Mutagenesis of Single/Combined NRTI Drugs in Human Cells

描述（由申请人提供）：高效抗逆转录病毒治疗 （HAART）有效地减少了艾滋病毒从母亲传播到 婴儿，但用于孕妇HAART的药物组合构成了 宫内暴露于核苷类似物的婴儿发生肿瘤的风险 逆转录酶抑制剂（NRTI）。这项建议的目的是 确定暴露于特定的 NRTI，单独或组合，在人淋巴母细胞样细胞（AZH-1）中，以及 确定人类突变易感性表型的变异性 脐带血淋巴细胞将进行实验以测量（通过特定的 RIA）齐多夫定（AZT）、拉米夫定（3 TC）和/或司他夫定的DNA掺入 (d4T)，并测量和表征HPRT的致突变反应， AZH-1细胞APRT基因座和脐血细胞HPRT基因座（用细胞 克隆试验）在培养中暴露于临床上重要的抗逆转录病毒 药物，作为单一药剂或组合。这项工作是研究的延伸 我们小组以前进行的研究子宫内致突变性的研究 婴儿在围产期接触AZT。结果表明，直接 DNA中AZT的含量与 在人类细胞中特定基因座诱导的突变水平。第二、 同时暴露于AZT和第二种NRTI（ddI）可增强AZT-DNA掺入 和体外突变诱导。第三，NRTI治疗单独使用AZT或与 3 TC在暴露于以下环境中的婴儿中诱导显著的遗传毒性和致突变效应： 在子宫内，致突变反应的增加持续至少一年 出生后数据表明，这一增长是由一个子集的驱动， 儿童，这表明个体易感因素可能会影响 子宫内预防导致的DNA损伤和突变水平。AZT 也是暴露小鼠和大鼠的经胎盘致癌物。拟议工作 将识别具有最低致突变潜力的药物/药物组合， 将启动研究，以确定增加易感性的基础， 在AZT-3 TC暴露婴儿的亚组中， 围产期预防定量风险评估基金会 单独的NRTI或NRTI的组合。

DESCRIPTION (provided by applicant): Highly active antiretroviral therapy (HAART) has been effective at reducing the transmission of HIV from mother to infant, but the combinations of drugs used for HAART in pregnant women poses a risk for neoplasia in the infants exposed in utero to nucleoside analogue reverse transcriptase inhibitors (NRTIs). The purpose of this proposal is to determine the extent of nuclear DNA damage induced by exposure to specific NRTI's, alone or in combination, in human lymphoblastoid cells (AZH-1), and to determine the variability in the mutation susceptibility phenotype in human cord blood lymphocytes. Experiments will be performed to measure (by specific RIAs) DNA incorporation of zidovudine (AZT), lamivudine (3TC), and/or stavudine (d4T), and to measure and characterize the mutagenic response at the HPRT and APRT loci of AZH-1cells and the HPRT locus of cord blood cells (using cell cloning assays) exposed in culture to clinically important antiretroviral drugs, as single agents or combinations. This work is an extension of studies previously conducted by our group to investigate the in utero mutagenicity of perinatal exposure of infants to AZT. It was demonstrated that a direct correlation exists between the level of the AZT incorporated into DNA and the levels of mutations induced at specific loci in human cells. Second, co-exposure to AZT and a second NRTI (ddI) potentiates AZT-DNA incorporation and mutation induction in vitro. Third, NRTI therapy using AZT alone or with 3TC induces significant genotoxic and mutagenic effects in infants exposed in utero, and the increases in mutagenic responses persist for at least one year after birth. Data indicate that this increase is driven by a subset of the children, suggesting that individual susceptibility factors may influence the levels of DNA damage and mutation that results from in utero prophylaxis. AZT is also a transplacental carcinogen in exposed mice and rats. The proposed work will identify the drugs/drug combinations with the lowest mutagenic potential, will initiate studies to define the basis for the increased susceptibility to mutagenesis in a subset of AZT-3TC exposed infants, and will form the foundation for quantitative risk assessments of perinatal prophylaxis using individual NRTIs or combinations of NRTIs.