Effects of anesthetics, dibucaine and methoxyflurane on the ATPase activity and physical state of Tetrahymena surface membranes

Is cardiolipin the target of local anesthetic cardiotoxicity?

BACKGROUND AND OBJECTIVES

Local anesthetics are used broadly to prevent or reverse acute pain and treat symptoms of chronic pain. Local anesthetic-induced cardiotoxic reaction has been considered the accidental event without currently effective therapeutic drugs except for recently reported intralipid infusion whose possible mechanism of action is not well known.

CONTENTS

Cardiolipin, an anionic phospholipid, plays a key role in determining mitochondrial respiratory reaction, fatty acid metabolism and cellular apoptosis. Mitochondrial energy metabolism dysfunction is suggested as associated with local anesthetic cardiotoxicity, from an in vitro study report that the local anesthetic cardiotoxicity may be due to the strong electrostatic interaction of local anesthetics and cardiolipin in the mitochondria membrane, although there is a lack for experimental evidence. Herein we hypothesized that local anesthetic-cardiolipin interactions were the major determinant of local anesthetic-associated cardiotoxic reaction, established by means of theoretic and structural biological methods. This interacting model would give an insight on the underlying mechanism of local anesthetic cardiotoxicity and provide clues for further in depth research on designing preventive drugs for such inadvertent accidence in routine clinical practice.

CONCLUSIONS

The interaction between local anesthetic and mitochondrial cardiolipin may be the underlying mechanism for cardiotoxicity affecting its energy metabolism and electrostatic status.

Mechanism of dibucaine-induced apoptosis in promyelocytic leukemia cells (HL-60)

Dibucaine, a local anesthetic, inhibited the growth of promyelocytic leukemia cells (HL-60) without inducing arrest of the cell cycle and differentiation to granulocytes. Typical DNA fragmentation and DNA ladder formation were induced in a concentration- and time-dependent manner. The half-maximal concentration of dibucaine required to induce apoptosis was 100 microM. These effects were prevented completely by the pan-caspase inhibitor z-Val-Ala-Asp-(OMe)-fluoromethylketone (z-VAD-fmk), thereby implicating the cysteine aspartase (caspase) cascade in the process. Dibucaine activated various caspases, such as caspase-3, -6, -8, and -9 (-like) activities, but not caspase-1 (-like) activity, and induced mitochondrial membrane depolarization and the release of cytochrome c (Cyt.c) from mitochondria into the cytosol. Processing of pro-caspase-3, -8, and -9 by dibucaine was confirmed by western blot analysis. Bid, a death agonist member of the Bcl-2 family, was processed by caspases following exposure of cells to dibucaine. However, 100 microM dibucaine scarcely inhibited oxidative phosphorylation, but it induced membrane permeability transition in isolated rat liver mitochondria. Taken together, these data suggest that dibucaine induced apoptosis of HL-60 cells through activation of the caspase cascade in conjunction with Cyt.c release induced by a processed product of Bid and depolarization of the mitochondrial membrane potential.

Induction of apoptotic cell death in a neuroblastoma cell line by dibucaine

Dibucaine, a local anesthetic known to interact with cell membranes, induced apoptosis in SK-N-MC human neuroblastoma cells in a dose-dependent manner. Apoptosis was demonstrated by direct visualization of morphological nuclear changes using a DAPI staining technique and confirmed by the production of characteristic ladder patterns of DNA fragmentation on gel electrophoresis. At concentrations which induced apoptosis, dibucaine significantly altered membrane fluidity, indicating that fluidity may be a major target for the cytotoxic action of dibucaine. Also, dibucaine increased intracellular calcium levels more effectively in calcium-containing Krebs-Ringer buffer than in calcium-free Krebs-Ringer buffer. Removal of extracellular calcium or addition of antioxidants or protein synthesis inhibitor effectively blocked dibucaine-induced apoptosis. These results suggest that membrane damage, intracellular calcium levels, and oxygen free radicals may be involved in the apoptosis induced by dibucaine.

Dibucaine interaction with phospholipid vesicles. A resonance energy-transfer study

Resonance energy transfer between a local anaesthetic, dibucaine (donor) and a set of functionalized probes [n-(9-anthroyloxy)stearic acids, n = 2, 3, 6, 7, 9 and 12 and 16-(9-anthroyloxy)palmitic acid] (acceptors) was found to be an efficient process with a critical radius of transfer Ro = 2.1 nm, this interaction being used to locate the drug in a model membrane system, small unilamellar vesicles of dipalmitoylglycerophosphocholine, both above and below the temperature of the gel-to-the-liquid-crystal transition of the phospholipid. From the sequence of relative quenching efficiencies of dibucaine fluorescence upon incorporation of the probes, it was concluded that the drug intercalates in the membrane near the glycerol backbone of the lipid. In addition, it was found that dibucaine location is not significantly affected upon crossing the phase-transition temperature of the phospholipid. Dibucaine photophysics was also studied and the short lifetime of the neutral form of the anaesthetic with respect to that of the monoprotonated species was attributed to an intramolecular charge-transfer interaction. From the study of its partition coefficient between the membrane and the aqueous phase, it was concluded that the only significant species present in the membrane is the charged one.

Distribution of tumor promoters in lipid membranes and changes in membrane structure

The interaction of tumor promoters differing in molecular structure, namely, 12-O-tetradecanoylphorbol 13-acetate (TPA) and teleocidin, with dipalmitoylphosphatidylcholine (DPPC) vesicles was studied. Investigation by Fourier transform infrared spectroscopy clarified the differences between the tumor promoters in the mode of interaction with lipid bilayer membranes. The temperature dependence of the bandwidth of the C-H or C = O stretching absorption of lipid molecules in the presence of tumor promoters relative to that in pure DPPC vesicles indicated that TPA is incorporated into the hydrophobic core of the lipid bilayer membrane whilst teleocidin binds predominantly to the membrane surface. However, both tumor promoters tend to restrict the motion of lipid molecules in membranes. The same conclusion was derived from measurements of steady-state fluorescence polarization, which showed that tumor promoters decreased the membrane fluidity. On the other hand, carboxyfluorescein (CF) leakage from vesicles was enhanced by the addition of TPA below the phase-transition temperature, whereas the effect of teleocidin on steady-state CF leakage was not as significant. It is considered that the difference in the profile of the TPA-induced increase in CF leakage compared to that of teleocidin might be ascribable to a different binding site for each tumor promoter in the membranes.

Permeability alterations and antihaemolysis induced by amphiphiles in human erythrocytes

In an attempt to define the parameters in amphiphilic molecules important for their interaction with the erythrocyte membrane, the effects of cationic, anionic, zwitterionic and nonionic amphiphilic agents (C10-C16) on osmotic fragility and transport of potassium and phosphate in human erythrocytes were studied. All the amphiphiles protected the erythrocytes against hypotonic haemolysis. Half-maximum protection occurred at a concentration which was about 15% of that inducing 50% haemolysis. The concentrations of amphiphiles required to induce protection or haemolysis were related to the length of the alkyl chain in a way indicating that a membrane/aqueous phase partition is the mechanism whereby the amphiphile monomers intercalate into the membrane. At antihaemolytic concentrations all the amphiphiles increased potassium efflux and passive potassium influx. The increase in the fluxes was about the same in both directions through the membrane and there were no clear differences in the effects of the different amphiphilic derivatives at equi-protecting concentrations. Active potassium influx was decreased by cationic, zwitterionic and non-ionic amphiphiles. The ability of the amphiphiles to inhibit the influx was not related to the length of the alkyl chain. Anionic amphiphiles had no or only a weak stimulatory effect on the influx. Phosphate efflux was reduced by all the amphiphiles. The inhibitory potency of the different amphiphiles decreased in the following order; anionic greater than zwitterionic, non-ionic greater than cationic. Short-chained amphiphiles were more potent inhibitors than long-chained. The possible participation of non-bilayer phases (mixed inverted micelles) in the intercalation of amphiphiles into the membrane is discussed.

Effects of local anesthetics on calmodulin-dependent guanylate cyclase in the plasma membrane of Tetrahymena pyriformis

A highly purified preparation of Tetrahymena calmodulin activated a membrane-bound guanylate cyclase by more than 40-fold. This activation of guanylate cyclase by calmodulin was inhibited completely by local anesthetics such as dibucaine, tetracaine, lidocaine and procaine at concentrations that had no appreciable effect on the activities of basal guanylate cyclase (without calmodulin) and adenylate cyclase. The inhibition by dibucaine of calmodulin-mediated activation of the enzyme activity was not reversed by calcium but was partially overcome by increasing the concentration of calmodulin. Kinetic analysis of local anesthetic-induced inhibition of activation of guanylate cyclase demonstrated a mixed type of antagonism. These results suggest the possibility that the inhibition of calmodulin-dependent guanylate cyclase resulted, in part, from interaction of the drugs with calmodulin.

A calcium regulated adenosine triphosphatase in Entamoeba histolytica

Axenically grown trophozoites of Entamoeba histolytica (NIH-200 strain) contain an active ATPase (170 nmol PO4/min per mg protein) with maximal activity at pH 8.8, a high affinity for ATP (Km approximately 40 micro M) and an absolute and specific requirement for Ca2+. The activation by Ca2+ shows positive cooperativity (nH = 2.48) at calcium concentrations below 8 micro M and no cooperativity between 8 and 25 micro M. The latter concentration fully saturates the enzyme. The observed activity is insensitive to oligomycin, ouabain and ruthenium red and is unaffected by a range of inhibitors of electron transport and uncouplers of oxidative phosphorylation. The enzyme exhibits structure bound latency and is tightly bound to cellular membranes. It is sedimentable ( greater than 80%) by high speed centrifugation of cell homogenates which are either protected osmotically or in which subcellular structures are damaged by sonication or treatment with Triton X-100. Arrhenius plots of V in the temperature range of 0-38 degrees C are linear without breaks, similar to other pyrophosphatases of E. histolytica. The calculated activation energy is 14.8 kcal/mol. This finding as well as the failure of phospholipase treatment to affect activity indicate that interactions with membrane lipids play no role in the catalytic function of this tightly membrane-bound ATPase.

Temperature-dependent nerve-blocking action of lidocaine and halothane

The effect of lidocaine and halothane on the compound action potential of rat sciatic nerves was studied under hypo-hyperthermic conditions. In drug-free desheathed nerves, a total but reversible cold block occurred at 10-11 degrees C, and an irreversible heat block at 46 degrees C. Cooling potentiated the dose-dependent blocking action of lidocaine (decreased amplitude, and increased duration and latency of the compound action potential). Total block of conduction occurred at 17 degrees C with 100 microM lidocaine, at 20 degrees C with 200 microM lidocaine and at 24 degrees microM with 400 microM lidocaine. In nerves equilibrated in 200 microM lidocaine solution, the lidocaine concentrations in the nerves decreased as the temperature decreased; at 20 degrees C, the lidocaine concentration was about half of that at 37 degrees C. The nerve-blocking effect of lidocaine was also potentiated by increasing the temperature above 37 degrees C. At 30 degrees C and 20 degrees C, 1 vol. % halothane caused a slight time-dependent inhibition of the compound action potential. When the nerves were exposed to 2.5 vol. % halothane, the decrease in amplitude and increase in duration and latency were potentiated by hypothermia and were also time dependent. Interaction of halothane and temperature of 40 degrees C was not significant. Although thermodynamic principles suggest similarities between high pressure and cooling in reversing anaesthesia, cooling was found to potentiate the anaesthetic effect of lidocaine and halothane in this study. Temperature may thus be an interesting physical variable in studying nerve-blocking mechanisms.

Pharmacological evidence for cell surface control of oral regeneration in Stentor coeruleus

This study suggests that membrane perturbations can affect oral morphogenesis in Stentor, possibly by a mechanism involving calcium ions. Exposure of regenerating Stentor to micromolar concentrations of the membrane active local anesthetics dibucaine, tetracaine, or procaine greatly delayed the progress of oral regeneration. In the case of tetracaine and dibucaine the greatest delays were observed in the early stages of regeneration prior to stage 4, when the majority of essential synthetic activity is occurring. The effects of dibucaine were generally readily reversible upon removal of the cells from the drug, with some residual effects occurring at higher dibucaine concentrations. Regenerating cells in the presence of dibucaine and excess extracellular calcium were not delayed, suggesting that the effects of dibucaine were reversible by calcium ions. The effects of tetracaine were not reversible by calcium ions, however. Exposure of regenerating cells to medium either lacking in, or containing an excess of, extracellular calcium had no effect on the time required to complete oral regeneration. The plant lectin, phytohemagglutinin, can also delay oral regeneration. The possible implications of these findings on the control of oral regeneration are discussed.