Telmisartan increases vascular reparative capacity in older HIV-infected adults: a pilot study.
| Autor: | Lake JE; a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA., Seang S; a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA., Kelesidis T; a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA., Currier JS; a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA., Yang OO; a Division of Infectious Diseases, Department of Medicine , University of California , Los Angeles , CA , USA.; b Department of Microbiology, Immunology, and Molecular Genetics , University of California , Los Angeles , CA , USA.; c AIDS Healthcare Foundation , Los Angeles , CA , USA. |
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| Jazyk: | angličtina |
| Zdroj: | HIV clinical trials [HIV Clin Trials] 2016 Nov; Vol. 17 (6), pp. 225-232. Date of Electronic Publication: 2016 Sep 23. |
| DOI: | 10.1080/15284336.2016.1234222 |
| Abstrakt: | Background: Endothelial progenitor cells (EPCs) are bone marrow-derived cells that contribute to vascular repair. EPCs may be reduced in HIV-infected (HIV+) persons, contributing to cardiovascular disease (CVD). Telmisartan is an angiotensin receptor blocker that increases EPCs in HIV-uninfected adults. Objective: To assess telmisartan's effects on EPC number and immunophenotype in older HIV + adults at risk for CVD. Methods: HIV + persons ≥50 years old with HIV-1 RNA < 50 copies/mL on suppressive antiretroviral therapy and ≥1 CVD risk factor participated in a prospective, open-label, pilot study of oral telmisartan 80 mg daily for 12 weeks. Using CD34 and CD133 as markers of early maturity and KDR as a marker of endothelial lineage commitment, EPCs were quantified via flow cytometry and defined as viable CD3 - /CD33 - /CD19 - /glycophorin - cells of four immunophenotypes: CD133 + /KDR + , CD34 + /KDR + , CD34 + /CD133 + , or CD34 + /KDR + /CD133 + . The primary endpoint was a 12-week change in EPC subsets (NCT01578772). Results: Seventeen participants (88% men, median age 60 years and peripheral CD4 + T lymphocyte count 625 cells/mm 3 ) enrolled and completed the study. After 6 and 12 weeks of telmisartan, frequencies of all EPC immunophenotypes were higher than baseline (all p < 0.10 except week 12 CD133 + /KDR + EPC, p = 0.13). Participants with lower baseline EPC levels had the largest gains. Additionally, the percentage of CD34 + cells with endothelial commitment (KDR + ) increased. Conclusions: Our data suggest that telmisartan use is associated with an increase in circulating EPCs in older HIV + individuals with CVD risk factors. Further controlled studies are needed to assess whether EPC increases translate to a reduction in CVD risk in this population. |
| Databáze: | MEDLINE |
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