Nevirapine (NVP) is a non-nucleoside reverse transcriptase inhibitor (NNRTI) used against HIV-1. Currently, NVP is the most widely used anti-HIV drug in developing countries, both in combination therapy and to prevent mother-to-child transmission of HIV. Despite its efficacy against HIV, NVP produces a variety of toxic responses, including hepatotoxicity and skin rash. It is also associated with increased incidences of hepatoneoplasias in rodents. In addition, epidemiological data suggest that NNRTI use is a risk factor for non-AIDS-defining cancers in HIV-positive patients. Current evidence supports the involvement of metabolic activation to reactive electrophiles in NVP toxicity. NVP metabolism includes oxidation to 12-hydroxy-NVP; subsequent Phase II sulfonation produces an electrophilic metabolite, 12-sulfoxy-NVP, capable of reacting with DNA to yield covalent adducts. Since 2’-deoxythymidine (dT) adducts from several alkylating agents are regarded as having significant mutagenic/carcinogenic potential, we investigated the formation of NVP-dT adducts under biomimetic conditions. Toward this goal, we initially prepared and characterized synthetic NVP-dT adduct standards using a palladium-mediated Buchwald-Hartwig coupling strategy. The synthetic standards enabled the identification, by LC-ESI-MS, of 12-(2'-deoxythymidin-N3-yl)-nevirapine (N3-NVP-dT) in the enzymatic hydrolysate of salmon testis DNA reacted with 12-mesyloxy-NVP, a synthetic surrogate for 12-sulfoxy-NVP. N3-NVP-dT, a potentially cytotoxic and mutagenic DNA lesion, was also the only dT-specific adduct detected upon reaction of dT with 12-mesyloxy-NVP. Our data suggest that N3-NVP-dT may be formed in vivo and play a role in the hepatotoxicity and/or putative hepatocarcinogenicity of NVP.
奈韦拉平 (
NVP) 是一种用于对抗 HIV-1 的非核苷逆转录酶
抑制剂 (NNRTI)。目前,
NVP是发展中国家使用最广泛的抗艾滋病毒药物,用于联合治疗和预防艾滋病毒母婴传播。尽管
NVP 具有对抗 HIV 的功效,但它会产生多种毒性反应,包括肝毒性和皮疹。它还与啮齿动物肝肿瘤发病率增加有关。此外,流行病学数据表明,NNRTI 的使用是 HIV 阳性患者患非艾滋病定义癌症的危险因素。目前的证据支持反应性亲电子试剂的代谢激活与
NVP 毒性有关。
NVP代谢包括氧化为12-羟基-
NVP;随后的第二阶段磺化产生亲电子代谢物 12-磺氧基-
NVP,能够与 DNA 反应产生共价加合物。由于几种烷化剂的 2'-脱氧
胸苷 (dT) 加合物被认为具有显着的致突变/致癌潜力,因此我们研究了仿生条件下
NVP-dT 加合物的形成。为了实现这一目标,我们最初使用
钯介导的 Buchwald-Hartwig 偶联策略制备并表征了合成
NVP-dT 加合物标准品。合成标准品能够通过 LC-ESI-MS 鉴定与 12-
甲磺酰氧基-反应的鲑鱼睾丸 DNA 的酶解产物中的 12-(2'-脱氧
胸苷-N3-基)-
奈韦拉平 (N3-
NVP-dT)。
NVP,12-磺氧基-
NVP 的合成替代品。 N3-
NVP-dT 是一种潜在的细胞毒性和诱变 DNA 损伤,也是 dT 与 12-甲磺氧基-
NVP 反应时检测到的唯一 dT 特异性加合物。我们的数据表明,N3-
NVP-dT 可能在体内形成,并在
NVP 的肝毒性和/或假定的肝癌致癌性中发挥作用。