Abstract

Deoxynucleoside analogs, AZT and/or ddN, are the therapeutic agents currently utilized to inhibit the human immunodeficiency virus (HIV) reverse transcriptase. The effects of their anabolic products, AZT-triphosphate (AZT-TP) and ddCTP on human cellular DNA metabolic processes were studied using highly purified, structurally and enzymatically defined forms of the two major human host DNA polymerases, alpha and beta, and compared to those of the reverse transcriptase purified from HIV viron. Human DNA polymerase alpha during processive DNA synthesis is able to incorporate AZT-monophosphate (AZT-MP) but not ddCMP into DNA, causing chain termination. During its initial encounter with a primer terminus, polymerase alpha is able to incorporate both AZT-MP and ddCMP into DNA chains. Polymerase beta is able to incorporate AZT-MP and ddCMP into DNA, causing chain termination in both modes of DNA synthesis. Steady state kinetic analyses demonstrate that polymerase alpha inserts one AZT-MP molecule into DNA for every 2500 dTMP molecules incorporated. Polymerase beta incorporates ddCMP with efficiency nearly equal to that of dCMP. HIV reverse transcriptase prefers to incorporate AZT-MP and ddCMP rather than dTMP and dCMP, respectively. The findings described here raise the concern that the capability of the two major host DNA polymerases to incorporate AZT-MP or ddCMP into DNA might cause adverse side effects on human DNA metabolism and mutation in the genomes of patients under long term continuous treatment with AZT and ddC.

Highlights

  • Deoxynucleoside analogs, AZT and/or ddN, are the been found to cause peripheral neuropathy in patients therapeutic agents currentlyutilized to inhibitthe hu- [7,8,9]

  • The preference of using these compounds is based on the rationale that HIVreverse transcriptase has higher Capability to incorporate these deoxynucleoside triphosphate analogs into viralDNA than the human to incorporate both AZT-MP and ddCMP into DNA host cellular DNA polymerases [6, 10]

  • The findings described here raise the concern none of these studies have used cellular polymerasesthat are that thecapability of the twomajor host DNA polym- enzymatically andstructurally defined, andthe effects of erases to incorporate AZT-MP or ddCMP into DNA these analogs onhost polymerases were not investigated might cause adverse side effects on human DNA metabolism and mutation in gtheenomes of patients under long termcontinuous treatment withAZT and ddC

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Summary

Introduction

Deoxynucleoside analogs, AZT and/or ddN, are the been found to cause peripheral neuropathy in patients therapeutic agents currentlyutilized to inhibitthe hu- [7,8,9]. AZT-primer termini and large amounts of 3’-dAMP 18- reaction (Fig. lB, lane 4).the nearenset ighbor sequence mer standing start primer-template.

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