HIV infection is associated the development of increased oxidative stress and deficiency of glutathione (GSH), the dominant endogenous antioxidant protein, but the underlying mechanisms contributing to GSH deficiency are hitherto unknown. Furthermore GSH metabolism has not been studied in HIV patients, in whom the burden of risk factors promoting oxidative stress is highest. Our previous studies in non-HIV human subjects with diabetes-related oxidative stress and GSH deficiency have demonstrated that the latter is due to decreased synthesis of GSH. Importantly, short-term dietary supplementation with the simple GSH precursor amino-acids cysteine and glycine, boosted GSH synthesis and cellular concentrations, corrected GSH deficiency, and reduced oxidative stress and oxidant damage. The current proposal will study whether (1) defective synthesis underlies GSH deficiency in patients with HIV, and will test a simple, inexpensive and rational therapy based on protein supplementation to improve GSH synthesis and concentrations and lower markers of oxidative stress and oxidant damage in these patients; (2) study if correction of GSH deficiency is asssociated with any changes in (a) impaired mitochondrial fuel oxidation in the fasted and insulin stimulated states; (b) insulin sensitivity; (c) body composition and anthropometry; (d) forearm muscle strength; (e) plasma biochemistry, and (f) quality of life indices in these subjects.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
10
Cysteine and glycine will be supplemented at doses of 0.81 mmol/kg/d and 1.31 mmol/kg/d for 2 weeks each
Subjects will receive oral dietary amino-acids (cystiene as n-acetylcysteine, and glycine)
Baylor GCRC
Houston, Texas, United States
Glutathione synthesis rates and concentrations
Fractional and absolute synthesis rates of glutathione and its concentrations
Time frame: 9 hours
Mitochondrial fuel oxidation
Lipolysis, fuel oxidation, and a hyperinsulinemic euglycemic clamp.
Time frame: Twice over 9 hours of the study on 2 occassions
Rates of fuel kinetics
Measure rate of lipolysis (from infused 13C-palmitate) and recovery of 13CO2 (from infused acetate tracer)
Time frame: 3 hours
Insulin sensitivity
Measure insulin sensitivity using a hyperglycemic euglycemic clamp
Time frame: 3 hours
Muscle strength
Time frame: Done once in each 9-hour study
Quality of life by SF36 questionnaire
Time frame: Before and after
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