title: Protective effects of alanyl-glutamine supplementation against nelfinavir-induced epithelial impairment in IEC-6 cells and in mouse intestinal mucosa.
abstract: OBJECTIVE
  Human Immunodeficiency Virus (HIV) protease inhibitors (PI) remain a crucial component of highly active therapy (HAART) and recently have been demonstrated to have potent antitumor effect on a wide variety of tumor cell lines. However, discontinuation of therapy is an important issue, which may be related to various side-effects, especially diarrhea. The aim of this study was to evaluate the effects of nelfinavir (NFV), an HIV PI, and of alanyl-glutamine (AQ) supplementation, on intestinal cell migration, proliferation, apoptosis and necrosis, using IEC-6 cells and on intestinal crypt depth, villus length, villus area, mitotic index and apoptosis in Swiss mice.
  
  
  METHODS
  Migration was evaluated at 12 and 24 h after injury using a wound healing assay. Cellular proliferation was measured indirectly at 24 and 48 h using tetrazolium salt WST-1. Apoptosis and necrosis were measured by flow cytometry using the Annexin V assay. Intestinal morphometry and mitotic index in vivo were assessed following a seven-day treatment with 100 mg/kg of NFV, given orally. In vivo proliferation and apoptosis were evaluated by intestinal crypt mitotic index and immunohistochemistry, respectively.
  
  
  RESULTS
  In vitro, AQ supplementation enhanced IEC-6 cell migration and proliferation, following challenge with NFV. In vivo, AQ increased intestinal villus length, villus area, crypt depth and cell proliferation and cell migration, following treatment with NFV. AQ did not decrease cell death induced by NFV both in vivo and in vitro.
  
  
  CONCLUSIONS
  AQ supplementation is potentially beneficial in preventing the effects of PIs, such as NFV, in the intestinal tract.
authors.affiliation: Clinical Research Unit & Institute of Biomedicine/Center for Global Health, Faculty of Medicine, Federal University of Ceará, Ceará, Brazil.
authors.forename: Manuel B
authors.initials: MB
authors.lastname: Braga-Neto
authors.forename: Bruna M C
authors.initials: BM
authors.lastname: Oliveira
authors.forename: Raphael S
authors.initials: RS
authors.lastname: Rodrigues
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Noronha
authors.forename: Renata F
authors.initials: RF
authors.lastname: Leitao
authors.forename: Gerly A C
authors.initials: GA
authors.lastname: Brito
authors.forename: Aldo A
authors.initials: AA
authors.lastname: Lima
authors.forename: Richard L
authors.initials: RL
authors.lastname: Guerrant
authors.forename: Cirle A
authors.initials: CA
authors.lastname: Warren
mesh_terms: D000818:Animals; D017209:Apoptosis / Q000187:drug effects*; D045744:Cell Line, Tumor; D002465:Cell Movement / Q000187:drug effects; D049109:Cell Proliferation / Q000187:drug effects; D004151:Dipeptides / Q000494:pharmacology*; D004847:Epithelial Cells / Q000187:drug effects; D017320:HIV Protease Inhibitors / Q000494:pharmacology; D007413:Intestinal Mucosa / Q000187:drug effects*; D007422:Intestines / Q000166:cytology / Q000187:drug effects / Q000473:pathology; D008297:Male; D051379:Mice; D009336:Necrosis; D019888:Nelfinavir / Q000494:pharmacology*; D051381:Rats; D014945:Wound Healing / Q000187:drug effects
chemical_list: D004151:Dipeptides; D017320:HIV Protease Inhibitors; D019888:Nelfinavir; C054122:alanylglutamine