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1.
HIV Med ; 16(3): 176-83, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25407158

RESUMO

OBJECTIVES: Pregnancy results in physiological changes altering the pharmacokinetics of drugs metabolized by cytochrome P450 3A4 (CYP3A4). The urinary ratio of 6-ß hydroxycortisol to cortisol (6ßHF : F) is a marker of CYP3A4 induction. We sought to evaluate its change in antiretroviral (ARV)-treated HIV-1-infected women and to relate this change to ARV pharmacokinetics. METHODS: Women receiving various ARVs had pharmacokinetic evaluations during the third trimester of pregnancy (>30 weeks) and postpartum with determination of 6ßHF : F carried out on the same days. The Wilcoxon signed rank test was used to compare the ratio antepartum to postpartum. The relationship between the change in ratio and the change in pharmacokinetics was analysed using Kendall's tau. RESULTS: 6ßHF : F ratios were available for 107 women antepartum, with 54 having postpartum values. The ratio was higher antepartum (P=0.033) (median comparison 1.35; 95% confidence interval 1.01, 1.81). For 71 women taking a protease inhibitor (PI), the antepartum vs. postpartum 6ßHF : F comparison was marginally significant (P=0.058). When the change in the 6ßHF : F ratio was related to the change in the dose-adjusted ARV area under the plasma concentration vs. time curve (AUC) between antepartum and postpartum, the 35 subjects in the lopinavir/ritonavir (LPV/r) arms demonstrated an inverse relationship (P=0.125), albeit this correlation did not reach statistical significance. CONCLUSIONS: A 35% increase in the urinary 6ßHF : F ratio was measured during late pregnancy compared with postpartum, indicating that CYP3A induction occurs during pregnancy. The trend towards an inverse relationship between the change in the 6ßHF : F ratio and the change in the LPV AUC antepartum vs. postpartum suggests that CYP3A induction may be one mechanism behind altered LPV exposure during pregnancy.


Assuntos
Fármacos Anti-HIV/farmacocinética , Citocromo P-450 CYP3A/metabolismo , Infecções por HIV/tratamento farmacológico , Infecções por HIV/enzimologia , HIV-1 , Hidrocortisona/análogos & derivados , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/enzimologia , Adolescente , Adulto , Fármacos Anti-HIV/administração & dosagem , Relação Dose-Resposta a Droga , Feminino , Infecções por HIV/metabolismo , Infecções por HIV/urina , Infecções por HIV/virologia , Humanos , Hidrocortisona/urina , Gravidez , Complicações Infecciosas na Gravidez/metabolismo , Complicações Infecciosas na Gravidez/urina , Terceiro Trimestre da Gravidez/metabolismo , Estudos Prospectivos
2.
HIV Med ; 16(8): 502-11, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25959631

RESUMO

OBJECTIVES: Tenofovir disoproxil fumarate (TDF) is increasingly used in the highly active antiretroviral therapy (HAART) regimens of pregnant women, but limited data exist on the pregnancy pharmacokinetics of chronically dosed TDF. This study described tenofovir pharmacokinetics during pregnancy and postpartum. METHODS: International Maternal Pediatric and Adolescent AIDS Clinical Trials (IMPAACT) P1026s is a prospective, nonblinded pharmacokinetic study of HIV-infected pregnant women that included a cohort receiving 300 mg TDF once daily. Steady-state 24-hour pharmacokinetic profiles were measured at the second and third trimesters, postpartum, and in maternal and umbilical cord samples collected at delivery. Tenofovir was measured by liquid chromatography-mass spectrometry (LC-MS). The target area under the concentration versus time curve from time 0 to 24 h post dose (AUC) was ≥ 1.99 µg h/mL (nonpregnant historical control 10th percentile). RESULTS: The median tenofovir AUC was decreased during the second (1.9 µg h/mL) and third (2.4 µg h/mL; P = 0.005) trimesters versus postpartum (3.0 µg h/mL). Tenofovir AUC exceeded the target for two of four women (50%) in the second trimester, 27 of 37 women [73%; 95% confidence interval (CI) 56%, 86%] in the third trimester, and 27 of 32 women (84%; 95% CI 67%, 95%) postpartum (P > 0.05). Median second/third-trimester troughs were lower (39/54 ng/mL) than postpartum (61 ng/mL). Median third-trimester weight was greater for subjects below the target AUC versus those above the target (97.9 versus 74.2 kg, respectively; P = 0.006). The median ratio of cord blood to maternal concentrations was 0.88. No infants were HIV infected. CONCLUSIONS: This study found lower tenofovir AUC and troughs during pregnancy. Transplacental passage with chronic TDF use during pregnancy was high. Standard TDF doses appear to be appropriate for most HIV-infected pregnant women but therapeutic drug monitoring with dose adjustment should be considered in pregnant women with high weight (> 90 kg) or inadequate HIV RNA response.


Assuntos
Fármacos Anti-HIV/farmacocinética , Infecções por HIV/tratamento farmacológico , Inibidores da Protease de HIV/farmacocinética , Complicações Infecciosas na Gravidez/tratamento farmacológico , Tenofovir/farmacocinética , Adolescente , Adulto , Fármacos Anti-HIV/uso terapêutico , Área Sob a Curva , Feminino , Infecções por HIV/metabolismo , Inibidores da Protease de HIV/uso terapêutico , HIV-1 , Humanos , Masculino , Período Pós-Parto , Gravidez , Complicações Infecciosas na Gravidez/metabolismo , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Tenofovir/uso terapêutico , Adulto Jovem
3.
HIV Med ; 13(4): 226-35, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22129166

RESUMO

OBJECTIVES: The aim of the study was to describe emtricitabine pharmacokinetics during pregnancy and postpartum. METHODS: The International Maternal Pediatric and Adolescent AIDS Clinical Trials (IMPAACT), formerly Pediatric AIDS Clinical Trials Group (PACTG), study P1026s is a prospective pharmacokinetic study of HIV-infected pregnant women taking antiretrovirals for clinical indications, including a cohort taking emtricitabine 200 mg once daily. Intensive steady-state 24-hour emtricitabine pharmacokinetic profiles were performed during the third trimester and 6-12 weeks postpartum, and on maternal and umbilical cord blood samples collected at delivery. Emtricitabine was measured by liquid chromatography-mass spectrometry with a quantification limit of 0.0118 mg/L. The target emtricitabine area under the concentration versus time curve, from time 0 to 24 hours post dose (AUC(0-24) ), was ≥7 mg h/L (≤30% reduction from the typical AUC of 10 mg h/L in nonpregnant historical controls). Third-trimester and postpartum pharmacokinetics were compared within subjects. RESULTS: Twenty-six women had pharmacokinetics assessed during the third trimester (median 35 weeks of gestation) and 22 postpartum (median 8 weeks postpartum). Mean [90% confidence interval (CI)] emtricitabine pharmacokinetic parameters during the third trimester vs. postpartum were, respectively: AUC: 8.0 (7.1-8.9) vs. 9.7 (8.6-10.9) mg h/L (P = 0.072); apparent clearance (CL/F): 25.0 (22.6-28.3) vs. 20.6 (18.4-23.2) L/h (P = 0.025); 24 hour post dose concentration (C(24) ): 0.058 (0.037-0.063) vs. 0.085 (0.070-0.010) mg/L (P = 0.006). The mean cord:maternal ratio was 1.2 (90% CI 1.0-1.5). The viral load was <400 HIV-1 RNA copies/mL in 24 of 26 women in the third trimester, in 24 of 26 at delivery, and in 15 of 19 postpartum. Within-subject comparisons demonstrated significantly higher CL/F and significantly lower C(24) during pregnancy; however, the C(24) was well above the inhibitory concentration 50%, or drug concentration that suppresses viral replication by half (IC(50) ) in all subjects. CONCLUSIONS: While we found higher emtricitabine CL/F and lower C(24) and AUC during pregnancy compared with postpartum, these changes were not sufficiently large to warrant dose adjustment during pregnancy. Umbilical cord blood concentrations were similar to maternal concentrations.


Assuntos
Antivirais/farmacocinética , Desoxicitidina/análogos & derivados , Infecções por HIV/metabolismo , Complicações Infecciosas na Gravidez/metabolismo , Adulto , Área Sob a Curva , Desoxicitidina/farmacocinética , Emtricitabina , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Humanos , Concentração Inibidora 50 , Taxa de Depuração Metabólica , Período Pós-Parto , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Carga Viral , Adulto Jovem
4.
J Exp Med ; 192(12): 1819-32, 2000 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-11120778

RESUMO

The highly sensitive quantitation of virus-specific CD8(+) T cells using major histocompatibility complex-peptide tetramer assays has revealed higher levels of cytotoxic T lymphocytes (CTLs) in acute and chronic virus infections than were recognized previously. However, studies in lymphocytic choriomeningitis virus infection have shown that tetramer assays may include measurement of a substantial number of tetramer-binding cells that are functionally inert. Such phenotypically silent CTLs, which lack cytolytic function and do not produce interferon (IFN)-gamma, have been hypothesized to explain the persistence of virus in the face of a quantitatively large immune response, particularly when CD4 help is impaired. In this study, we examined the role of functionally inert CTLs in chronic HIV infection. Subjects studied included children and adults (n = 42) whose viral loads ranged from <50 to >100,000 RNA copies/ml plasma. Tetramer assays were compared with three functional assays: enzyme-linked immunospot (Elispot), intracellular cytokine staining, and precursor frequency (limiting dilution assay [LDA]) cytotoxicity assays. Strong positive associations were observed between cell numbers derived by the Elispot and the tetramer assay (r = 0.90). An even stronger association between tetramer-derived numbers and intracellular cytokine staining for IFN-gamma was present (r = 0.97). The majority (median 76%) of tetramer-binding cells were consistently detectable via intracellular IFN-gamma cytokine staining. Furthermore, modifications to the LDA, using a low input cell number into each well, enabled LDAs to reach equivalence with the other methods of CTL enumeration. These data together show that functionally inert CTLs do not play a significant role in chronic pediatric or adult HIV infection.


Assuntos
Citotoxicidade Imunológica , Infecções por HIV/imunologia , Linfócitos T Citotóxicos/imunologia , Adulto , Contagem de Linfócito CD4 , Criança , Doença Crônica , Testes Imunológicos de Citotoxicidade , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Infecções por HIV/tratamento farmacológico , HIV-1/genética , HIV-1/imunologia , HIV-1/fisiologia , Humanos , Interferon gama/análise , Contagem de Linfócitos , Fragmentos de Peptídeos/imunologia , RNA Viral/análise , Linfócitos T Citotóxicos/citologia , Carga Viral
5.
HIV Med ; 11(4): 232-8, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20002783

RESUMO

BACKGROUND: Pregnancy may alter protein binding (PB) of highly bound protease inhibitors due to changes in plasma concentrations of albumin and alpha-1 acid glycoprotein (AAG). Small changes in PB can greatly impact the fraction of drug unbound (FU) exerting pharmacological effect. We report lopinavir (LPV) PB during third trimester (antepartum, AP) compared to > or =1.7 weeks postpartum (PP) to determine if FU changes compensate for reduced total concentrations reported previously. METHODS: P1026s enrolled women receiving LPV/ritonavir, soft gel capsules 400/100 mg or 533/133 mg twice daily. LPV FU, albumin and AAG were determined AP and PP. RESULTS: AP/PP samples were available from 29/25 women respectively with all but one woman receiving the same dose AP/PP. LPV FU was increased 18% AP vs. PP (mean 0.96+/-0.16% AP vs. 0.82+/-0.21% PP, P=0.001). Mean protein concentrations were reduced AP (AAG=477 mg/L; albumin=3.28 mg/dL) vs. PP (AAG=1007 mg/L; albumin=3.85 mg/dL) (P<0.0001 for each comparison). AAG concentration correlated with LPV binding. Total LPV concentration did not correlate with LPV FU AP or PP. However, higher LPV concentration PP was associated with reduced PB and higher FU after adjustment for AAG. CONCLUSIONS: LPV FU was higher and AAG lower AP vs. PP. The 18% increase in LPV FU AP is smaller than the reduction in total LPV concentration reported previously and is not of sufficient magnitude to eliminate the need for an increased dose during pregnancy.


Assuntos
Proteínas de Fase Aguda/metabolismo , Infecções por HIV/tratamento farmacológico , Inibidores da Protease de HIV/metabolismo , HIV-1 , Complicações Infecciosas na Gravidez/tratamento farmacológico , Pirimidinonas/metabolismo , Adolescente , Adulto , Terapia Antirretroviral de Alta Atividade , Quimioterapia Combinada , Feminino , Infecções por HIV/metabolismo , Inibidores da Protease de HIV/administração & dosagem , Humanos , Lopinavir , Gravidez , Complicações Infecciosas na Gravidez/metabolismo , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Ligação Proteica , Pirimidinonas/administração & dosagem , Ritonavir/administração & dosagem , Adulto Jovem
6.
HIV Med ; 9(10): 875-82, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18795962

RESUMO

OBJECTIVES: Our objective was to evaluate the pharmacokinetics of nelfinavir (NFV) (625 mg tablets) 1250 mg twice daily during pregnancy and postpartum. METHODS: The participants were HIV-1-infected pregnant women enrolled in P1026s and receiving NFV (625 mg tablets) 1250 mg twice daily as part of routine clinical care. Intensive steady-state 12-h NFV pharmacokinetic profiles were performed during pregnancy and postpartum. The target NFV area under the plasma concentration-time curve (AUC(0-12)) was >or=10th percentile NFV AUC(0-12) in non-pregnant historical controls (18.5 microg h/mL). RESULTS: Of 27 patients receiving NFV, pharmacokinetic data were available for four (second trimester), 27 (third trimester) and 22 (postpartum) patients. The NFV maximum concentration (C(max)), 12-h post-dose concentration (C(12)) and AUC(0-12) were significantly lower during the third trimester compared to postpartum (P

Assuntos
Infecções por HIV/tratamento farmacológico , Inibidores da Protease de HIV/farmacocinética , HIV-1 , Nelfinavir/farmacocinética , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adolescente , Adulto , Área Sob a Curva , Contagem de Linfócito CD4 , Esquema de Medicação , Feminino , Infecções por HIV/metabolismo , Inibidores da Protease de HIV/administração & dosagem , Humanos , Recém-Nascido , Nelfinavir/administração & dosagem , Gravidez , Complicações Infecciosas na Gravidez/metabolismo , Infecção Puerperal/tratamento farmacológico , Infecção Puerperal/metabolismo , RNA Viral , Carga Viral , Adulto Jovem
7.
J Clin Invest ; 90(2): 511-4, 1992 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-1322941

RESUMO

Western blot analysis was used to compare the herpes simplex virus (HSV)-2 antibody profiles of 40 infants less than 2 wk of age who had been exposed to maternal genital HSV-2 at birth. 4 mothers were HSV seronegative at delivery and seroconverted to HSV-2 ("primary infection"), 9 had HSV-1 antibodies and seroconverted to HSV-2 ("nonprimary first episode infection"), and 27 were HSV-2 seropositive ("recurrent infection"). Neonatal herpes infections developed in 1 of 4 infants of women with primary infection, in 3 of 9 infants of women with nonprimary first episode infection, and in none of the 27 infants of women with recurrent HSV-2. Antibodies to HSV-2 proteins gG-2, VP5, and ICP35 were detected in 83, 89, and 72% of the 36 uninfected infants, respectively. None of the four infected infants had detectable antibodies to gG-2 and only one (25%) had antibodies to VP5 or ICP35. The more limited profiles of the 13 infants born to mothers with first episodes of HSV-2 were then analyzed separately; these profiles were similar among infected and uninfected infants except for gG-2, which elicits antibodies that are type specific for HSV-2. None of the infected infants versus seven of nine (78%) uninfected infants were gG-2 seropositive. These comparisons suggest that maternal type-specific antibodies may play a role in preventing neonatal infection after exposure to HSV-2.


Assuntos
Herpes Simples/imunologia , Simplexvirus/imunologia , Anticorpos Antivirais/imunologia , Especificidade de Anticorpos , Humanos , Imunização Passiva , Recém-Nascido , Estudos Prospectivos , Proteínas Virais/imunologia
8.
J Clin Invest ; 85(6): 1914-24, 1990 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-2112157

RESUMO

Cytokines produced by mononuclear cells are important regulatory and effector molecules and evidence has been presented to support a role at least for tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) in host defense against Leishmania. In the present study, we examined the production of TNF-alpha and interleukin 1 (IL-1) by resting and IFN-gamma-primed peripheral blood monocytes infected in vitro with Leishmania donovani. Monocytes produced neither IL-1 nor TNF-alpha during challenge with Leishmania. Cells preinfected with Leishmania synthesized normal amounts of TNF-alpha, but had diminished production of IL-1 in response to stimulation with either S. aureus or lipopolysaccharide (LPS). The induction by S. aureus or LPS of IL-1 beta mRNA accumulation in infected cells was normal despite diminished intracellular or supernatant IL-1 protein and bioactivity. Thus, inhibition of IL-1 production by Leishmania most probably reflected diminished translation of IL-1 beta mRNA. Pretreatment of cells with IFN-gamma abrogated infection-induced inhibition of IL-1 production and primed cells for the production of both IL-1 and TNF-alpha upon subsequent exposure to Leishmania. These results indicate that L. donovani has evolved the capacity to infect mononuclear phagocytes, without stimulating the production of two potentially host-protective monokines. The ability of IFN-gamma to prime monocytes to produce TNF-alpha and IL-1 in response to infection with Leishmania and to prevent inhibition of IL-1 production may have implications for immunotherapy with this lymphokine.


Assuntos
Interferon gama/farmacologia , Interleucina-1/biossíntese , Leishmania donovani/imunologia , Leishmaniose Visceral/imunologia , Monócitos/imunologia , Fator de Necrose Tumoral alfa/biossíntese , Animais , Northern Blotting , Células Cultivadas , Expressão Gênica/efeitos dos fármacos , Humanos , Imunidade Celular , Técnicas In Vitro , Interleucina-1/genética , Lipopolissacarídeos/farmacologia , RNA Mensageiro/genética , Staphylococcus aureus/imunologia , Fator de Necrose Tumoral alfa/genética
9.
Dis Aquat Organ ; 69(1): 101-10, 2006 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-16703772

RESUMO

The potential role of viruses in coral disease has only recently begun to receive attention. Here we describe our attempts to determine whether viruses are present in thermally stressed corals Pavona danai, Acropora formosa and Stylophora pistillata and zoanthids Zoanthus sp., and their zooxanthellae. Heat-shocked P. danai, A. formosa and Zoanthus sp. all produced numerous virus-like particles (VLPs) that were evident in the animal tissue, zooxanthellae and the surrounding seawater; VLPs were also seen around heat-shocked freshly isolated zooxanthellae (FIZ) from P. danai and S. pistillata. The most commonly seen VLPs were tail-less, hexagonal and about 40 to 50 nm in diameter, though a diverse range of other VLP morphotypes (e.g. rounded, rod-shaped, droplet-shaped, filamentous) were also present around corals. When VLPs around heat-shocked FIZ from S. pistillata were added to non-stressed FIZ from this coral, they resulted in cell lysis, suggesting that an infectious agent was present; however, analysis with transmission electron microscopy provided no clear evidence of viral infection. The release of diverse VLPs was again apparent when flow cytometry was used to enumerate release by heat-stressed A. formosa nubbins. Our data support the infection of reef corals by viruses, though we cannot yet determine the precise origin (i.e. coral, zooxanthellae and/or surface microbes) of the VLPs seen. Furthermore, genome sequence data are required to establish the presence of viruses unequivocally.


Assuntos
Antozoários/virologia , Vírion/isolamento & purificação , Animais , Citometria de Fluxo/métodos , Microscopia Eletrônica de Transmissão/métodos , Vírion/patogenicidade , Vírion/ultraestrutura
10.
Cryo Letters ; 27(5): 295-303, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17256061

RESUMO

During a 5 degree C and a 5/-1 degree C cold acclimation (CA) regime there was a significant decline in the water potential of winter barley, and a concurrent decline in tissue water content of the 5/-1 degree C CA plants. Results of carbohydrate analysis illustrated a significant (P < 0.001) accumulation of sucrose, fructose and glucose in the 5/-1 degree C CA plants, which was inversely correlated to water potential. Using an infrared imaging radiometer during a convection frost test the water release time (WRT) of 5/-1 degree C CA was demonstrated to be significantly (P < 0.001) longer than that observed in non-cold acclimated plants. This observation is consistent with visual analysis of exotherm curves where the rate of cellular water release to extracellular ice is reduced in the 5/-1 degree C CA plants, compared to the non-cold acclimated plants. These biochemical and physiological changes were correlated to increased plant health following a non-lethal freezing test to -5 degree C, where non-cold acclimated plants produced 2.3 +/- 0.3 tillers and 5 degree C and 5/-1 degree C CA plants produced 2.4 +/- 0.3 and 4.7 +/- 0.7 tillers, respectively. Results from this study imply that cold acclimation leads to changes in the physical state of water that result in a less osmotically responsive cellular environment and subsequently significantly less damage to meristematic tissue.


Assuntos
Aclimatação , Temperatura Baixa , Congelamento , Hordeum/fisiologia , Água/metabolismo , Diagnóstico por Imagem , Frutose/metabolismo , Glucose/metabolismo , Hordeum/citologia , Hordeum/metabolismo , Raios Infravermelhos , Osmose , Sacarose/metabolismo , Fatores de Tempo
11.
J Neuroimmunol ; 91(1-2): 19-27, 1998 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-9846815

RESUMO

Acute disseminated encephalomyelitis (ADEM), a postinfectious illness of the central nervous system (CNS), is thought to be an autoimmune disease. Here, we characterized the cytokines secreted by myelin-reactive T cells generated from patients with ADEM. The frequency of MBP-reactive T cell lines was ten-fold higher in patients with ADEM compared to patients with encephalitis and normal subjects. Whereas there was no significant IFN-gamma secretion, the predominant cytokine secreted by MBP-reactive T cell lines was IL-4 in patients with ADEM. In contrast, IL-4 secretion was only rarely detected in the controls. The presence of high frequencies of MBP-reactive IL-4 secreting T cells in subjects with ADEM during their recovery phase may be similar to myelin reactive IL-4 secreting T cells observed during the spontaneous recovery of animals with EAE.


Assuntos
Encefalomielite Aguda Disseminada/imunologia , Encefalomielite Autoimune Experimental/imunologia , Proteína Básica da Mielina/análise , Proteína Básica da Mielina/imunologia , Linfócitos T/química , Anticorpos Antivirais , Autoimunidade/imunologia , Criança , Pré-Escolar , Doenças Desmielinizantes/imunologia , Doenças Desmielinizantes/metabolismo , Doenças Desmielinizantes/virologia , Encefalomielite Aguda Disseminada/metabolismo , Encefalomielite Autoimune Experimental/metabolismo , Epitopos , Feminino , Herpes Zoster/imunologia , Herpesvirus Humano 3/imunologia , Humanos , Lactente , Interferon gama/imunologia , Interleucina-2/imunologia , Interleucina-4/imunologia , Masculino , Linfócitos T/imunologia , Linfócitos T/virologia
12.
Immunol Lett ; 79(1-2): 109-16, 2001 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-11595297

RESUMO

Cytotoxic T lymphocytes (CTL) play a central role in containment of HIV infection. Evasion of the immune response by CTL escape is associated with progression to disease. It is therefore hypothesised that transmitted viruses encode escape mutations within epitopes that are required for successful control of viraemia. In order to test this hypothesis, escape through the dominant HLA-A2-restricted CTL epitope SLYNTVATL (p17 Gag residues 77-85 SL9) in the setting of mother-to-child-transmission (MTCT) was investigated. Initial data from two families in which the HIV-infected mother expressed HLA-A*0201 and had transmitted the virus to other family members were consistent with this hypothesis. In addition, analysis of the gag sequence phylogeny in one family demonstrated that CTL escape variants can be successfully transmitted both horizontally and vertically. To test the hypothesis further, a larger cohort of transmitting mothers (n=8) and non-transmitters (n=14) were studied. Variation within the SL9 epitope was associated with expression of HLA-A2 (P=0.04) but overall no clear link between variation from the SL9 consensus sequence and MTCT was established. However, the high level of background diversity within p17 Gag served to obscure any possible association between escape and MTCT. In conclusion, these studies highlighted the obstacles to demonstrating CTL escape arising at this particular epitope. Alternative strategies likely to be more definitive are discussed.


Assuntos
Produtos do Gene gag/genética , Antígenos HIV/genética , Infecções por HIV/imunologia , Infecções por HIV/transmissão , Antígeno HLA-A2 , Linfócitos T Citotóxicos/imunologia , Proteínas Virais , Sequência de Aminoácidos , Variação Antigênica , Criança , Pré-Escolar , Epitopos/genética , Feminino , HIV/genética , HIV/imunologia , Infecções por HIV/genética , Infecções por HIV/virologia , Antígeno HLA-A2/genética , Humanos , Transmissão Vertical de Doenças Infecciosas , Masculino , Mutação , Linhagem , Filogenia , Gravidez , Produtos do Gene gag do Vírus da Imunodeficiência Humana
13.
Brain Res Mol Brain Res ; 49(1-2): 95-102, 1997 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-9387868

RESUMO

Quantitative in situ hybridization was utilized to map the distribution and abundance of the serotonin, dopamine and norepinephrine transporter (SERT, DAT and NET, respectively) mRNAs. SERT mRNA was quantified within the dorsal raphe (DR) and the median raphe (MR), DAT mRNA within the ventral tegmental area -substantia nigra (VTA-SN) region and NET mRNA within the locus coeruleus (LC). SERT mRNA expression within the raphe complex was organized into distinct subregional domains with the rank order of mRNA abundance: ventromedial (vm) DR > dorsomedial (dm) DR > MR > dorsolateral (dl) DR. The relative abundance of DAT mRNA also varied across subregions: SN pars compacta > the parabrachial pigmentosis (PBP) > the intrafascicular (IF). The effects of a 'binge' paradigm of cocaine administration on SERT, DAT and NET mRNA abundance were compared in the brains of behaviorally sensitized rats. Cocaine significantly decreased the abundance of the SERT mRNA within the dlDR and DAT mRNA abundance within the SNc and the PBP, and increased the abundance of the NET mRNA within the LC. Finally, correlational analysis indicated that post-cocaine levels of DAT, SERT and NET mRNAs were not associated with cocaine-induced sensitization.


Assuntos
Encéfalo/metabolismo , Proteínas de Transporte/biossíntese , Cocaína/farmacologia , Glicoproteínas de Membrana/biossíntese , Proteínas de Membrana Transportadoras , Transtornos Relacionados ao Uso de Substâncias/metabolismo , Simportadores , Transcrição Gênica/efeitos dos fármacos , Animais , Encéfalo/efeitos dos fármacos , Dopamina/metabolismo , Proteínas da Membrana Plasmática de Transporte de Dopamina , Locus Cerúleo/metabolismo , Masculino , Proteínas do Tecido Nervoso/biossíntese , Norepinefrina/metabolismo , Proteínas da Membrana Plasmática de Transporte de Norepinefrina , Especificidade de Órgãos , RNA Mensageiro/biossíntese , Núcleos da Rafe/metabolismo , Ratos , Ratos Endogâmicos F344 , Serotonina/metabolismo , Proteínas da Membrana Plasmática de Transporte de Serotonina , Substância Negra/metabolismo
14.
Pediatr Infect Dis J ; 15(12): 1087-91, 1996 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8970217

RESUMO

BACKGROUND: It is known that plasma or serum viral load is high in vertically HIV-infected children during the first year of life, but the changes in these titers after the first birthday have not been described. Information on the natural history of circulating extracellular virus will be useful in elucidating the pathogenesis of pediatric HIV infection and in using viral load measurement to guide prognosis and therapy. METHODS: We measured serum RNA by reverse transcriptase-polymerase chain reaction and immune complex-dissociated p24 antigen enzyme-linked immunosorbent assay over time in 48 unselected children followed in our clinics and analyzed the findings in relation to age and clinical outcome. RESULTS: In first-available samples from the 48 children there was a gradual reduction in HIV RNA values with increasing age, with a slope of -0.21 log copy/ml/year (P < 0.001, R2 = 0.6022). This downward trend was seen in subsets of children with all degrees of immunodeficiency. The mean slope of repeated HIV RNA measurements in individual children was similarly in a downward direction (slope -0.11 (P = 0.007 for difference from zero)). The slope was more negative in children who were younger at baseline. Immune complex-dissociated p24 antigen values were much less predictable and predictive. CONCLUSIONS: Viral load in vertically infected children, measured by reverse transcriptase-polymerase chain reaction, falls very gradually over time, descending from very high titers at the end of the first year, and reaching values seen in horizontally infected adults at approximately 5 years of age.


Assuntos
Proteína do Núcleo p24 do HIV/análise , Infecções por HIV , Soropositividade para HIV/epidemiologia , HIV/imunologia , RNA Viral/análise , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Estudos de Coortes , Ensaio de Imunoadsorção Enzimática , Feminino , HIV/patogenicidade , Proteína do Núcleo p24 do HIV/sangue , Infecções por HIV/imunologia , Infecções por HIV/transmissão , Humanos , Incidência , Lactente , Transmissão Vertical de Doenças Infecciosas , Modelos Lineares , Masculino , Reação em Cadeia da Polimerase , Prognóstico , RNA Viral/sangue , Estudos Retrospectivos , Estudos de Amostragem , Taxa de Sobrevida , Fatores de Tempo
15.
Pediatr Infect Dis J ; 15(3): 247-54, 1996 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-8852914

RESUMO

BACKGROUND: Neonatal herpes simplex virus (HSV) infections limited to the skin, eyes and mouth (SEM) can result in neurologic impairment. A direct correlation exists between the development of neurologic deficits and the frequency of cutaneous HSV recurrences. Thus, the National Institutes of Allergy and Infectious Diseases Collaborative Antiviral Study Group conducted a Phase I/II trial of oral acyclovir therapy for the suppression of cutaneous recurrences after SEM disease in 26 neonates. METHODS: Infants < or = 1 month of age with virologically confirmed HSV-2 SEM disease were eligible for enrollment. Suppressive oral acyclovir therapy (300 mg/m2/dose given either twice daily or three times per day) was administered for 6 months. RESULTS: Twelve (46%) of the 26 infants developed neutropenia (< 1000 cells/mm3) while receiving acyclovir. Thirteen (81%) of the 16 infants who received drug 3 times per day experienced no recurrences of skin lesions while receiving therapy. In comparison, a previous Collaborative Antiviral Study Group study found that only 54% of infants have no cutaneous recurrences in the 6 months after resolution of neonatal HSV disease if oral acyclovir suppressive therapy is not initiated. In one infant, HSV DNA was detected in the cerebrospinal fluid during a cutaneous recurrence, and an acyclovir-resistant HSV mutant was isolated from another patient during the course of the study. CONCLUSIONS: Administration of oral acyclovir can prevent cutaneous recurrences of HSV after neonatal SEM disease. The effect of such therapy on neurologic outcome must be assessed in a larger, Phase III study. As such, additional investigation is necessary before routine use of suppressive therapy in this population can be recommended.


Assuntos
Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Infecções Oculares Virais/tratamento farmacológico , Herpes Genital/tratamento farmacológico , Herpesvirus Humano 2/efeitos dos fármacos , Doenças da Boca/tratamento farmacológico , Dermatopatias Virais/tratamento farmacológico , Aciclovir/farmacocinética , Administração Oral , Antivirais/farmacocinética , Resistência a Medicamentos , Infecções Oculares Virais/líquido cefalorraquidiano , Infecções Oculares Virais/virologia , Feminino , Herpes Genital/líquido cefalorraquidiano , Herpes Genital/virologia , Herpesvirus Humano 2/genética , Humanos , Recém-Nascido , Masculino , Doenças da Boca/líquido cefalorraquidiano , Doenças da Boca/virologia , Recidiva , Estudos Retrospectivos , Dermatopatias Virais/líquido cefalorraquidiano , Dermatopatias Virais/virologia
16.
Arch Pediatr Adolesc Med ; 151(3): 228-32, 1997 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-9080928

RESUMO

OBJECTIVE: To determine the prevalence of human immunodeficiency virus type 1 (HIV-1) in the saliva of infected children and adolescents. METHODS: Saliva and blood samples were collected from 13 patients (age range, 1-15 years) with HIV-1 infection. Eleven were taking antiretroviral agents. The presence of HIV-1 was determined by polymerase chain reaction analysis of RNA and DNA as well as by viral culture of the saliva samples and by culture of peripheral blood mononuclear cells. RESULTS: Although HIV-1 was cultured from peripheral blood mononuclear cells of 12 patients, it was not cultured from their saliva. Only 1 of 13 saliva samples yielded positive test results for HIV-1 RNA, and none did so for HIV-1 DNA. The specimen containing HIV-1 RNA was from an untreated 10-year-old asymptomatic boy with a CD4+ lymphocyte count of 0.91 x 10(9)/L (913 cells/microL) and no infectious virus detected in plasma. CONCLUSION: The prevalence of HIV-1 in the saliva of HIV-1-infected children and adolescents is low and may not be infectious.


Assuntos
Infecções por HIV/virologia , HIV-1/isolamento & purificação , Saliva/virologia , Adolescente , Fatores Etários , Contagem de Linfócito CD4 , Criança , Pré-Escolar , Feminino , Infecções por HIV/sangue , Humanos , Lactente , Leucócitos Mononucleares/virologia , Masculino , Reação em Cadeia da Polimerase , Carga Viral
17.
Ann Clin Lab Sci ; 6(3): 233-9, 1976.
Artigo em Inglês | MEDLINE | ID: mdl-942181

RESUMO

Despite the rapidly expanding clinical use of leukocyte biochemistry, there is a limited amount of data available on normal human leukocytes. Some of the problems associated with the clinical use of leukocytes are discussed briefly. Enzyme activities of alkaline and acid phosphatase, lysozyme, and beta-galactosidase are presented. Results are reproducible between normals when expressed per mg of leukocyte deoxyribonucleic acid (DNA). Much higher lymphocyte activties of lysozyme and alkaline phosphatase are noted than previously reported with cytochemical or intact cell systems. It has been demonstrated that leukocytes cannot be considered chemically homogenous but should be separated and considered as individual cell types.


Assuntos
Leucócitos/enzimologia , Fosfatase Ácida/análise , Fosfatase Alcalina/análise , DNA/análise , Galactosidases/análise , Humanos , Linfócitos/enzimologia , Muramidase/análise , Neutrófilos/enzimologia
18.
J Invest Surg ; 9(4): 313-9, 1996.
Artigo em Inglês | MEDLINE | ID: mdl-8887069

RESUMO

Preliminary studies on ischemia/reperfusion injury in transplanted small bowel grafts showed that secretory phospholipase A2 (sPLA2) may play a substantial role by breaking down membrane phospholipids. This study sought to determine the normal values of sPLA2 in the rat small bowel as a function of site and length as a baseline for future studies. The entire small bowel of male Lewis rats (200 g) was flushed with normal saline to eliminate solid contents. In group 1, the entire small bowel was divided into 5-cm segments (numbered 1-9), which were snap frozen and processed the same day for sPLA2. In group 2, a 25-cm segment of bowel (corresponding to segments 2-6 in group 1) was harvested from each animal, snap frozen, and immediately processed for sPLA2. To assess the effect of bowel storage on enzyme content, group 3 and group 4 grafts were stored for 7 and 14 days, respectively, at -85 degrees C prior to processing. All samples were homogenized in buffer, extracted with H2SO4 and assayed for sPLA2 activity using [1-14C]oleate-labeled autoclaved Escherichia coli as substrate. Results were analyzed statistically by ANOVA. sPLA2 activity rose from 85.46 +/- 14.46% hydrolysis/min fraction-1 in segment 1, to 476.38 +/- 176.75% hydrolysis/min fraction-1 in segment 9. The increase was linear and statistically significant (p < .0001). There was no significant difference in enzymatic activity between groups 2, 3, and 4. Group 2 activity was 263.02 +/- 43.74% hydrolysis/min fraction-1. This value was not statistically different from the mathematically calculated mean of segments 2-6 in group 1 (237.75). The results show that (1) sPLA2 activity increases predictably with distance from the ligament of Treitz (2) storage at -85 degrees C does not affect sPLA2, activity, and (3) 25-cm grafts may be evaluated in toto with reproducible baseline enzyme activity. Given the variability of enzyme activity along the course of the rat small bowel, it is imperative that exact location be identified in any studies evaluating sPLA2 activity.


Assuntos
Intestino Delgado/enzimologia , Intestino Delgado/transplante , Fosfolipases A/metabolismo , Animais , Ativação Enzimática , Masculino , Fosfolipases A2 , Ratos , Ratos Endogâmicos Lew , Traumatismo por Reperfusão/enzimologia , Traumatismo por Reperfusão/cirurgia
19.
Bioresour Technol ; 91(2): 171-8, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14592747

RESUMO

Cattle manure from stock bedded on straw was aerobically composted under ambient conditions, turning with either a tractor-mounted front-end loader or a rear discharge manure spreader. Three composting experiments, each of approximately four months duration, were conducted to investigate the effect of turning regime and seasonal weather conditions on nitrogen and phosphorus losses during aerobic composting of cattle manure. Manure stacks of 12-15 m(3) initial volume were constructed in separate 5 x 5 m concrete compartments. Experiment 1 (January-April 1999) compared manure heaps turned once (T1) or three times (T3) using a front-end loader with an unturned static (S) control manure stack. Experiment 2 (June-September 1999) compared the same treatments as Experiment 1. Experiment 3 (September-December 1999) compared T1 and T3 turning regimes using a front end loader with turning by a rear-discharge spreader (TR1 and TR1T2) for more effective aeration of the manure. Turning took place at 6 weeks for the one turn treatments, and after 2, 6 and 10 weeks for the three turn treatments. Leachate losses were dominated by NH(4)-N during the first three weeks of composting, after which time NH4-N and NO3-N concentrations in leachates were approximately the same, in the range 0-20 mg N l(-1). The concentrations of both NH4-N and NO3-N in leachate were higher after turning. Molybdate-reactive P concentrations in leachate tended not to be significantly influenced by turning regime. Gaseous losses of NH3 and N2O rose quickly during the initial phases of composting, peaking at 152 g N t(-1) d(-1) for the T3 treatment. Mean NH3 emission rate (25-252 g N t(-1) d(-1)) for the first two weeks of Experiment 2 conducted during the period June-September were an order of magnitude greater (1-10 g N t(-1) d(-1)) than Experiment 3, conducted during the colder, wetter autumn period (September-December). Nitrous oxide emission rates ranged between 1-14 g N t(-1) d(-1) and showed little influence of turning regime. Total N and P concentrations in turned (T) and static (S) manure were elevated at the end of all experiments, due to loss of dry matter. Mean total N losses were 30.4% (T1) and 36.8% (T3) and total P losses 28.2% (T1) and 27.4% (T3).


Assuntos
Agricultura/métodos , Esterco/microbiologia , Microbiologia do Solo , Solo/análise , Ar , Animais , Bovinos , Nitrogênio/metabolismo , Fósforo/metabolismo , Tempo (Meteorologia)
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