Researchers at the University of Toronto and partner hospitals are conducting a comprehensive study to examine the effects of anti-HIV drugs on pregnancy, with a focus on the potential impact of critical antiretroviral drugs on fetuses.
Led by Professor Reina Bendayan from the Leslie Dan Faculty of Pharmacy and co-principal investigator Lena Serghides from the Toronto General Hospital Research Institute, the study aims to provide crucial information on the membrane transport proteins, including folate transporters, that regulate the distribution and delivery of anti-HIV drugs to the fetus.
While these antiretroviral drugs have proven effective in preventing the transmission of HIV from mother to baby, concerns have arisen about potential risks, especially after a paper highlighted an increased risk of birth defects in babies exposed to the anti-HIV drug dolutegravir in utero.
Bendayan’s lab, which has a history of researching HIV antiretroviral treatments, noticed a potential link between these drugs and folate deficiency, which can lead to neurodevelopmental defects in children. The current study will delve deeper into this potential interaction, examining how first-line anti-HIV drugs during pregnancy may inhibit folate uptake in the placenta.
Using human cells, placenta tissue, and research models, the researchers will investigate changes in the expression and location of transport proteins throughout gestation, their impact on drug distribution into the placenta, and whether this results in any neurodevelopmental defects. The study will also explore potential differences between male and female fetuses in membrane transport expression, drug concentrations, and toxicity levels.
Teresa Bennett, a pharmaceutical sciences master’s degree student involved in the research, emphasizes the importance of the study in providing valuable insights into the impact of these critical drugs on fetuses. The researchers hope that their findings will contribute to better guidelines for the use of antiretroviral drugs during pregnancy, ensuring the health of both pregnant individuals with HIV and their babies.
Professor Bendayan underscores the need to clarify whether newer drugs in this class might be a safer choice, shedding light on potential toxicity implications. The ultimate goal is to offer physicians better guidance on recommending antiretroviral drugs to their patients during pregnancy.
