title: Vascular endothelial toxicity induced by HIV protease inhibitor: evidence of oxidant-related dysfunction and apoptosis.
abstract: HIV-protease inhibitor (HIV-PI) drugs are critical for highly active antiretroviral therapy (HAART) efficacy, but several recent reports have suggested that metabolic and/or cardiovascular toxicities are associated with these drugs. Given the importance of the HIV-PI drug class and the widespread and chronic use of these agents in an expanding patient population, further understanding of this potential drug toxicity is imperative. Here, we investigated a role for direct endothelial toxicity induced by saquinavir (SAQ), the first HIV-PI drug marketed in the United States and still an important component of HAART therapies. In initial studies using isolated vascular tissues, we observed selective impairment of endothelium-dependent vasodilation with no effect on contractile responses. Subsequent studies using human endothelial cells in culture at clinically relevant concentrations (5 and 10 microM, 2-48 h) demonstrated concentration-dependent increases in cell death, mainly via apoptosis rather than necrosis (determined via Annexin-V positive membrane labeling). Live cell imaging also demonstrated increased intracellular oxidant production (as measured by DCF fluorescence), which could be abrogated by incubation with the antioxidant N-acetylcysteine (NAC). NAC also prevented SAQ- induced apoptotic cell death. These data demonstrate that SAQ has direct toxicological effects on endothelial cells, and that the toxicity apparently involves apoptotic pathway activation via reactive oxygen and/or nitrogen species.
authors.affiliation: Department of Pharmacology, College of Pharmacy, Ohio State University, Columbus, OH 43205, USA.
authors.forename: Reshma S
authors.initials: RS
authors.lastname: Baliga
authors.forename: Cynthia
authors.initials: C
authors.lastname: Liu
authors.forename: Dale G
authors.initials: DG
authors.lastname: Hoyt
authors.forename: Alysia A
authors.initials: AA
authors.lastname: Chaves
authors.forename: John A
authors.initials: JA
authors.lastname: Bauer
mesh_terms: D000818:Animals; D001013:Aorta, Thoracic / Q000187:drug effects / Q000502:physiology; D017209:Apoptosis; D002460:Cell Line; D002470:Cell Survival / Q000187:drug effects; D042783:Endothelial Cells / Q000166:cytology / Q000187:drug effects*; D004730:Endothelium, Vascular / Q000166:cytology / Q000187:drug effects* / Q000502:physiology; D017320:HIV Protease Inhibitors / Q000633:toxicity*; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D009336:Necrosis; D051381:Rats; D017207:Rats, Sprague-Dawley; D017382:Reactive Oxygen Species / Q000378:metabolism; D019258:Saquinavir / Q000633:toxicity*; D014471:Umbilical Veins; D014664:Vasodilation / Q000187:drug effects
chemical_list: D017320:HIV Protease Inhibitors; D017382:Reactive Oxygen Species; D019258:Saquinavir