title: Differential adipose tissue gene expression profiles in abacavir treated patients that may contribute to the understanding of cardiovascular risk: a microarray study.
abstract: OBJECTIVE
  To compare changes in gene expression by microarray from subcutaneous adipose tissue from HIV treatment naïve patients treated with efavirenz based regimens containing abacavir (ABC), tenofovir (TDF) or zidovidine (AZT).
  
  
  METHODS
  Subcutaneous fat biopsies were obtained before, at 6- and 18-24-months after treatment, and from HIV negative controls. Groups were age, ethnicity, weight, biochemical profile, and pre-treatment CD4 count matched. Microarray data was generated using the Agilent Whole Human Genome Microarray. Identification of differentially expressed genes and genomic response pathways was performed using limma and gene set enrichment analysis.
  
  
  RESULTS
  There were significant divergences between ABC and the other two groups 6 months after treatment in genes controlling cell adhesion and environmental information processing, with some convergence at 18-24 months. Compared to controls the ABC group, but not AZT or TDF showed enrichment of genes controlling adherence junction, at 6 months and 18-24 months (adjusted p<0.05) and focal adhesions and tight junction at 6 months (p<0.5). Genes controlling leukocyte transendothelial migration (p<0.05) and ECM-receptor interactions (p = 0.04) were over-expressed in ABC compared to TDF and AZT at 6 months but not at 18-24 months. Enrichment of pathways and individual genes controlling cell adhesion and environmental information processing were specifically dysregulated in the ABC group in comparison with other treatments. There was little difference between AZT and TDF.
  
  
  CONCLUSIONS
  After initiating treatment, there is divergence in the expression of genes controlling cell adhesion and environmental information processing between ABC and both TDF and AZT in subcutaneous adipose tissue. If similar changes are also taking place in other tissues including the coronary vasculature they may contribute to the increased risk of cardiovascular events reported in patients recently started on abacavir-containing regimens.
authors.affiliation: School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Shahmanesh
authors.affiliation: ILS Genomics (formerly Beckman Coulter Genomics), Morrisville, North Carolina, United States of America.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Phillips
authors.affiliation: University Hospital Birmingham NHS Foundation Trust, HIV Medicine, Birmingham, United Kingdom.
authors.forename: Meg
authors.initials: M
authors.lastname: Boothby
authors.affiliation: Oxford Centre for Diabetes Endocrinology and Metabolism, University of Oxford, Headington, Oxford, United Kingdom.
authors.forename: Jeremy W
authors.initials: JW
authors.lastname: Tomlinson
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D015224:Dideoxynucleosides / Q000009:adverse effects* / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D020411:Oligonucleotide Array Sequence Analysis; D012306:Risk; D050151:Subcutaneous Fat / Q000187:drug effects* / Q000378:metabolism* / Q000473:pathology; D013997:Time Factors; D059467:Transcriptome / Q000187:drug effects*; D000099227:Abacavir
chemical_list: D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D000099227:Abacavir