Interaction of local anesthetics with the transport system of glucose in human erythrocytes

Lidocaine has better antioxidant potential than ropivacaine and bupivacaine: in vitro comparison in a model of human erythrocytes submitted to an oxidative stress

BACKGROUND

Local anesthetic agents may exert antioxidant properties in various models. The aim of this work was to compare the antioxidant properties of lidocaine, bupivacaine and ropivacaine using an in vitro model of human erythrocytes submitted to an oxidative stress.

METHODS

Blood was obtained from healthy volunteers. After separation, erythrocytes were suspended in phosphate buffer. Oxidative stress was induced by incubation with 2,2'-azobis (2-amidinopropane) hydrochloride (AAPH). (1) Effects of four different concentrations (50, 100, 300 and 600 microg ml(-1)) of lidocaine, bupivacaine and ropivacaine were studied in absence or presence of AAPH (20 mM). Potassium efflux was assessed by flame photometry. (2) Effects of 50 and 600 microg ml(-1) of lidocaine, bupivacaine and ropivacaine on AAPH (50 mM) induced hemolysis were also studied. (3) The oxygen radical absorbing capacity of lidocaine, bupivacaine and ropivacaine at the four concentrations was evaluated by the analysis of the allophycocyanin fluorescence.

RESULTS

In absence of AAPH, neither extracellular potassium nor hemolysis was noted. AAPH (20 mM) induced a significant increase in extracellular potassium that was reduced by all local anesthetic agents, with greater effects for lidocaine. AAPH-induced hemolysis was significantly decreased by all the local anesthetic agents at higher concentration, but only by lidocaine at 50 microg ml(-1). Finally, none of the local anesthetic agents modified the allophycocyanin fluorescence.

CONCLUSION

In this model, lidocaine was proved more effective than bupivacaine and ropivacaine in protecting human erythrocytes submitted to an oxidative challenge. This was not due to a free radical scavenging effect.

Effects of proparacaine on actin cytoskeleton of corneal epithelium

Chronic use of proparacaine, a topical ocular anesthetic, is associated with punctate keratopathy and delayed epithelial wound healing. Spreading corneal epithelial cells normally elaborate cytoplasmic arrays of actin-rich stress fibers which insert onto the inner surface of the cell membrane at discrete adhesion complexes. As actin is implicated in cell-to-substratum adhesion and cell motility, the effects of proparacaine on the actin cytoskeleton of corneal epithelial cells were studied in vitro. Spreading rat corneal epithelial cells in tissue culture were treated with proparacaine hydrochloride. At the lowest drug concentration used (0.01 mM), no effects were seen on the actin cytoskeleton. At 1.0 mM, some disruption of stress fibers was evident and actin was redistributed in a diffuse fashion. Many of the intact stress fibers had abnormal morphology, distribution, and orientation. Scanning electron microscopy showed a loss of cell extensions and cell-to-substratum adhesiveness at the leading epithelial edge. Above 1.0 mM, cell spreading was completely abolished and most cells detached from the substratum. After a washout period with drug-free media, these effects were reversible at concentrations of 1.0 mM or less. We postulate that one mechanism by which proparacaine inhibits corneal epithelial migration and adhesion is through alteration of the actin cytoskeleton.

Effect of lidocaine on in vitro absorption of glucose in jejunal and ileal segments of the rat

The influence of lidocaine on the intestinal glucose absorption was investigated on Tyrode-perfused isolated intestinal segments of the rat. In ileal segments the transmural transfer of glucose decreased with increasing lidocaine concentration (5 X 10(-9) -2 X 10(-4) mol/l), whereas the water movement was unaffected. No inhibitory effect on glucose and water absorption was observed in the proximal jejunum.

Different concentrations of local anaesthetics have different modes of action on human lymphocytes

Lidocaine and Bupivacaine inhibit in vitro 3H-TdR incorporation into peripheral lymphocytes, in a dose dependent ratio, either under PHA stimulus or not. Lidocaine added to cultures at various times from PHA stimulus show a reduced inhibition only when added after the 24th hour. This suggests a sensitizing action of PHA. Lidocaine effect on mitosis of doses between 2000 and 500 micrograms/ml was not completely reversible even when the drug was removed after only 15 min; between 200 and 50 micrograms/ml this effect is reversible. Lymphocyte viability by Trypan Blue exclusion is clearly unrelated to mitotic inhibition; it is however dose related. High Lidocaine and Bupivacaine concentration alter adhesion of cells to plastics and decrease lymphocyte aggregation by PHA. Electrophoretic mobility of lymphocytes incubated with 2000 micrograms/ml of Lidocaine is slower compared to controls; there is no change at 200 micrograms/ml. Local anaesthetics modify steric membrane structure reducing surface charge density. Increased Ca++ in the medium containing local anaesthetic increases lymphocyte stimulation index slightly only for Lidocaine and Bupivacaine doses, which neither alter membrane function nor interfere with lymphocyte viability nor electrophoretic mobility. Increased Na+ and K+ in the medium do not affect local anaesthetic action.

Urea and ethylene glycol-facilitated transport systems in the human red cell membrane. Saturation, competition, and asymmetry

The equilibrium exchange of [14C]urea and ethylene glycol was measured using a new type of fast flow system. Approximately equal volumes of saline and air were mixed to form a segmented fluid stream into which 14C-loaded red cells are injected. The stream flows through three filter chambers which allow sampling of the 14C in the extracellular fluid at three time points. The chambers are designed so that they do not disrupt the segmented bubble pattern. The alternating air and saline segments prevent laminar dispersion in the flowing stream and ensure good mixing at the injection and sampling sites. The equilibrium exchange of both urea and ethylene glycol showed saturation kinetics. The maximum permeability (Po) measured in the limit of zero solute concentration is 1.6 X 10(-3) cm/s for urea and 4.8 X 10(-4) cm/s for ethylene glycol (T = 23 degrees C). The apparent dissociation constant (Km) was 218 mM for urea and 175 mM for ethylene glycol. The Po for thiourea is 2.3 X 10(-6) cm/s and the Km is 19 mM. Urea and thiourea inhibit the transport of each other and the inhibition constant (KI) is approximately equal to the Km for both compounds. 53 other analogues of urea were screened for their inhibition of urea or thiourea transport. Several analogues [e.g., 1-(3,4-dichloro-phenyl)-2-thiourea] had a KI in the range of 0.03 mM. The affinity of the inhibitor increased as it was made more hydrophobic. The urea analogues did not significantly inhibit the ethylene glycol or osmotic permeability. Glycerol inhibited ethylene glycol permeability with a KI of 1,200 mM.

The competitive inhibition of glucose transport in human erythrocytes by compounds of different structures

By kinetic analysis we found that the transport protein for glucose in human erythrocyte membranes has different binding sites for competitive inhibitors. They all change the transport protein with the effect that it loses its affinity to glucose. Some of the competitive inhibitors alter the conformation of the transport protein, so that other ones cannot be bound. There are inhibitors, however, which do not affect the affinity of other competitive inhibitors. A schematic model of our assumption about the mechanism of the competitive inhibition of glucose transport is presented.

Local anesthetics, mepacrine, and propranolol are antagonists of calmodulin

Local anesthetics such as dibucaine, QX572, tetracaine, and phenacaine, as well as other drugs with local anesthetic-like properties (e.g., mepacrine, propranolol, and SKF 525A) inhibit the specific calmodulin-dependent stimulation of erythrocyte Ca2+-ATPase (ATP phosphohydrolase, EC 3.6.1.3) and cyclic nucleotide phosphodiesterases (3',5'-cyclic-nucleotide 5'-nucleotidohydrolase, EC 3.1.4.17) from brain and heart. Basal activities of these enzymes in the absence of calmodulin are relatively unaffected by concentrations of local anesthetics that strongly inhibit the specific stimulation by calmodulin. Increasing calmodulin, but not Ca2+, overcomes the inhibitory action of the local anesthetics on brain phosphodiesterase. However, excess calmodulin does not fully restore activity of erythrocyte CA2+-stimulated ATPase. Although the mechanism(s) by which the local anesthetics act is unclear, they inhibit binding of 125I-labeled calmodulin to the erythrocyte membrane. Antagonism of calmodulin provides a molecular mechanism that may explain the inhibition of many Ca2+-dependent cellular processes by local anesthetics--e.g., Ca2+ transport, exocytosis, excitation-contraction coupling, non-muscle-cell motility, and aggregation.

Toxicology investigations with cell culture systems

This review concerns some of the cell culture systems that are most frequently used in toxicology investigations. In particular, it sets out to evaluate the effectiveness of these cell culture systems in assessing the toxic potential of chemicals. Metabolic studies and general and specific toxicology investigations are highlighted. Specific toxicology investigations relate to the effects of the tests substances on the highly specialized functions typical of the cell systems chosen. The general toxicology investigations include most of the other studies where differentiated or undifferentiated cells have been used to evaluate the effects of the tested substances on common basic biochemical processes essential for life. Lastly, we have attempted to focus attention on the most promising applications of cell cultures in toxicology studies for the near future and to identify those areas where further research is needed. Because of the several excellent reviews that already exist, we have decided not to consider cell cultures utilized in screening potential mutagens and carcinogens. We have also excluded investigations of drug therapeutic effects and action mechanisms of drugs.

Inhibition of anion and glucose permeabilities by anesthetics in erythrocytes. The mechanisms of action of positively and negatively charged drugs

(1) The mode of action of anesthetics as inhibitors of Cl- and glucose transports in human red cells was studied. The term anesthetic is taken in its broad meaning as defined by Seeman (Seeman, P. (1972) Pharmacol. Rev. 24, 583-655) and covers anionic and cationic liposoluble compounds which reversibly block the rising phase of the action potential, without effect on the resting membrane potential. (2) Phenothiazine derivatives were chosen as prototypes of anesthetics because they represent a set of compounds having the same basic chemical structure, the phenothiazine ring, but with either a positive or a negative charge. (3) The Cl- self-exchange is inhibited by both cationic and anionic derivatives. However, to obtain the same level of inhibition, it is necessary to use a concentration 10-100 times higher with cationic than with anionic drugs. (4) At a concentration which inhibits Cl- permeability, cationic derivatives induce a very strong morphological change (cup-shaped cells: stomatocytes or spherostomatocytes) and protect erythrocytes against osmotic hemolysis, signifying that the membrane is fully expanded. Conversely, with anionic derivatives, inhibition occurs at a concentration which does not induce any apparent shape change or protect against osmotic hemolysis: there is no significant membrane expansion. (5) Glucose permeability, measured by glucose exit, is inhibited by cationic and anionic phenothiazine, but always at a concentration which fully expands the membrane as indicated by morphological changes and anti-hemolytic effects. It is interesting to point out that whilst glucose exit shows inhibition by cationic derivatives, glucose exchange flux is scarcely altered. (6) It is concluded that cationic and anionic anesthetics are general inhibitors of transmembrane solute movements involving a facilitated-diffusion process. However, the mechanism of inhibition is not identical for all: inhibition of glucose permeability by anionic and cationic anesthetics, as well as inhibition of Cl- permeability by cationic anesthetics may be of a non-specific nature and result from their interaction with the bilayer (this indirect effect is discussed); on the other hand, inhibition of Cl- permeability by anionic anesthetics may result from a specific perturbation of the transport mechanism according to recent evidence in some cases (Cousin, J.L. and Motais, R. (1979) J. Membrane Biol. 46, 125-153; Zaki, L., Ruffing, W. Gärtner, E.M., Fasold, H., Motais, R. and Passow, H. (1977) 11th FEBS Meeting, Copenhagen, A4 17-671.

The effect of homologous local anesthetics of the 4-alkoxy- and 4-alkylamino-benzoic acid-diethylamino-esthylester- hydrochloride series on the glucose transport in human erythrocytes

The homologous compounds of the 4-alkoxy- and 4-alkylamino-series inhibit the exchange transport of glucose in human erythrocytes; they show a competitive inhibition with one or two inhibitor molecules which become bound to a singular site of the transport system for glucose. The importance of length of hydrocarbon chain of the localanesthetics for the mode of their action is discussed.

Selection and characterization of a varient of murine L5178Y lymphoma resistant to local anesthetics

A varient of murine L5178Y lymphoma resistant to procaine hydrochloride (PH) was selected by exposing the cells to gradual increments of PH in the growth medium until the cell grew exponentially in the presence of 1.5 mM PH. Using cinephotomicrography, it was observed that the majority of cells that initially succumbed to PH failed to undergo successful mitosis. With respect ot chromosomal, cell size distribution and flow microfluorometric analyses, the PH-resistant cells are very similar to a spontaneous tetraploid cell line (R1T) previously cloned. The isolated cells, designated R1/P, were also found to be cross-resistant to analogues of PH, namely, lidocaine, tetracaine and dibucaine. The naturally-occurring tetraploid cell line (R1T) was also found to be more resistant to local anesthetics, although not to the same extent as R1/P cells. Since the enzyme that hydrolyzes procaine appears to be absent in all these lymphoid cell lines, the difference in resistance does not appear to depend on differences in the ability of these cells to remove the agent. It is suggested that an alteration in the structure and/or function of the plasma membrane in R1/P cells have rendered them either less sensitive to the membrane-perturbing effects of the local anesthetics or less permeable to local anesthetics molecules. The ability of local anesthetics to affect membranes and cytoskeleton structures may play a role in the genesis and/or selection of these cell variants.

Specific D-glucose transport in sarcolemma vesicles

The sarcolemmal fraction prepared from rat skeletal muscle consists of osmotically active vesicles that accumulate D-glucose in preference to L-glucose, apparently by facilitated diffusion into intravesicular space. Stereospecific D-glucose uptake by these vesicles is a saturable rpocess, inhibited by phloridzin, by cytochalasin B, and by certain sugars, and enhanced by counterflow. An additional leak pathway permits entry of both D- and L-glucose into the vesicles. Stereospecific D-glucose transport by sarcolemmal vesicles is enhanced to a small extent by insulin, provided the hormone is administered prior to cell disruption. In membranes prepared from insulin-pretreated muscle, Ca2+ produces a small further enhancement. Local anesthetics preferentially inhibit stereospecific D-glucose transport. Apparent uptake of both D- and L-glucose is greater when vesicles are suspended in salt solutions rather than sucrose, an effect attributed to increased functional vesicular volume.

Inhibition of glucose transport in human erythrocytes by benzylalcohol

The inhibition of glucose transport by the non-ionizable local-anesthetic denzylalcohol is of the mixed type and independent of pH. The affinity of benzylalcohol to the free carrier is about three times larger than that to the carrier-glucose complex.