Over 34 million Americans have used cocaine and >1.5 million are estimated to use this agent habitually.1 Cocaine causes severe cardiotoxicity and stimulates reactive oxygen species (ROS) production leading to left ventricle hypertrophy and dysfunction.2-4 We showed that cocaine administration to mice transgenic for HIV-1 worsens left ventricle hypertrophy, causes premature death and induces pathological changes that are more severe than those observed in wild-type mice.5 Cocaine use predisposes to human immunodeficiency virus (HIV-1) infection and HIV/AIDS.6, 7 In the developed world, HIV-1 infection is commonly treated with anti-retroviral drugs that have untoward cardiovascular effects, including cardiomyopathy.8-10 Cardiomyopathy in HIV/AIDS patients is prevalent (6%), and has a poor prognosis.11-13 Research from our laboratory and others has shown that gene products of HIV-1 and antiretroviral drugs alter mitochondrial function, stimulate mitochondrial production of ROS, and cause heart failure.14-20 The cardiovascular system is particularly prone to interactions and complications from cocaine and HIV/AIDS, however, mechanisms are poorly understood.2, 9, 10 We propose that the interaction of HIV/AIDS, antiretroviral nucleosides, and cocaine causes alterations in cardiomyocytes through undefined mechanisms that lead to cardiomyopathy and heart failure (Figure 1). The complexity of each scenario requires a systems biology approach to understand their interactions and illuminate therapeutic options. The following aims will be addressed:
Aim 1 : To define how nDNA genetic and epigenetic events in HIV/AIDS, antiretroviral therapy, and cocaine administration impact cardiomyopathy in vivo.
Aim 2 : To define genetic and epigenetic events from HIV/AIDS and cocaine that impact mRNA expression and mtDNA abundance in the heart.
Aim 3 : To prevent cardiomyopathy in HIV/AIDS, cocaine, and antiretrovirals by ameliorating oxidative stress. Our team is uniquely qualified to address the aims. We will employ a multidisciplinary approach to study transcriptional and epigenetic analysis, physiological and biochemical phenotyping and novel mathematical systems analyses to unravel this complex problem.

Public Health Relevance

Cardiomyopathy is linked to HIV/AIDS and cocaine, but those clinical interactions are complex: The purpose of this application is to use a systems biological analytical approach to dissect complex interactions between pathological, physiological, biochemical and genetic events in HIV/AIDS and cocaine. Ultimately, information obtained may help to formulate testable hypotheses about pathogenesis and treatment of cardiomyopathy in HIV/AIDS and cocaine.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Special Emphasis Panel (ZDA1-EXL-T (13))
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Satterlee, John S
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Emory University
Schools of Medicine
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Koczor, Christopher A; Ludlow, Ivan; Fields, Earl et al. (2016) Mitochondrial polymerase gamma dysfunction and aging cause cardiac nuclear DNA methylation changes. Physiol Genomics 48:274-80
Koczor, Christopher A; Jiao, Zhe; Fields, Earl et al. (2015) AZT-induced mitochondrial toxicity: an epigenetic paradigm for dysregulation of gene expression through mitochondrial oxidative stress. Physiol Genomics 47:447-54
Koczor, Christopher A; Ludlow, Ivan; Hight 2nd, Robert S et al. (2015) Ecstasy (MDMA) Alters Cardiac Gene Expression and DNA Methylation: Implications for Circadian Rhythm Dysfunction in the Heart. Toxicol Sci 148:183-91
Koczor, Christopher A; Fields, Earl; Jedrzejczak, Mark J et al. (2015) Methamphetamine and HIV-Tat alter murine cardiac DNA methylation and gene expression. Toxicol Appl Pharmacol 288:409-19
Koshman, Yevgeniya E; Sternlicht, Mark D; Kim, Taehoon et al. (2015) Connective tissue growth factor regulates cardiac function and tissue remodeling in a mouse model of dilated cardiomyopathy. J Mol Cell Cardiol 89:214-22
Torres, Rebecca A; Lewis, William (2014) Aging and HIV/AIDS: pathogenetic role of therapeutic side effects. Lab Invest 94:120-8
Remick, Joshua; Georgiopoulou, Vasiliki; Marti, Catherine et al. (2014) Heart failure in patients with human immunodeficiency virus infection: epidemiology, pathophysiology, treatment, and future research. Circulation 129:1781-9
Koczor, Christopher A; Torres, Rebecca A; Fields, Earl J et al. (2013) Thymidine kinase and mtDNA depletion in human cardiomyopathy: epigenetic and translational evidence for energy starvation. Physiol Genomics 45:590-6
Koczor, Christopher A; Torres, Rebecca A; Fields, Earl J et al. (2013) Mitochondrial matrix P53 sensitizes cells to oxidative stress. Mitochondrion 13:277-81
Koczor, Christopher A; Lee, Eva K; Torres, Rebecca A et al. (2013) Detection of differentially methylated gene promoters in failing and nonfailing human left ventricle myocardium using computation analysis. Physiol Genomics 45:597-605

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