CTNPT 043: Endocannabinoid system and inflamm-aging in HIV-associated atherosclerosis

About The Study

CTNPT 043 is a cross-sectional pilot study using previously collected blood specimens from the Canadian HIV Aging Cohort Study (CTN 272). Various molecules will be measured in participants’ blood samples to look at a specific signaling system within the body called the endocannabinoid system. The goal is to describe the interaction between the endocannabinoid system, the immune system, and inflammation. Ultimately, CTNPT 043 aims to understand how these factors could affect the risk of developing chronic diseases, like atherosclerosis (hardening of the arteries), in people living with HIV who are taking antiretroviral therapy.

Background

In the modern antiretroviral therapy (ART) era, people living with HIV have an increased risk of some chronic diseases, including atherosclerosis and coronary artery disease (atherosclerosis in the arteries that supply blood to the heart). In fact, accelerated atherosclerosis is the second leading cause of death among people living with HIV. The increased risk of chronic disease may be because, as a result of the virus or ART, people living with HIV have a persistent level of inflammation throughout the body known as “inflamm-aging”. Addressing chronic inflammation is a key research area to improve quality of life for people living with HIV.

The endocannabinoid system is a key player in the maintenance and functionality of heart and blood vessels. The endocannabinoid system can act differently depending on biological sex and age. This project aims to document the changes in the endocannabinoid system in people living with HIV with or without coronary artery disease compared with people not living with HIV, with or without coronary artery disease. These findings will help determine whether there are changes in the endocannabinoid system associated with HIV and whether the endocannabinoid system could be used to reduce inflammation.

Study Approach

A total of 124 participants will be equally split among four distinct groups:

• (1) people living with HIV and CAD
• (2) people living with HIV but without CAD
• (3) people not living with HIV, but with CAD and
• (4) people not living with HIV or CAD

The specimens for this pilot study are already available via the CTN 272 cohort, where they have been previously collected and stored for future use. Endocannabinoids, inflammatory markers, and immune cells will be measured using various laboratory evaluations. As part of CTN 272, all participants previously underwent computed tomography (CT) angiography, a non-invasive tool to identify and measure the extent of artherosclerosis. CTNPT 043 aims to include both males and females in each group to allow for sex-specific comparisons. Analysis of the data will also take gender into account, which has been shown previously to impact outcomes following heart attack.