Interaction of pregnancy steroid hormones and zidovudine in inhibition of HIV type 1 replication in monocytoid and placental Hofbauer cells: implications for the prevention of maternal-fetal transmission of HIV.

Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

AIDS Res Hum Retroviruses. 1997 Sep 20;13(14):1235-42. Unique Identifier : AIDSLINE /MED97454216
Lee AW; Mitra D; Laurence J; Department of Medicine, Cornell University Medical College, New York,; New York 10021, USA.

Abstract: Zidovudine (AZT) has been shown to reduce maternal-fetal transmission of HIV-1 by more than two-thirds in a variety of clinical settings. However, the mechanism of action of AZT in this setting is unclear. Suppression of vertical transmission has occurred in the absence of an impact on maternal plasma viremia and no lower threshold of viral load for such transmission has been identified. We hypothesized that augmentation of the anti-HIV effect of AZT may occur locally, at the maternal-fetal interface. We report that the pregnancy hormone progesterone at broad concentrations has little effect on acute HIV-1 infection of a monocytic cell line or primary peripheral blood cells. However, the combination of physiologic concentrations of progesterone (10[-7] to 10[-6] M) and low-dose AZT (10[-8] to 10[-9] M) produced markedly synergistic inhibition of HIV-1 replication within acutely infected monocytic cell lines (U937), and additive inhibition of HIV-1 growth within chronically infected monocytic cells (U1) and primary placental macrophages Hofbauer cells). Anti-HIV effects were not seen with another pregnancy steroid hormone, estrogen. In terms of possible mechanisms of action for progesterone, we demonstrated that it incompletely suppressed tat activation of long terminal repeat LTR)-driven gene expression in monocytic cells. However, the progesterone-mediated suppession of tat activation was not affected by mutation of the three consensus progesterone/androgen/glucocorticoid response elements within the HIV-1 LTR, previously shown by our group to be involved in glucocorticoid-mediated suppression of LTR-driven transcription. It is likely that progesterone suppresses LTR-driven gene expression through a nontranscriptional mechanism, and augments the efficacy of AZT through enhancement of its phosphorylation.

Keywords: *Anti-HIV Agents/PHARMACOLOGY *HIV-1/DRUG EFFECTS *HIV-1/GROWTH & DEVELOPMENT *Monocytes/DRUG EFFECTS *Monocytes/VIROLOGY *Placenta/DRUG EFFECTS *Placenta/VIROLOGY *Progesterone/PHARMACOLOGY *Virus Replication/DRUG EFFECTS *Zidovudine/PHARMACOLOGY
980130
M9811030

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, Gill Foundation, the National Library of Medicine, Quest Diagnostics, Roche and Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 1998. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1998. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .