揭示抗逆转录病毒疗法引起的骨质疏松症的基础：多替拉韦、达芦那韦和阿扎那韦对成骨的影响。
Unveiling the basis of antiretroviral therapy-induced osteopenia: the effects of Dolutegravir, Darunavir and Atazanavir on osteogenesis.
机构信息
General Pathology.
Infectious Diseases Unit, Department of Biomedical and Clinical Sciences 'Luigi Sacco', Università degli Studi di Milano, Milan, Italy.
出版信息
AIDS. 2021 Feb 2;35(2):213-218. doi: 10.1097/QAD.0000000000002732.
OBJECTIVES
Osteopenia is frequent in HIV-infected patients treated with antiretroviral therapy (ART) and has been linked to increased osteoclastogenesis. Little is known about the effects of ART on osteogenesis.
DESIGN
We investigated the effect on human mesenchymal stem cells (hMSC) and osteoblasts of Darunavir and Dolutegravir, the most highly used as anchor drugs within a three-drug regimen, and Atazanavir, which was widely utilized in the past.
RESULTS
We found that Atazanavir and Dolutegravir delay the osteogenic differentiation of hMSC, impair the activity of osteoblasts and inhibit their conversion into osteocytes, whereas Darunavir exerts no effect.
CONCLUSION
Atazanavir and Dolutegravir impair osteogenesis. It is essential to diagnose impaired osteogenesis early and to devise effective therapeutic interventions to preserve bone health in ART-treated HIV patients, putting it in the context of a correct antiretroviral combination.
目的
接受抗逆转录病毒疗法（ART）治疗的 HIV 感染患者常出现骨质减少症，且其与破骨细胞生成增加有关。然而，ART 对成骨作用的影响知之甚少。
设计
我们研究了目前在三药方案中最常作为基础药物使用的达芦那韦和度鲁特韦，以及过去广泛应用的阿扎那韦对人骨髓间充质干细胞（hMSC）和成骨细胞的影响。
结果
我们发现，阿扎那韦和度鲁特韦延迟 hMSC 的成骨分化，损害成骨细胞的活性并抑制其向成骨细胞的转化，而达芦那韦则没有这种作用。
结论
阿扎那韦和度鲁特韦会损害成骨作用。在接受 ART 治疗的 HIV 患者中，早期诊断成骨作用受损并设计有效的治疗干预措施以维持骨骼健康至关重要，这需要结合正确的抗逆转录病毒组合来考虑。
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