Extracellular vesicles-based drug delivery of antiretroviral regimen to target CNS HIV reservoirs

我们建议设计和开发具有药理学意义和临床意义的药物传递策略。 使用新的纳米载体和针对中枢神经系统艾滋病毒宿主的药物方案。由于无法抗逆转录病毒 药物(ARV)通过血脑屏障(BBB)和ARV引起的神经毒性，目前的ARV方案 无法治疗艾滋病毒相关的中枢神经系统功能障碍，包括艾滋病毒相关的神经认知障碍 (手)。我们的药物输送策略旨在增强血脑屏障的通透性，促进药物通过 并有效抑制中枢神经系统储备库中的病毒，特别是巨噬细胞和 小胶质细胞，神经毒性最小/可耐受。我们试图开发一种新型的“生物纳米颗粒”递送方式 使用“细胞外小泡(EV)”的系统，已知这种小泡可以穿过血脑屏障，并在体内大量积累。 小胶质细胞。在药物装载方面，我们将使用整合酶抑制剂elvitegravir(EVG)及其 药物增强剂，Cobicistat(COBI)，是毒性最低的ARV类别的成员，用作第一个 一系列治疗方法。我们将把EVG与一种化学营养剂结合起来，这已经被证明在 治疗许多中枢神经系统疾病，减少炎症和氧化应激，这是艾滋病毒的标志 发病机制。我们的中心假设是EVG-Cobi和化学膳食剂在EVS中的双重负载，将 绕过外流转运体，穿过血脑屏障，靶向巨噬细胞和小胶质细胞，并传递EVG和 化学营养剂给这些细胞，导致艾滋病毒抑制。我们将通过以下方式检验假设：目标1：开发 EV-药物制剂，并使用体外血脑屏障模型测定其在巨噬细胞和小胶质细胞中的疗效， 和目标2：确定肠道病毒药物制剂在中国的药代动力学、组织分布和安全性 动物模型。我们希望在电动汽车中实现EVG-Cobi和化学膳食剂的新型纳米配方， 穿过血脑屏障，靶向巨噬细胞和小胶质细胞。通过我们未来的研究，这些养生法最终将 有望改善中枢神经系统的艾滋病毒治疗结果，并降低手部和其他神经系统疾病的患病率 精神错乱。

We propose to design and develop pharmacologically relevant and clinically significant drug delivery strategies using novel nanocarrier and drug regimens that target CNS HIV reservoirs. Due to the inability of antiretroviral drugs (ARVs) to cross the blood-brain-barrier (BBB) and ARV-induced neurotoxicity, the current ARV regimens are incapable of treating HIV-associated CNS dysfunction, including HIV-associated neurocognitive disorders (HAND). Our drug delivery strategies are designed for enhanced BBB permeability, facilitating drug passage across the BBB and effectively suppressing the virus in CNS reservoirs, especially in macrophages and microglia, with minimal/tolerable neurotoxicity. We seek to develop a novel “biological nanoparticle” delivery system using “extracellular vesicles (EVs)”, which are known to cross the BBB and largely accumulate in microglia. For drug loading, we will use elvitegravir (EVG), an integrase inhibitor, along with its pharmacoenhancer, cobicistat (COBI), which are a member of the least toxic class of ARVs and used as first line of therapy. We will combine EVG with a chemodietary agent, which has been proven to be effective in treating many CNS diseases and in reducing inflammation and oxidative stress, the hallmark of HIV pathogenesis. Our central hypothesis is that dual loading of EVG-COBI and chemodietary agent within EVs, will bypass efflux transporters, cross the BBB, target macrophages and microglia, and deliver EVG and chemodietary agent to these cells, leading to HIV suppression. We will test the hypothesis by: Aim 1: Developing EV-drug formulations and determining their efficacy in macrophages and microglia using an in vitro BBB model, and Aim 2: Determining pharmacokinetic, tissue distribution, and safety profile of EV-drug formulations in an animal model. We expect to achieve novel nano-formulations of EVG-COBI and chemodietary agent in EVs that cross the BBB and target macrophages and microglia. Through our future studies, these regimens are eventually expected to improve HIV treatment outcomes in the CNS and reduce prevalence of HAND and other neurological disorders.