Titre du document / Document title

Antiretoviral therapy and the lipodystrophy syndrome, part 2: concepts in aetiopathogenesis

Auteur(s) / Author(s)

NOLAN David ⁽¹⁾ ; JOHN Mina ⁽¹⁾ ; MALLAL Simon ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Centre for Clinical Immunology and Biomedical Statistics, Royal Perth Hospital and Murdoch University, Western Australia, AUSTRALIE

Résumé / Abstract

Clinical research has indicated that the use of nucleoside reverse transcriptase inhibitor (NRTI) and HIV protease inhibitor (PI) therapy is associated with a risk of long-term toxicity syndromes, and that the aetiopathogenesis of these adverse effects is independent of the antiretroviral effects of these drugs. In relation to the lipodystrophy syndrome, it appears that the most powerful determinant of subcutaneous fat wasting is an interaction between these two drug classes. In this review, possible mechanisms underlying the contributions of both PI and NRTI drugs are reviewed, with an emphasis on their effects on adipose tissue. On this basis, an 'adipocentric', or minimal model of the syndrome is developed, in which divergent effects at the adipocyte of NRTIs (mitochondrial toxicity) and PIs (insulin resistance and impaired adipocyte maturation) interact to produce a phenotype that is consistent with clinical observations.

Revue / Journal Title

Antiviral therapy   ISSN 1359-6535 

Source / Source

2001, vol. 6, n^o3, pp. 145-160 (111 ref.)

Langue / Language

Anglais

Editeur / Publisher

International Medical Press, London, ROYAUME-UNI  (1996) (Revue)

Mots-clés anglais / English Keywords

Adipose tissue disorders ; Skin disease ; Hydrolases ; Enzyme ; Transferases ; Nucleotidyltransferases ; Virus ; Resistance ; Protein hormone ; Pancreatic hormone ; Insulin ; Mitochondria ; Adipocyte ; Drug interaction ; Nucleoside ; Toxicity ; Enzyme inhibitor ; Peptidases ; RNA-directed DNA polymerase ; Lipodystrophy ; Retroviridae ; Review ; Antiviral ;

Mots-clés français / French Keywords

Tissu adipeux pathologie ; Peau pathologie ; Hydrolases ; Enzyme ; Transferases ; Nucleotidyltransferases ; Virus ; Résistance ; Hormone protéine ; Hormone pancréatique ; Insuline ; Mitochondrie ; Adipocyte ; Interaction médicamenteuse ; Nucléoside ; Toxicité ; Inhibiteur enzyme ; Peptidases ; RNA-directed DNA polymerase ; Lipodystrophie ; Retroviridae ; Article synthèse ; Antiviral ;

Mots-clés espagnols / Spanish Keywords

Tejido adiposo patología ; Piel patología ; Hydrolases ; Enzima ; Transferases ; Nucleotidyltransferases ; Virus ; Resistencia ; Hormona proteina ; Hormona pancreática ; Insulina ; Mitocondria ; Adipocito ; Interacción medicamentosa ; Nucleósido ; Toxicidad ; Inhibidor enzima ; Peptidases ; RNA-directed DNA polymerase ; Lipodistrofia ; Retroviridae ; Artículo síntesis ; Antiviral ;

Localisation / Location

INIST-CNRS, Cote INIST : 27047, 35400010314434.0010