Multiomics plasma effects of switching from triple antiretroviral regimens to dolutegravir plus lamivudine

从三联抗逆转录病毒方案转换为多替拉韦加拉米夫定的多组学血浆效应

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作者:Elisa de Lazzari, Eugenia B Negredo, Pere Domingo, Juan M Tiraboschi, Esteve Ribera, Nadia Abdulghani, Verònica Alba, Salvador Fernández-Arroyo, Consuelo Viladés, Joaquim Peraire, Jose M Gatell, Jose L Blanco, Francesc Vidal, Anna Rull, Esteban Martinez

Conclusions

Untargeted multiomics profiling studies identified molecular changes potentially associated with inflammation immune pathways, and with lipid and glucose metabolism. Although these changes could be associated with potential metabolic or cardiovascular consequences, their clinical significance remains uncertain. Further work is needed to confirm these findings and to assess their long-term clinical consequences.

Methods

Multiomics plasma profile was performed to gain further insight into whether this therapy switch might affect specific biological pathways. DOLAM (EudraCT 201500027435) is a Phase 4, randomized, open-label, non-inferiority trial in which virologically suppressed persons with HIV treated with 3DR were assigned (1:1) to switch to 2DR or to continue 3DR for 48 weeks. Untargeted proteomics, metabolomics and lipidomics analyses were performed at baseline and at 48 weeks. Univariate and multivariate analyses were performed to identify changes in key molecules between both therapy arms.

Results

Switching from 3DR to 2DR showed a multiomic impact on circulating plasma concentration of N-acetylmuramoyl-L-alanine amidase (Q96PD5), insulin-like growth factor-binding protein 3 (A6XND0), alanine and triglyceride (TG) (48:0). Correlation analyses identified an association among the up-regulation of these four molecules in persons treated with 2DR. Conclusions: Untargeted multiomics profiling studies identified molecular changes potentially associated with inflammation immune pathways, and with lipid and glucose metabolism. Although these changes could be associated with potential metabolic or cardiovascular consequences, their clinical significance remains uncertain. Further work is needed to confirm these findings and to assess their long-term clinical consequences.

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