Background: Tadala�il (Cialis, Lilly ICOS) and Sildena�il citrate (Viagra, P�izer) are by far the most popular and widely used drugs for enhancing male erectile function. Recent studies have suggested that Tadala�il administration increases the expression of CXCR4 in human endothelial progenitor cells (EPC). CXCR4 is also a major co-receptor for HIV (Human Immunode�iciency Virus) infection of human CD4 T cells. In addition, the viral tropism switch to CXCR4 is associated with rapid disease progression in patients.
Findings:We investigated whether Tadala�il and Sildena�il increased CXCR4 expression on human CD4 T cells, which may potentially facilitate HIV infection and transmission. We found that both drugs transiently increase CXCR4 expression on CD4 T cells. We further used an HIV-1 Rev-dependent reporter cell (Rev-CEM-Luc-GFP) to evaluate possible drug enhancement of viral replication in vitro. We also found that no signi�icant impact of viral replication was observed, when cells were transiently exposed to these drugs. In contrast, both drugs inhibited HIV-1 infection when cells were treated for extended periods of time, likely resulting from interference with intracellular signaling environment involved in HIV-1 infection.
Conclusion:These results suggest that although both drugs enhance CXCR4 expression, they may not enhance HIV replication and increase HIV transmission.
KeywordsHIV-1; Tadala�il; Sildena�il; Rev-CEM-Luc-GFP; PBMC We further tested the effects of these drugs on promoting HIV infection. We used an HIV-1 Rev-dependent indicator CD4 T cell line, Rev-CEM-Luc-GFP [18,19], which expresses luciferase and GFP only after HIV infection. To measure the effects of Tadala�il and Sildena�il, we �irst performed transient treatment of Rev-CEM-Luc-GFP cells with these drugs. Cells were pre-treated for 1 hour with Tadala�il or Sildena�il, and then infected with HIV-1 for two hours in the presence of the drug. Following infection, cells were washed and then cultured in fresh medium for 72 hours without the drug being added back. GFP expression was measured at 72 hours by �low cytometry. Infected cells were also stained for apoptosis with propidium iodide (P.I.) during cytometry to exclude drug cytotoxicity. GFP expression was measured only in the viable cell population (low P.I. staining). As shown in (Figure 2A), HIV-1 infection led to the GFP expression in 2.12% cells, whereas brief treatment of cells with Tadala�il in a range of dosages (from 10 nM to 10 μM) during infection did not enhance viral replication. We performed a similar infection experiment in Sildena�il-treated cells. As shown in (Figure 2B), HIV-1 infection led to the GFP expression in 1.58% cells, whereas brief treatment of cells with Sildena�il in a range of dosages (from 10 nM to 10 μM) during infection did not lead to signi�icant enhancement of viral replication (GFP+ cells, 1.89-2.20%). Similar results were observed when concentrated high titer viruses (2500ng p24) were used for infection (Figure 3).We also investigated the dru...