Zidovudine (AZT, 3'-azido-3'deoxythymidine) is a primary drug used to treat HIV/AIDS patients worldwide including the prevention of HIV vertical transmission in pregnant women. While AZT effectively inhibits HIV reverse transcriptase and thus viral replication, studies have also shown AZT to induce a drug-specific muscle myopathy and increased oxidative stress via inhibition of mitochondrial DNA γ polymerase. Previously we have shown that AZT treatment produces respiratory muscle contractile dysfunction in adults rodents (Herb et al., 1997, 2000). To determine if neonatal respiratory muscle was susceptible to AZT toxicity, adult, Sprague-Dawley dams (n = 12) were randomly assigned to a control group or treated with AZT (10mg/kg/day) administered via drinking water ad libitum 28 days prior to and throughout gestation (21 days). Following birth, adult females and pups were maintained on oral AZT for 28 days post-partum prior to contractile experiments. Respiratory muscle function was assessed using two costal diaphragm strips removed from each neonate and evaluated for force-frequency relationship, maximal isometric specific tension, and fatigue resistance (30 min test) using a field stimulation preparation. In vitro studies indicated that neonatal AZT treatment significantly altered the F-F relationship, decreased specific tension development (21%) and reduced fatigue resistance (min 20+) when compared to controls. To our knowledge, this study is the first to address the impact of AZT on neonatal respiratory muscle function. These data support the hypothesis that in utero and post-partum exposure to AZT deleteriously impacts neonatal diaphragm function in a manner similar to that seen in adult diaphragms. We conclude that these data provide evidence indicating the need for an improved understanding of the mechanism(s) responsible for the observed results as well as clinical therapies that can ameliorate the impact of AZT on neonatal respiratory muscle function. Supported by the American Lung Association, NAU Hooper Undergraduate Research Grant, & GlaxoSmithKline
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