18 May Diabetes Medication May Improve Cardiac Profile Of HIV Patients on Antiretroviral Therapy
MedicalResearch.com Interview with:
Kevin Yarasheski, PhD
Assistant Director, Biomedical Mass Spectrometry Research Facility
Professor of Medicine, Cell Biology & Physiology, Physical Therapy
Washington University School of Medicine
Medical Research: What is the background for this study?
Dr. Yarasheski: People living with HIV and taking combination antiretroviral therapy (cART) have successfully reduced the amount of HIV virus in their blood and have partially reconstituted their immune system (CD4+ T-cell count >250 cells/µL). Despite this, many still experience residual immune cell activation and inflammation that is believed to increase HIV morbidity (non-AIDS conditions e.g., CVD, T2DM, obesity, liver fat, bone loss, dementia) and mortality. Scientists are seeking safe and effective interventions for residual immune cell activation and inflammation, that have the potential to reduce non-AIDS complications that threaten quality and quantity of life among HIV infected adults.
We have been testing the safety and efficacy of sitagliptin in people living with HIV; a dipeptidyl peptidase 4 inhibitor that is FDA approved for treating T2DM, and appears to have favorable anti-inflammatory and immune modulatory properties that might specifically benefit people living with HIV and experiencing cardiometabolic complications associated with residual immune cell activation and inflammation.
Medical Research: What are the main findings?
Dr. Yarasheski: In a randomized, double-blinded, placebo controlled 8-wk trial, we found that sitagliptin had beneficial anti-inflammatory, immune regulatory, hematopoietic progenitor cell mobilizing, and glucose lowering effects in cART-treated virally suppressed HIV adults with impaired glucose tolerance. Sitagliptin improved glucose tolerance (a risk factor for CVD), reduced circulating and adipose-specific inflammatory markers (risk factors for obesity, T2DM, liver fat accumulation, and CVD), and increased the number of blood stem cells that can repair damage and inflammation in the vascular walls.
Medical Research: What should clinicians and patients take away from your report?
Dr. Yarasheski: Larger, longer-term studies of sitagliptin in people living with HIV are required. However, our preliminary findings strongly suggest that sitagliptin may be a safe and effective therapy for reducing several underlying causes of cardiometabolic complications among cART-treated people living with HIV and experiencing residual immune cell activation and inflammation.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Yarasheski: We propose a longer-term study (1 yr) that will directly examine the effects of sitagliptin on vascular inflammation responsible for atherosclerotic plaque progression and increased incidence of stroke and myocardial infarction in people living with HIV. We hypothesize that sitagliptin will reduce vascular inflammation and reduce plaque progression among cART-treated people living with HIV. We also propose to directly examine the effects of sitagliptin on liver adiposity in cART-treated people living with HIV. Fatty liver is a common and insidious metabolic complication (among HIV+ and the general population), for which there are very few safe and effective medications. We anticipate that the anti-inflammatory and glucoregulatory properties of sitagliptin will reduce liver adipose content in cART-treated people living with HIV.
MedicalResearch.com Interview with: Kevin Yarasheski, PhD (2015). Diabetes Medication May Improve Cardiac Profile Of HIV Patients on Antiretroviral Therapy MedicalResearch.com