Effect of Cocaine and LTR Polymorphism on HIV-1 Pathogenesis

描述(由申请人提供)：本实验室以前的研究表明，与感染艾滋病毒-1的非吸毒者相比，非法吸毒者的病毒遗传多样性和对蛋白酶抑制剂(PI)的初级抗药性更高。为了探索吸毒与更大的病毒复制、多样性和抗逆转录病毒耐药性之间的潜在联系，我们建议利用以下发现：1)可卡因滥用刺激与AP-1相关的即刻早期转录因子的高水平；2)只有大约40%的B分支感染者携带含有AP-1结合位点的HIV-1 LTR长度多态性(MFNLP)。通过使用范德比尔特临床护理中心跟踪的HIV-1感染受试者的大量可卡因队列，我们将解决这样的假设，即携带带有AP-1结合位点的HIV-1分支B LTR多态的可卡因使用者将比其病毒不携带LTR多态的可卡因使用者或非可卡因使用者具有更高的病毒载量、更大的基因多样性和更强的抗逆转录病毒主要耐药性。为了探索这一假设，我们将1)在一群HIV-1阳性、接受抗逆转录病毒治疗的初学者中，确定在LTR中携带MFNLP病毒的可卡因使用者和非可卡因使用者。因此，我们将确定四个群体进行额外分析：有无MFNLP的HIV-1感染可卡因使用者，以及有MFNLP的和没有MFNLP的非可卡因使用者。2)定量检测AP-1即刻早期基因组分c-fos和JunB在四组患者外周血中CD4T淋巴细胞和单核细胞的表达水平。同样，使用凝胶移位分析或新的高通量试剂盒，我们将量化来自四个组的这些细胞群体中AP-1的水平。3)利用454高通量测序技术，对产酶区域进行测序，以确定寄主遗传多样性和对PI的初步抗性突变。使用多样性、对PI的耐药性突变和病毒载量作为结果，我们将使用多变量分析来检查可卡因使用的影响、即刻早期基因表达水平、AP-1数量以及MFNLP的存在。

DESCRIPTION (provided by applicant): Previous studies from this laboratory have demonstrated significantly higher viral genetic diversity and a higher frequency of primary resistance to protease inhibitors (PI) among illicit drug users compared to HIV-1 infected non-drug users. To explore the potential link between drug use and greater viral replication, diversity and antiretroviral resistance, we propose to exploit the findings that 1) cocaine abuse stimulates high levels of the AP-1 transcription factor associated immediate early genes and 2) only about 40% of Clade B infected individuals carry an HIV-1 LTR length polymorphism (MFNLP) containing an AP-1 binding site. Using a large cohort of cocaine using HIV-1 infected subjects followed at the Vanderbilt Clinical Care Center, we will address the hypothesis that cocaine users infected with HIV-1 carrying the Clade B HIV-1 LTR polymorphism with an AP-1 binding site will have higher viral loads, greater genetic diversity, and greater primary resistance to antiretrovirals than either cocaine users whose virus does not carry the LTR polymorphism or non-cocaine users. To explore this hypothesis we will 1) Identify among a cohort of HIV-1 positive, antiretroviral therapy naive individuals those cocaine-using and non-cocaine using individuals with virus carrying the MFNLP within the LTR. We will thereby have identified four groups for additional analyses: HIV-1 infected cocaine users with and without the MFNLP and non-cocaine users with and without the MFNLP. 2) Within the four groups quantify the expression levels within peripheral blood CD4 T lymphocytes and monocytes of c-fos and JunB, as representative immediate early gene components of AP-1. Similarly, using gel-shift assays or a new high throughput kit, we will quantify levels of AP-1 within those cell populations from the four groups. 3) Using 454 high throughput sequencing technology we will sequence the protease region to define within host genetic diversity and primary resistance mutations to PI. Using diversity, resistance mutations to PI and viral load as outcomes, we will examine using a multivariate analysis, the effect of cocaine use, immediate early gene expression levels, AP-1 quantities, and the presence of the MFNLP.