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  • br Methods and materials br


    Methods and materials
    Acknowledgements The authors thank the NIH AIDS Reagent Program for providing the materials and reagents. The HIV-1 1084i envelope gene was a generous gift from Dr. Charles Wood. This work was supported in part by grants to S.-H. X. from the Bill and Melinda Gates Foundation (#51783) and the Agricultural Research Division (ARD), UNL. J.S. was supported by NIH grants AI124982 and AI100645 and by a gift from the late William F. McCarty-Cooper. A.F. was supported by CIHR foundation grant #352417 and by the Canada Research Chair on Retroviral Entry #RCHS0235. D.B. is an NIH Ruth L. Kirschstein Fellow (5T32AI06547-8). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have no conflicts of interest to report.
    Introduction Buprenorphine is a semi-synthetic derivative of thebaine. It has a molecular weight of 467 and its structure is typically opioid with the inclusion of a C-7 side-chain containing a t-butyl group. Comparison of the antinociceptive effects of methadone and buprenorphine shows that GSK J4 3mg/kg for methadone is the effective analgesic dose, and 0.3mg/kg for buprenorphine in rats using the hot-plate test (Bulka et al., 2004). Respiratory depression caused by opioids can be potentially life-threatening but is much less of a problem with buprenorphine than with many other opioids including morphine, hydromorphone, methadone, oxycodone, and transdermal fentanyl (Dahan et al., 2005). This advantage is due to the unique pharmacological characteristics of buprenorphine as a partial mu-agonist. Its ceiling effect, associated with a bell-shaped dose–response (D–R) curve with regard to respiratory depression, means that the risk to induce respiratory arrest does not linearly follow dose-increments of the drug. Although methadone is used as a pharmacotherapy for opioid dependence in HIV-1-infected individuals, its use has been associated with several adverse drug interactions with HIV-1 therapies that can produce either elevated methadone concentrations with toxicity, or decreased methadone levels with withdrawal (Gruber and McCance-Katz, 2010, McCance-Katz, 2005). In contrast, buprenorphine has not been shown to produce significant adverse drug interactions with antiretroviral therapy drugs such as delavirdine, efavirenz, nelfinavir, ritonavir or lopinavir/ritonavir (Gruber and McCance-Katz, 2010, McCance-Katz, 2005). The lack of drug interaction between antiretroviral therapy and buprenorphine is potentially an important advantage of buprenorphine treatment of opioid dependence in HIV-1 infected patients. Opioid abuse and therapeutic use are frequently associated with HIV infection. With the global HIV prevalence estimated at 35.3 million, approximately 30% of HIV-positive individuals, within developed countries, are intravenous (IV) drug users, and it is the third most frequently reported risk factor for HIV-1 infection in the United States (CDC, 2009). In addition, pain is part of the clinical picture associated with HIV and AIDS. Opioids are among the most effective and commonly used analgesics in clinical practice for severe pain. However, the use of opioid medications is clinically limited by several adverse properties including dependence. Currently, there is no data available examining the physical dependence to buprenorphine in neuroAIDS. Therefore, we determined the physical dependence to these opioids in the context of HIV.
    Materials and methods
    Discussion The effects of HIV-1 infection on neuronal systems are associated with the entry of the virus into the brain, which occurs soon after the initial infection (Nathanson et al., 1994). While evidence of neuronal infection by HIV-1 is lacking, it is well known that components of the virus such as the coat protein gp120 can bind to, and signal via, neuronal chemokine receptors. Within the brain, gp120, the surface envelope protein used by the virus to gain access into immune cells, has been implicated as a neurotoxic factor in HIV-infected individuals. Gp120 has been detected in the brains of HIV-1-infected individuals, localized by immunohistochemistry to microglia and multinucleated giant cells (Jones et al., 2000). Neurodegeneration and gliosis similar to that seen in patients with HIV-associated dementia (HAD) was found in CNS-targeted gp120 transgenic mice (Mucke et al., 1995, Toggas et al., 1994). To examine whether the presence of gp120 in the brain interferes with the physical dependence to buprenorphine, gp120 has been infused directly into PAG, one of the brain areas involved in physical dependence to opioid, and spontaneous withdrawal behaviors monitored following the discontinuation of the chronic administration of this opioid. Gp120 did not enhance or precipitate the withdrawal-induced weight loss associated with the discontinuation of buprenorphine.