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Vojtek M, Gonçalves-Monteiro S, Pinto E, Kalivodová S, Almeida A, Marques MPM, Batista de Carvalho ALM, Martins CB, Mota-Filipe H, Ferreira IMPLVO, Diniz C. Preclinical Pharmacokinetics and Biodistribution of Anticancer Dinuclear Palladium(II)-Spermine Complex (Pd 2Spm) in Mice. Pharmaceuticals (Basel) 2021; 14:ph14020173. [PMID: 33672377 PMCID: PMC7926495 DOI: 10.3390/ph14020173] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/13/2021] [Accepted: 02/17/2021] [Indexed: 02/07/2023] Open
Abstract
Palladium-based compounds are regarded as potential analogs to platinum anticancer drugs with improved properties. The present study assessed the pharmacokinetics and biodistribution of a dinuclear palladium(II)-spermine chelate (Pd2Spm), which has previously been shown to possess promising in vitro activity against several therapy-resistant cancers. Using inductively coupled plasma-mass spectrometry, the kinetic profiles of palladium/platinum in serum, serum ultrafiltrate and tissues (kidney, liver, brain, heart, lungs, ovaries, adipose tissue and mammary glands) were studied in healthy female Balb/c mice after a single intraperitoneal bolus injection of Pd2Spm (3 mg/kg bw) or cisplatin (3.5 mg/kg bw) between 0.5 and 48 h post-injection. Palladium in serum exhibited biphasic kinetics with a terminal half-life of 20.7 h, while the free palladium in serum ultrafiltrate showed a higher terminal half-life than platinum (35.5 versus 31.5 h). Palladium was distributed throughout most of the tissues except for the brain, with the highest values in the kidney, followed by the liver, lungs, ovaries, adipose tissue and mammary glands. The in vitro cellular accumulation was also evaluated in breast cancer cells, evidencing a passive diffusion as a mechanism of Pd2Spm’s cellular entry. This study reports, for the first time, the favorable pharmacokinetics and biodistribution of Pd2Spm, which may become a promising pharmacological agent for cancer treatment.
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Affiliation(s)
- Martin Vojtek
- LAQV/REQUIMTE, Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.G.-M.); (S.K.)
- Correspondence: (M.V.); (C.D.)
| | - Salomé Gonçalves-Monteiro
- LAQV/REQUIMTE, Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.G.-M.); (S.K.)
| | - Edgar Pinto
- LAQV/REQUIMTE, Laboratory of Bromatology and Hydrology, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (E.P.); (I.M.P.L.V.O.F.)
- Department of Environmental Health, School of Health, P.Porto, CISA/Research Center in Environment and Health, 4200-072 Porto, Portugal
| | - Sára Kalivodová
- LAQV/REQUIMTE, Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.G.-M.); (S.K.)
| | - Agostinho Almeida
- LAQV/REQUIMTE, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
| | - Maria P. M. Marques
- “Molecular Physical-Chemistry” R&D Unit, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal; (M.P.M.M.); (A.L.M.B.d.C.); (C.B.M.)
- Department of Life Sciences, University of Coimbra, 3000-456 Coimbra, Portugal
| | - Ana L. M. Batista de Carvalho
- “Molecular Physical-Chemistry” R&D Unit, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal; (M.P.M.M.); (A.L.M.B.d.C.); (C.B.M.)
| | - Clara B. Martins
- “Molecular Physical-Chemistry” R&D Unit, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal; (M.P.M.M.); (A.L.M.B.d.C.); (C.B.M.)
| | - Helder Mota-Filipe
- iMed.ULisboa, Faculty of Pharmacy, University of Lisbon, 1649-003 Lisbon, Portugal;
| | - Isabel M. P. L. V. O. Ferreira
- LAQV/REQUIMTE, Laboratory of Bromatology and Hydrology, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (E.P.); (I.M.P.L.V.O.F.)
| | - Carmen Diniz
- LAQV/REQUIMTE, Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.G.-M.); (S.K.)
- Correspondence: (M.V.); (C.D.)
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Inkol JM, Poon AC, Mutsaers AJ. Inhibition of copper chaperones sensitizes human and canine osteosarcoma cells to carboplatin chemotherapy. Vet Comp Oncol 2020; 18:559-569. [PMID: 32060984 DOI: 10.1111/vco.12579] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 12/11/2022]
Abstract
Osteosarcoma (OSA) is the most common primary bone cancer in children, adolescents and dogs. Current combination surgical and chemotherapeutic treatments have increased survival. However, in recurrent or metastatic disease settings, the prognosis significantly decreases, representing an urgent need for better second-line and novel chemotherapeutics. The current gold standard for combination chemotherapy in OSA often includes a platinum agent, for example, cisplatin or carboplatin. These platinum agents are shuttled within the cell via copper transporters. Recent interest in targeting copper transport has been directed towards antioxidant protein 1 (Atox1) and copper chaperone for superoxide dismutase 1 (CCS), with Atox1 demonstrating the ability to aggregate platinum agents, preventing them from forming DNA adducts. DC_AC50 is a small molecule inhibitor of both Atox1 and CCS. To assess the impact of targeting these pathways on chemotherapy response, two human and two canine OSA cell lines were utilized. After treatment with single agent or combination drugs, cell viability was evaluated and pharmacological synergism calculated using the combination index method. Apoptosis, cell cycle distribution, clonogenic survival and migration were also evaluated. DC_AC50 synergised with carboplatin in combination treatment of human and canine OSA cells to reduce cancer cell viability. DC_AC50-treated cells were significantly less mitotically active, as demonstrated by decreased expression of phospho-histone H3 and cell cycle analysis. DC_AC50 also potentiated carboplatin-induced apoptosis in OSA cells and decreased clonogenic survival. Finally, DC_AC50 reduced the migratory ability of OSA cells. These results justify further investigation into inhibiting intracellular copper chaperones as a means of reducing/preventing acquired chemotherapy resistance.
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Affiliation(s)
- Jordon M Inkol
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Andrew C Poon
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Anthony J Mutsaers
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.,Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Poon AC, Inkol JM, Luu AK, Mutsaers AJ. Effects of the potassium-sparing diuretic amiloride on chemotherapy response in canine osteosarcoma cells. J Vet Intern Med 2018; 33:800-811. [PMID: 30556178 PMCID: PMC6430882 DOI: 10.1111/jvim.15382] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 11/14/2018] [Indexed: 02/07/2023] Open
Abstract
Background Osteosarcoma (OSA) is a common bone tumor of mesenchymal origin in dogs. Chemotherapy delays metastasis, yet most dogs die of this disease within 1 year of diagnosis. The high metabolic demand of cancer cells promotes proton pump upregulation, leading to acidification of the tumor microenvironment and chemoresistance. The potassium‐sparing diuretic amiloride is among a class of proton pump inhibitors prescribed for refractory heart failure treatment in dogs. Objective We hypothesized that amiloride treatment improves chemotherapy response by reducing acidification in canine OSA cells. Our objective was to assess the in vitro effects of amiloride on cell viability, apoptosis, and metabolism. Methods In vitro study. Assessments of cell viability and apoptosis were performed after single agent or combination treatment, along with calculations of pharmacological synergism using the combination index. Protein signaling during apoptosis was evaluated by Western blotting. Metabolic profiling was performed using a Seahorse bioanalyzer. Results Amiloride strongly synergized with doxorubicin in combination treatment and exhibited additive or antagonistic effects with carboplatin in canine OSA cells. Combination treatment with doxorubicin significantly upregulated p53‐mitochondrial signaling to activate apoptosis and downregulate Akt phosphorylation. Amiloride‐treated cells further exhibited metabolic switching with reductions in glycolytic capacity and maximal respiration. Conclusion and Clinical Importance Amiloride synergized with doxorubicin to potentiate apoptosis in canine OSA cells. These results justify further investigation into repurposing of amiloride as an oncology drug for the treatment of OSA in dogs.
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Affiliation(s)
- Andrew C Poon
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Jordon M Inkol
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Anita K Luu
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Anthony J Mutsaers
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.,Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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Ibrahim ME, Chang C, Hu Y, Hogan SL, Mercke N, Gomez M, O'Bryant CL, Bowles DW, George B, Wen X, Buckley B, Aleksunes L, Joy MS. Pharmacokinetic determinants of cisplatin-induced subclinical kidney injury in oncology patients. Eur J Clin Pharmacol 2018; 75:51-57. [PMID: 30220072 DOI: 10.1007/s00228-018-2552-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 08/30/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE The ability to predict and detect clinical and subclinical nephrotoxicity early in the course of therapy has the potential to improve long-term outcomes in cancer patients receiving cisplatin chemotherapy. Pharmacokinetic parameters could serve as predictors of cisplatin-induced nephrotoxicity. METHODS Participants [n = 13] were treated with a 1-h cisplatin infusion [30-75 mg/m2]. Blood was collected pre-dose and up to 6 h post-dose. Urinary biomarkers [KIM-1, calbindin, clusterin, GST-pi, β2M, albumin, NGAL, osteopontin, clusterin, MCP-1, cystatin C, and TFF3] were measured at baseline, days 3 and 10. Total and unbound platinum concentrations were measured using ICP/MS. Noncompartmental analysis was performed, and correlation and regression analyses evaluated the relationships between platinum pharmacokinetics and nephrotoxicity. RESULTS Peak platinum urinary concentrations correlated with urinary levels of KIM-1, calbindin, clusterin, GST-pi, β2M, albumin, NGAL, osteopontin, clusterin, cystatin C, and TFF3 at day 10. Unbound platinum plasma concentrations at 2 h also correlated with urinary clusterin, β2M, cystatin C, NGAL, osteopontin, and TFF3 at day 3. Regression analyses suggested 2-h total plasma platinum concentrations greater than 2000 ng/ml, and peak urinary platinum concentrations above 24,000 ng/ml may serve as potential approximations for elevated risk of nephrotoxicity. Platinum area under the plasma concentration time curve was associated with serum creatinine and estimated glomerular filtration rate. CONCLUSIONS Peak plasma and urinary platinum concentrations and pharmacokinetic parameters were associated with risk of subclinical cisplatin-induced kidney injury as assessed using novel urinary biomarkers. Future studies will examine these relationships in larger clinical populations of cisplatin-induced acute kidney injury.
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Affiliation(s)
- Mustafa E Ibrahim
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Anschutz Medical Campus, 12850 E. Montview Blvd, Mail Stop C238, Room V20-4108, Aurora, CO, 80045, USA
| | - Cara Chang
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Anschutz Medical Campus, 12850 E. Montview Blvd, Mail Stop C238, Room V20-4108, Aurora, CO, 80045, USA
| | - Yichun Hu
- Kidney Center, University of North Carolina School of Medicine, Division of Nephology and Hypertension, Chapel Hill, NC, 27516, USA
| | - Susan L Hogan
- Kidney Center, University of North Carolina School of Medicine, Division of Nephology and Hypertension, Chapel Hill, NC, 27516, USA
| | - Nickie Mercke
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Anschutz Medical Campus, 12850 E. Montview Blvd, Mail Stop C238, Room V20-4108, Aurora, CO, 80045, USA
| | - Madeleine Gomez
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Anschutz Medical Campus, 12850 E. Montview Blvd, Mail Stop C238, Room V20-4108, Aurora, CO, 80045, USA
| | - Cindy L O'Bryant
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Anschutz Medical Campus, 12850 E. Montview Blvd, Mail Stop C238, Room V20-4108, Aurora, CO, 80045, USA.,Cancer Center, University of Colorado, Anschutz Medical Campus, 1665 Aurora Ct, Aurora, CO, 80045, USA
| | - Daniel W Bowles
- Cancer Center, University of Colorado, Anschutz Medical Campus, 1665 Aurora Ct, Aurora, CO, 80045, USA
| | - Blessy George
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Rutgers University, Davidson Hall, 96 Davidson Rd, Piscataway, NJ, 08854, USA
| | - Xia Wen
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Rutgers University, Davidson Hall, 96 Davidson Rd, Piscataway, NJ, 08854, USA
| | - Brian Buckley
- Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - Lauren Aleksunes
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Rutgers University, Davidson Hall, 96 Davidson Rd, Piscataway, NJ, 08854, USA.,Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Rd, Piscataway, NJ, 08854, USA
| | - Melanie S Joy
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Anschutz Medical Campus, 12850 E. Montview Blvd, Mail Stop C238, Room V20-4108, Aurora, CO, 80045, USA. .,Cancer Center, University of Colorado, Anschutz Medical Campus, 1665 Aurora Ct, Aurora, CO, 80045, USA. .,Division of Renal Diseases and Hypertension, University of Colorado, Anschutz Medical Campus, School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA.
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Hucke A, Ciarimboli G. The Role of Transporters in the Toxicity of Chemotherapeutic Drugs: Focus on Transporters for Organic Cations. J Clin Pharmacol 2017; 56 Suppl 7:S157-72. [PMID: 27385173 DOI: 10.1002/jcph.706] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 12/11/2015] [Accepted: 01/06/2016] [Indexed: 12/11/2022]
Abstract
The introduction of chemotherapy in the treatment of cancer is one of the most important achievements of modern medicine, even allowing the cure of some lethal diseases such as testicular cancer and other malignant neoplasms. The number and type of chemotherapeutic agents available have steadily increased and have developed until the introduction of targeted tumor therapy. It is now evident that transporters play an important role for determining toxicity of chemotherapeutic drugs not only against target but also against nontarget cells. This is of special importance for intracellularly active hydrophilic drugs, which cannot freely penetrate the plasma membrane. Because many important chemotherapeutic agents are substrates of transporters for organic cations, this review discusses the known interaction of these substances with these transporters. A particular focus is given to the role of transporters for organic cations in the development of side effects of chemotherapy with platinum derivatives and in the efficacy of recently developed tyrosine kinase inhibitors to specifically target cancer cells. It is evident that specific inhibition of uptake transporters may be a possible strategy to protect against undesired side effects of platinum derivatives without compromising their antitumor efficacy. These transporters are also important for efficient targeting of tyrosine kinase inhibitors to cancer cells. However, in order to achieve the aims of protecting from undesired toxicities and improving the specificity of uptake by tumor cells, an exact knowledge of transporter expression, function, regulation under normal and pathologic conditions, and of genetically and epigenetically regulation is mandatory.
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Affiliation(s)
- Anna Hucke
- Experimental Nephrology, Medical Clinic D, Münster University Hospital, Münster, Germany
| | - Giuliano Ciarimboli
- Experimental Nephrology, Medical Clinic D, Münster University Hospital, Münster, Germany
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Galgamuwa R, Hardy K, Dahlstrom JE, Blackburn AC, Wium E, Rooke M, Cappello JY, Tummala P, Patel HR, Chuah A, Tian L, McMorrow L, Board PG, Theodoratos A. Dichloroacetate Prevents Cisplatin-Induced Nephrotoxicity without Compromising Cisplatin Anticancer Properties. J Am Soc Nephrol 2016; 27:3331-3344. [PMID: 26961349 DOI: 10.1681/asn.2015070827] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 01/27/2016] [Indexed: 01/01/2023] Open
Abstract
Cisplatin is an effective anticancer drug; however, cisplatin use often leads to nephrotoxicity, which limits its clinical effectiveness. In this study, we determined the effect of dichloroacetate, a novel anticancer agent, in a mouse model of cisplatin-induced AKI. Pretreatment with dichloroacetate significantly attenuated the cisplatin-induced increase in BUN and serum creatinine levels, renal tubular apoptosis, and oxidative stress. Additionally, pretreatment with dichloroacetate accelerated tubular regeneration after cisplatin-induced renal damage. Whole transcriptome sequencing revealed that dichloroacetate prevented mitochondrial dysfunction and preserved the energy-generating capacity of the kidneys by preventing the cisplatin-induced downregulation of fatty acid and glucose oxidation, and of genes involved in the Krebs cycle and oxidative phosphorylation. Notably, dichloroacetate did not interfere with the anticancer activity of cisplatin in vivo. These data provide strong evidence that dichloroacetate preserves renal function when used in conjunction with cisplatin.
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Affiliation(s)
| | - Kristine Hardy
- Faculty of Education, Science, Technology and Mathematics, University of Canberra, Australian Capital Territory, Australia
| | - Jane E Dahlstrom
- ACT Pathology and ANU Medical School, The Canberra Hospital, Australian Capital Territory, Australia
| | | | - Elize Wium
- Departments of Cancer Biology and Therapeutics and
| | | | | | | | | | - Aaron Chuah
- Genome Discovery Unit, John Curtin School of Medical Research, Australian National University, Australian Capital Territory, Australia
| | - Luyang Tian
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China; and
| | - Linda McMorrow
- Archaeogeochemistry and Marine Biogeochemistry Groups, Research School of Earth Sciences, Australian National University, Australian Capital Territory, Australia
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Navolotskii DV, Ivanenko NB, Solovyev ND, Fedoros EI, Panchenko AV. Pharmacokinetics and tissue distribution of novel platinum containing anticancer agent BP-C1 studied in rabbits using sector field inductively coupled plasma mass spectrometry. Drug Test Anal 2015; 7:737-44. [PMID: 26061351 PMCID: PMC4744679 DOI: 10.1002/dta.1824] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/19/2015] [Accepted: 05/19/2015] [Indexed: 11/17/2022]
Abstract
A method of platinum quantification in whole blood samples after microwave digestion using sector field inductively coupled plasma mass spectrometry has been developed. The following analytical figures of merit have been established: limit of detection 1.1 µg/L for blood samples, dynamic range 3.6–200 µg/L, intra‐day precision (relative standard deviation, n = 9) did not exceed 5%. Spiked samples were analyzed for method validation. The method was used for pharmacokinetics studies of a novel anti‐cancer drug BP‐С1, a complex of cis‐configured platinum and benzene‐poly‐carboxylic acids. Main pharmacokinetic parameters (area under curve, maximum concentration, clearance, half‐life times for α‐ and β‐phase) were estimated for two dosage forms of BP‐C1 0.05 and 0.125 mass %. Pharmacokinetic curves were assessed for single and course administration. Studies were performed using rabbits (n = 6) as a model. BP‐C1 was injected intramuscularly. The study established dose proportionality of the tested dosage forms and suggested clinical dosing schedule: 5 days of injections followed by 2 days’ break. Platinum tissue distribution was studied in tissue samples collected 20 days after the last injection. Predominant platinum accumulation was observed in kidneys, liver, and muscles near injection site. ‘Slow’ phase of platinum excretion kinetics may be related to the muscles at the injection site. © 2015 The Authors. Drug Testing and Analysis published by John Wiley & Sons Ltd.
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Affiliation(s)
- Denis V Navolotskii
- Institute of Toxicology of Federal Medico-Biological Agency, St. Petersburg, Russian Federation
| | - Natalya B Ivanenko
- Institute of Toxicology of Federal Medico-Biological Agency, St. Petersburg, Russian Federation.,Institute of Chemistry, Saint Petersburg State University, St. Petersburg, Russian Federation
| | - Nikolay D Solovyev
- Institute of Chemistry, Saint Petersburg State University, St. Petersburg, Russian Federation
| | - Elena I Fedoros
- Nobel LTD, St. Petersburg, Russian Federation.,N.N. Petrov Research Institute of Oncology, St. Petersburg, Russian Federation
| | - Andrey V Panchenko
- N.N. Petrov Research Institute of Oncology, St. Petersburg, Russian Federation
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Harrach S, Ciarimboli G. Role of transporters in the distribution of platinum-based drugs. Front Pharmacol 2015; 6:85. [PMID: 25964760 PMCID: PMC4408848 DOI: 10.3389/fphar.2015.00085] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 04/02/2015] [Indexed: 12/21/2022] Open
Abstract
Platinum derivatives used as chemotherapeutic drugs such as cisplatin and oxaliplatin have a potent antitumor activity. However, severe side effects such as nephro-, oto-, and neurotoxicity are associated with their use. Effects and side effects of platinum-based drugs are in part caused by their transporter-mediated uptake in target and non target cells. In this mini review, the transport systems involved in cellular handling of platinum derivatives are illustrated, focusing on transporters for cisplatin. The copper transporter 1 seems to be of particular importance for cisplatin uptake in tumor cells, while the organic cation transporter (OCT) 2, due to its specific organ distribution, may play a major role in the development of undesired cisplatin side effects. In polarized cells, e.g., in renal proximal tubule cells, apically expressed transporters, such as multidrug and toxin extrusion protein 1, mediate secretion of cisplatin and in this way contribute to the control of its toxic effects. Specific inhibition of cisplatin uptake transporters such as the OCTs may be an attractive therapeutic option to reduce its toxicity, without impairing its antitumor efficacy.
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Affiliation(s)
- Saliha Harrach
- Experimental Nephrology, Medical Clinic D, University of Münster, University Hospital MünsterMünster, Germany
| | - Giuliano Ciarimboli
- Experimental Nephrology, Medical Clinic D, University of Münster, University Hospital MünsterMünster, Germany
- Interdisciplinary Center for Clinical Research (IZKF), University of Münster, University Hospital MünsterMünster, Germany
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Khakhariya R, Rathod SP, Gandhi H, Variya B, Trivedi J, Bhamre P, Rajput SJ. Carboplatin-induced Fanconi-like syndrome in rats: amelioration by pentoxifylline. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2014; 37:185-194. [PMID: 24361643 DOI: 10.1016/j.etap.2013.11.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 11/22/2013] [Accepted: 11/27/2013] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Carboplatin is a congener of cisplatin used in the treatment of ovarian, head and neck and small-cell lung cancer. However, the clinical efficacy of carboplatin is marred by the development of ROS-dependent nephrotoxicity. The pathophysiological damage inflicted upon the kidney by carboplatin closely resembles to that of Fanconi syndrome. AIMS AND OBJECTIVES The present study aimed at inducing Fanconi-like syndrome in rats by administration of carboplatin. Objectives of the study involved evaluation of biochemical parameters coherent to Fanconi-like syndrome. Further, an attempt was made to evaluate the potential therapeutic effect of pentoxifylline in this condition. RESULTS The results of the study demonstrated that the urinary excretion profile of carboplatin treated rats closely resembled to that of patients suffering from Fanconi-like condition. Pentoxifylline was able to ameliorate this nephrotoxic condition as suggested by the change in levels of membrane bound ATPases, MDA and GSH. The urinary levels of tyrosine and cysteine correlate well with that of Fanconi-like condition in animals and humans. CONCLUSION In lieu of these observations, our study suggested that carboplatin-induced renovascular damage resembles to Fanconi-like condition which can be mitigated by pentoxifylline.
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Affiliation(s)
- Ravi Khakhariya
- Pharmacology Laboratory, Pharmacy Department, Faculty of Technology and Engineering, The M.S. University of Baroda, India
| | - S P Rathod
- Pharmacology Laboratory, Pharmacy Department, Faculty of Technology and Engineering, The M.S. University of Baroda, India
| | - Hardik Gandhi
- Pharmacology Laboratory, Pharmacy Department, Faculty of Technology and Engineering, The M.S. University of Baroda, India.
| | - Bhavesh Variya
- Pharmacology Laboratory, Pharmacy Department, Faculty of Technology and Engineering, The M.S. University of Baroda, India
| | - Jinal Trivedi
- Pharmacology Laboratory, Pharmacy Department, Faculty of Technology and Engineering, The M.S. University of Baroda, India
| | - Prachi Bhamre
- Pharmaceutical Quality Assurance Laboratory, Pharmacy Department, Faculty of Technology and Engineering, The M.S. University of Baroda, India
| | - S J Rajput
- Pharmaceutical Quality Assurance Laboratory, Pharmacy Department, Faculty of Technology and Engineering, The M.S. University of Baroda, India
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Ciarimboli G. Membrane transporters as mediators of Cisplatin effects and side effects. SCIENTIFICA 2012; 2012:473829. [PMID: 24278698 PMCID: PMC3820462 DOI: 10.6064/2012/473829] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 10/23/2012] [Indexed: 06/02/2023]
Abstract
Transporters are important mediators of specific cellular uptake and thus, not only for effects, but also for side effects, metabolism, and excretion of many drugs such as cisplatin. Cisplatin is a potent cytostatic drug, whose use is limited by its severe acute and chronic nephro-, oto-, and peripheral neurotoxicity. For this reason, other platinum derivatives, such as carboplatin and oxaliplatin, with less toxicity but still with antitumoral action have been developed. Several transporters, which are expressed on the cell membranes, have been associated with cisplatin transport across the plasma membrane and across the cell: the copper transporter 1 (Ctr1), the copper transporter 2 (Ctr2), the P-type copper-transporting ATPases ATP7A and ATP7B, the organic cation transporter 2 (OCT2), and the multidrug extrusion transporter 1 (MATE1). Some of these transporters are also able to accept other platinum derivatives as substrate. Since membrane transporters display a specific tissue distribution, they can be important molecules that mediate the entry of platinum derivatives in target and also nontarget cells possibly mediating specific effects and side effects of the chemotherapeutic drug. This paper summarizes the literature on toxicities of cisplatin compared to that of carboplatin and oxaliplatin and the interaction of these platinum derivatives with membrane transporters.
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Affiliation(s)
- Giuliano Ciarimboli
- Experimentelle Nephrologie, Medizinische Klinik D, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A14, 48149 Münster, Germany
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Yoo KH, Lee SH, Lee J, Sung KW, Jung HL, Koo HH, Lim DH, Kim JH, Shin HJ. Improved outcome of central nervous system germ cell tumors: implications for the role of risk-adapted intensive chemotherapy. J Korean Med Sci 2010; 25:458-65. [PMID: 20191048 PMCID: PMC2826748 DOI: 10.3346/jkms.2010.25.3.458] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Accepted: 06/25/2009] [Indexed: 11/20/2022] Open
Abstract
To determine the impact of treatment protocols on the outcome of central nervous system germ cell tumors (CNS-GCTs), we reviewed the medical records of 53 patients who received front-line chemotherapy from September 1997 to September 2006. Pure germinoma, normal alpha-fetoprotein level and beta-human chorionic gonadotropin level <50 mIU/mL were regarded as low-risk features and the others as high-risk. Patients from different time periods were divided into 3 groups according to the chemotherapy protocols. Group 1 (n=19) received 4 cycles of chemotherapy comprising cisplatin, etoposide and bleomycin. Group 2 (n=16) and group 3 (n=18) received 4 cycles of chemotherapy with cisplatin, etoposide, cyclophosphamide and vincristine in the former and with carboplatin, etoposide, cyclophosphamide and bleomycin in the latter. In group 2 and group 3, high-risk patients received double doses of cisplatin, carboplatin and cyclophosphamide. Radiotherapy was given after chemotherapy according to the clinical requirements. The event-free survivals of groups 1, 2, and 3 were 67.0%, 93.8%, and 100%, respectively (group 1 vs. 2, P=0.06; group 2 vs. 3, P=0.29; group 1 vs. 3, P=0.02). Our data suggest that risk-adapted intensive chemotherapy may improve the outcome of patients with malignant CNS-GCTs.
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Affiliation(s)
- Keon Hee Yoo
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo Hyun Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeehun Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Woong Sung
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Lim Jung
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hong Hoe Koo
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Do Hoon Lim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Hyun Kim
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung Jin Shin
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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The immediate early genes, c-fos, c-jun and AP-1, are early markers of platinum analogue toxicity in human proximal tubular cell primary cultures. Toxicol In Vitro 2009; 23:780-8. [DOI: 10.1016/j.tiv.2009.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 04/08/2009] [Accepted: 04/09/2009] [Indexed: 11/21/2022]
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13
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Arafa HMM. Carnitine deficiency aggravates carboplatin nephropathy through deterioration of energy status, oxidant/anti-oxidant balance, and inflammatory endocoids. Toxicology 2008; 254:51-60. [PMID: 18852009 DOI: 10.1016/j.tox.2008.09.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Revised: 09/04/2008] [Accepted: 09/05/2008] [Indexed: 12/30/2022]
Abstract
We have recently shown that carnitine deficiency could represent a risk factor in paracetamol hepatotoxicity. By the same token, d-carnitine-induced carnitine deficiency aggravated carboplatin nephropathy following challenge with a single dose (35mg/kg, IP) of the platinum drug in male Swiss albino rats. The combination modality induced marked degenerative changes and severe inflammation in kidney tissues that surpassed either carboplatin or d-carnitine given alone. The combined regimen synergistically increased the serum levels of creatinine, blood urea nitrogen (BUN), tumor necrosis factor alpha (TNF-alpha), palmitate, and kidney malondialdehyde (MDA), adenosine triphosphate (ATP), nitric oxide (NO) contents as well as kidney myeloperoxidase (MPO) activity. The only parameter that has been notably decreased was the kidney reduced glutathione (GSH) level. Exaggeration by carnitine deficit of the deleterious effects of carboplatin is most probably ascribed to energy starvation. The reduction in kidney content of ATP parcels was associated with elevation of serum palmitate level that reflected debilitated fatty acid oxidation, and this further deteriorated energy resources in kidney tissues. Compromising the oxidant/anti-oxidant balance and modulating the release of some inflammatory endocoids namely, TNF-alpha and NO could also possibly account for such combinatorial detrimental toxicity. The current study was further extended to elucidate any possible nephroprotective effects of l-carnitine. Interestingly, carnitine supplementation ahead of carboplatin challenge ameliorated and almost normalized all the biochemical parameters and also mitigated the injurious effects of the cytotoxic drug. Thus, one could conclude that carnitine deficiency, whether being a causative clue or a sequela, might represent a risk factor in carboplatin nephropathy.
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Affiliation(s)
- Hossam M M Arafa
- Department of Pharmacol & Toxicol, Faculty of Pharmacy, Al-Azhar University, Nasr City, Cairo, Egypt.
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14
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Wang X, Au-Yeung SCF, Ho YP. Pharmacokinetics and tissue distribution of novel traditional Chinese medicine-platinum anticancer agents in rats. J Inorg Biochem 2007; 101:909-17. [PMID: 17428541 DOI: 10.1016/j.jinorgbio.2007.02.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2006] [Revised: 02/12/2007] [Accepted: 02/27/2007] [Indexed: 11/24/2022]
Abstract
The pharmacokinetics and tissue distribution profiles of a novel series of traditional Chinese medicine-platinum (TCM-Pt) compounds [Pt(C(8)H(8)O(5))(NH(2)R)(2)]: 1 (where R=H), 3 (R=CH(3)) and 5 (R=C(6)H(10)), were studied in Sprague-Dawley rats following a single bolus intravenous (i.v.) injection. Platinum concentrations in total plasma, plasma ultrafiltrate, urine and tissues were measured by flameless atomic absorption spectroscopy. Pharmacokinetic studies showed that plasma concentrations of total and free platinum for the novel TCM-Pt compounds as well as cisplatin and carboplatin declined in a biexponential manner with a short distribution half-life (t(1/2alpha): 0.12-0.34h). Compared with cisplatin, the novel TCM-Pt compounds had a longer elimination half-life (t(1/2beta)), larger dose normalized area under the curve (AUC/D), larger volume of distribution at steady-state (V(ss)), slower clearance (CL) of free platinum and higher percentage of cumulative urinary excretion (CUE), which can be attributed to their lower chemical reactivities. In tissues, the highest Pt concentrations were found in the kidney, followed by the liver and the lowest in the heart; no Pt was detected in the brain. Twenty-four hours after drug administration, platinum concentrations in tissues were significantly lower for the novel TCM-Pt compounds. These findings suggest that the novel compounds might afford higher clinical efficacy and reduced systemic side effects, when compared with cisplatin.
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Affiliation(s)
- Xinning Wang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
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15
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Lanvers-Kaminsky C, Krefeld B, Dinnesen AG, Deuster D, Seifert E, Würthwein G, Jaehde U, Pieck AC, Boos J. Continuous or repeated prolonged cisplatin infusions in children: a prospective study on ototoxicity, platinum concentrations, and standard serum parameters. Pediatr Blood Cancer 2006; 47:183-93. [PMID: 16302218 DOI: 10.1002/pbc.20673] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND To overcome the ototoxicity of cisplatin, single bolus infusions were replaced by repeated prolonged infusions of lower doses or by continuous infusions at still lower infusion rates. However, considering ototoxicity little is, in fact, known about the tolerance of repeated prolonged or continuous infusion in children. PROCEDURE Auditory function was monitored along with plasma concentrations of free and total platinum (Pt), and with standard serum parameters (sodium, potassium, calcium, magnesium, phosphate, chloride, and creatinine) in 24 children receiving cisplatin by continuous infusion for the treatment of neuroblastoma and osteosarcoma or by repeated 1 or 6 hr infusions for the treatment of germ cell tumors. RESULTS Hearing deteriorated in 10/15 osteosarcoma patients, 2/3 neuroblastoma patients, and 1/6 patients with germ cell tumors. Ototoxicity occurred after cumulative doses between 120 and 360 mg/m(2) cisplatin. In osteosarcoma patients, ototoxicity was associated with a comparatively higher mean plasma concentration of free Pt. However, Pt plasma concentrations did not discriminate between patients with or without ototoxicity. In patients experiencing ototoxicity serum creatinine increased by 45% compared to pre-treatment levels (mean). Serum creatinine increased by 26% in patients without ototoxicity (P < 0.05, Mann-Whitney Rank sum test). Despite standardized hydration, discrete but significant changes of potassium, sodium, magnesium, and phosphate were observed during and/or after cisplatin infusion, which, however, did not discriminate between patients with and without ototoxicity. CONCLUSIONS While continuous cisplatin infusions are less nephrotoxic than repeated prolonged infusions, we observed considerable ototoxicity in patients treated with continuous cisplatin infusions, which necessitates further evaluations on the tolerance of continuous cisplatin infusions in children.
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Affiliation(s)
- C Lanvers-Kaminsky
- Department of Paediatric Haematology and Oncology, University Children's Hospital, Albert-Schweitzer Street 33, Muenster, Germany.
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16
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Hoffmann K, Marten A, Lindel K, Fritz S, Jager D, Buchler MW, Schmidt J. Major combined electrolyte deficiency during therapy with low-dose cisplatin, 5-fluorouracil and interferon alpha: report on several cases and review of the literature [ISRCTN62866759]. BMC Cancer 2006; 6:128. [PMID: 16686958 PMCID: PMC1475608 DOI: 10.1186/1471-2407-6-128] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2005] [Accepted: 05/10/2006] [Indexed: 01/13/2023] Open
Abstract
Background Low-dose Cisplatin and Interferon alpha treatment of solid tumors rarely has been associated with severe hypocalcaemia. To the authors knowledge the phenomenon has not been reported previously in patients with pancreatic carcinoma. Case presentation A patient with resected adenocarcinoma of the pancreas was treated with adjuvant radio-chemo-immunotherapy using a combination of low-dose Cisplatin, 5-Fluorouracil and Interferon alpha together with external beam radiation. Severe hypocalcaemia without signs of acute renal failure or electrolyte disturbance occurred within 2 days at the 4th week of treatment and required intensive care treatment. Conclusion Combination of biological and cytotoxic therapies may increase the incidence of severe hypocalcaemia in pancreatic cancer. Oncologists should remain attentive of this problem as more highly active regimes become available.
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Affiliation(s)
- Katrin Hoffmann
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Angela Marten
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Katja Lindel
- National Centre of Tumor Diseases, University of Heidelberg, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - Stefan Fritz
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
- National Centre of Tumor Diseases, University of Heidelberg, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - Dirk Jager
- National Centre of Tumor Diseases, University of Heidelberg, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - Markus W Buchler
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Jan Schmidt
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
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17
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Goren MP. Cisplatin nephrotoxicity affects magnesium and calcium metabolism. MEDICAL AND PEDIATRIC ONCOLOGY 2003; 41:186-9. [PMID: 12868117 DOI: 10.1002/mpo.10335] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cisplatin is not directly toxic to bone, but cisplatin nephrotoxicity leading to magnesium wasting may affect magnesium and calcium metabolism, both of which contribute to bone integrity. The specificity of the magnesium lesion suggests that cisplatin may have an affinity for proteins that regulate magnesium absorption. Sulfhydryls such as amifostine can reduce the toxicity of cisplatin in adults, but current pediatric data do not indicate a role for sulfhydryl therapy to reduce cisplatin toxicity in children.
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Affiliation(s)
- Marshall P Goren
- Department of Urology, The University of Tennessee, Memphis, Tennessee, USA.
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Husai K, Jagannathan R, Hasan Z, Trammell GL, Rybak LP, Hazelrigg SR, Somani SM. Dose response of carboplatin-induced nephrotoxicity in rats. PHARMACOLOGY & TOXICOLOGY 2002; 91:83-9. [PMID: 12420797 DOI: 10.1034/j.1600-0773.2002.910207.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract: Carboplatin, a second-generation platinum-containing anticancer drug, is currently being used against a variety of cancers. High-dose carboplatin chemotherapy can cause renal tubular injury in cancer patients. However, the biochemical mechanism of carboplatin-induced renal injury has not been well studied. This study investigated the dose response of carboplatin-induced changes in endogenous antioxidants, lipid peroxidation and platinum content in rat kidney. Male Wistar rats (250-300 g) were divided into five groups and treated as follows: (1) control (saline, intraperitoneally); (2) carboplatin (64 mg/kg, intraperitoneally); (3) carboplatin (128 mg/kg, intraperitoneally); (4) carboplatin (192 mg/kg, intraperitoneally); and (5) carboplatin (256 mg/kg, intraperitoneally). The animals were sacrificed four days after treatment. The blood and kidneys were isolated and analyzed. Plasma creatinine and blood urea nitrogen levels were increased significantly in response to carboplatin in a dose-dependent manner. Renal superoxide dismutase and catalase activities were decreased significantly due to carboplatin at dosages of 128 mg/kg and above. The protein expressions of renal copper/zinc-superoxide dismutase and manganese-superoxide dismutase significantly depleted after carboplatin. Carboplatin (192 and 256 mg/kg) significantly increased lipid peroxidation (malondialdehyde concentration) in rat kidneys. Carboplatin dose-dependently increased the renal platinum concentration, with significance at dosages of 128 mg/kg and above. Carboplatin (256 mg/kg) significantly increased renal xanthine oxidase activity, while ratio of reduced to oxidized glutathione depleted significantly. The data suggested that carboplatin caused dose-dependent oxidative renal injury, as evidenced by renal antioxidant depletion, enhanced lipid peroxidation, platinum content, plasma creatinine and blood urea nitrogen levels in rats.
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Affiliation(s)
- Kazim Husai
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield 62794-9638, USA.
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Hartmann JT, Fels LM, Knop S, Stolt H, Kanz L, Bokemeyer C. A randomized trial comparing the nephrotoxicity of cisplatin/ifosfamide-based combination chemotherapy with or without amifostine in patients with solid tumors. Invest New Drugs 2000; 18:281-9. [PMID: 10958599 DOI: 10.1023/a:1006490226104] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study evaluates the degree of kidney damage during cisplatin/ifosfamide-based combination chemotherapy and its possible prevention by amifostine. Thirty-one patients with solid tumors stratified according to pretreatment were randomized to receive VIP- or TIP-chemotherapy with or without amifostine (910 mg/m2) given as a short infusion prior to cisplatin. Chemotherapy consisted of cisplatin (50 mg/m2), ifosfamide (4 g/m2) and either etoposide (500 mg/m2) (= VIP) or paclitaxel (175 mg/m2) (= TIP) repeated at 3 weekly intervals. For all patients the glomerular filtration rate (GFR) measured by creatinine-clearance, serum creatinine, electrolytes and differential urinary protein/enzyme excretion were determined prior to, during and after each cycle. A total of 62 cycles of chemotherapy were evaluable. In the amifostine-group GFR was fully maintained after application of two cycles of chemotherapy, whereas in the control group a > 30%-reduction of median GFR (108 to 80 ml/min) was observed (p < 0.001). Patients receiving amifostine had a lower degree of high molecular weight proteins excretion indicating less glomerular damage. In both groups significant increases of tubular marker profiles peaking at day 3 after chemotherapy were observed with a nearly complete reversibility of these changes prior to the next chemotherapy cycle. The number of patients with low magnesium serum levels during treatment was 17% after amifostine application versus 69% in control patients. The results seem to indicate that treatment with amifostine can preserve GFR after application of two cisplatin/ifosfamide-based chemotherapy cycles. This may be advantageous if repetitive cycles of chemotherapy or subsequent administration of high dose chemotherapy is planned.
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Affiliation(s)
- J T Hartmann
- Department of Hematology and Oncology, UKT-Medical Center II, Eberhard-Karls-University of Tübingen, Germany.
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Uozumi J, Koikawa Y, Yasumasu T, Tokuda N, Ueda T, Kumazawa J. The effect of methylprednisolone on platinum kinetics and urinary enzyme excretion following intravenous cisplatin in vivo and on the growth inhibition of LLC-PK1 cells by cisplatin in vitro. RESEARCH IN EXPERIMENTAL MEDICINE. ZEITSCHRIFT FUR DIE GESAMTE EXPERIMENTELLE MEDIZIN EINSCHLIESSLICH EXPERIMENTELLER CHIRURGIE 1996; 196:211-7. [PMID: 8903096 DOI: 10.1007/bf02576843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In order to evaluate the mechanism of the protective action of methylprednisolone against cisplatin-induced nephrotoxicity, platinum kinetics and urinary enzyme excretion following intravenous cisplatin, with or without methylprednisolone, were studied in vivo. The growth inhibition of LLC-PK1 cells by cisplatin in the presence or absence of methylprednisolone was studied in vitro. Rats intravenously injected with cisplatin combined with subcutaneous methylprednisolone 4 h prior to the cisplatin injection excreted more platinum in urine than rats treated with cisplatin alone. Both plasma and kidney platinum concentrations in rats injected with both cisplatin and methylprednisolone were significantly lower than those in rats given cisplatin alone at 4 h after cisplatin injection. However, there was no significant difference in urinary excretion of lactate dehydrogenase, gamma-glutamyl transpeptidase or N-acetyl-beta-D-glucosaminidase between methylprednisolone-treated rats and control rats. Methylprednisolone did not affect the inhibitory effects of cisplatin on the cell growth of LLC-PK1. These findings indicate that methylprednisolone-induced increase in urinary platinum excretion, accompanied by a decrease in plasma and kidney platinum concentrations following cisplatin injection in rats, may be one of the mechanisms responsible for the protective action of methylprednisolone.
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Affiliation(s)
- J Uozumi
- Department of Urology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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