HIV protease inhibitors decrease VEGF/HIF-1alpha expression and angiogenesis in glioblastoma cells

Neoplasia. 2006 Nov;8(11):889-95. doi: 10.1593/neo.06535.


Glioblastomas are malignant brain tumors that are rarely curable, even with aggressive therapy (surgery, chemotherapy, and radiation). Glioblastomas frequently display loss of PTEN and/or epidermal growth factor receptor activation, both of which activate the PI3K pathway. This pathway can increase vascular endothelial growth factor (VEGF) and hypoxia-inducible factor (HIF)-1alpha expression. We examined the effects of two human immunodeficiency virus protease inhibitors, nelfinavir and amprenavir, which inhibit Akt signaling, on VEGF and HIF-1alpha expression and on angiogenesis. Nelfinavir decreased VEGF mRNA expression and VEGF secretion under normoxia. Downregulation of P-Akt decreased VEGF secretion in a manner similar to that of nelfinavir, but the combination of the two had no greater effect, consistent with the idea that nelfinavir decreases VEGF through the PI3K/Akt pathway. Nelfinavir also decreased the hypoxic induction of VEGF and the hypoxic induction of HIF-1alpha, which regulates VEGF promoter. The effect of nelfinavir on HIF-1alpha was most likely mediated by decreased protein translation. Nelfinavir's effect on VEGF expression had the functional consequence of decreasing angiogenesis in in vivo Matrigel plug assays. Similar effects on VEGF and HIF-1alpha expression were seen with a different protease inhibitor, amprenavir. Our results support further research into these protease inhibitors for use in future clinical trials for patients with glioblastoma multiformes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Brain Neoplasms / blood supply
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / pathology*
  • Cell Line, Tumor
  • Collagen / chemistry
  • Drug Combinations
  • Gene Expression Regulation, Neoplastic*
  • Glioblastoma / blood supply
  • Glioblastoma / drug therapy*
  • Glioblastoma / pathology
  • HIV Protease Inhibitors / pharmacology*
  • Humans
  • Hypoxia-Inducible Factor 1, alpha Subunit / biosynthesis*
  • Laminin / chemistry
  • Nelfinavir / pharmacology
  • Neovascularization, Pathologic*
  • Proteoglycans / chemistry
  • Signal Transduction
  • Time Factors
  • Vascular Endothelial Growth Factor A / biosynthesis*


  • Drug Combinations
  • HIV Protease Inhibitors
  • Hypoxia-Inducible Factor 1, alpha Subunit
  • Laminin
  • Proteoglycans
  • Vascular Endothelial Growth Factor A
  • matrigel
  • Collagen
  • Nelfinavir