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Improved adipose tissue function with initiation of protease inhibitor-only ART

Identifieur interne : 001C97 ( Main/Exploration ); précédent : 001C96; suivant : 001C98

Improved adipose tissue function with initiation of protease inhibitor-only ART

Auteurs : Robert T. Maughan [Irlande (pays)] ; Eoin R. Feeney [Irlande (pays)] ; Emilie Capel [France] ; Jacqueline Capeau [France] ; Pere Domingo [Espagne] ; Marta Giralt [Espagne] ; Joep M. A. Lange [Pays-Bas, Thaïlande] ; Praphan Phanuphak [Thaïlande] ; David A. Cooper [Australie] ; Peter Reiss [Pays-Bas, Thaïlande] ; Patrick W. G. Mallon [Irlande (pays)]

Source :

RBID : PMC:5079304

Descripteurs français

English descriptors

Abstract

Objectives

Use of ART containing HIV PIs has previously been associated with toxicity in subcutaneous adipose tissue (SAT), potentially contributing to the development of lipodystrophy and insulin resistance. However, the effect of PIs on SAT function in ART-naive patients independent of other ART classes is unknown. This study aimed to elucidate the effect of initiating PI-only ART on SAT function in ART-naive subjects.

Methods

In the HIVNAT-019 study, 48 HIV-infected, ART-naive Thai adults commencing PI-only ART comprising lopinavir/ritonavir/saquinavir for 24 weeks underwent assessments of fasting metabolic parameters and body composition. In a molecular substudy, 20 subjects underwent SAT biopsies at weeks 0, 2 and 24 for transcriptional, protein, mitochondrial DNA (mtDNA) and histological analyses. ClinicalTrials.gov registration number: NCT00400738.

Results

Over 24 weeks, limb fat increased (+416.4 g, P = 0.023), coinciding with larger adipocytes as indicated by decreased adipocyte density in biopsies (−32.3 cells/mm2, P = 0.047) and increased mRNA expression of adipogenesis regulator PPARG at week 2 (+58.1%, P = 0.003). Increases in mtDNA over 24 weeks (+600 copies/cell, P = 0.041), decreased NRF1 mRNA expression at week 2 (−33.7%, P < 0.001) and increased COX2/COX4 protein ratio at week 24 (+288%, P = 0.038) indicated improved mitochondrial function. Despite decreased AKT2 mRNA at week 2 (−28.6%, P = 0.002) and increased PTPN1 mRNA at week 24 (+50.3%, P = 0.016) suggesting insulin resistance, clinical insulin sensitivity [by homeostasis model assessment (HOMA-IR)] was unchanged.

Conclusions

Initiation of PI-only ART showed little evidence of SAT toxicity, the changes observed being consistent with a return to health rather than contributing to lipodystrophy.


Url:
DOI: 10.1093/jac/dkw301
PubMed: 27516476
PubMed Central: 5079304


Affiliations:


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Le document en format XML

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,
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<addr-line>Barcelona</addr-line>
,
<country>Spain</country>
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<addr-line>Academic Medical Center, Department of Global Health and Division of Infectious Diseases</addr-line>
,
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,
<addr-line>Amsterdam</addr-line>
,
<country>The Netherlands</country>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
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,
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,
<country>Thailand</country>
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<country xml:lang="fr">Thaïlande</country>
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<name sortKey="Phanuphak, Praphan" sort="Phanuphak, Praphan" uniqKey="Phanuphak P" first="Praphan" last="Phanuphak">Praphan Phanuphak</name>
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<addr-line>Bangkok</addr-line>
,
<country>Thailand</country>
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<country xml:lang="fr">Thaïlande</country>
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,
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,
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,
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<country xml:lang="fr">Australie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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,
<addr-line>Amsterdam</addr-line>
,
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,
<country>Ireland</country>
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<title level="j">Journal of Antimicrobial Chemotherapy</title>
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<term>Adult</term>
<term>Biopsy</term>
<term>DNA, Mitochondrial (analysis)</term>
<term>Female</term>
<term>Gene Expression Profiling</term>
<term>HIV Infections (drug therapy)</term>
<term>HIV Protease Inhibitors (adverse effects)</term>
<term>HIV Protease Inhibitors (therapeutic use)</term>
<term>Histocytochemistry</term>
<term>Humans</term>
<term>Male</term>
<term>Proteome (analysis)</term>
<term>Subcutaneous Fat (drug effects)</term>
<term>Subcutaneous Fat (physiology)</term>
<term>Thailand</term>
</keywords>
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<term>ADN mitochondrial (analyse)</term>
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<term>Analyse de profil d'expression de gènes</term>
<term>Biopsie</term>
<term>Femelle</term>
<term>Graisse sous-cutanée ()</term>
<term>Graisse sous-cutanée (physiologie)</term>
<term>Histocytochimie</term>
<term>Humains</term>
<term>Infections à VIH (traitement médicamenteux)</term>
<term>Inhibiteurs de protéase du VIH (effets indésirables)</term>
<term>Inhibiteurs de protéase du VIH (usage thérapeutique)</term>
<term>Mâle</term>
<term>Protéome (analyse)</term>
<term>Thaïlande</term>
</keywords>
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<term>HIV Protease Inhibitors</term>
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<term>DNA, Mitochondrial</term>
<term>Proteome</term>
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<term>Subcutaneous Fat</term>
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<term>HIV Infections</term>
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<term>Inhibiteurs de protéase du VIH</term>
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<keywords scheme="MESH" qualifier="physiologie" xml:lang="fr">
<term>Graisse sous-cutanée</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en">
<term>Subcutaneous Fat</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en">
<term>HIV Protease Inhibitors</term>
</keywords>
<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr">
<term>Infections à VIH</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr">
<term>Inhibiteurs de protéase du VIH</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Adult</term>
<term>Biopsy</term>
<term>Female</term>
<term>Gene Expression Profiling</term>
<term>Histocytochemistry</term>
<term>Humans</term>
<term>Male</term>
<term>Thailand</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr">
<term>Adulte</term>
<term>Analyse de profil d'expression de gènes</term>
<term>Biopsie</term>
<term>Femelle</term>
<term>Graisse sous-cutanée</term>
<term>Histocytochimie</term>
<term>Humains</term>
<term>Mâle</term>
<term>Thaïlande</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Objectives</title>
<p>Use of ART containing HIV PIs has previously been associated with toxicity in subcutaneous adipose tissue (SAT), potentially contributing to the development of lipodystrophy and insulin resistance. However, the effect of PIs on SAT function in ART-naive patients independent of other ART classes is unknown. This study aimed to elucidate the effect of initiating PI-only ART on SAT function in ART-naive subjects.</p>
</sec>
<sec>
<title>Methods</title>
<p>In the HIVNAT-019 study, 48 HIV-infected, ART-naive Thai adults commencing PI-only ART comprising lopinavir/ritonavir/saquinavir for 24 weeks underwent assessments of fasting metabolic parameters and body composition. In a molecular substudy, 20 subjects underwent SAT biopsies at weeks 0, 2 and 24 for transcriptional, protein, mitochondrial DNA (mtDNA) and histological analyses. ClinicalTrials.gov registration number: NCT00400738.</p>
</sec>
<sec>
<title>Results</title>
<p>Over 24 weeks, limb fat increased (+416.4 g,
<italic>P </italic>
= 0.023), coinciding with larger adipocytes as indicated by decreased adipocyte density in biopsies (−32.3 cells/mm
<sup>2</sup>
,
<italic>P </italic>
= 0.047) and increased mRNA expression of adipogenesis regulator
<italic>PPARG</italic>
at week 2 (+58.1%,
<italic>P </italic>
= 0.003). Increases in mtDNA over 24 weeks (+600 copies/cell,
<italic>P </italic>
= 0.041), decreased
<italic>NRF1</italic>
mRNA expression at week 2 (−33.7%,
<italic>P </italic>
< 0.001) and increased COX2/COX4 protein ratio at week 24 (+288%,
<italic>P </italic>
= 0.038) indicated improved mitochondrial function. Despite decreased
<italic>AKT2</italic>
mRNA at week 2 (−28.6%,
<italic>P </italic>
= 0.002) and increased
<italic>PTPN1</italic>
mRNA at week 24 (+50.3%,
<italic>P </italic>
= 0.016) suggesting insulin resistance, clinical insulin sensitivity [by homeostasis model assessment (HOMA-IR)] was unchanged.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>Initiation of PI-only ART showed little evidence of SAT toxicity, the changes observed being consistent with a return to health rather than contributing to lipodystrophy.</p>
</sec>
</div>
</front>
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<affiliations>
<list>
<country>
<li>Australie</li>
<li>Espagne</li>
<li>France</li>
<li>Irlande (pays)</li>
<li>Pays-Bas</li>
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</list>
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<country name="Irlande (pays)">
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<name sortKey="Phanuphak, Praphan" sort="Phanuphak, Praphan" uniqKey="Phanuphak P" first="Praphan" last="Phanuphak">Praphan Phanuphak</name>
<name sortKey="Phanuphak, Praphan" sort="Phanuphak, Praphan" uniqKey="Phanuphak P" first="Praphan" last="Phanuphak">Praphan Phanuphak</name>
<name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name>
</country>
<country name="Australie">
<noRegion>
<name sortKey="Cooper, David A" sort="Cooper, David A" uniqKey="Cooper D" first="David A." last="Cooper">David A. Cooper</name>
</noRegion>
</country>
</tree>
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</record>

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