventricular arrhythmias, and SCD. Herein, we show that the HIV protein Tat (HIVTat: 0–52 ng/mL) and therapeutic levels of the antiretroviral drugs atazanavir (ATV: 0–25,344 ng/mL), efavirenz (EFV: 0–11,376 ng/mL), and ritonavir (RTV: 0–25,956 ng/mL) bind to and modulate the opening and closing of RyR2. Abacavir (0–14,315 ng/mL), bictegravir (0–22,469 ng/mL), Rilpivirine (0–14,360 ng/mL), and tenofovir disoproxil fumarate (0–18,321 ng/mL) did not alter [³H]ryanodine binding to RyR2. Pretreating RyR2 with low HIV-Tat (14 ng/mL) potentiated the abilities of ATV and RTV to bind to open RyR2 and enhanced their ability to bind to EFV to close RyR2. In silico molecular docking using a Schrodinger Prime protein–protein docking algorithm identified three thermodynamically favored interacting sites for HIV-Tat on RyR2. The most favored site resides between amino acids (AA) 1702–1963; the second favored site resides between AA 467–1465, and the third site resides between AA 201–1816. Collectively, these new data show that HIV-Tat, ATV, EFV, and RTV can bind to and modulate the activity of RyR2 and that HIV-Tat can exacerbate the actions of ATV, EFV, and RTV on RyR2. Whether the modulation of RyR2 by these agents increases the risk of arrhythmias and SCD remains to be explored.