[Detection of urinary polyamine by a new enzymatic differential assay. (III). Studies on urinary polyamines in patients with malignant genitourinary diseases]

A new enzymatic method for isolation and determination of urinary polyamines was presented and basically studied in previous report 1 and 2 in comparison with existing techniques. Using the new method, urinary polyamines were isolated and determined in 56 patients with genitourinary cancer. Urinary polyamines were also determined in 63 controls consisting of 20 normal subjects, 25 patients with benign urological disease and 18 patients with BPH. The mean concentrations of Diamine, Spermidine, Spermine in 20 normal subjects were 16.6 +/- 5.8 mumoles/g Cr, 4.7 +/- 2.0 mumoles/g Cr and 0.99 +/- 0.51 mumoles/g Cr respectively. To emphasize the specificity to cancer, the level of positiveness was modified to a higher value than M+3SD. The positive values thus calculated were 40 mumoles/g Cr for Diamine, 15 mumoles/g Cr for Spermidine and 3 mumoles/g Cr for Spermine. The positive ratios of Diamine in patients with early cancer were 43% in renal cell cancer, 20% in pelvic and ureter cancer, 0% in bladder cancer and 20% in prostatic cancer. Those of Spermidine were 29% in renal cell cancer, 0% in pelvic and ureter cancer, 20% in bladder cancer and 40% in prostatic cancer. Those of Spermine were 29% in renal cell cancer, 20% in pelvic and ureter cancer, 20% in bladder cancer and 0% in prostatic cancer. In early diagnoses, Diamine indicated high positive ratios to renal cell cancer and Spermidine to prostatic cancer. Relatively high positive ratios were demonstrated, when any one of the isolated polyamines was found positive: namely, 57% in renal cell cancer, 20% in pelvic and ureter cancer, 30% in bladder cancer and 40% in prostatic cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

[Therapy with inhibitors of polyamine biosynthesis in refractory prostatic carcinoma. An experimental and clinical study]

Transplantable prostate adenocarcinoma were treated with polyamine biosynthetic inhibitors. alpha-difluoromethylornithine (alpha-DFMO), an inhibitor of ornithine decarboxylase and by s-methylglyoxal-bisguanylhydrazone (MGBG), an inhibitor of s-adenosylmethionine decarboxylase. The therapeutic regimen of 0.8-1.11 g/kg DFMO reduced the tumor growth by 40% whilst the combination with 10.5 mg/kg MGBG completely destroyed the prostate adenocarcinomas in the tumor-bearing animals. The polyamine content of spermidine and spermine in the cancerous tissues is significantly lower whereas the putrescine levels remain unchanged. The MGBG therapy distinctly stimulates the activity of ornithine decarboxylase and increases the putrescine concentration up to toxic levels. The application of alpha-DFMO prevented the toxic accumulation of putrescine and allowed higher doses of MGBG. Clinical trials with polyamine antimetabolites appeared useful due to pathological polyamine excretion of patients with metastatic prostate cancer. The therapy with 0.2-0.3 g/kg DFMO in patients with hormone-resistent prostate cancer and metastasis displayed a moderate anti-tumor activity following 2 months additional treatment. High levels of side effects, however, were registered and were similar to those of other cytotoxic compounds. A combined therapy with DFMO/MGBG in a patient with metastatic anaplastic prostate cancer did not improve the survival rate but showed regressive effects of the histological pattern.

Polyamine levels in gynecologic malignancies

Polyamines are closely related to many aspects of cell growth. Since increased amounts of polyamines in the urine of human cancer patients were reported in 1971, polyamines have been studied from the standpoint of tumor markers. In this study, polyamines in erythrocytes, plasma and urine were determined in 42 controls and 105 patients with gynecologic malignant tumors. The changes in polyamine levels were investigated before and after treatment. With advances in the stage of uterine cervical cancer, the frequency of abnormal levels of polyamines (concentrations greater than two standard deviations above the mean control level) became greater, and reached nearly 80% in recurrent and ovarian cancer. In the early stage of cancer, the diagnostic value was low. Comparison with carcinoembryonic antigen (CEA) was also performed. The polyamines lack specificity for malignant diseases, but they can be used to some extent as a tumor marker in the gynecologic field.

An enzymatic differential assay for urinary diamines, spermidine, and spermine

Subsequent to the hydrolysis of urinary conjugated amines by heating with hydrochloric acid, free amines were isolated by cation-exchange chromatography. SPD and SPM in an aliquot of amine extract were first oxidized by PAO from Penicillium chrysogenum, producing PUT and hydrogen peroxide. DIAs, which consist of the initially present DIAs plus PUT produced by PAO, were subsequently oxidized by PUO from Micrococcus rubens, producing hydrogen peroxide. In an another aliquot of the amine extract DIAs and SPD were oxidized by PUO, producing hydrogen peroxide. Quinone dye, derived from hydrogen peroxide generated in each end-point reaction, was measured spectrophotometrically at 555 nm, and the amounts of the respective amines in urine were calculated. Significantly elevated levels of DIA, SPD, SPM, and an elevated DIA to SPD ratio were found in urine from 46 cancer patients, as compared to 34 normal control subjects. An increase in DIA and the ratio of DIA to SPD was found at clinical tumor stage I of the alimentary tract. The levels of DIA remained fairly constant and the ratio of DIA to SPD was consistently decreased with advancing clinical tumor stages. In patients who had undergone curative resection, there were greater decreasing rates (80% of cases for DIA and 80% for SPD) than in patients who had undergone noncurative resection (45.5% for DIA and 36.4% for SPD).

Total polyamines and their non-alpha-amino acid metabolites simultaneously determined in urine by capillary gas chromatography, with nitrogen-phosphorus detector; and some clinical applications

A capillary gas-chromatographic method with nitrogen-phosphorus detection is used here to simultaneously determine 1,3-diaminopropane, putrescine, cadaverine, spermidine, spermine, isoputreanine , putreanine , and N-(3-aminopropyl)-N'-(2-carboxyethyl)-1,4- diaminobutane in urine. After acid hydrolysis the compounds are isolated by adsorption onto silica gel and converted into their methyl-heptafluorobutyryl derivatives. We give quality-control data and age-dependent values for urinary excretion of these analytes by 76 apparently healthy controls. Circadian rhythmicity in the excretion of spermidine and (especially) isoputreanine was established and is discussed in the light of its implications for monitoring therapy of cancer. Investigation of menstrual-cycle-dependent diurnal variation in one normal woman showed no distinct, consistent fluctuations. We applied the method to monitor (by use of 24-h urine specimens) an uncomplicated, normally progressing pregnancy, a patient with metastatic melanoma being treated with cytostatic drugs, and (in more detail) the treatment of a patient with high-grade non-Hodgkin lymphoma.

Urinary polyamines for evaluating the course of disease for patients with small cell carcinoma of the lung

Clinical correlates with urinary excretion of polyamines were evaluated for 29 newly diagnosed and 35 previously treated patients with small cell carcinoma of the lung (SCC). The frequencies of pretreatment abnormalities were 12 (41%) for putrescine, 18 (62%) for spermidine, and 20 (69%) for spermine. In assessing disease parameters, the combined use of the abnormalities of spermidine and spermine as a discriminant was more effective than that of all three polyamines; it correlated significantly with extent of limited and extensive disease (P less than 0.001), and also resulted in significant separation of survival curves, the median survival of 11 months for both elevated compared to 19 months for neither or only one elevated (P = 0.062). No significant difference was seen in the abnormalities between no metastasis and one metastasis, whereas the frequencies of the abnormalities was highly increased in two or more metastases. The distribution of polyamines determined at regular treatment intervals showed distinctively more elevated patterns in progressive disease than in stable disease or partial and complete responses (P less than 0.01). In order to evaluate therapeutic effects on the relationship between polyamine excretion and tumor regression, correlations between urinary putrescine and spermidine were determined. The values of the ratio of spermidine to putrescine were significantly smaller in responders than in nonresponders (P less than 0.01); and these may be related to smaller tumor mass and higher tumor proliferative activity in responders, and larger tumor mass and lower tumor proliferative activity in nonresponders.

Circadian rhythmicity of polyamine urinary excretion

Polyamines are small, highly charged, organic cations of possible regulatory importance in RNA-dependent protein synthesis, the production of which reflects cellular growth and division. The cytokinetics of normal cell populations is circadian rhythmic. This is reflected by a circadian rhythmicity undescribed previously in urinary monoacetylputrescine and the ratio of N1-acetylspermidine to N8-acetylspermidine in healthy individuals. Patients harboring advanced cancers sometimes excrete abnormal quantities of certain acetylated polyamines, and their urine samples may exhibit an abnormally high ratio of N1-acetylspermidine to N8-acetylspermidine. Changes in polyamine production and excretion associated with cancer may be best perceived by rhythmometric analysis of carefully timed samplings.

Further evidence for the use of polyamines as biochemical markers for malignant tumors

One hundred ninety patients with a variety of tumor presented within a specified time period and fit a specified protocol. Multiple serial urinary putrescine, spermidine, and spermine levels were obtained in these patients, and their disease activity over time, defined as either active or nonactive, was determined by clinical examination, the results of laboratory tests, and radiological criteria. Twenty-four-hr urine collections were used for analysis of polyamine levels. A linear mixed-effects model and the method of maximum likelihood estimation were used for statistical analysis. Statistically significant differences were found in polyamine levels between patients with active or nonactive disease for tumors of the breast, stomach, prostate, female genital tract, and a variety of metastatic carcinomas of unknown origin. There were 105 patients with these tumors; 319 polyamine determinations were obtained from this subset of patients. Our results suggest that serial determination of polyamine levels in urine may have clinical utility for monitoring the disease states for these tumors.

Single-step high-performance liquid chromatographic method for the analysis of acetylated polyamines

A high-performance liquid chromatography method for the determination of urinary acetyl derivatives of the polyamines putrescine, cadaverine and spermidine is described. This procedure utilizes an ion-exchange column for the separation of acetyl derivatives and the compounds are quantitated by fluorescence after reaction with o-phthalaldehyde. The steps necessary for sample preparation are minimized, and the assay is both sensitive and reproducible. This chromatographic procedure was used for the determination of the urinary acetylated polyamines of seven normal volunteers and three cancer patients.

On the biogenesis of diamines and polyamines in the pregnant rat

The urinary excretion of the diamines histamine, methylhistamine, putrescine and cadaverine and the polyamines spermidine and spermine was studied in rats which on the 19th day of pregnancy were subjected to various ectomizing operations. In sham-operated rats the urinary excretion of all the amines studied except spermine was highly elevated on the day preceding the sham-operation and on the 3 days studied post-operatively, i.e. sham-operation did not affect the elevated urinary amine excretion during pregnancy. Foetectomy resulted in an abolished increase in the urinary excretion of histamine and methylhistamine while the excretion of putrescine, cadaverine and spermidine was still significantly increased. Removal of both the foetuses and placentae reduced the excretion of putrescine, cadaverine and spermidine towards the level of non-pregnant rats. Combined hysterectomy and ovariectomy did not cause any additional effects to those after removal of the foetuses and the placentae except for cadaverine, the excretion of which was further reduced.

Altered polyamine excretion in Duchenne muscular dystrophy

Increased urinary levels of the polyamines, putrescine, spermidine, and spermine are present in Duchenne muscular dystrophy (DMD) patients. Alterations in excretion are detectable when based on nanomoles per milligram creatinine, micromoles per 24-hour urine collection, or nanomoles per kilogram body weight per 24-hour urine collection. Evaluation of creatinine levels in spot collections of urine versus 24-hour collections suggests a more consistent urinary creatinine in spot urines from DMD patients and normals, with wider variability in 24-hour specimens. We postulate that polyamines may be useful markers to evaluate disease activity and to screen for drug efficacy, as they have proved useful in cancer patients in assessing alterations in tumor kinetic parameters.

Urinary polyamine excretion in man: I. Influence of sex and age

Urinary di- and polyamines were analysed by gas-liquid chromatography in 63 normal volunteers. Subjects were divided into two age groups for each sex (males: from 18 to 40 years, and 40 to 70; females from 15 to 35 and 35 to 50), in order to establish age and sex dependent variations in the normal excretion of polyamines. Age appears to have some influence only in the excretion of spermine in male subjects. Sex on the contrary, has a considerable influence on urinary polyamines. Mean values of excretion for putrescine and spermine in female subjects are higher than those in males and show a wide variation in standard deviations.

Biologic markers in breast carcinoma: clinical correlations with urinary polyamines

Urinary polyamine levels were evaluated in patients with breast carcinoma. The individual levels of putrescine, spermidine, spermine, and cadaverine, and the product/precursor levels of putrescine, spermidine, and spermine were analyzed. Elevations of one or more individual polyamines or of the ratios were found in 50% of patients with metastatic disease, 38.5% of preoperative patients, and 35.7% of 5--24 week postoperative N + patients. Sequential sampling of patients with metastatic disease suggested that changes in elevated polyamine levels tend to reflect the clinical course of the disease, especially for the association of treatment failure with rising elevated values. The presence of one or more elevated parameters prior to treatment of metastatic disease tended to be associated with a higher response rate (85.7 vs. 68.4%) than all normal levels. Five of nine patients who recurred postoperatively had preceding postoperative polyamine elevations. In addition, there was a trend for a shorter disease-free time among patients with one of more elevated polyamine parameters between 5--24 weeks postoperatively than among patients with normal parameters. These data suggest that measurement of urinary polyamine levels, including calculation of the product/precursor levels, may be a useful clinical adjunct in the management of patients with breast carcinoma.

Polyamine metabolism in Menkes kinky hair disease

Clinical investigations of the urinary excretion of putrescine and the polyamines spermidine and spermine in a patient with Menkes kinky hair disease are reported. This disorder, characterized by intra- and extracellular copper deficiency, is associated with significant depression of diamine oxidase and monoamine oxidase activity. Urinary excretion of diamine and polyamines, monitored over a 2-month interval in a 4-month old patient with Menkes kinky hair disease, documented a 3- to 10-fold increase in the excretion of free putrescine, spermidine and spermine as well as the conjugated derivatives of putrescine and spermidine. These observations suggest that abnormalities in diamine and polyamine concentration occur in disease states in which the metabolic transformation of these compounds is impaired.

Polyamine-pyridoxal Schiff bases in urine

Schiff bases of the diamines 1,3-diaminopropane, putrescine, and cadaverine and the polyamines spermidine and spermine with pyridoxal or pyridoxal phosphate occur in human urine, as shown by gas chromatographic/mass spectrometric selected ion-monitoring techniques. By use of synthetic standards, procedures were devised for conversion of the Schiff bases to stable derivatives amenable to gas chromatographic/mass spectrometric analysis. These procedures involve borohydride reduction of the C = N double bond, hydrolytic removal of the phosphate group, chromatographic separation from the bulk of urinary constituents, and trifluoroacetylation of polar functional groups. The levels of the polyamine-pyridoxal Schiff bases were estimated to be in the range of pmol/ml or urine.

Altered polyamine metabolism in cystic fibrosis

Children with cystic fibrosis excreted elevated urinary levels of all three polyamines--putrescine, spermidine, and spermine. Heterozygote parents excreted intermediate concentrations of the polyamines, but not levels significantly different from levels in normal controls. Patients with cystic fibrosis who were administered a tracer amount of [14C]spermidine excreted 11--13% of the radiolabel within 72 hr whereas normal controls excreted 60--76% of the radiolabel within 72 hr. Spermine excretion was positively correlated with increased pathology as assessed by the National Institutes of Health (NIH) clinical score, whereas urinary putrescine and spermidine levels were negatively correlated with increased pathology.

Lowered cutaneous and urinary levels of polyamines with clinical improvement in treated psoriasis

Polyamine metabolism is important in cell proliferation and may play a role in the epidermal cell hyperproliferation of psoriasis. We have determined changes in polyamine levels in skin and urine accompanying clinical improvement in psoriasis following topical therapy. Nine hospitalized patients were examined at the beginning and end of their courses of treatment. Skin biopsy specimens and portions of 24-hour urine collections were analyzed for polyamines with a modified automatic amino acid analyzer. Treatment resulted in lower cutaneous levels of putrescine (by 50%, P less than .05), spermidine (by 24%, P less than .05), and spermine (by 35%, P less than .005), and lower urinary levels of spermidine (by 20%, P less than .025) and spermine (by 35%, P less than .025). These results suggest that in psoriasis, the skin significantly contributes to the levels of spermidine and spermine in systemic fluids. Topical therapy may reduce epidermal cell proliferation in psoriasis by lowering polyamine levels.

Separation and quantification of urinary di- and polyamines by gas chromatography with electron capture detection

A sensitive and specific gas chromatographic assay procedure employing electron capture detection has been developed for the assay of free and total di- and polyamines in human urine. Urine samples, hydrolysed with hydrochloric acid where necessary for the measurement of total amine output, were evaporated to dryness and, after the residues had been taken up in water, purified successively on Porapak Q and Dowex 50 X2 columns. Following evaporation of eluate, pentafluoropropionyl derivatives were made and analysed gas chromatographically using temperature programming. Di- and polyamines can be measured accurately at the picomole level and normal urinary output values calculated using this method agree well with those noted by other workers.

Urinary polyamine levels in patients with psoriasis

Polyamine contents in 24 h urine of 16 psoriatic patients and seven healthy individuals are measured. The average values of putrescine and spermine showed slight increase in the psoriatic group, while those of spermidine were unchanged. When psoriatic patients are divided into three groups according to the extent of their skin lesion, the putrescine level is found to be higher in the group more severely affected.

Increased formation of diamines and polyamines in the pregnant rat

1. The urinary excretion of histamine, methylhistamine, putrescine, cadaverine, spermidine and spermine was examined before, during and after pregnancy in rats. 2. During the last third of undisturbed pregnancy a distinct and steep rise occurred in the excretion of all amines studied except spermine. The peak values were found a few days before the birth of the young. In spermidine excretion a second peak was observed one or two days after delivery. 3. Before and during the first 2 weeks of gestation on a molar basis putrescine excretion was the greatest one. During the last trimester histamine was excreted in the largest amount. 4. Under the influence of the diamine oxidase inhibitor aminoguanidine the general pattern of excretion of diamines and polyamines in pregnant rats remained essentially unchanged but the total amount excreted increased. Most conspicuous was the great elevation of urinary contents of putrescine and cadaverine.

Polyamines in amniotic fluid, plasma, and urine during normal pregnancy

Polyamines have been implicated as markers of cell kinetic parameters. Putrescine and spermine were elevated in the urine of women with normal pregnancies. Particularly striking was the over 75-fold increase in spermine excretion. Putrescine was more than twofold that found for normal women. In several patients followed serially during pregnancy to assess the temporal pattern of the urinary excretion of polyamines, it was found that the highest levels of all three polyamines occurred at 12 weeks of gestation. In amniotic fluid, putrescine was higher prior to 30 weeks of gestation whereas spermidine was significantly higher at or beyond 30 weeks of gestation. Spermine was relatively high in both groups. Studies are ongoing to assess whether alterations from these normally elevated patterns will occur in the fluids of pregnant women at high risk for abnormal fetal development.

Determination of polyamines by liquid chromatography and precolumn labelling for fluorescence detection

Procedures are described for the separation and detection of picomole quantities of putrescine, spermidine, and spermine by liquid chromatography. The polyamines are labelled by precolumn derivatization with dansyl chloride followed by reversed-phase chromatography with a methanol and water mobile phase. The derivatized polyamines are measured with a fluorescence detector using an excitation wavelength of 340 nm and emission wavelength of 515 nm. The polyamines are eluted within 12 min and 0.5 ng of each could be detected. Some preliminary data on urine samples is presented.

A gas chromatographic method for the determination of di- and polyamines in human urine

A gas chromatographic method for the determination of di- and polyamines in human urine has been developed. The di- and polyamines have been extracted from standard solutions or from urine by a butanolic method modified to improve its sensitivity in relation to the low concentration of the amines in human normal urine. The quantitation is controlled by using two internal standards: 1,6-diaminohexane for Putrescine and Cadaverine, l-ephedrine for Spermidine and Spermine. Distilled water was the final solvent injected into the GLC column and the detector response was linear between 5 and 100 ng.

A quantitative approach to determining disease response during therapy using multiple biologic markers: application to carcinoma of the breast

This analytical study was undertaken in an effort to develop a model for a quantitative approach to the evaluation of multiple biological marker levels in blood and urine as a means for determining tumor changes during treatment of patients with malignant disease. The potential biologic markers measured in patients with carcinoma of the breast consist of three urinary polyamines (putrescine, spermidine and spermine), three urinary nucleosides (pseudouridine, N2, N2-dimethylguanosine and 1-methylinosine), and plasma carcinoembryonic antigen (CEA). The distribution patterns of the seven markers measured pretreatment and five weeks after initiating therapy were examined by grouping the patients into the three categories of progression, stable, or regression based on their clinical response to treatment. In addition to the individual marker measurements, the pretreatment and posttreatment values of the ratios of the polyamine levels (spermine/putrescine, spermine/spermidine, and spermidine/putrescine) and the nucleoside levels (N2, N2-dimethylguanosine/pseudouridine, 1-methylinosine/pseudouridine, and 1-methylinosine/N2, N2-dimethylguanosine) were also evaluated. In the pretreatment measurements, CEA levels were elevated for 76% of the patients and the three nucleosides were elevated for 36% of the patients and the three nucleosides were elevated for 36% to 37% of the patients. Urinary spermidine and spermine levels were abnormal for 27% and 24%, respectively, while putrescine levels were elevated for 7% of the patients. When all 14 marker measurements and the 12 ratios of these measurements were considered, the multiple regression equation evaluated the treatment results with a multiple correlation coefficient (R = 0.891; P less than 0.100) about 2.4 times higher than with the most sensitive single marker variable, N2, N2-dimethylguanosine/pseudouridine (R = 0.377; P less than 0.05), alone. Stepwise regression analysis revealed that the minimum number of multiple marker measurements and their ratios required to achieve the maximum value of the multiple correlation coefficient (R = 0.653; p = 0.010) was fifteen. These include the pre and posttreatment measurements of CEA, spermine, N2, N2-dimethylguanosine and 1-methylinosine, as well as two ratios of the polyamines and three ratios of the nucleosides in the post-treatment of the polyamines and three ratios of the nucleosides in the post-treatment measurements. These data suggest that the utilization of regression analysis to evaluate the monitoring utility of multiple marker measurements may be of clinical value.

Urinary metabolites of polyamines in rats

Urinary metabolites of polyamines in rats were studied systematically by the intraperitoneal injection of radioactive polyamines. Urinary metabolites were fractionated into 4 fractions containing non-polar and acidic compounds, acidic and neutral ampholytes, basic ampholytes and polyamines. A large amount of radioactivity was detected in the fractions containing non-polar and acidic compounds and polyamines of urine of rats injected with radioactive putrescine, while in the case of the injection of radioactive spermidine or spermine a relatively large amount of radioactivity was found in the basic ampholyte fraction as well as in the polyamine fraction. Analysis of these fractions indicated that gamma-aminobutyric acid, N-monoacetylputrescine, 2(3)-hydroxyputrescine, putreanine, N-(3-aminopropyl)-4-aminobutyric acid (isoputreanine), spermic acid, N-(3-aminopropyl), N'-(2-carboxyethyl)-1,4-diaminobutane, and N-monoacetylspermidine A and B were excreted as urinary metabolites of the polyamines in addition to putrescine, spermidine and spermine.

Simplified micro-method for the quantitative analysis of putrescine, spermidine and spermine in urine

A simplified micro-method for the quantitative analysis of urinary polyamines is described. After acid hydrolysis of urine, the polyamines are converted to fluorescent 1-dimethylaminonaphthalene-5-sulfonyl (Dns; dansyl) derivatives and separated by means of thin-layer chromatography. Dns-NH2, which has been reported to interfere with the determination of putrescine, is well separated from di-Dns-putrescine. Putrescine, spermidine and spermine are quantitated by in situ scanning of their fluorescent spots on the chromatogram. The present method is both sensitive and reproducible. It eliminates a number of time-consuming steps and thus reduces preparative losses. Yet an adequate chromatographic resolution is obtained. Representative polyamine analyses of urine from normal volunteers and from cancer patients are reported. Elevated levels occur in the urines of pregnant women and of patients with various types of cancer.

Rapid chromatographic method to determine polyamines in urine and whole blood

A procedure is described for the rapid determination of putrascine, spermine and spermidine in ruine and whole blood. The samples are hydrolyzed with barium hydroxide and are neutralized with sulfuric acid. The polyamines are concentrated and separated from amino acids on a small bed of ion-exchange resin that then serves to load the samples on a two-channel, automated ion-exchange chromatography apparatus. As many as 100 samples can be analyzed in a 24-h period. The method has been shown to be applicable to the analysis of urine and whole blood samples, but further development is needed for application to serum samples.

Polyamines as markers of response and disease activity in cancer chemotherapy

One hundred twenty-four patients with hematological and solid neoplasms had pretreatment urinary polyamine determinations. Putrescine, spermidine, and spermine were all significantly increased as compared to normals (p less than 0.001). Polyamine levels were directly related to disease activity and tumor burden. In patients with multiple myeloma, putrescine levels were significantly correlated with clinical disease activity as well as the in vitro labeling index of marrow plasma cells. Spermidine values reflected tumor cell burden. Serial studies in 56 patients indicated that greater than twofold rise in urinary spermidine during treatment was highly correlated with cell kill and subsequent clinical response (p less than 0.001). Serum polyamine levels in 17 patients were found to be comparable to urinary values. Our data indicate that polyamine determinations can potentially be clinically useful, i.e., baseline values as indicators of tumor cell mass and growth fraction, and increases in spermidine during treatment as an excellent marker of tumor cell kill.

Conjugation of radiolabeled polyamines in the rat

Initial work reporting elevated polyamine levels in body fluids of cancer patients indicated that a percentage of the polyamine pools was present in conjugated form making hydrolysis necessary for assessment of the total polyamine content in urine and serum. In this paper, we report plasma decay curves for [14C]polyamines after i.v. administration and the temporal appearance of conjugates. Following the administration of [14C]polyamines, the radiolabel rapidly disappeared from the plasma in the order; spermidine greater than putrescine greater than spermine. Separation of the [14C]polyamines from conjugated radiolabeled compounds with Dowex chromatography indicated that [14C]putrescine and [14C]spermidine were rapidly conjugated, whereas no significant conjugation of spermine was detectable. After near-total hepatectomy of rats, there was no detectable formation of conjugates, whereas unilateral nephrectomy had little effect on the appearance of conjugates. This suggests that conjugation may take place in the liver. Free putrescine or spermidine could be regenerated from the conjugates by acid hydrolysis, suggesting that the conjugation process does not involve any alteration of the polyamines.

The effect of nandrolone, an anabolic steroid on putrescine metabolism in the mouse

1 The catabolism of injected 14 C-putrescine was studied in mice treated with nandrolone phenpropionate, an anabolic steroid. 2 The putrescine was rapidly metabolized; almost 50% of the injected radioactivity was recovered within 2 h as 14 CO2 in the expired air. 3 Considerable amounts of radioactive gamma-aminobutyric acid (GABA) and an unidentified compound were found in the kidney and in the urine in addition to radioactive putrescine, spermidine and spermine both in controls and nandrolone-treated mice. 4 Nandrolone elevated the concentration of endogenous putrescine in the kidney and urine, eightfold and twentyfold, respectively, and the concentrations of spermidine and spermine were also increased 5 after the injection of 14C-putrescine the incorporation of 14C into spermidine was significantly increased in the kidney of mice receiving nandrolone.

Polyamines in malignant melanoma. Urinary excretion and disease progress

Urinary polyamine concentrations in 91 samples were assayed in 79 patients with malignant melanoma who were classified as to clinical stage, as well as to activity of disease. Patients with active disease had higher mean polyamine values, increased frequency of polyamine elevations, and increased frequency of two or more elevations, than did patients with stable disease. Elevations of a single polyamine were seen as frequently in patients whose disease was considered stable as in those who showed progression. The polyamines may be useful as guides to activity of the disease, provided further studies can identify additional sources of nonspecific elevations.

Circadian rhythms in polyamine excretion by rats bearing an immunocytoma

Large-amplitude circadian rhythms were observed in the urinary excretion of polyamines by rats bearing an immunocytoma. Control animals excreted polyamines at a lower rate but also with marked circadian variation. In confirmation of earlier observations, light-chain excretion by the tumor-bearing rats also exhibited a circadian rhythm, superimposed on an increasing trend. The potential of these rhythms as markers for the chronotherapy of cancer is noted.

Altered polyamine metabolism in the PRO/Re strain of inbred mice

The PRO/Re strain of inbred mice are characterized by abnormally high concentrations of proline in both blood (hyperprolinaemia) and urine (prolinuria). They excrete increased amounts of polyamines in their urine. Male PRO/Re mice excreted putrescine at 175% and spermidine at 300% the amount of male C57BL/6J controls. Female PRO/Re mice excreted putrescine at 115% and spermidine at 150% of the amount in the urine of female controls. Examination of the enzymes involved in polyamine biosynthesis revealed that ornithine decarboxylase, the initial enzyme in the polyamine-biosynthetic pathway, was increased by 150% in the kidneys and by 100% in the liver of male PRO/Re mice. There was no significant difference between PRO/Re and C57BL/6J male mice for either putrescine- or spermidine-stimulated S-adenosylmethionine decarboxylase activity. Female PRO/Re mice showed no significant difference from female C57BL/6J mice for any of the enzymes examined. When the concentrations of the polyamines in the tissues of the PRO/Re mice were determined, spermidine and spermine concentrations in the kidneys of the male PRO/Re mice were twice those of the controls. Spermidine concentration in the livers of both male and female PRO/Re mice was approx. 130% that of the controls. Polyamine concentrations in the brains were similar in controls and mutants. The increased polyamine biosynthesis and excretion in the PRO/Re mutant mice may be a mechanism to decrease the extent of proline accumulation.

Urinary putrescine, spermidine, and spermine in human blood and solid cancers and in an experimental gastric tumor of rats

An improved method of assay of urinary polyamines (putrescine, spermidine, and spermine) was applied to the study of cancer patients and an experimental gastric tumor of rats. Although total polyamines (putrescine, spermidine, and spermine) in urine of patients with blood and solid cancers were significantly high, putrescine concentrations also increased significantly and were shown to be of diagnostic aid even in solid cancers. A significant increase in putrescine was also noted in the urine of rats with experimental stomach tumors induced by N-methyl-N-nitro-N'-nitrosoguanidine.

An improved isolation procedure for the gas chromatographic analysis of urinary polyamines

The isolation of polyamines from urinary hydrolysates in a sufficiently pure state for subsequent analysis by gas chromatography has proved to be difficult. However, by using columns of Porapak-Q and ion-exchange resins, urinary hydrolysates are readily purified and formation of trifluoroacetyl derivatives of polyamines proceeds in high yield without carryover of artifacts in the gas chromatographic elution profile. Good yields from the trifluoroacetylation reaction are not achieved if large quantities of salts or urinary pigments are present. By obtaining the polyamine carbonates in the final stages of the method described, the trifluoroacetylation reaction yields excellent derivatives of nanogram or microgram amounts, particularly after standing over-night at room temperature. The procedure described in detail should permit routine urinary polyamine analysis where rapidity, ease of handling many samples, freedom from complications and artifacts are a consideration.

Urinary excretion of polyamines by patients with advanced malignancy

Levels of putrescrine, spermidine, and spermine in urine were determined by means of a sensitive ion-exchange chromatographic method in patients with advanced solid tumor malignancies, in patients with diseases other than cancer, and in normal control subjects. Elevation above 2 SDS of the normal mean were found in varying number of patients in each tumor category. For those malignancies studied that involved more than 20 patients, the greatest incidences of increased excretion were 66% for spermine in patients with colon carcinoma and 50% for putrescine and spermidine in patients with bronchogenic carcinoma. The highest levels and greatest frequency of elevated polyamine levels were found in patients with Burkitt's lymphoma, and changes in clinical tumor status associated with treatment appeared to correlate well with polyamine levels in this disease. Abnormal amounts of polyamines were also excreted by some patients with diseases other than cancer, indicating that increased polyamine excretion is not restricted or specific to the neoplastic state. It was also found that the levels of polyamines were apparently not affected by the intake of meat or the diet eaten, and remained in a rather narrow excretion range for any one individual at different time intervals. This study was carried out as part of a program to determine and evaluate biologic materials present in body fluids that may be used to follow and evaluate response or progression of neoplastic disease in patients during treatment regimens. The results suggest that abnormal urinary polyamine levels may be characteristic of neoplastic growth for some patients with malignant disease. Further studies are necessary to determine if these compounds may be helpful in assessing disease status for patients with such solid tumor malignancies as colon and bronchogenic carcinoma although their potential as useful "biologic markers" appears less promising than originally anticipated.

Polyamine excretion in the urine of cancer patients

In the human body, the production of three polyamines--putrescine, spermidine and spermine--is largely associated with tissue growth, while that of a fourth--cadaverine--seems to be the result of bacterial action. In 37 (88%) of 42 cancer patients and in 24 (44%) of 54 patients with various nonmalignant diseases, increased amounts of polyamines were found in the urine. In the nonmalignant group, which served as a control group, the increased polyamine excretion was especially evident in patients with infections. There were, however, differences in the excretion patterns of the cancer and control groups: combinations of elevated levels of putrescine, spermidine and spermine were seen exclusively in the cancer patients; spermine was not found in the urine of women in the control group. The determination of urinary polyamines appears to hold promise as an aid in the diagnosis of malignant disease and in following up the results of therapy.

Urinary polyamines in patients with gastric cancer and their change after gastrectomy

Urinary polyamines in patients with gastric cancer were determined and changes in their content due to gastrectomy were studied. Total polyamines (spermine plus spermidine) in patients with gastric cancer of either stage II or III decreased significantly after the operation, the mean values before and after operation being 8.35 and 2.71 mg/day, respectively. The mean value of total polyamines in normal cases has been reported to 4.02 +/- 1.35 mg/day, so that the value in these patients after the operation is within the normal range.

Estimation of urinary diamines and polyamines by thin-layer chromatography

The dansylated derivatives of ammonia, 1,3-diaminopropane, 1,4-diaminobutane, 1,5-diaminopentane, spermidine, histamine, and spermine were separated by one ascending development in chloroform-triethylamine (5:1) on a 250-mum silica gel 60 plate. Putrescine, cadaverine, spermidine, and spermine in human urine were quantitated by a direct scan of the fluorescent intensity of the spots corresponding to these compounds. Higher amounts of spermidine and spermine were found in the urines of cancer patients compared to the values of these substances in normal urine.

Urinary polyamine levels in the diagnosis of carcinoma of the prostate

Urinary excretion of the basic polyamine, spermidine, was significantly elevated in patients with prostatic carcinoma as compared to a control group of patients, Of 44 urine specimens from patients with prostatic malignancy 31 had spermidine levels more than 2 mg. per 24 hours, while only 3 of 13 urine specimens from the control groups had levels in excess of this value. The increase in spermidine appeared to be correlated with the histologic grading of the tumor, that is 30 of 34 specimens from patients with grade II, III or IV carcinoma had excessive spermidine excretion and only 1 of 10 urine specimens from patients with grade I tumors had similiar spermidine elevations. High spermidine levles were found in tumors localized to the prostate and in 7 of 8 patients with negative pelvic and para-aortic lymph node biopsies. This study raises the possibility that urinary spermidine determinations may aid in the development of a biochemical screening test for prostatic neoplasms.