Evaluation of tumor energy metabolism and microvascular blood flow after glucose or mannitol administration using 31P nuclear magnetic resonance spectroscopy and laser Doppler flowmetry

The effects of intraperitoneally administered glucose or mannitol (5 mg/g body weight, 25% solutions) on tumor energy metabolism and tumor red blood cell flux were studied using 31P-nuclear magnetic resonance spectroscopy and laser Doppler flowmetry. Isotransplants of a spontaneous murine fibrosarcoma growing in the hind foot dorsum were used. 31P-nuclear magnetic resonance and laser Doppler flowmetry studies in glucose treated animals were performed on small (congruent to 100 mm3) and large (congruent to 300 mm3) tumors. In mannitol treated animals, tumors with an average volume of congruent to 200 mm3 were used. Using this tumor model, intraperitoneally administration of the hypertonic sugar solutions caused similar declines in tumor microcirculation (mannitol, 60 +/- 8% flow reduction; glucose, 72 +/- 4% flow reduction; t = 60 min). These changes were not glucose-specific and can primarily be explained by a water shift into the abdominal cavity and an associated hypovolemic hemoconcentration. A stable (small tumors) or transiently increased (large tumors) tumor energy metabolism which occurred after glucose administration was probably caused by a transiently increased glucose availability. The decline in energy metabolism after mannitol, a non-metabolized sugar alcohol, and the earlier decline in tumor pH seen in the glucose treated animals, supports this conclusion. The differences in the high energy phosphate response to glucose seen in small compared with large tumors, suggests that the baseline metabolic state of larger tumors includes a glucose deficiency in addition to tumor hypoxia.     

The measurement of radiosensitizer-induced changes in mouse tumor metabolism by 31P magnetic resonance spectroscopy.

Flunarizine and nicotinamide have previously been shown to increase blood perfusion to experimental mouse tumors and consequently, to increase their sensitivity to X rays. These agents were examined for their ability to alter metabolism, measured by 31P magnetic resonance spectroscopy, in the SCCVII/Ha carcinoma and the KHT sarcoma. Flunarizine at 5 mg/kg I.P. produced a 45% reduction in the ratio of inorganic phosphate to total phosphate (Pi/total) in the SCCVII/Ha tumor but only a 24% reduction in this ratio in the KHT tumor. These effects were seen 45 min after drug administration, and ratios returned to control levels by 90 min. In the SCCVII/Ha tumor, nicotinamide at 1000 mg/kg I.P. reduced Pi/total by 56% from 30 min to at least 2 hr after injection, and the ratio was reduced by 59% in the KHT tumor at 30 min after injection, returning to control levels by 2 hr. For the SCCVII/Ha tumor, the time course for the effects of flunarizine and nicotinamide on the inorganic phosphate ratio coincided with that previously reported for radiosensitization.     

Assessment of tumor energy and oxygenation status by bioluminescence, nuclear magnetic resonance spectroscopy, and cryospectrophotometry

The energy and oxygenation status of tumors from two murine sarcoma lines (KHT, RIF-1) and two human ovarian carcinoma xenograft lines (MLS, OWI) were assessed using three independent techniques. Tumor energy metabolism was investigated in vivo by 31P nuclear magnetic resonance spectroscopy. After nuclear magnetic resonance measurements, tumors were frozen in liquid nitrogen to determine the tissue ATP concentration by imaging bioluminescence and to register the intracapillary oxyhemoglobin (HbO2) saturation using the cryospectrophotometric method. There was a positive correlation between the nucleoside triphosphate beta/total resonance ratio or a negative correlation between the Pi/total resonance ratio and the model ATP concentration obtained by bioluminescence, respectively. This was true for small tumors with no extended necrosis irrespective of tumor type. Moreover, a positive correlation was obtained between the HbO2 saturations and the ATP concentration measured with bioluminescence. The results demonstrate the potential of combined studies using noninvasive, integrating methods and high-resolution imaging techniques for characterizing the metabolic milieu in tumors.     

Levels of high energy phosphates in human lung cancer cell lines by 31P nuclear magnetic resonance spectroscopy

Human lung cancers are divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) based on established criteria. SCLC differs from NSCLC by the expression of biomarkers, including creatine kinase-BB isoenzyme (EC 2.7.3.2). Subtypes of SCLC are referred to as classic and variant, both of which have elevated levels of creatine kinase-BB isoenzyme. We, therefore, applied 31P nuclear magnetic resonance spectroscopy to cell lines of classic SCLC, variant SCLC, and NSCLC human tumors, using continuous perfusion to identify any differences in the detectable levels of intracellular high-energy phosphate compounds. The spectra indicate that only the variant SCLC cells maintain high levels of phosphocreatine. Additionally, the classic SCLC cells express elevated levels of a diphosphodiester. Neither phosphocreatine nor diphosphodiesters are found in the NSCLC cell spectra.     

31P magnetic resonance spectroscopy of human colon cancer

Phosphatic metabolite profiles of 19 malignant and normal human colon specimens were analyzed by techniques of perchloric acid extraction and 31P magnetic resonance spectroscopy at 202.4 MHz. Thirty-one individual phosphorus-containing intermediates of metabolism were identified and quantified for statistical intergroup comparisons. Elevations in relative concentrations of phosphorylethanolamine, IMP, NADP 2'-P, an uncharacterized resonance at 3.72 delta, glycerol 3-phosphorylcholine, phosphorylated glycans and the nucleoside diphosphosugars were seen in malignant tissues concurrently with reductions in relative concentrations of phosphorylcholine, phosphocreatine (PCr), and ATP. The malignant and normal tissue groups were further characterized and contrasted by computing metabolic indices from spectral data. Significant elevations in phosphomonoesters, glycerolphosphodiesters, the ratio of phosphorylethanolamine/phosphorylcholine, and phosphomonoesters/inorganic orthophosphate were detected in malignant tissues along with significant reductions in the ratios of PCr/inorganic orthophosphate, PCr/ATP, the energy charge of the adenylate system and the tissue energy modulus. These results revealed significant alterations in high energy metabolism, low energy metabolism, and membrane metabolism characteristic of malignant tissues. The reduction in high energy phosphates ATP and PCr was balanced by the net increase in nucleoside diphosphosugar and a shift in equilibrium to metabolism involving low energy phosphomonoesters. The spectral data of the tumors, which were of epithelial origin, demonstrated minor metabolites not previously detected in tissue extract analysis of malignant tissues. Detection of these minor metabolites represents an indirect measurement of phospholipid metabolism in malignant tissues.     

Use of high-resolution 31P-labeled topical magnetic resonance spectroscopy to monitor in vivo tumor metabolism in rats

A probe using a single-tuned solenoid coil has been constructed to study in vivo metabolism of rats in a wide-bore Bruker nuclear magnetic resonance spectrometer. Transplantable rat mammary adenocarcinomas (estrogen receptor negative) were implanted into the hind leg muscle of 8-week-old rats. The other leg without tumor was used as a control. Tumor metabolism could be distinguished from that of surrounding muscle by the appearance of inorganic phosphate and sugar phosphate resonances, reflecting tissue necrosis, and increased glycolysis. Tumor growth was accompanied by an increase in the size of these peaks, and the chemical shifts of the inorganic phosphate peak indicated that the intracellular pH became more acidic. Administration of methotrexate (i.v.) reversed these patterns and decreased tumor volume. Changes in the phosphocreatine peaks indicated changes in tumor volume rather than in tumor metabolism. These studies show that topical magnetic resonance not only can monitor the growth of tumors in vivo but can be also used to evaluate the efficacy of chemotherapeutic drugs.     

31P nuclear magnetic resonance studies of growth inhibition and dexamethasone resistance in human leukemic cells

31P Nuclear magnetic resonance spectra of perchloric acid extracts from wild-type human leukemic CEM-C7 cells and the dexamethasone-resistant CEM-C1 mutant reveal significant differences in concentrations of phospholipid precursors and ATP+, which indicate metabolic differences between these two cell lines. At high cell concentrations the CEM-C7 cells are growth inhibited, which is reflected by low phospholipid precursor levels, indicative of low phospholipid turnover. The CEM-C1 mutant does not exhibit this growth inhibition and has constant phospholipid precursor levels over the same cell concentration range. Dexamethasone causes phospholipid precursor and ATP levels in CEM-C7 to drop after 48 h, but spectra obtained for CEM-C1 cells continue to show high cell viability up to 72 h.     

Changes in radiation sensitization induced by Fluosol-DA as measured by 31P nuclear magnetic resonance spectroscopy

Numerous agents have been studied in attempts to sensitize radioresistant hypoxic tumor cells. We have investigated the effect of Fluosol-DA plus carbogen (95% oxygen and 5% CO2) on the sensitivity of a radioresistant mammary carcinoma in C3H/He mice and also on tumor metabolism by 31P nuclear magnetic resonance spectroscopy. Statistically significant increases in phosphocreatine/Pi were noted for small- (150-350 mm3) and medium- (351-650 mm3) sized tumors treated with Fluosol-DA plus carbogen. Small tumors were shown to undergo significant radiosensitization in the presence of Fluosol-DA plus carbogen and medium-sized tumors showed a lesser degree of radiosensitization. Large tumors (greater than 900 mm3) showed no effect. Fluosol-DA or carbogen alone had no effects on animals with any tumor volume, as monitored by significant changes in radiosensitivity or nuclear magnetic resonance parameters. An approximately linear relationship was found between the decrease in the values for radiation dose which yields 50% tumor control and the increase in phosphocreatine/Pi, with a correlation of r = -0.93. 31P nuclear magnetic resonance spectroscopy may be useful for monitoring changes in radiosensitivity induced by agents which alter tumor oxygenation and subsequent metabolic status.     

Response of solid tumors to chemotherapy monitored by in vivo 31P nuclear magnetic resonance spectroscopy: a review

In vivo 31P nuclear magnetic resonance (MR) spectroscopy has shown great promise as a tool for cancer research and the clinical management of solid tumors. It is now possible in some cases to integrate MR spectroscopy with routine MR imaging of the cancer patient, so that tissue identified as tumor on an MR image can be examined biochemically and monitored following treatment. Alterations have been observed in the phosphorus MR spectra of patient tumors after treatment, but the causes and consequences of these alterations are poorly understood. Here we review data obtained from experimental animal tumor models treated with chemotherapy in order to gain insight into the biological events reflected in MR spectroscopic changes, and to determine what information the spectra provide about the success or failure of therapeutic interventions. An attempt is made to relate these experimental findings to the cancer clinic and to analyze the contributions of MR spectroscopy to the understanding of tumor biology.     

Response of radiation-induced fibrosarcoma-1 in mice to cyclophosphamide monitored by in vivo 31P nuclear magnetic resonance spectroscopy

In vivo 31P nuclear magnetic resonance spectroscopy has been used to examine the RIF-1 fibrosarcoma in mice during untreated growth and following chemotherapy with cyclophosphamide. Levels of inorganic phosphate increase relative to phosphocreatine or nucleoside triphosphates during early untreated growth. After the tumor reaches a volume of approximately 1 g, no further decrease in energy level is observed. Following treatment with cyclophosphamide, tumor phosphorus metabolite ratios and pH are significantly altered, compared to untreated age-matched controls. During the growth delay period following chemotherapy there is a significant reduction in the ratio of inorganic phosphate to other phosphate metabolites, compared to age-matched controls. In addition, a more alkaline pH is observed in the tumors of treated animals. When the growth delay period ends, nuclear magnetic resonance spectra return to pretreatment patterns. The magnitude of the differences in 31P nuclear magnetic resonance spectral parameters between treated animals and untreated controls is dose dependent. However, doses of cyclophosphamide above 200 mg/kg do not result in earlier spectroscopic alterations, nor in larger effects by Day 3 after treatment, even though clonogenic cell killing and growth delay are greater at these higher doses.     

Modulation of murine radiation-induced fibrosarcoma-1 tumor metabolism and blood flow in situ via glucose and mannitol administration monitored by 31P and 2H nuclear magnetic resonance spectroscopy

The hyperglycemia-induced in situ metabolism and blood flow changes produced in s.c. implanted murine radiation-induced fibrosarcoma-1 tumors, grown on the flanks of female C3H/HeJ mice, were examined with 31P and 2H nuclear magnetic resonance. Initial experiments verified a hyperglycemic tumor acidification similar to that reported earlier with a different substrain of mice, C3H/AnF (J.L. Evelhoch et al., Proc. Natl. Acad. Sci. USA, 81: 6496-6500, 1984). Changes in the tumor pH, phosphorus metabolites, and blood flow were then compared after administration of saline, glucose, or mannitol (a nonmetabolizable glucose analogue) using a mole-equivalent dose of the sugars (i.e., 0.8 mmol/20g mouse). Neither saline (n = 8) nor mannitol (n = 6) administration had any marked effect upon tumor pH, whereas glucose administration produced a mean maximum tumor pH reduction of 0.74 +/- 0.09 (SE; n = 9) during the 2.5 h post-glucose injection. No significant changes in high energy phosphate concentrations were observed during the same period after saline injection. After glucose injection, the [phosphocreatine] gradually decreased by 64% (P = 0.0001). After the initial 1 h post-glucose injection, the [inorganic phosphate] increased by 58% (P = 0.0001), and the [nucleoside triphosphates] decreased by 29% (P = 0.0001) during the following 1.5 h. After mannitol injection, while there was no change in [inorganic phosphate] over time (P = 0.37), the [phosphocreatine] decreased by 33% (P = 0.0001) and the [nucleoside triphosphates] decreased by 21% (P = 0.0015) within 20 min, then both the [phosphocreatine] and [nucleoside triphosphates] remained at constant levels during the following 2 h. In parallel experiments, the volumetric rate of tumor blood flow and perfusion was measured by 2H nuclear magnetic resonance monitoring of 2H2O washout kinetics (S-G. Kim and J. J. H. Ackerman, Cancer Res., 48: 3449-3453, 1988); tumor blood flow decreased by 80% (P = 0.0001, n = 11), 60% (P = 0.0031, n = 4), and 20% (P = 0.058, n = 10) at 2 h after glucose, mannitol, or saline injections, respectively. These results suggest that anaerobic glycolysis is a requirement for hyperglycemic tumor acidification. However, the decrease in tumor blood flow accompanying hyperglycemic acidification suggests that flow reduction also may be a contributing or a required cofactor for acidification via inhibition of lactic acid egress.(ABSTRACT TRUNCATED AT 400 WORDS)     

Dietary fat modulation of murine mammary tumor metabolism studied by in vivo 31P-nuclear magnetic resonance spectroscopy

The effect of dietary fat concentration and saturation on high energy phosphate metabolites and phospholipid turnover in transplanted line 168 murine mammary tumors was studied using surface coil 31P-nuclear magnetic resonance spectroscopy. Female BALB/c mice were fed one of five diets each containing at least the minimum of essential fatty acids (EFA). Four diets contained additional safflower or palm oil for a total fat concentration of 5 or 20% by weight. The growth rate of tumors from mice fed the high safflower oil diet was significantly greater than the growth rate of tumors for mice fed all other diets including the one which contained the minimal EFA. 31P-nuclear magnetic resonance-observable phosphate metabolite ratios. ATP/Pi, ATP/phosphomonoester (ATP/PME), and PME/Pi, and tumor pH of line 168 tumors decreased with increasing tumor volume, indicating a shift from active to inactive tumor metabolism. The rates of those decreases with progressive tumor growth differed significantly among tumors of mice fed the different diets. Decreases in ATP/Pi, ATP/PME, and pH were the most rapid in the tumors of mice fed the high safflower oil diet and significantly faster than tumors of mice fed the diet containing minimum EFA. In addition, the decrease in the PME/Pi ratio of tumors was significantly greater in mice fed the high fat (high palm oil and high safflower oil) diets than mice fed the diet containing the minimum of EFA. The rate of decline of ATP/Pi and ATP/PME with progressive tumor growth was directly correlated with levels of linoleic acid as well as total unsaturated fat. High levels of a polyunsaturated fat had a significant effect on mammary tumor metabolism particularly during early stages of tumor growth. Differences in high energy phosphate metabolite dynamics relative to dietary fat were present in tumors of equal volume. Thus, dietary fat influences on mammary tumorigenesis may be related to high energy phosphate metabolites.     

FSaII mouse tumor metabolic changes with different doses of glucose measured by 31P nuclear magnetic resonance

Tumor acidosis and energy deprivation enhance thermal sensitivity. We have used in vivo 31P nuclear magnetic resonance spectroscopy to noninvasively monitor changes in pH and energy metabolism in FSaII mouse tumors after i.p. administration of glucose. A dose of 5 g/kg glucose induced a pH drop of 0.31 units without any statistically significant change in energy status. The pH changes resolved within 2 h. In contrast, administration of 10 g/kg glucose resulted in a severe acidosis (mean nadir pH of 6.19 corresponding to a mean pH drop of 0.96 units) and loss of energy, the latter most probably being due to an acidosis-induced inhibition of glycolysis during ischemic hypoxia. The resulting acidosis and energy loss were more persistent and resolved in 5.5-28 h. In contrast, after an identical dose of mannitol (10 g/kg), a pH drop of approximately only 0.1 units over 72 min was noted. The data suggest that both cleavage of glucose to lactic acid and blood flow inhibition are involved in glucose induced tumor acidosis. In vivo 31P nuclear magnetic resonance spectroscopy may be useful clinically to monitor therapeutic attempts at enhancing thermal sensitivity.     

Follow-up by 31P NMR spectroscopy of the energy metabolism of malignant tumor in rats during treatment

The energy metabolism of tumors in rats was investigated by in vivo 31P-NMR spectroscopy. The effects of radiotherapy, chemotherapy or radiotherapy combined with 5-fluorouracil (5-FU) chemotherapy were evaluated by observing the changes of these spectra in chemically induced subcutaneous fibrosarcoma in rats. Two milligrams of DMBA in solution in olive oil were administered subcutaneously in the flank of 20 Wistar rats and 17 fibrosarcoma occurred. 31P NMR spectra were recorded with a Brüker Medspec 30/47 spectrometer using a surface coil positioned over the tumor. We did not observe significant changes in the spectra during tumor growth. Radiotherapy and 5-FU chemotherapy alone did not induce major changes in the 31P spectra. But the situation was completely different for animals receiving the therapeutic combination. A clear increase in the ratio of inorganic phosphate to total phosphorus signal was observed 48 h after the first irradiation session. The pH shifted concurrently to the acidic range. No effect on tumor regression was observed in the rats from the chemotherapy group, while regression was less than 50% in rats treated by irradiation only, and at least 80% in the combined group.     

环磷酰胺治疗小鼠S180肉瘤的体内31P磁共振波谱研究

目的 观察环磷酰治疗小鼠Ｓ１８０肉瘤的＾３１ＰＭＲＳ参数变化,以及这些参数的变化是否早于常规观察的瘤体积变化。方法 利用表面线圈＾３１ＰＮＭＲ方法,并研究了小鼠皮下接种Ｓ１８０肉瘤的体积。结果：对照组的ＰＣｒ／Ｐｉ和＋β－ＮＴＰ／Ｐｉ比值降低,而环磷酰胺给药组升高,且给药后２４,４８,７２ｈ时显著高于对照组（Ｐ〈０．０５）,对照组的ＰＭＥ／β－ＮＴＰ比值继续升高,而给药组ＰＭＥ／β－ＮＴＰ比值在给     

pH dependence of 5-fluorouracil uptake observed by in vivo 31P and 19F nuclear magnetic resonance spectroscopy

Multinuclear nuclear magnetic resonance spectroscopy was used to follow the metabolism and kinetics of 5-fluorouracil (5FU) after i.v. administration at a dose of 100 mg/kg on Wistar rats. 31P spectra allow one to determine both the energetic status and the pH of the tissues under investigation, while serial 19F spectra reveal the drug clearance. Analyses of 5FU kinetics show that the half-life of 5FU elimination is about 35 min in tissue with a pH of 7.3. However, this half-life increases 2.5-fold when the local pH decreases below 6.9. Thus, acidification seems to induce a local retention of 5FU, which tends to prove the existence of active transport. This retention of the drug may have significant clinical implications for assessing and improving chemotherapy alone or in combination.     

Modification of the 31P magnetic resonance spectra of a rat tumour using vasodilators and its relationship to hypotension

The effects of different doses of hydralazine and prostacyclin on the 31P magnetic resonance spectra of the LBDS1 fibrosarcoma were investigated and related to their effects on mean arterial blood pressure (MABP) and heart rate. The effect of reducing MABP by bleeding the animals, via the tail artery, was also investigated. Tumour spectral changes following high dose drug treatment (an increase in inorganic phosphate, a reduction in nucleotide triphosphates and a reduction in pH) were consistent with nutrient deprivation. These changes were dose dependent. Changes in MABP and heart rate were consistent with vasodilatation in normal tissues. However, for the same fall in MABP, hydralazine produced a greater rise in tumour inorganic phosphate (Pi) and a greater fall in tumour pH than did prostacyclin. Controlled bleeding was effective in reducing MABP. It also reduced tumour pH but had no significant effect on tumour Pi. The clinical application of the two drugs for reducing tumour blood flow and pH for therapy is likely to be limited by the large degree of hypotension necessary to produce an effect. The differential effect of the two drugs for the same fall in MABP may be related to different degrees of direct tumour vasodilatation or to a direct effect of hydralazine on tumour energy metabolism. The observation that controlled bleeding does not change tumour Pi is further evidence indicating that the degree of arterial hypotension is not the sole factor in determining tumour energy status.     

Determination of the urinary excretion of ifosfamide and its phosphorated metabolites by phosphorus-31 nuclear magnetic resonance spectroscopy

Summary Phosphorus-31 nuclear magnetic resonance spectroscopy was used to analyze urine samples obtained from patients treated with ifosfamide (IF). This technique allows the individual assay of all phosphorated metabolites of IF in a single analysis without the need for prior extraction. In addition to the classic IF metabolites 2-dechloroethylifosfamide (2DECIIF), 3-dechloroethylifosfamide (3DECIIF), carboxyifosfamide (CARBOXYIF), and iso-phosphoramide mustard (IPM), several signals corresponding to unknown phosphorated compounds were observed. Four of them were identified: one is alcoifosfamide (ALCOIF), two come from the degradation of 2,3-didechloroethylifosfamide (2,3-DECIIF), and one results from the decomposition of 2DECIIF. The total cumulative drug excretion as measured over 24 h in nine patients was 51% of the injected IF dose; 18% of the dose was recovered as unchanged IF. The major urinary metabolites were the dechloroethylated compounds, with 3DECIIF excretion (11% of the injected dose) always being superior to 2DECIIF elimination (4% of the injected dose). Degradation compounds of 2DECIIF and 2,3DECIIF represented 0.4% of the injected dose. The metabolites of the dechloroethylation pathway always predominated over those of the activation pathway (CARBOXYIF, ALCOIF, and IPM, representing 3%, 0.8%, and 0.2% of the injected dose, respectively). In all, 14% of the injected dose was excreted as unknown phosphorated compounds. The interpatient variation in levels of IF metabolites was obvious and involved all of the metabolites. Renal excretion was not complete at 24 h, since 11% of the injected dose was recovered in the 24- to 48-h urine samples.This research was financially supported by the Association pour la Recherche sur le Cancer (grant 6635) and by the Ligue Nationale Française contre le Cancer (Comité des Hautes-Pyrénées)