title: L-carnitine reduces lymphocyte apoptosis and oxidant stress in HIV-1-infected subjects treated with zidovudine and didanosine.
abstract: Apoptosis is critical to the progression of human immunodeficiency virus-1 (HIV-1) infection. It appears reasonable that antiretroviral therapies may not achieve a full control of the infection in the absence of an impact on apoptosis. We assigned 20 asymptomatic HIV-infected subjects with advanced immunodeficiency to receive either zidovudine (AZT), and didanosine (DDI) or the same regimen plus L-carnitine, a known antiapoptotic drug, for 7 months. Immunologic and virologic parameters were measured at baseline and after 15, 60, 120, and 210 days of treatment. We assessed on each time point the following: (a) the frequency of peripheral blood apoptotic CD4 and CD8 lymphocytes, CD4 and CD8 cells with disrupted mitochondrial membrane potential, and CD4 and CD8 cells undergoing oxidant stress; (b) the expression of the molecular markers of apoptosis Fas and caspase-1; and (c) the expression of p35/cdk-5 regulatory subunit that is involved in regulating cell survival and apoptosis. Absolute CD4 and CD8 counts and plasma viremia were also measured. Apoptotic CD4 and CD8 cells, lymphocytes with disrupted mitochondrial membrane potential, and lymphocytes undergoing oxidant stress were greatly reduced in subjects treated with AZT and DDI plus L-carnitine compared with those who did not receive L-carnitine. Fas and caspase-1 were down-expressed and p35 over-expressed in lymphocytes from patients of the L-carnitine group. No difference was found in CD4 and CD8 counts and viremia between the groups. No toxicity of L-carnitine was recognized. The addition of L-carnitine is safe and allows apoptosis and oxidant stress to be greatly reduced in lymphocytes from subjects treated with AZT and DDI.
authors.affiliation: Department of Experimental Medicine, University of L'Aquila, Rome, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Moretti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Famularo
authors.forename: Sonia
authors.initials: S
authors.lastname: Marcellini
authors.forename: Antonio
authors.initials: A
authors.lastname: Boschini
authors.forename: Gino
authors.initials: G
authors.lastname: Santini
authors.forename: Vito
authors.initials: V
authors.lastname: Trinchieri
authors.forename: Luciano
authors.initials: L
authors.lastname: Lucci
authors.forename: Edoardo
authors.initials: E
authors.lastname: Alesse
authors.forename: Claudio
authors.initials: C
authors.lastname: De Simone
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D017209:Apoptosis / Q000187:drug effects / Q000276:immunology / Q000502:physiology*; D002331:Carnitine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016049:Didanosine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005434:Flow Cytometry; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D015497:HIV-1 / Q000276:immunology / Q000378:metabolism; D006801:Humans; D006861:Hydrogen Peroxide / Q000378:metabolism; D008297:Male; D008564:Membrane Potentials / Q000502:physiology; D008928:Mitochondria / Q000378:metabolism; D016877:Oxidants / Q000378:metabolism; D018384:Oxidative Stress; D010641:Phenotype; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D013481:Superoxides / Q000378:metabolism; D013601:T-Lymphocytes / Q000378:metabolism*; D015215:Zidovudine / Q000627:therapeutic use*; D019014:fas Receptor / Q000378:metabolism
chemical_list: D019380:Anti-HIV Agents; D016877:Oxidants; D018894:Reverse Transcriptase Inhibitors; D019014:fas Receptor; D013481:Superoxides; D015215:Zidovudine; D006861:Hydrogen Peroxide; D016049:Didanosine; D002331:Carnitine