Enhanced delivery of AZT to macrophages via acetylated LDL.

It is known that infected macrophages play an important role in HIV pathogenesis acting as a reservoir for dissemination of the virus to various organs. Enhanced and/or specific delivery of anti-HIV agents to infected cells is expected to improve their therapeutic index by increasing efficacy and reducing toxicity. Acetylated low density lipoproteins (AcLDL) are known to be taken up by macrophages via scavenger receptors and appear to be good carriers for targeting drug molecules to macrophages. This study investigated the delivery of 3'-azido-3'-deoxythymidine (AZT), an anti-HIV agent, to macrophages using AcLDL. Since the incorporation of AZT into AcLDL was found to be low, several derivatives of AZT including 5'-O-13-oxamyristate-AZT (5'-O-oxaMyr-AZT) have been synthesized as prodrugs. The prodrugs were incorporated into AcLDL using two different methods, namely the contact method and the microemulsion method. Our results demonstrated that the microemulsion method was more effective. The physicochemical properties of the AcLDL/prodrug complex were evaluated by electrophoresis and electron microscopy (EM). Incubation of the complex with plasma resulted in little distribution of the incorporated drug molecules from AcLDL to other components of the plasma, suggesting that the complex was quite stable. Cellular uptake studies using J774.A and U937 demonstrated that AcLDL/prodrug was taken up about 10 times more than AZT. The presence of excess AcLDL was found to inhibit the cellular uptake of AcLDL/5'-O-oxaMyr-AZT by macrophages while excess high density lipoprotein (HDL) or low density lipoprotein (LDL) was found to have little effect, suggesting that the AcLDL/prodrug complex is taken up into macrophages via the scavenger receptor.