HIV/AIDS is the most threatening and challenging infectious diseases of our time, with the highest increase of newly infected cases reported. This infectious disease was discovered in the early eighties under homosexual men and was later to be discovered in heterosexuals. HIV is a systemic immunosuppressive disorder which causes a depletion of CD4+ T cells and develops into the acquired immunodeficiency syndrome - AIDS. Africa is the continent most affected by HIV/AIDS with the southern parts of Africa having the highest prevalence rates compared to the rest of Africa. Statistics indicate that AIDS is responsible for 3% of deaths in children worldwide - one in seven people dying of an HIV-related illness is a child under the age of 15 years. It was stated by the WHO that countries should develop improved antiretrovirals regimes for the prevention of mother-to-child transmission. Difficulties in administering antiretrovirals (ARVs) to patients (especially children) are the strict dosage regimes and the severe adverse reactions. These factors complicate patient adherence. The list of problems in treating patients is endless and includes the distribution, stability as well as the low efficacy of these drugs. Most of the above mentioned problems and obstacles related to ARVs and ARV treatment could be minimized or eliminated by the use of a stable and effective drug delivery system. Enhancing ARV treatment may be accomplished by the use of the Pheroid™ drug delivery system. Pheroids™ consists mainly of fatty acids and sterile nitrous oxide gassed water. Pharmacological active substances are entrapped into submicron and micron sized structures called Pheroids™. Research showed promising results and advantages in delivering drugs through oral and transdermal routes using Pheroid™ technology. The focus of this study was to test the possible enhancement of the efficacy of antiretrovirals using Pheroid™ technology. The assays used to study this possible enhancement were a modified neutral red and a modified 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium (MTT) assay. These assays confirmed and illustrated the toxic and protective properties of the tested ARVs (stavudine, lamivudine and nevirapine). An MT-2 cell line was used and infected with an HIV-1 strain, SW7-TCL. Applying Pheroid™ technology in these assays resulted in massive cell death, due to increased ARV toxic levels within the cells. Viability tests proved that Pheroids™ had no effect on the viability of cells at the concentration typically used. This confirmed the enhancing properties of Pheroids™ in the delivery of drugs into the cells. The MTT assay was further adapted from a seven day incubation period to a three day incubation period. By using a low concentration series and a three day incubation period the loss of cells through toxicity was partially overcome. One of the problems that arose form this study was the non-reproducibility of the results. Absorbance levels fluctuated at specific concentrations of the same ARV, which cause difficulties in comparing results. This result was repeatedly confirmed in this syncytium forming infection model. In conclusion, Pheroid™ technology enhanced the delivery of ARVs into the cells although it resulted in cell death. Both the neutral red and MTT assays were found to be inaccurate but further development, research and assay optimization could result in improved in vitro studies. The article format was used for this thesis, as described in the general academic rules in section A.13.7.3 of the North West University. Chapter 1 deals with HIV/AIDS related problems, statistics and treatment obstacles. Chapter 2 is a summary of the cell viability assays used in this study. Pheroid™ technology and its application to ARV treatment are dealt with in chapter 3. The proposed article for submission in the journal Cell Death and Differentiation has been included in chapter 4. Some of the results from the study are reported in the article and annexures, whilst other results are shown and discussed in Chapter 5. Chapter 6 gives a conclusion and final summary of this study. All other experimental methods and results are enclosed in the annexures, as is the "Guide for authors" for the article. / Thesis (M.Sc. (Pharmaceutics))--North-West University, Potchefstroom Campus, 2008.

HIV/AIDS is the most threatening and challenging infectious diseases of our time, with the highest increase of newly infected cases reported. This infectious disease was discovered in the early eighties under homosexual men and was later to be discovered in heterosexuals. HIV is a systemic immunosuppressive disorder which causes a depletion of CD4+ T cells and develops into the acquired immunodeficiency syndrome - AIDS. Africa is the continent most affected by HIV/AIDS with the southern parts of Africa having the highest prevalence rates compared to the rest of Africa. Statistics indicate that AIDS is responsible for 3% of deaths in children worldwide - one in seven people dying of an HIV-related illness is a child under the age of 15 years. It was stated by the WHO that countries should develop improved antiretrovirals regimes for the prevention of mother-to-child transmission. Difficulties in administering antiretrovirals (ARVs) to patients (especially children) are the strict dosage regimes and the severe adverse reactions. These factors complicate patient adherence. The list of problems in treating patients is endless and includes the distribution, stability as well as the low efficacy of these drugs. Most of the above mentioned problems and obstacles related to ARVs and ARV treatment could be minimized or eliminated by the use of a stable and effective drug delivery system. Enhancing ARV treatment may be accomplished by the use of the Pheroid™ drug delivery system. Pheroids™ consists mainly of fatty acids and sterile nitrous oxide gassed water. Pharmacological active substances are entrapped into submicron and micron sized structures called Pheroids™. Research showed promising results and advantages in delivering drugs through oral and transdermal routes using Pheroid™ technology. The focus of this study was to test the possible enhancement of the efficacy of antiretrovirals using Pheroid™ technology. The assays used to study this possible enhancement were a modified neutral red and a modified 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium (MTT) assay. These assays confirmed and illustrated the toxic and protective properties of the tested ARVs (stavudine, lamivudine and nevirapine). An MT-2 cell line was used and infected with an HIV-1 strain, SW7-TCL. Applying Pheroid™ technology in these assays resulted in massive cell death, due to increased ARV toxic levels within the cells. Viability tests proved that Pheroids™ had no effect on the viability of cells at the concentration typically used. This confirmed the enhancing properties of Pheroids™ in the delivery of drugs into the cells. The MTT assay was further adapted from a seven day incubation period to a three day incubation period. By using a low concentration series and a three day incubation period the loss of cells through toxicity was partially overcome. One of the problems that arose form this study was the non-reproducibility of the results. Absorbance levels fluctuated at specific concentrations of the same ARV, which cause difficulties in comparing results. This result was repeatedly confirmed in this syncytium forming infection model. In conclusion, Pheroid™ technology enhanced the delivery of ARVs into the cells although it resulted in cell death. Both the neutral red and MTT assays were found to be inaccurate but further development, research and assay optimization could result in improved in vitro studies. The article format was used for this thesis, as described in the general academic rules in section A.13.7.3 of the North West University. Chapter 1 deals with HIV/AIDS related problems, statistics and treatment obstacles. Chapter 2 is a summary of the cell viability assays used in this study. Pheroid™ technology and its application to ARV treatment are dealt with in chapter 3. The proposed article for submission in the journal Cell Death and Differentiation has been included in chapter 4. Some of the results from the study are reported in the article and annexures, whilst other results are shown and discussed in Chapter 5. Chapter 6 gives a conclusion and final summary of this study. All other experimental methods and results are enclosed in the annexures, as is the "Guide for authors" for the article. / Thesis (M.Sc. (Pharmaceutics))--North-West University, Potchefstroom Campus, 2008.

Als Prüfung auf das genotoxische Potenzial einer Substanz ist die Entstehung von Micronuclei in proliferierendem Gewebe als genetischer Endpunkt wissenschaftlich und behördlich anerkannt. Zugrunde liegendes Experimentalmodell für diesen Test sind zumeist Mäuse und Ratten, deren Knochenmark das Zielgewebe dieses Tests darstellt. Dieses Testmodell geht mit dem Tod der verwendeten Tiere einher. Die vorliegende Arbeit greift den von Wolf & Lüpke (1997) sowie Wolf (1999) vorgestellten HET-MN (Hen’s Egg Test for MicroNucleus induction) auf, der angebrütete Hühnereier als Experimentalmodell verwendet (Bebrütungsdauer 11 Tage, d11). Zielorgan ist das periphere Blut der extraembryonalen Membranen. Das entnommene Blut wurde nach modifizierten hämatologischen Standard-verfahren angefärbt und die Zellen im Hellfeld-Durchlicht-Mikroskop bei 1000-facher Vergrößerung ausgezählt. Anhand der nucleosidanalogen Reverse Transkriptase Hemmer Zidovudin, Stavudin, Zalcitabin, Lamivudin und Didanosin fand ein Abgleich mit den durch Tierversuche gewonnenen Daten statt. In den versuchsreihen zu Zidovudin, Stavudin Zalcitabin, Didanosin und in den Kombinationsversuchen mit Zidovudin und Didanosin konnten die Daten aus der Literatur reproduzierbar bestätigt werden; wobei der HET-MN sensitiver reagierte als das Testmodell am Tier. Für Lamivudin konnte reproduzierbar eine biologisch und statistisch relevante, dosisabhängige Erhöhung der Micronucleusfrequenz erzielt werden. Damit steht der HET-MN in Kontrast zu den in der Literatur verfügbaren Informationen. Die im HET-MN gewonnenen Daten ließen in allen Versuchsreihen auf vergleichbare oder höhere Sensitivität als im Micronucleustest an Nagern schließen. Damit stellt der HET-MN eine kostengünstige und methodisch leicht durchführbare Alternative zum Tierversuch dar und wird trotz seiner hohen Komplexität und den damit verbundenen in-vivo-ähnlichen Bedingungen allen Belangen des Tierschutzes gerecht.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2015-01-13T11:03:19Z No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação - Alline Torquato Vasconcelos - 2014.pdf: 3499445 bytes, checksum: 93905607504e61e452d7ce82396c17a9 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-01-13T11:04:23Z (GMT) No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação - Alline Torquato Vasconcelos - 2014.pdf: 3499445 bytes, checksum: 93905607504e61e452d7ce82396c17a9 (MD5) / Made available in DSpace on 2015-01-13T11:04:23Z (GMT). No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação - Alline Torquato Vasconcelos - 2014.pdf: 3499445 bytes, checksum: 93905607504e61e452d7ce82396c17a9 (MD5) Previous issue date: 2014-06-06 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Lamivudine (β-L-2',3'-dideoxy-3'-thiacytidine, 3TC) is a nucleoside-based anti-HIV/HBV drug that has provided insights into the nucleic acid double-stranded helix assembly. Two crystal structures thereof assembled with nucleobase pairing and helical stacking as mimicries of DNA, but without the phosphodiester linkages in the fiber periphery, have recently demonstrated that nucleosides bring themselves the chemical information to assemble DNA duplexes even if the covalent backbone is absent. Here, we report the third structural example in which nucleosides are base-paired and helically base-stacked. A DNA-like double stranded helix was prepared cocrystallizing lamivudine with fumaric acid. We have named it as lamivudine duplex III. When substituting maleic acid present in the first example of lamivudine duplex for its trans-stereoisomer, the formation of a DNA-mimicry is still observed but with changes in the crystal stoichiometry, nucleobase pairing pattern and duplex backbone. Lamivudine duplex III exhibits both base pairing motifs present in the antecedent duplexes. In this structure, there are four protonated lamivudine molecules paired in-plane with four neutral ones. These crystallographically independent base pairs are held together through three hydrogen bonds as occurs in lamivudine duplex I made up of cytosine-cytosine+ base pairing only. But, contrarily to the duplex I with pairing between neutral and cationic drug units only, the duplex III has one neutral 3TC=3TC pair in its asymmetric unit. These molecules are kept in contact through only two peripheral N―H•••O hydrogen bonds as in two of the three neutral lamivudine pairs of the second example of lamivudine duplex. In both structures, each neutral pair is face-to-face stacked on top of one another and face-to-tail stacked on bottom of another one. Even in agreement with its higher structural complexity, the duplex III is present with very puckering conformations besides the three different orientations of the OH moiety at C5’. Five-membered oxathiolane ring adopts three envelop puckering modes and two twist conformations. This is the first report of a twist pucker for lamivudine despite of the large number of reported crystal structures thereof. Another remarkable characteristic of the duplex III is in its fiber periphery. There are hydrogen bonds between the 5’-OH moieties of neighbor pairs pointing in the direction of the missing phosphodiester linkages that would covalently bond two adjacent monomers in the strand. Furthermore, the geometry of these interactions reveals the antiparallel orientation of each strand relative to one another into the nucleoside duplex backbone. Noteworthy similarities between the duplexes crystallizing together with either hydrogen maleate or hydrogen fumarate are their left handedness and the outline of surface grooves of similar depth. But, while all hydrogen maleate counterions are lodged on the grooves of the duplex I, some hydrogen fumarate units are also interacting with themselves into one-dimensional chain of counterions. The third example of unusual double-stranded helices of lamivudine strengthens the fact that nucleosides can self-aggregate into DNA-like duplexes even without the covalent phosphodiester linkages in fiber periphery. Besides that, the structure described here adds knowledge on lamivudine versatility to assemble DNA-mimicry in crystals. / A lamivudina (β-L-2',3'-dideoxy-3'-thiacytidine, 3TC) é um fármaco a base de nucleosídeos utilizado para o tratamento de SIDA e Hepatite B. A obtenção de estruturas do tipo dupla hélice de ácidos nucleicos com esse fármaco tem sido alvo de estudo. Recentemente foram reportadas duas estruturas cristalinas mimetizando DNA, formadas por pares de nucleosídeos empacotados em uma dupla hélice, mas sem ligações fosfodiéster na periferia da cadeia. Estas estruturas demonstraram que os nucleosídeos possuem informação química suficiente para a formação de estruturas dessa natureza mesmo com a ausência das ligações covalentes fosfodiéster. Neste trabalho um terceiro exemplo de uma estrutura contendo bases de nuclosídeos pareadas e sobrepostas helicoidalmente, mimetizando DNA, é reportado. Essa modificação cristalina foi preparada através da cocristalização da lamivudina com o ácido fumárico e a estrutura obtida foi denominada duplex III. Com a substituição do ácido maleico, presente no primeiro exemplo de dupla hélice de lamivudina, pelo seu estéreoisômero trans, o ácido fumárico, a formação de uma estrutura mimetizando o DNA também foi observada, porém, com diferenças na estequiometria do cristal, nos padrões de interação do pareamento das bases, assim como no esqueleto da dupla hélice. O pareamento das bases na duplex III de lamivudina possui padrões de interação semelhante a ambas estruturas precedentes. Na duplex III existem quatro pares parcialmente protonados, onde uma lamivudina protonada está pareada com outra neutra. Esse tipo de pareamento se dá através de três ligações de hidrogênio e é semelhante ao pareamento presente na estrutura da duplex I de lamivudina composto apenas por pares do tipo 3TC+≡3TC. Diferentemente da duplex I que possui exclusivamente pares parcialmente protonados, a duplex III possui também um par neutro do tipo 3TC=3TC na sua unidade assimétrica. O pareamento dessas bases é formado apenas por duas ligações de hidrogênio do tipo N―H•••O, semelhante a dois dos três pares neutros que constituem a duplex II de lamivudina. O empacotamento dos pares neutros na duplex III é semelhante ao da duplex II, cada par neutro empacota com uma padrão face a face com o par que o antecede e face a cauda com o par subsequente. Devido à grande complexidade estrutural da duplex III, temos uma maior variação nas conformações assumidas tanto pelo anel oxatiolano quanto pelo fragmento citosinico, assim como nas três orientações adotadas pelo grupo hidroxílico ligado ao carbono C5’. O anel oxatiolano de cinco membros, adota três diferentes conformações do tipo envelope e duas conformações do tipo cambaleante. Apesar de essas serem as primeiras estruturas reportadas com conformações do tipo cambaleante para a lamivudina, esse tipo de conformação é comum para várias outras estruturas cristalinas. Outra característica que merece destaque na estrutura obtida da duplex III está nos padrões de interação presentes na periferia da dupla hélice. Nota-se a presença de ligações de hidrogênio entre os grupos 5’-OH de pares vizinhos, que ocorrem na direção onde as ligações fosfodiéster deveriam existir entre dois monômeros adjacentes. Além disso, a geometria dessas ligações de hidrogênio revelam uma orientação antiparalela de uma fita em relação a outra no esqueleto da duplex. Existem algumas semelhanças notáveis entre as duplexes I e III, cristalizadas com hidrogenomaleato e hidrogenofumarato, como a espiralização a esquerda e o fato de ambas não possuírem diferença entre sulcos principais e secundários, uma vez que todos os sulcos ao longo da cadeia possuem dimensões semelhantes. Porém, todos os contraíons estão acomodados nos sulcos da duplex I, enquanto que na duplex III alguns contraíons interagem entre si formando uma cadeia unidimensional de contraíons. Esse terceiro exemplo de uma estrutura atípica de dupla hélice de lamivudina reforça o fato de que nucleosídeos podem se agregar em estruturas semelhantes a dupla hélice do DNA, mesmo com a ausência das ligações covalentes fosfodiéster. Além disso a estrutura da duplex III adiciona conhecimento quanto a versatilidade da lamivudina em formar estruturas mimetizando DNA em cristais.