Neurotoxicity of Adriamycin and misonidazole in the mouse

Cell size and geometry of spinal cord motoneurons in the adult cat following the intramuscular injection of adriamycin: comparison with data from aged cats

Adriamycin (ADM), an antineoplastic antibiotic, when injected intramuscularly, is taken up by motoneuron axonal terminals and retrogradely transported to the motoneuron soma where it exerts its neurotoxic effect. In the present study, ADM was injected into the hindlimb muscles of five adult cats. Measurements of the electrophysiological properties of the lumbar motoneurons innervating these muscles were obtained using intracellular techniques. Based upon these data the equivalent cylinder model of motoneurons was employed to evaluate ADM-induced changes in cell size and cell geometry. The size of cell somas in the ventral horn was also measured using light microscopy and computer imaging software. There were significant increases in the membrane time constant (25%) and input resistance (50%) in motoneurons whose muscles were treated with ADM (ADM-MNs) compared with data from control motoneurons (control-MNs). The increase in membrane time constant is attributed to an increase in membrane resistance; the increase in input resistance appears to depend upon both an increase in membrane resistance and a decrease in total cell surface area. Cell capacitance, which is proportional to the total cell surface area, was significantly reduced (15%) in ADM-MNs. Calculations based on cable theory indicate that while there was no significant change in the length of the equivalent cylinder for ADM-MNs, there was a significant decrease (17%) in the diameter of the equivalent cylinder. These data indicate that there is a decrease in total cell surface area which can be attributed to the shrinkage of branches throughout the dendritic tree. There was also a small (7%) but statistically significant decrease in the electrotonic length of ADM-MNs. Morphological analysis also revealed that the mean cross-sectional area of the somas of those ventral horn neurons which are likely to correspond to the motoneuron population was significantly reduced on the ADM-treated side compared to that of neurons on the control side. We conclude that significant geometrical changes were induced in lumbar motoneurons of adult cats after ADM was injected to their muscles. In old cats, spinal cord motoneurons exhibit similar patterns of changes in their electrophysiological characteristics which have also been suggested to be correlated with changes in cell geometry. The question then arises as to whether the response of motoneurons to ADM and the aging process reflects a stereotypic reaction of motoneurons to a variety of insults or whether the response to ADM mirrors specific aspects of the aging process.

Low prevalence of cisplatin-induced neuropathy after 4-day continuous infusion in head and neck cancer

The toxicity of cisplatin on peripheral nerves was studied using electrophysiologic recordings in 52 patients with head and neck squamous cell carcinoma. Induction chemotherapy (cisplatin: 25 mg/m2/day, days 1-4; 5-fluorouracil: 1 g/m2/day, days 1-4) was administered by continuous infusion every 3 weeks. Electrophysiologic recordings were performed before and after the completion of three courses of chemotherapy (cisplatin total dose: 250-300 mg/m2). The comparison between the recordings showed 14% of the patients had an increase in the latency of the soleus muscle monosynaptic reflex as studied by the Hoffman reflex and 9% showed a decrease in the conduction velocity of the cutaneous sensory fibers of the median nerve. These results indicated a low prevalence of cisplatin-induced neuropathy. The respective roles played by the continuous infusion of the drug and by the potentiation of neurotoxic effects resulting from the association of cisplatin with other neurotoxins is discussed to explain this low toxicity.

Cardiovascular autonomic function in anthracycline-treated breast cancer patients

Preclinical studies suggest that in addition to the well-known direct damage to the myocardium, anthracycline antineoplastic drugs exert toxic effects on the cardiovascular autonomic system as well. To investigate whether this phenomenon occurs in the clinic, we carried out noninvasive, widely used tests of cardiovascular autonomic physiology in 55 women with stage II or III breast cancer. In all, 31 were being treated with anthracycline-containing chemotherapy regimens, and 24 who were receiving CMF (cyclophosphamide, Methotrexate, and fluorouracil) served as controls. Of 279 tests conducted in anthracycline (A)-treated patients, 123 were abnormal, vs 54 of 216 tests carried out in 24 controls (44% vs 25%; P less than 0.005). Abnormal variations in heart rate on standing and in diastolic blood pressure during handgrip was found in 25 (81%) and 17 patients receiving A, vs 9 (37%; P less than 0.005) and 5 (21%; P less than 0.0001), respectively, in controls. The incidence of abnormal tests was significantly higher in A-treated patients greater than 60 years of age (41%) vs 67%; P less than 0.05). Radionuclide ventriculography was carried out in 19 patients who showed abnormal tests of cardiovascular autonomic function after greater than or equal to 6 courses of a-containing chemotherapy; only 1 of them had abnormal cardiac contractility (global hypokinesia), suggesting that abnormal tests of cardiovascular autonomic function may occur in the absence of a detectable deterioration in left ventricular ejection fraction. A large number of factors may alter cardiovascular autonomic function in cancer patients, including age, radiation therapy to the chest, and multidrug treatment. Even after correcting for the most obvious of these, chemotherapy with anthracyclines is associated with a significantly higher percentage of abnormal tests for cardiovascular autonomic function. Although indirect and semi-quantitative, our results are compatible with the idea of A-induced cardiac autonomic dysfunction.

Evaluation of membrane fluidity effects and enzyme activities alterations in adriamycin neurotoxicity

Adriamycin (ADR) increased the lipid fluidity of dog brain synaptosomal plasma membranes (SPM) labeled with 1,6-diphenyl-1,3,5-hexatriene (DPH), as indicated by the steady-state fluorescence anisotropy [(ro/r)-1]-1. Arrhenius-type plots of [(ro/r)-1]-1 indicated that the lipid phase separation of the membrane at 23.3 +/- 1.2 degrees was perturbed by ADR such that the temperature was reduced to 16.2 +/- 1.1 degrees. Arrhenius plots of (Na+ + K+)-stimulated ATPase activity exhibited a break point at 22.8 +/- 1.1 degrees in control SPM which was reduced to 15.8 +/- 1.0 degrees in ADR treated SPM, suggesting differences in the interaction of (Na+ + K+)-stimulated ATPase with lipids between ADR treated and untreated SPM. (Na+ + K+)-stimulated ATPase and Ca2+-stimulated ATPase activities were increased at a concentration range 10(-18)-10(-15) M of ADR; higher concentrations (up to 10(-7) M), however, led to a progressive inhibition of the enzyme activities. The allosteric properties of SPM-bound (Na+ + K+)-stimulated ATPase by fluoride (F-) (as reflected by changes in the Hill coefficient) were modulated by ADR whereas those of SPM-bound acetylcholinesterase remained unaffected. We propose that ADR achieves these effects through asymmetric perturbations of the membrane lipid structure and that changes in membrane fluidity may be an early key event in ADR induced neurotoxicity.