The toxicity of amodiaquine and its principal metabolites towards mononuclear leucocytes and granulocyte/monocyte colony forming units.

The cytotoxicity of amodiaquine (AQ), amodiaquine quinoneimine (AQQI) and desethylamodiaquine (AQm) has been assessed in comparison with that of chloroquine (CQ) using mononuclear leucocytes (MNL) and granulocyte/monocyte colony forming units (GM-CFU) from haematologically normal subjects. Toxicity toward MNL was assessed after 2 h and 16 h incubations with each compound. After 2 h, AQ, AQm and AQQI but not CQ (within the concentration range 1-100 mumols l-1) produced a significant decrease in cell viability. After 16 h, all four compounds significantly increased cell death. After both 2 h and 16 h incubations CQ was the least toxic and AQQI the most toxic of the four compounds towards MNL. Toxicity to GM-CFU was assessed by the inhibition of colony formation in vitro. After 10-14 days incubation, there was significant concentration-dependent inhibition of colony formation by AQ, AQm, AQQI and CQ (within the range 0.1-10.0 mumols l-1). There were no significant differences between the ability of the four compounds to inhibit colony formation but toxicity towards GM-CFU was observed at drug concentrations at least 10-fold lower than those that were toxic to MNL. These data show that the four compounds are equally toxic in vitro toward GM-CFU, although some differences in their toxicity toward MNL were seen. The possible mechanisms of AQ's toxicity are discussed.     

The effects of sulphasalazine and its metabolites on prostaglandin production by human mononuclear cells.

Although it has been proposed that sulphasalazine (SASP) and its metabolite 5-aminosalicylic acid (5-ASA) act therapeutically by inhibiting production of vasoactive and immunoregulatory prostaglandins (PGs), in previous in vitro studies these drugs have both inhibited and promoted PG production. This study demonstrates that SASP and 5-ASA promote or inhibit peripheral blood mononuclear cell PG production depending upon the PG measured, the concentration of the drug, and whether the cells were stimulated. Sulphapyridine, the other constituent of SASP, only inhibited production. At high concentrations of SASP and 5-ASA the viability of mononuclear cells was reduced. The enhancement of PG production and toxicity was greater with SASP than 5-ASA, while the PGs most affected by SASP were not those most affected by 5-ASA. Thus, in vitro SASP may possess properties other than those of 5-ASA and this may explain the different therapeutic properties of these two compounds.     

Actions of sulphasalazine and its metabolites on polymorphonuclear leucocyte superoxide

In recent years, interest has been focused on the possibility that sulphasalazine (SASP), which is used in the treatment of both rheumatoid arthritis and inflammatory bowel disease, may act by inhibition of PMN Superoxide generation and/or by scavenging of reactive oxygen products. In this article, we summarize our own studies in this field and discuss our findings in relation to other reports on the same subject. It is evident that SASP and SP, in vitro, inhibit PMN Superoxide production elicited by receptor-mediated stimuli and a calcium ionophore, and that this effect seems to be dependent on inhibition of intracellular Ca²⁺ mobilization. 5-Aminosalicylic acid (5-ASA), on the other hand, excerts its effects by scavenging oxygen free radicals.     

The acute in vitro effect of ethanol, its metabolites and other toxic alcohols on ion flux in isolated human leucocytes and erythrocytes

Using isolated healthy human leucocytes and erythrocytes as model cells, we investigated the inhibitory effect of ethanol, its metabolites and of other toxic alcohols on the active fluxes of rubidium (Rb: equivalent to K) and sodium (Na), and on Na,K-ATPase activity. Ethanol (80 mmol X l-1) inhibited total and ouabain-sensitive 86Rb influx and 22Na efflux in leucocytes, this being dose-related for total, ouabain-sensitive and ouabain-insensitive fluxes at higher concentrations. In erythrocytes inhibition occurred at 20 mmol X l-1 for 86Rb influx, dose-related at higher concentrations as for leucocytes. 22Na efflux was inhibited at 80 mmol X l-1 and above. Acetaldehyde (0.1 and 0.2 mmol X l-1), 1,2-propanediol (0.8 mmol X l-1) and 2,3-butanediol (0.4 mmol X l-1) inhibited all fractions of 86Rb influx in erythrocytes, but not in leucocytes. Methanol, 2-propanol and 1,2-ethanediol (16 and 32 mmol X l-1) inhibited 86Rb influx in erythrocytes, but not in leucocytes. The order of potency was 2-propanol greater than 1,2-ethanediol greater than methanol. Na,K-ATPase activity was inhibited in lysed leucocyte and erythrocyte preparations only at very high concentrations of the alcohols--suggesting that inhibition is due to an alteration in membrane structure and not to a direct effect on the enzyme.     

Clinical pharmacokinetics of sulphasalazine, its metabolites and other prodrugs of 5-aminosalicylic acid

There is accumulating clinical evidence that 5-aminosalicylic acid (5-ASA) represents the therapeutic moiety of sulphasalazine in the treatment of inflammatory bowel disease. For more than 4 decades, the active metabolite, 5-ASA, has been administered in the form of the 'prodrug' sulphasalazine; however, in contrast to sulphasalazine, the pharmacokinetics of 5-ASA were unknown until recently. Sulphasalazine itself is poorly absorbed (3 to 12%) and its elimination half-life of about 5 to 10 hours is probably affected by the absorption process. The major part of sulphasalazine is split by bacterial azo-reduction in the colon into 5-ASA and sulphapyridine, the latter accounting for most of the adverse effects of sulphasalazine. The effective cleavage of sulphasalazine depends on an intact colon and transit time. It is markedly reduced in patients taking antibiotics and after removal of the large bowel. The formed sulphapyridine is almost completely absorbed and eliminated by hydroxylation, glucuronidation and polymorphic acetylation. Depending on the genetic phenotype, the elimination half-life and apparent oral clearance of sulphapyridine are approximately 14 hours and 40 ml/min (slow acetylators) or 6 hours and 150 ml/min (fast acetylators), respectively. Of the 5-ASA released from its 'vehicle' sulphapyridine in the colon, at least 25% is absorbed and after acetylation is subsequently excreted in the urine. At least 50% is eliminated in the faeces. Recently, 5-ASA has also been administered directly in the form of enemas, suppositories and oral slow-release preparations. While the elimination half-life of 5-ASA is short (0.5 to 1.5 h), its major acetylated metabolite (which may be active) exhibits a half-life of 5 to 10 hours. During therapy with sulphasalazine or 5-ASA, steady-state plasma concentrations of 5-ASA are relatively low (less than or equal to 2 micrograms/ml); thus its mode of action appears to be topically rather than systemically. Another approach to deliver the active 5-ASA to the gastrointestinal tract is accomplished with novel 'prodrugs' of 5-ASA, in which the carrier molecule sulphapyridine is replaced by 5-ASA itself (azodisalicylate) or other compounds.     

The effect of sulphasalazine and its metabolites on the colonic epithelial Caco-2 cells

Sulphaselazine (SAS) is a drug commonly used to treat patients suffering from chronic inflammatory states such as inflammatory bowel diseases. It was shown that besides bacteriostatic, antiinflammatory and immunosuppressive activity of this drug, the risk of neoplastic changes in the colon and rectum was substantially diminished during ulcerative colitis therapy with SAS. In the present study the effects of SAS and its main metabolites--sulphapyridine (SP) and 5-aminosalicylic acid (5-ASA) on colon adenocarcinoma Caco-2 cells viability and proliferation was evaluated. Significant inhibitory impact of SAS was observed already at 1 mM concentration whereas 5-ASA and SP impaired cellular growth when used at 5 mM concentration. 5 mM SAS exerted a strong cytotoxic effect on Caco-2 cells resulting in their necrotic death. The inhibition of cellular proliferation and the cytotoxic effects of SAS and its metabolites (5-ASA and SP) on the colonic carcinoma cells (Caco-2) confirm the suggestions that these compounds at appropriate concentrations may reduce the risk of neoplastic changes frequently initiated by prolonged inflammatory states.     

Simultaneous high-performance liquid chromatographic determination of carbamazepine and its principal metabolites in human plasma and urine

A rapid high-performance liquid chromatographic method is described for the simultaneous determination of carbamazepine and the 10,11-epoxide, 10,11-dihydroxy, and 2-hydroxy metabolites of carbamazepine. The chromatographic system involves the use of a 18C-microsorb, reversed-phase column with acetonitrile/water (28:72) as the mobile phase. Detection and quantitation are monitored by ultraviolet absorption at 212 nm. The compounds are extracted from 250 microliters of plasma or from 100 microliters urine with methyl-t-butyl ether and 0.1 M sodium hydroxide; 2-methylcarbamazepine is added as internal standard. If phenytoin and/or phenobarbital are present in plasma or urine samples, it is necessary to use 1.0 M sodium hydroxide. The limits of quantitation for carbamazepine and its metabolites are 10 ng/ml.     

Ulcerative colitis: effect of sulphasalazine, its metabolites and indomethacin on the ability of human colonic mucosa to metabolize prostaglandins in vitro.

1 Homogenates of mucosa from human colon metabolize [3H]-prostaglandin E1 in the presence of nicotinamide adenine dinucleotide to 15-oxo prostaglandin E1 or 15-oxo, 13,14 dihydro prostaglandin E1. 2 Metabolic capacity of tissue from patients with active ulcerative colitis under treatment with sulphasalazine (0.021 +/- 0.004 nmol/Mg protein +/- s.e. mean) did not differ from mucosa of normal patients (0.02 +/- 0.004 nmol/mg protein) during 1 h incubation. 3 Sulphasalazine inhibits prostaglandin E1 metabolism by mucosal homogenates in a dose-dependent manner with an ID50 of 125 microM. Its therapeutically active metabolite, 5-aminosalicylic acid (2.6 mM) was without significant inhibitory activity. 4 Indomethacin inhibits prostaglandin E1 metabolism by colonic mucosa with an ID50 of 388 microM. 5 At present we cannot clearly relate the therapeutic benefit of sulphasalazine and its therapeutically active metabolite, 5-aminosalicylic acid, in ulcerative colitis to their effects on prostaglandin E synthesis or metabolism in vitro.     

The scavenging of oxidants by sulphasalazine and its metabolites. A possible contribution to their anti-inflammatory effects?

Sulphasalazine (Salazopyrin) and its metabolites sulphapyridine and 5-aminosalicylate are powerful scavengers of the hydroxyl radical, determined by pulse radiolysis and confirmed by assays based on deoxyribose degradation by hydroxyl radicals. 5-Aminosalicylate can also protect alpha 1-antiprotease against attack by the myeloperoxidase-derived oxidant hypochlorous acid. The ability to scavenge oxidants produced at sites of inflammation may contribute to the anti-inflammatory action of sulphasalazine and its metabolites.     

Effects of sulphasalazine and its metabolites on prostaglandin synthesis, inactivation and actions on smooth muscle

1 We have investigated the effects of sulphasalazine and of its principal colonic metabolites (5-aminosalicylic acid and sulphapyridine) on prostaglandin inactivation, synthesis and actions on gastrointestinal smooth muscle.

2 Sulphasalazine inhibits prostaglandin F_2α breakdown in 100,000 g supernatants in all organs so far tested from 7 species with an ID₅₀ of approx. 50 μM; it has a selective action on prostaglandin 15-hydroxydehydrogenase and does not inhibit prostaglandin Δ-13 reductase, prostaglandin 9-hydroxydehydrogenase or `enzyme X' at millimolar concentrations. Enzyme activities were measured radiochemically or by bioassay.

3 Sulphapyridine and 5-aminosalicylic acid do not inhibit prostaglandin inactivation in vitro (4 species tested). A methyl analogue of sulphasalazine is a more potent inhibitor than the parent compound. Rabbit colon prostaglandin F_2α metabolism in vitro was inhibited by the following drugs with ID₅₀ values (μM) of: diphloretin phosphate 20, sulphasalazine 50, indomethacin 220, frusemide 1000 and aspirin 10,000. A similar rank order of potencies was obtained with rabbit kidney.

4 Sulphasalazine at 50 to 100 μM inhibited inactivation of prostaglandin E₂ in the perfused rat and guinea-pig lung by 3 to 40% (rat) and 32 to 100% (guinea-pig) when measured by superfusion cascade bioassay and of prostaglandin F_2α by 43.6 ± 6.5% in rat lung perfused with 50 μM sulphasalazine and assayed radiochemically.

5 Prostaglandins E₁ and E₂ were 97.0 ± 8.2% and 92.3 ± 6.8% inactivated in the lungs after intravenous injection in the anaesthetized rat as measured by reference to their vasodepressor potencies when injected intra-arterially. Prostaglandin A₂ was not similarly inactivated. Pulmonary inactivation was prevented in the presence of an intravenous infusion of 16.3 μg kg^-1 min^-1 sulphasalazine and partially inhibited at a lower infusion rate.

6 Prostaglandin biosynthesis from arachidonic acid was measured in microsomal preparations from four sources by bioassay and radiochemical methods. Indomethacin was a potent inhibitor (ID₅₀ 0.8 to 4.1 μM) but sulphasalazine and its methyl analogue were very weak inhibitors (ID₅₀ 1500 to > 5000 μM), 5-aminosalicylic acid was weaker still and sulphapyridine inactive.

7 Sulphasalazine at 50 μM did not affect the actions of prostaglandins on five smooth muscle preparations; at 500 μM there was a rapidly reversible and probably non-specific antagonism of responses to low doses of prostaglandins.

8 The specificity and selectivity of the interaction of sulphasalazine and its metabolites with the formation, breakdown and actions of prostaglandins are discussed.

     

Pharmacological effects of the antianxiety compound suriclone and its principal metabolites

The pharmacodynamic effects of 4-methyl-1-piperazinecarboxylic acid ester with (+/-)-6-(7-chloro-1,8-naphthyridin-2-yl)-2,3,6,7-tetrahydro-7-h ydr oxy-5H-p- dithiino[2,3-c]pyrrol-5-one (suriclone, RP-31264) and its principal metabolites M1 and M2 on respiration, cardiovascular system, autonomic nervous system, smooth muscle and other physiological parameters were investigated in various animal species. Suriclone, 1 mg/kg i.v., increased the amplitude of respiratory movement, decreased the respiratory rate and blood pressure and increased the heart rate in conscious rabbits. The respiratory and depressor effects were more evident in pentobarbital anesthetized rabbits. In anesthetized dogs, suriclone, 0.05 or 0.5 mg/kg i.v., produced essentially the same effects as seen in the anesthetized rabbits. The ECG pattern was not significantly changed in any animal. Such effects on respiration and on the cardiovascular system of metabolites M1 and M2 in the rabbits were weak. In the isolated guinea-pig atria, suriclone, 10(-6) g/ml, had no effect but increased contractility and decreased heart rate at a high concentration of 10(-5) g/ml. Both M1 and M2 had weak effects. Suriclone had no action on flow rate of the perfusate through the blood vessels of the isolated rabbit ear. In anesthetized dogs, suriclone 0.5 mg/kg i.v., did not affect the responses to vagal stimulation or to pre- and postganglionic stimulation of cardiac ganglion. Suriclone instilled onto the eye or i.v. had no appreciable effect on pupillary diameter or the miotic response in rabbits, but an abnormal oculogyration was evoked when the drug was given i.v. at 1 mg/kg. M1 or M2 had no such effect. Suriclone did not exert analgesic effects in mice.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of antihistamines on isolated human lung mast cells, basophil leucocytes and erythrocytes

Low concentrations of H1- and H2-receptor directed compounds inhibited the immunologic secretion of histamine from human lung mast cells and basophil leucocytes and protected human erythrocytes from hypotonic lysis. Higher concentrations induced a release of the amine from the histaminocytes. These results are discussed in terms of the possible membrane effects of the test compounds.     

Determination of disulfiram and its metabolites in human blood.

This work was initiated by the lack of a sensitive method for the determination of disulfiram and its metabolites in blood of patients treated with this drug. A method is described which allows the separate determination of carbon disulfide, free diethyldithiocarbamate and disulfides derived from disulfiram with adequate precision in 10 ml patient blood. It is based on a spectrophotometric determination of a yellow compound formed by trapping carbon disulfide produced from diethyldithiocarbamate and disulfiram in an ethanolic solution of diethylamine and copper(II)-acetate. Good quantitation of disulfiram and diethyldithiocarbamate in blood was achieved by trapping carbon disulfide produced when formic acid and cystein were added to the samples. During daily administration of 200 mg disulfiram to humans, concentrations of zero to 0.6 mug carbon disulfide and 0.2 to 1.0 mug diethyldithiocarbamate per ml blood were found using this method.     

Evaluation of methylglyoxal toxicity in human erythrocytes,leukocytes and platelets

Methylglyoxal (MG) is a reactive dicarbonyl metabolite originated mainly from glucose degradation pathway that plays an important role in the pathogenesis of diabetes mellitus (DM). Reactions of MG with biological macromolecules (proteins, DNA and lipids) can induce cytotoxicity and apoptosis. Here, human erythrocytes, leukocytes and platelets were acutely exposed to MG at concentration ranging from 0.025 to 10?mM. Afterwards, hemolysis and osmotic fragility in erythrocytes, DNA damage and cell viability in leukocytes, and the activity of purinergic ecto-nucleotidases in platelets were evaluated. The levels of glycated products from leukocytes and free amino groups from erythrocytes and platelets were also measured. MG caused fragility of membrane, hemolysis and depletion of amino groups in erythrocytes. DNA damage, loss of cell viability and increased levels of glycated products were observed in leukocytes. In platelets, MG inhibited the activity of enzymes NTPDase, 5′-nucleotidase and adenosine deaminase (ADA) without affecting the levels of free amino groups. Our findings provide insights for understanding the mechanisms involved in MG acute toxicity towards distinct blood cells.     

Distribution of ifosfamide and metabolites between plasma and erythrocytes.

The distribution of ifosfamide (IF) and its metabolites 2-dechloroethylifosfamide (2DCE), 3-dechloroethylifosfamide (3DCE), 4-hydroxyifosfamide (4OHIF) and ifosforamide mustard (IFM) between plasma and erythrocytes was examined in vitro and in vivo. In vitro distribution was investigated by incubating blood with various concentrations of IF and its metabolites. In vivo distribution of IF, 2DCE, 3DCE and 4OHIF was determined in 7 patients receiving 9 g/m(2)/72 h intravenous continuous IF infusion. In vitro distribution equilibrium between erythrocytes and plasma was obtained quickly after drug addition. Mean (+/-sem) in vitro and in vivo erythrocyte (e)-plasma (p) partition coefficients (P(e/p)) were 0.75+/-0.01 and 0.81+/-0.03, 0.62+/-0.09 and 0.73+/-0.05, 0.76+/-0.10 and 0.93+/-0.05 and 1.38+/-0.04 and 0.98+/-0.09 for IF, 2DCE, 3DCE and 4OHIF, respectively. These ratios were independent of concentration and unaltered with time. The ratios of the area under the erythrocyte and plasma concentration--time curves (AUC(e/p)) were 0.96+/-0.03, 0.87+/-0.07, 0.98+/-0.06 and 1.34+/-0.39, respectively. A time- and concentration-dependent distribution--equilibrium phenomenon was observed with the relative hydrophilic IFM. It is concluded that IF and metabolites rapidly reach distribution equilibrium between erythrocytes and plasma; the process is slower for IFM. Drug distribution to the erythrocyte fraction ranged from about 38% for 2DCE to 58% for 4OHIF, and was stable over a wide range of clinically relevant concentrations. A strong parallelism in the erythrocyte and plasma concentration profiles was observed for all compounds. Thus, pharmacokinetic assessment using only plasma sampling yields direct and accurate insights into the whole blood kinetics of IF and metabolites and may be used for pharmacokinetic-pharmacodynamic studies.     

GLC determination of heroin and its metabolites in human urine.

Heroin and its metabolites, 6-monoacetylmorphine, morphine, and normorphine, were determined in human urine with a GLC procedure. Heroin was extracted with chloroform at pH 4.5 and chromatographed at a temperature programmed from 200-250 degrees by 8 degrees/min. 6-Monoacetylmorphine and morphine were extracted with ethylene dichloride containing 30% isopropanol at pH 8.5, and normorphine was extracted at pH 10.4 wtih the same solvent. The extract was derivatized with trimethylsilylimidazole and chromatographed at 230 degrees for the determination of 6-monoacetylmorphine and morphine and at 220 degrees for normorphine and morphine.     

Stability of diltiazem and its metabolites in human blood samples.

The stability of diltiazem and its metabolites in blood samples from patients under chronic diltiazem therapy was investigated. When whole blood was kept for 1 h at room temperature between sampling and centrifugation, the concentration of N-demethyldiltiazem (MA) decreased significantly, with an average loss of 24%. Under the same conditions, an average loss of 14% of diltiazem occurred, whereas the concentrations of the metabolites deacetyldiltiazem and N-demethyldeacetyldiltiazem did not change significantly. No significant decrease in MA and diltiazem concentrations was observed when whole blood was stored for 1 h in an ice bath. In spiked plasma samples kept at room temperature, only MA was unstable, with an average loss of 13% after 4 h. The present study shows the importance of observing rigorous conditions for the transport and treatment of blood samples. To achieve accurate determination of diltiazem and related compounds, the blood must be centrifuged immediately after collection or kept on ice for up to 1 h. The plasma samples must be immediately frozen at -80 degrees C and can be stored for up to 5 weeks before analysis. Using these rigorous conditions, we observed that MA is the main metabolite of diltiazem in plasma from patients under chronic oral diltiazem therapy.     

Detection of cocaine and its metabolites in human amniotic fluid.

The dramatic rise in maternal drug abuse and the incidence of positive drug findings during neonatal testing has increased the need for prenatal toxicological testing for drugs of abuse. Human amniotic fluid samples collected after 13-39 weeks of pregnancy were screened for cocaine metabolite (benzoylecgonine) by fluorescence polarization immunoassay (FPIA). All positive samples, as well as any accompanying maternal serum, were confirmed by gas chromatography/mass spectrometry (GC/MS) for cocaine and its metabolites. Five samples out of 450 were positive for cocaine, benzoylecgonine, and ecgonine methyl ester by GC/MS. In addition, one sample was also positive for cocaethylene. Two maternal serum samples were positive for benzoylecgonine and ecgonine methyl ester. The presence of cocaine, benzoylecgonine, ecgonine methyl ester, and cocaethylene in the amniotic fluid suggests that the fetus is exposed to cocaine and its metabolites through maternal circulation. The impact of this exposure on the health of the newborn is unknown.