Accumulation of platinum in the intervertebral discs and vertebrae of ovarian tumor-bearing patients treated with cisplatin

Selective Inhibition on Organic Cation Transporters by Carvedilol Protects Mice from Cisplatin-Induced Nephrotoxicity

PURPOSE

The organic cation transporters (OCTs) and multidrug and toxin extrusions (MATEs), located in the basolateral and apical membrane of proximal tubular cells respectively, are crucial determinants of renal elimination and/or toxicity of cationic drugs such as cisplatin. The purpose of this study was to discover selective OCT inhibitors over MATEs, and explore their potential to protect against cisplatin-induced nephrotoxicity that is clinically common.

METHODS

The inhibition by select compounds on the uptake of the probe substrate metformin was assessed in HEK293 cells overexpressing human OCT2, OCT1, MATE1, MATE2-K, and mouse Oct2, Oct1, and Mate1. Furthermore, the effects of carvedilol on organic cation transporter-mediated cellular and renal accumulation of metformin and cisplatin, and particularly the toxicity associated with cisplatin, were investigated in HEK293 cells and mice.

RESULTS

Five selective OCT inhibitors were identified through the screening of forty-one drugs previously reported as the inhibitors of OCTs and/or MATEs. Among them, carvedilol showed the most selectivity on OCTs over MATEs (IC₅₀: 3.6 μM for human OCT2, 103 μM for human MATE1 and 202 μM for human MATE2-K) in the cellular assays in vitro, with the selectivity in mice as well. Moreover, carvedilol treatment could significantly decrease cisplatin accumulation and ameliorate its toxicity both in vitro in cells and in vivo in mouse kidney.

CONCLUSIONS

Our data indicate that selective inhibition of OCTs by carvedilol may protect from cisplatin-induced nephrotoxicity by restraining the cellular entry of cisplatin via OCTs, while having no impact on its elimination through MATEs.

Atomic absorption spectrometry analysis of trace elements in degenerated intervertebral disc tissue

Background

Few studies have investigated trace elements (TE) in human intervertebral disc (IVD) tissue.

Trace element presence can have diverse meanings: essential TE show the metabolic modalities of the tissue, while environmentally-related TE indicate pollution and tissue-specific absorption and accumulation.

IVD is a highly specific compartment with impaired communication with adjacent bone. Analysis of TE in IVD provides new insights regarding tissue metabolism and IVD communication with other tissues.

Material/Methods

Thirty intervertebral discs were acquired from 22 patients during surgical treatment for degenerative disease. Atomic absorption spectrometry was used to evaluate the concentrations of Al, Cd, Pb, Cu, Ni, Mo, Mg, and Zn.

Results

Al, Pb, Cu, Mg, and Zn were detected in all samples. Pb was significantly positively correlated with age, and Ni concentration was weakly correlated with population count in the patient’s place of residence. Only Cu was observed in higher concentrations in IVD compared to in other tissues. Significant positive correlations were observed between the following pairs: Mg/Zn, Mg/Al, Mg/Pb, Zn/Al, Zn/Pb, and Al/Pb. Negative correlations were observed between Mg/Cd, Zn/Cd, Mg/Mo, and Mo/Pb.

Conclusions

This study is one of few to profile the elements in intervertebral discs in patients with degenerative changes. We report significant differences between trace element concentrations in intervertebral discs compared to in other tissues. Knowledge of the TE accumulation pattern is vital for better understanding intervertebral disc nutrition and metabolism.

Comparison of trace element concentration in bone and intervertebral disc tissue by atomic absorption spectrometry techniques

BACKGROUND

Trace element (TE) analysis in human tissue has the dual purpose of assessing environmental pollution and metabolism. In literature, bone TE analysis is common, but studies in intervertebral disc (IVD) tissue are lacking. The aim of the study was evaluation of the difference of TE concentration in intervertebral disc and bone in patients with degenerative changes. The comparison of the tissues differing in metabolism, blood perfusion, or separateness from adjoining tissues but playing similar biomechanical role and presenting some common morphological traits may shed new light on metabolism nuances, degenerative process, as well as accumulation potential of IVD in respect to bone.

METHODS

In the study, we analyzed two types of samples: intervertebral disc (n =30, from 22 patients operated due to degenerative disc disease) and femoral bone (n =26, separately femoral head and neck, from 26 patients, acquired in total hip arthroplasty procedure in course of idiopathic osteoarthritis of the hip joint). In the samples we analyzed, with atomic absorption spectrometry, the concentrations of Pb, Ni, Mo, Cu, Mg, and Zn.

RESULTS

The element concentrations identified in bone are comparable to those presented in the literature. In the case of Pb, Ni, Mo, Mg, and Zn, the concentration in the bone was 2 to 25.8 times higher than that observed in the disc. Only the Cu concentration was higher in disc tissue than in bone. In disc tissue, fewer samples had TE concentrations below the detection threshold. We found significant differences in TE profiles in the compared tissues.

CONCLUSIONS

The results show that the disc could serve as a more stable compartment for evaluating TE concentration, especially for TEs that are environmentally related.

The application of inductively coupled plasma mass spectrometry in clinical pharmacological oncology research

Metal-based anticancer agents are frequently used in the treatment of a wide variety of cancer types. The monitoring of these anticancer agents in biological samples is important to understand their pharmacokinetics, pharmacodynamics, and metabolism. In addition, determination of metals originating from anticancer agents is relevant to assess occupational exposure of health care personnel working with these drugs. The high sensitivity of inductively coupled plasma mass spectrometry (ICP-MS) has resulted in an increased popularity of this technique for the analysis of metal-based anticancer drugs. In addition to the quantitative analysis of the metal of interest in a sample, ICP-MS can be used as an ultrasensitive metal selective detector in combination with speciation techniques such as liquid chromatography. In the current review we provide a systematic survey of publications describing the analysis of platinum- and ruthenium-containing anticancer agents using ICP-MS, focused on the determination of total metal concentrations and on the speciation of metal compounds in biological fluids, DNA- and protein-adducts, and environmental samples. We conclude that ICP-MS is a powerful tool for the quantitative analysis of metal-based anticancer agents from multiple sample sources.

Tissue platinum after clinical treatment with cisplatin or carboplatin in tumor-bearing patients

Tissue platinum (Pt) levels were measured in tumor-bearing patients treated with either cisplatin or carboplatin. Cisplatin was given by intra-arterial, intraperitoneal, and intravenous (iv) administrations. After death, vertebrae and intervertebral disks were removed from eight human subjects, and livers and kidneys were removed from the half of them. When cisplatin was administered intraperitoneally, Pt of the liver was higher than that of the kidney, and a high content of Pt was detected in the vertebra by comparing with the other administration methods. At the intra-arterial administration of cisplatin, Pt was mainly accumulated in the kidney. At the iv administration of cisplatin, a high level of Pt was found in the vertebra and intervertebral disk, especially at the highest value at 10.31 micrograms/g in the intervertebral disk of one case, whereas a low level of Pt was detected in the liver. On the contrary, it was found that the iv administration of carboplatin did not result in high accumulations of Pt in the liver, kidney, intervertebral disk, and vertebra. Therefore, Pt is accumulated in different organs, depending on the way cisplatin is administered, but Pt is accumulated least in them by the administration of carboplatin.

Lipopolysaccharide-induced platinum accumulation in the cerebral cortex after cisplatin administration in mice: Involvement of free radicals

The relationship between the accumulation of platinum in the cerebral cortex following cisplatin administration and injury to the blood-brain barrier after lipopolysaccharide (LPS) treatment was investigated. The appearance of intravenously injected fluorescein in the brain was significantly increased 10-24 h after LPS treatment, the effect being dose-dependent. Platinum was detectable in the cerebral cortex of cisplatin-treated mice 24 h after LPS treatment, but not without LPS treatment. In mice pretreated with α-tocopherol, LPS administration did not significantly augment fluorescein penetration into the brain, whereas pretreatment with either allopurinol or ascorbic acid did not modify the LPS-induced increase in fluorescein penetration. In contrast, platinum in the cerebral cortex after cisplatin administration was still detectable in the allopurinol-, ascorbic acid-, and α-tocopherol-pretreated groups, and the levels of platinum in these groups were not significantly different from those in the group treated with LPS only. Administration of superoxide dismutase (SOD), but not of catalase, tended to inhibit the penetration of fluorescein. Both SOD and catalase significantly lowered platinum content in the cerebral cortex following cisplatin administration in mice treated with LPS. Thus, free radicals may injure the blood-brain barrier in mice challenged with LPS, and allow cisplatin to penetrate into the cerebral cortex, resulting in platinum accumulation.

Detection of platinum in the brain of mice treated with cisplatin and subjected to short-term hypoxia

Cisplatin is widely used for cancer treatment but has strong side-effects, including nephrotoxicity. Neurotoxicity has been thought to be limited to peripheral damage because the blood-brain barrier is thought to be impervious to hydrophilic substances such as cisplatin. Because anoxic ischaemia has been associated with lesions of the barrier, inductively coupled plasma mass spectrometry has been used to monitor the accumulation of platinum in the brains of mice treated with cisplatin and exposed to oxygen-deficient atmospheres. Platinum was detected in the cerebral cortex of mice 24 h after the administration of cisplatin (3 mg kg-1) followed by exposure for 60 s to an atmosphere containing 7% oxygen, but not in the cerebral cortex of mice exposed to normal atmospheres. Platinum was also observed in the cerebral cortex after exposure for 120 s to an atmosphere containing 14% oxygen, and platinum levels increased as the concentration of oxygen was reduced. The highest platinum levels were obtained 10 h after administration of cisplatin and exposure for 120 s to an atmosphere containing 7% oxygen. Platinum was still retained in the cerebral cortex one week after administration. In contrast, platinum levels in the blood and kidney decreased with time. Platinum levels were measured in seven regions of the brain: the right and left cerebral cortices, the basal ganglia, the thalamus and hypothalamus, the bulbus olfactorius, the cerebellum, and the mesencephalon. When cisplatin was administered to mice not subjected to hypoxia, platinum was not detected in the right and left cerebral cortices, basal ganglia or the thalamus and hypothalamus, but was detected in the bulbus olfactorius, cerebellum and mesencephalon. When such mice were exposed to low levels of oxygen, however, platinum was detected in the right and left cerebral cortices, the basal ganglia and the thalamus and hypothalamus. Platinum levels in the cerebellum and mesencephalon of mice exposed to low levels of oxygen were higher than those of mice exposed to normal air. In addition, platinum levels in the bulbus olfactorius were significantly higher than those in the other regions, although the platinum content of the bulbus olfactorius was not affected by hypoxia. From these observations, it is concluded that platinum is easily accumulated in the bulbus olfactorius after the administration of cisplatin, and that after exposure to atmospheres containing low levels of oxygen, platinum easily passes through the blood-brain barrier and accumulates in all parts of the brain.

Anatomy of intervertebral disc and pathophysiology of herniated disc disease

This discussion reviews developments in normal and abnormal disc biology over the past decade. The anatomic and biochemical structure of the disc is reviewed. Emphasis is placed on recent neurochemical changes identified in disc degeneration and disc herniation. Biomechanical considerations for the normal disc are presented. Influence of mechanical factors on disc nutrition, disc degeneration and disc herniation is reviewed. Biologic events underlying the diagnostic methods used in evaluating disorders of the intervertebral disc are presented. The biologic consequences of iatrogenic disc injury in discectomy are also discussed.

Comparison of three different methods for measurement of tissue platinum level

We attempted to make a comparison of three methods for tissue platinum; atomic absorption spectrometry (AAS), inductively coupled plasma atomic emission spectrometry (ICP-AES), and inductively coupled plasma mass spectrometry (ICP-MS). The determination limits were 0.05 ng/mL on ICP-MS, 50 ng/mL on ICP-AES, and 200 ng/mL on AAS, and the recovery rates were 97.7 +/- 6.9% on ICP-MS, 69.0 +/- 3.0% on ICP-AES, and 102.4 +/- 4.0% on AAS, respectively. Platinum was detected by ICP-AES and ICP-MS in human vertebrae, but the level was higher by ICP-AES than by ICP-MS. In the mouse kidney treated with cisplatin, platinum was detected by ICP-MS, but not by ICP-AES. As cadmium gives the absorption peak close to platinum, cadmium was measured together with platinum by ICP-AES in the vertebrae. From these, ICP-MS is the most sensitive for measurement at tissue platinum. The sensitivity of ICP-AES looks worse for measuring the tissue platinum, and it is necessary to take care of the contaminant of metals, especially cadmium. AAS is not suitable for measurement of tissue platinum as in the vertebrae and kidneys, because platinum was not detectable by AAS.