The “Pro-drug” RibCys Decreases the Mutagenicity of High-LET Radiation in Cultured Mammalian Cells

Comparison of the efficacy of cysteamine 5% cream and hydroquinone 4%/ascorbic acid 3% combination cream in the treatment of epidermal melasma

BACKGROUND

Few safe and effective treatments are available for melasma. Cysteamine, a non-melanocytotoxic molecule is a safer alternative to hydroquinone and usable for the long-term use.

AIM

To evaluate the effect of cysteamine 5% cream in the treatment of melasma METHODS: Sixty-five of 80 patients completed this single-blind, randomized, controlled trial. The patients received cysteamine 5% or hydroquinone 4%/ascorbic acid 3% (HC) cream. The therapeutic response was evaluated by modified MASI (mMASI) and melanin index (SkinColorCatch) after 2 and 4 months of treatment. Effect of treatment on the quality of life was also assessed.

RESULTS

The decrease for mMASI score was from 6.69±2.96 to 4.47±2.16 in cysteamine group and from 6.26±3.25 to 3.87±2.00 in HC group after 4 months (p values<0.001). The melanin index decreased from 37.72±10.17 to 31.47±11.90 in the cysteamine group and from 36.37±10.80 to 23.16±8.83 in HC group after 4 months (p-value=0.003 and <0.001, respectively). The difference between mMASI score at baseline and month 4 was not significant between both groups (p-value>0.05).The difference between melanin index at baseline and month 4 was significantly more pronounced in HC group (p-value=0.002). Quality of life improved in both groups (p-value<0.05), but was not significantly different between groups (p-value>0.05).

CONCLUSION

Cysteamine was confirmed to be an effective treatment for melasma, with equivalent results to HC in reducing mMASI score and improving quality of life, despite lesser melanin index reduction observed. Cysteamine and HC efficacy was confirmed in patients recalcitrant to previous treatments, by a significant reduction of mMASI and melanin index.

Evaluation of carbohydrate-cysteamine thiazolidines as pro-drugs for the treatment of cystinosis

Cystinosis is a genetic disorder caused by malfunction of cystinosin and is characterized by accumulation of cystine. Cysteamine, the medication used in cystinosis, causes halitosis resulting in poor patient compliance. Halitosis is mainly caused by the formation of dimethylsulfide as the final product in the cysteamine metabolism pathway. We have synthesized carbohydrate-cysteamine thiazolidines, and hypothesized that the hydrolytic breakdown of cysteamine-thiazolidines can result in free cysteamine being released in target organs. To examine our hypothesis, we tested these analogs in vitro in patient-derived fibroblasts. Cystinotic fibroblasts were treated with different concentrations of arabinose-cysteamine, glucose-cysteamine and maltose-cysteamine. We demonstrated that the analogs break down into cysteamine extracellularly and might therefore not be fully taken up by the cells under the form of the pro-drug. Potential modifications of the analogs that enable their intracellular rather than extracellular breakdown, is necessary to pursue the potential of these analogs as pro-drugs.

Ascorbic acid gives different protective effects in human cells exposed to X-rays and heavy ions

We studied the effects and mechanisms of ascorbic acid as a radiation protector. Cell survival, repair of DNA double strand breaks (DSBs), and sister chromatid exchanges (SCEs) were examined in normal human fibroblasts irradiated with X-rays and heavy ions. Post-irradiation treatment with 5mM ascorbic acid for 24 h in plateau phase (non-cycling) cells enhanced cell survival and DNA double strand break repair, and reduced SCEs after X-rays irradiation. On the other hand, only reduced SCEs were observed after heavy ion exposure such as to carbon ions. Judging from our data, it is possible that the radioprotective action of ascorbic acid would be effective in non-complex type DNA damage such as induced by X-rays. These findings provide new insight into the mechanism of DNA damage and repair produced by heavy ion irradiation.

Dihydropyridines decrease X-ray-induced DNA base damage in mammalian cells

Compounds with the structural motif of 1,4-dihydropyridine display a broad spectrum of biological activities, often defined as bioprotective. Among them are L-type calcium channel blockers, however, also derivatives which do not block calcium channels exert various effects at the cellular and organismal levels. We examined the effect of sodium 3,5-bis-ethoxycarbonyl-2,6-dimethyl-1,4-dihydropyridine-4-carboxylate (denoted here as DHP and previously also as AV-153) on X-ray-induced DNA damage and mutation frequency at the HGPRT (hypoxanthine-guanine phosphoribosyl transferase) locus in Chinese hamster ovary CHO-K1 cells. Using formamido-pyrimidine glycosylase (FPG) comet assay, we found that 1-h DHP (10nM) treatment before X-irradiation considerably reduced the initial level of FPG-recognized DNA base damage, which was consistent with decreased 8-oxo-7,8-dihydro-2'-deoxyguanosine content and mutation frequency lowered by about 40%. No effect on single strand break rejoining or on cell survival was observed. Similar base damage-protective effect was observed for two calcium channel blockers: nifedipine (structurally similar to DHP) or verapamil (structurally unrelated). So far, the specificity of the DHP-caused reduction in DNA damage - practically limited to base damage - has no satisfactory explanation.

A role for long-lived radicals (LLR) in radiation-induced mutation and persistent chromosomal instability: counteraction by ascorbate and RibCys but not DMSO

Miazaki, Watanabe, Kumagai and their colleagues reported that induction of HPRT(-) mutants by X-rays in cultured human cells was prevented by ascorbate added 30min after irradiation. They attributed extinction of induced mutation to neutralization by ascorbate of radiation-induced long-lived mutagenic radicals (LLR), found using spectroscopy to have half-lives of minutes or hours. We find that post-irradiation treatment with ascorbate reduces, but does not eliminate, induction of CD59(-) mutants in human-hamster hybrid A(L) cells exposed to high-LET carbon-ions (LET of 100KeV/microm). A(L) cells contain a standard set of Chinese hamster ovary (CHO) chromosomes and a single copy of human chromosome 11 containing the CD59 gene which encodes the CD59 cell surface antigen, a convenient marker for mutation. RibCys [2(R, S)-D-ribo-(1',2',3',4'-tetrahydroxybutyl)thiazolidine-4(R)-carboxylic acid] a 'prodrug' of l-cysteine which also scavenges LLR, had a similar but lesser effect on induced mutation. DMSO, which scavenges classical radicals like H* and OH* but not LLR, also reduced mutation, but only when it was present during irradiation. The lethality of carbon-ions was not altered by ascorbate, RibCys no matter when added. Post-radiation addition of ascorbate and RibCys also affected the quality of CD59(-) mutations induced by carbon-ions. The major change in mutant spectra was a reduction in the prevalence of small, intragenic mutations (mutations not detected by PCR) and in the prevalence of unstable, complicated mutants, which display high levels of persistent chromosomal instability. Thus, ascorbate and RibCys may suppress some kinds of mutations induced by ionizing radiation including those displaying aspects of radiation-induced genomic instability. Countering the effects of both classical radicals and LLR may be important in preventing genetic diseases.

Mutations Induced by Heavy Charged Particles

The relative biological-effectiveness of radiation is increased when cells or tissue are exposed to densely ionizing (high-LET) radiation. A large number of studies focus on the following aspects of the biological effects of high-LET radiation: (i) basic understanding of radiation damage and repair; (ii) developing radiotherapy protocols for accelerated charged particles; and (iii) estimation of human risks from exposure to high-LET heavy charged particles. The increased lethal effectiveness (cell inactivation) of high-LET radiation contributes to new methods for using radiation therapy, but it is also necessary to study the enhanced mutagenic effect of high LET radiation, because higher frequencies of mutation can be expected to provide higher rates of carcinogenicity with human exposure. It is important to note that both measures of biological effectiveness (lethality and mutagenicity) depend on the quality of radiation, the dose, dose-rate effects, and the biological endpoints studied. This paper is intended to provide a review of current research on the mutagenic effects of high-LET radiation, and is organized into three sections. First, are descriptions of the induced mutations studied with various detection systems (section 1) because the detectable mutations induced by ionizing radiation, including heavy-ions, depend largely on the detection system used. Second is a discussion of the biological significance of the dependence of induced mutations on LET (section 2). This is related to the molecular nature of radiation lesions and to the repair mechanisms used to help cells recover from such damage. Finally, applications of mutation detection systems for studies in space (section 3) are described, in which the carcinogenic effects of space environmental radiation are considered.