An interaction of aminoglycoside antibiotics with Ca binding to lipid monolayers and to biomembranes

Long-term blocking of calcium channels in mdx mice results in differential effects on heart and skeletal muscle

The disease mechanisms underlying dystrophin-deficient muscular dystrophy are complex, involving not only muscle membrane fragility, but also dysregulated calcium homeostasis. Specifically, it has been proposed that calcium channels directly initiate a cascade of pathological events by allowing calcium ions to enter the cell. The objective of this study was to investigate the effect of chronically blocking calcium channels with the aminoglycoside antibiotic streptomycin from onset of disease in the mdx mouse model of Duchenne muscular dystrophy (DMD). Treatment in utero onwards delayed onset of dystrophic symptoms in the limb muscle of young mdx mice, but did not prevent degeneration and regeneration events occurring later in the disease course. Long-term treatment had a positive effect on limb muscle pathology, reduced fibrosis, increased sarcolemmal stability, and promoted muscle regeneration in older mice. However, streptomycin treatment did not show positive effects in diaphragm or heart muscle, and heart pathology was worsened. Thus, blocking calcium channels even before disease onset does not prevent dystrophy, making this an unlikely treatment for DMD. These findings highlight the importance of analyzing several time points throughout the life of the treated mice, as well as analyzing many tissues, to get a complete picture of treatment efficacy.

Vestibular primary afferent activity in an in vitro preparation of the mouse inner ear

Most information on the properties of mammalian vestibular primary afferents has been obtained in deeply anesthetized animals, in vivo. Generally, non-human primates and larger rodents have been the species of choice. Investigations using smaller rodents, such as the laboratory mouse, have been limited despite the increasing availability of naturally occurring or engineered mutants that result in balance disorders. Furthermore, in vitro preparations of the intact peripheral vestibular apparatus are only available for non-mammalian vertebrates. To take advantage of the genetic/molecular advances available in mice and the utility of in vitro preparations that permit manipulations of the extracellular milieu, we developed an isolated mouse inner ear preparation with the attached eighth cranial nerve for electrophysiological recording. Intra-axonal recordings of background activity in vestibular primary afferents were obtained in a modified Ringer's solution (0.25 mM Ca2+; 3.25 mM Mg2+) at 22 degrees C. We also recorded afferent activity in the presence of neuroactive drugs known to affect various stages of the transduction cascade. These results, together with responses to sinusoidal mechanical deformation of the membranous ducts, showed that transduction mechanisms remain viable. Where possible, we also obtained results in vivo for comparison. In future, the in vitro mouse preparation will allow investigation of the effects of genetic manipulations and pharmacological agents on the intact peripheral vestibular apparatus.

The polycationic aminoglycosides modulate the vasoconstrictive effects of endothelin: relevance to cerebral vasospasm

1. The vasoactive peptide endothelin (ET) has been implicated in the pathogenesis of cerebral vasospasm following subarachnoid haemorrhage. In these studies we investigated the involvement of protein kinase C (PKC) in sustained vasoconstriction induced by ET-1 in canine cerebral arteries. We also examined the ability of the aminoglycoside antibiotics to reverse the effects mediated by ET-1 in canine cerebrovascular smooth muscle cells (CVSMC). 2. The ET(A) receptor antagonist, BQ-123, showed a competitive inhibition of the ET-1 responses. 3. The vasoconstrictor action of both ET-1 (0.5 nM) and phorbol myristate acetate (PMA) (160 nM) was reversed by a selective PKC inhibitor, Ro-32-0432. 4. In cerebral arteries precontracted with ET-1 the aminoglycosides caused a concentration-dependent relaxation. The EC(50s) for the relaxation were as follows: 0.54+/-0.05, 0.63+/-0.01, 1.88+/-0.46 and 2.3+/-0.92 mM for gentamicin, neomycin, streptomycin and kanamycin, respectively. 5. Gentamicin caused a concentration-dependent decrease of the PMA-induced responses in calcium free medium. 6. PKC activity was elevated in CVSMC exposed to ET-1 (170%) and PMA (167%) for a period of time (60 min) corresponding to maximum tonic contraction induced by these agents in arterial rings. 7. The administration of the aminoglycosides to CVSMC, in concentrations corresponding to the EC(50s) from contractility studies, reduced the effects of both ET-1 and PMA on PKC activity to the levels not different from controls. 8. These results show that the aminoglycosides are able to inhibit sustained vasoconstriction induced by ET-1, an effect which is due, at least in part, to the inhibition of PKC.

Effect of some fractions of alveolar surfactant (phospholipids and SP-A) on the bactericidal activity of different antimicrobials against some respiratory pathogens

OBJECTIVES

To investigate the effects of physiologic concentrations, at alveolar level, of some fractions of pulmonary surfactant (phospholipids and SP-A) on the bactericidal activity of different antimicrobials against some respiratory pathogens.

METHODS

The antimicrobial agents cefdinir, sparfloxacin, clarithromycin, teicoplanin, cefepime, ciprofloxacin, netilmicin and tobramycin, depending on their specific activity, were investigated against Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Klebsiella pneumoniae and Pseudomonas aeruginosa. Killing curves were carried out with antimicrobials at 0.5 and 2 MIC, SP-A at 1 and 5 mg/L and phospholipids at 50 mg/L.

RESULTS

Time-kill experiments showed that while SP-A never modified the activity of antimicrobials, phospholipids exerted, in some cases, a weak antagonistic effect. Among antibacterials and pathogens investigated, phospholipids were able to decrease the rate of killing of cefepime and ciprofloxacin only on P. aeruginosa, both at 0.5 and at 2 MIC, with an increase of about 1 log in CFU. The combination of SP-A and phospholipids never modified the effect observed in the presence of lipids alone.

CONCLUSIONS

The paucity of data only allow us to observe that the examined antibiotics do not have substantially reduced activity against respiratory pathogens studied in the presence of physiologic concentrations of some fractions of surfactant. Cefepime alone already exerted a small effect, and ciprofloxacin at 2 MIC, even in the presence of phospholipids, retained its bactericidal activity.

Modification of stretch-induced shortening of repolarization by streptomycin in the isolated rabbit heart

The exact mechanism of mechano-electrical feedback and stretch-induced arrhythmias is unknown, but the role of stretch-activated ion channels and specific calcium channels has been proposed. The aim of the present study was to test the hypothesis that stretch-activated ion channels and not calcium channels contribute to stretch-related alterations of repolarization and that these effects can be neutralized by stretch-activated channel block. We studied the interaction of acute ventricular dilatation and the stretch-activated channel blocker streptomycin and the specific calcium channel blocker verapamil in an isolated retrogradely perfused rabbit heart model in which the left ventricular size is modified by abruptly changing the volume of a fluid-filled balloon placed in the left ventricle. Acute ventricular dilatation led to a rate-dependent decrease in repolarization. The mean effective refractory period (ERP) and monophasic action potential duration (MAP90) for cycle lengths between 300 and 1,000 ms decreased from 174.2+/-9 ms and 178.9+/-7 ms to 161.6+/-11 ms and 169.7+/-5 ms, respectively. Streptomycin (80 microM) inhibited this stretch-related shortening of repolarization (ERP: 175.4+/-8 ms; MAP90: 179.7+/-8 ms, p < 0.05) but had almost no effect on already dilated ventricles. Counteraction of the observed electrophysiologic changes could only be achieved by increasing the streptomycin concentration to 200 microM. Streptomycin nearly completely suppressed stretch-related ectopic ventricular complexes. In contrast, verapamil (1 microM) had no effect on stretch-related changes in repolarization and stretch-induced arrhythmias. The present study indirectly implicates stretch-activated ion channels in the genesis of stretch-related changes in repolarization and arrhythmias. The electrophysiologic changes after ventricular dilatation to a degree that increases left ventricular pressure in a clinically relevant range can be influenced by the stretch-activated channel blocker streptomycin but not by specific calcium channel block. This may have clinically important implications for the development of new antiarrhythmic drugs.

Molecular parameters involved in aminoglycoside nephrotoxicity

Aminoglycoside antibiotics are hydrophilic molecules consisting of an animated cyclitol associated with amino sugar. They bind in vivo as well as in vitro to negatively charged membranes. Their use as chemotherapeutic agents is unfortunately accompanied by oto- and nephrotoxic reactions, and the purpose of this review is to examine the role of the molecular interactions between aminoglycosides and membranes in the development of nephrotoxicity. 31P Nuclear magnetic resonance (NMR) and fluorescence depolarization have been used to characterize the effect of aminoglycosides on phosphate heads and fatty acyl chains of phospholipids. 15N NMR has been used to obtain interesting information on regioselective interactions of amino groups of antibiotics with phospholipids. The binding of aminoglycosides with negatively charged membranes is associated with impairment of phospholipid catabolism, change in membrane permeability, and membrane aggregation. Biochemical analysis and 1H NMR spectroscopy have brought information on the molecular mechanism involved in the impairment of phospholipid catabolism. Nephrotoxic aminoglycosides could induce sequestration of phosphatidylinositol and therefore reduce the amount of negative charge available for optimal lysosomal phospholipase activity toward phosphatidylcholine included in liposomes that also contain cholesterol and sphingomyelin. Conformational analysis shows that aminoglycosides, which have a high potency to inhibit lysosomal phospholipase activity, adopt an orientation parallel to the lipid/water interface. This orientation of the aminoglycoside molecule at the interface is also critical to explain the marked increase of membrane permeability induced by less nephrotoxic aminoglycosides such as isepamicin and amikacin. This effect is indeed only observed with aminoglycosides oriented perpendicular to this interface, probably related to the creation of a local condition of disorder. The impairment of phospholipid catabolism, which is considered to be an early and significant step in the development of aminoglycoside toxicity, is therefore not related to the change in membrane permeability. However, the role of this latter phenomenon and of membrane aggregation for aminoglycoside nephrotoxicity could be further investigated.

Influence of pulmonary surfactant on in vitro bactericidal activities of amoxicillin, ceftazidime, and tobramycin

The influence of a natural pulmonary surfactant on antibiotic activity was investigated to assess the possible use of exogenous surfactant as a vehicle for antibiotic delivery to the lung. The influence of surfactant on the bactericidal activity of amoxicillin was tested against Staphylococcus aureus and Streptococcus pneumoniae, and the influence of surfactant on the activities of ceftazidime and tobramycin was tested against Klebsiella pneumoniae, Pseudomonas aeruginosa, S. aureus, and S. pneumoniae. In vitro antibiotic activity was determined by killing curve studies in media with and without surfactant. Amoxicillin and ceftazidime activities were not changed in the presence of surfactant, except for a decreased killing rate of S. pneumoniae by ceftazidime in medium with additional rabbit serum. In contrast, killing curves with low concentrations of tobramycin (0.25x and 1x the MIC) showed a decreased level of activity of tobramycin against all pathogens tested in the presence of surfactant. With higher tobramycin concentrations (4x the MIC) killing rates were decreased less or were unchanged in the presence of surfactant. Concluding from the results of the study, both amoxicillin and ceftazidime can be combined with surfactant without the loss of activity. For mixing surfactant with tobramycin, dosages should be adjusted to overcome the partial inactivation of tobramycin by surfactant.

Electron probe microanalysis of gentamicin-induced changes on ionic composition of the vestibular gelatinous membrane

Gentamicin-induced changes in ionic composition in the otolithic membrane of adult OF1 mice were evaluated in the gelatinous layers of the saccule and utricle by quantitative electron probe X-ray microanalysis. The otolithic membranes were plunge-frozen and freeze-dried to prevent the redistribution of elements. Quantitative analysis was carried out with an energy dispersive detector using the peak-to-background (P/B) ratio method and different salts dissolved in dextran as standards to calibrate the P/B ratio against the concentration of the elements P, S and K in the microprobe. Gentamicin selectively decreased the concentrations of P (P < 0.001) and S (P < 0.01) in the gelatinous membrane of the saccule, and had no effect in the utricle. The concentration of K also increased in the utricular gelatinous membrane (P < 0.05). The mechanism of ototoxicity in the gelatinous membrane is unknown, but the ability of aminoglycosides to block calcium channels may induce disturbances in the ionic equilibrium of the endolymphatic fluid, and thus affect the biochemical composition of the gelatinous membrane. This technique can be useful to evaluate the distribution of ions in the process of drug-induced ototoxicity.

Reduction of streptomycin-induced acute and chronic toxicities

The acute and chronic toxicities of streptomycin sulfate (SS) and of the streptomycin hydrochloride-calcium chloride complex (SCC) were compared. The LD50 determined in mice was significantly higher for SCC than for SS. Chronic toxicity was evaluated by recording the nystagmus induced by damped torsion pendulum in rabbits. SS and SCC treatments (200 mg/kg intramuscularly of absolute streptomycin base) decreased the duration, the maximal frequency, and the total number of beats of nystagmus. However, SCC-induced changes were significantly lower than SS-induced ones. The extent of the lesion in the crista ampullaris was evaluated by light and electron microscopy and was correlated with the electrophysiological findings. Because the authors also demonstrated that there are no differences in the antibacterial effects of these salts, SCC may have a place in long-term streptomycin treatment.

Behavior of antibiotics during human necrotizing pancreatitis

The aim of the study was to verify whether antibiotics excreted by the normal pancreas are also excreted in human necrotizing pancreatitis, reaching the tissue sites of the infection. Twelve patients suffering from acute necrotizing pancreatitis were treated with imipenem-cilastatin (0.5 g), mezlocillin (2 g), gentamicin (0.08 g), amikacin (0.5 g), pefloxacin (0.4 g), and metronidazole (0.5 g). Serum and necrotic samples were collected simultaneously at different time intervals after parenteral drug administration by computed tomography-guided needle aspiration, intraoperatively, and from surgical drainages placed during surgery. Drug concentrations were determined by microbiological and high-performance liquid chromatography assays. All antibiotics reached the necrotic tissues, but with varying degrees of penetration, this being low for aminoglycosides (13%) and high in the case of pefloxacin (89%) and metronidazole (99%). The concentrations of pefloxacin (13.0 to 23 micrograms/g) and metronidazole (8.4 micrograms/g) in the necrotic samples were distinctly higher than the MICs for the organisms most commonly isolated in this disease; the concentrations in tissue of imipenem (3.35 micrograms/g) and mezlocillin (8.0 and 15.0 micrograms/g) did not always exceed the MICs for 90% of strains tested, whereas the aminoglycoside concentrations in necrotic tissue (0.5 microgram/g) were inadequate. Repeated administration of drugs (for 3, 7, 17, and 20 days) seems to enhance penetration of pefloxacin, imipenem, and metronidazole into necrotic pancreatic tissue. The choice of antibiotics in preventing infected necrosis during necrotizing pancreatitis should be based on their antimicrobial activity, penetration rate, persistence, and therapeutic concentrations in the necrotic pancreatic area. These requisites are provided by pefloxacin and metronidazole and to a variable extent by imipenem and mezlocillin.

Alterations in membrane permeability induced by aminoglycoside antibiotics: studies on liposomes and cultured cells

Aminoglycoside antibiotics bind to negatively-charged membranes in vitro as well as in vivo. We have examined if this binding could be associated with a change in the properties of membrane permeability. We have used a series of aminoglycoside derivatives and two independent test systems, namely (i) the release of calcein and of Mn2+ from phosphatidylinositol-containing large unilamellar vesicles, and (ii) the influx of Ca2+ into cultured macrophages. We found that certain aminoglycosides (e.g., streptomycin, isepamicin) markedly increase the membrane permeability whereas others (e.g., gentamicin) barely or do not influence it. This increase, when it occurs, is slower or less extensive than observed with pore-forming agents (mellitin, nystatin) or a Ca(2+)-ionophore (ionomycin). It is not observed with an agent [bis(beta-diethylaminoethylether)hexestrol] known to cause membrane fusion, and is not associated with any detectable change in membrane fluidity. In computer-aided conformational analysis of mixed monolayers between phosphatidylinositol and the aminoglycosides studied, it was found that those derivatives inducing an increase in membrane permeability in our experiments adopted an orientation rather perpendicular to the interface, whereas those with no or only a moderate effect were placed in a parallel orientation to this interface. The perpendicular orientation might cause a local condition of disorder which could explain the effects observed.

Accessibility of aminoglycosides, isolated and in interaction with phosphatidylinositol, to water. A conformational analysis using the concept of molecular hydrophobicity potential

The mode of interaction between aminoglycosides and negatively charged phospholipids plays a critical role in the inhibition of lysosomal phospholipases induced by these antibiotics and therefore in their nephrotoxicity. Previous works suggested that accessibility of the drug interacting with phospholipids to water could be crucial in this respect. We have used the concept of molecular hydrophobicity potential described by Brasseur [J Med Chem 266: 16120-16127, 1991] to visualize the hydrophobic and hydrophilic envelopes around aminoglycosides assembled with phosphatidylinositol molecules, and to obtain a three-dimensional representation of the complex formed. Using a series of different aminoglycosides, we showed that molecules with a lower inhibitory potential (gentamicin B, amikacin and isepamicin) are surrounded by both hydrophobic and hydrophilic envelopes whereas aminoglycosides which are more inhibitory are enveloped primarily by either hydrophilic (kanamycin A or B) or hydrophobic (gentamicin C1a) envelopes. This approach, which is here for the first time applied to the study of drug-lipid complexes, could help in the better understanding of the molecular mechanism of lysosomal phospholipase inhibition induced by aminoglycosides.

Centrally administered aminoglycoside antibiotics antagonize naloxone-precipitated withdrawal in mice acutely dependent on morphine

The effects of i.c.v. administration of several aminoglycoside antibiotics on naloxone-precipitated morphine withdrawal symptoms were evaluated in mice acutely dependent on morphine. Neomycin (10-40 micrograms/mouse), gentamicin (40-160 micrograms/mouse) and kanamycin (80-320 micrograms/mouse) produced a dose-dependent reduction of the number of precipitated jumps, forepaw tremors and head shakes. The order of potency of the aminoglycoside antibiotics on all withdrawal symptoms was neomycin > gentamicin > kanamycin, which is the same order that these drugs show as N-type calcium channel blockers. The capacity of several drugs that decrease neuronal calcium availability (such as lanthanum and L-type calcium channel blockers) to antagonize opiate withdrawal is well known. In the light of these findings, our results suggest that the mechanism of aminoglycoside-induced inhibition of morphine abstinence may be related to the capacity of these antibiotics to block N-type calcium channels, and to decrease neuronal calcium availability.

The polycationic compound gentamicin inhibits the calcium paradox in guinea-pig hearts

The polycationic drug gentamicin and two calcium antagonists were studied with respect to their protecting action against the calcium paradox in perfused guinea-pig hearts. Besides the mechanograms the release of creatine kinase was recorded; in parallel experiments the Na(+)-content of the hearts was measured before and at the end of the Ca(2+)-lack period, and during re-exposure to normal [Ca2+]0. The calcium paradox was induced by perfusion, for 50 s, with Ca(2+)-free solution containing EGTA (3 x 10(-4) M). Nifedipine and verapamil in concentrations which reduced the equilibrium contractile force by 50%, only mitigated the extent of the calcium paradox, whereas gentamicin applied in a concentration also reducing the contractile amplitude by 50% was able to suppress the calcium paradox completely. The dose-response curves for nifedipine, with respect to the reduction of contractile force and contracture, were identical. In contrast, gentamicin was more effective in attenuating the contracture of the paradox than in reducing the equilibrium contractile force. The large gain of Na+ during the Ca(2+)-lack period was diminished by both nifedipine and gentamicin. The partial protection of calcium antagonists can be related to their interference with the uptake of Na+ through L-type Ca(2+)-channels during the Ca(2+)-lack period, whereas gentamicin seems to act by an additional inhibition of the Na/Ca exchange during the re-exposure to normal [Ca2+]0.

Tubular injury and regeneration in the rat kidney following acute exposure to gentamicin: a time-course study

Aminoglycoside antibiotics act as nephrotoxic drugs, inducing a lysosomal phospholipidosis and necrotic lesions essentially in convoluted proximal tubules. Previous studies have demonstrated that tubular injury caused by these compounds elicits a process of renal tissue repair (tubular regeneration) involving an increase of cell turnover in tubular epithelium. The present study was performed in order to: (i) achieve further insight into the temporal relationship between aminoglycoside-induced phospholipidosis, tubular necrosis, and tubular regeneration; and (ii) approach the control of tubular regeneration after nephrotoxin-induced insult. To investigate the latter point, we examined by immunocytochemistry the intrarenal distribution of epidermal growth factor (EGF) during tubular regeneration. Five groups of female Sprague-Dawley rats (n = 5) were treated for 4 days with gentamicin i.p. at a daily dose of 50 mg/kg delivered in 2 injections per day. Sham-treated animals (n = 5) received an equivalent amount of vehicle (0.9% NaCl) according to the same protocol. Groups of treated rats, and controls, were terminated 16 h (day 1), 4 days, 7 days, 14 days, and 21 days after the end of gentamicin administration. One hour prior to necropsy, each animal was given an i.p. injection of 40 mg 5-bromo-2'-deoxyuridine (BrdU) for the immunocytochemical demonstration of S-phase cells, using an anti-BrdU monoclonal antibody. Renal tissue was processed for light microscopy analysis, namely: a computer-aided morphometry of lysosomes in proximal tubular cells, a single-blind evaluation of gentamicin-induced tubular injury, the measurement of cell proliferation by immunocytochemical detection of BrdU-labeled nuclei, the demonstration of EGF-like immunoreactive material in renal tissue by using anti-rat EGF antiserum and immunogold-silver staining. As revealed by the morphometry of lysosomes in proximal tubular epithelium, the degree of gentamicin-induced phospholipidosis was maximum at day 1 (relative area occupied by lysosomes was increased 25-fold over mean control value) and declined thereafter. In contrast, tubular necrosis reached a peak 4 days after the end of drug administration. In proximal tubular epithelium, the stimulation of cell turnover associated with tubular regeneration showed a peak at day 7 (15-fold the mean control value). Tubular regeneration was also accompanied by mild interstitial hyperplasia. Three weeks after treatment with gentamicin, morphological evidence of drug-induced injury had disappeared due to the tissue repair process, except for the occasional presence of small hyperplastic foci in renal cortex interstitium. In both treated animals and controls, EGF immunoreactivity as revealed by immunocytochemical staining was associated with distal tubules (renal cortex and outer medulla).(ABSTRACT TRUNCATED AT 400 WORDS)

Streptomycin blocks the postsynaptic effects of excitatory amino acids on the vestibular system primary afferents

It has been suggested that streptomycin might be an antagonist of the glutamate receptors, and that it selectively blocks quisqualic acid receptors. We studied whether streptomycin blocks the responses to excitatory amino acid agonists on the vestibular system primary afferents, and if it allows us to differentiate between kainate (KA) and quisqualate (QA) receptor mediated responses. The experiments were performed in the axolotl (Ambystoma tigrinum). Intra- and extracellular records of the electrical activity of semicircular canal afferent fibers were obtained. Drugs were applied by pressure ejection in volumes of 20 microliters in a 10 ml bath. Streptomycin (0.01-10 mM), induced a dose dependent reversible inhibition of the basal spike discharge of the afferent fibers. This coincided with a reduction in the amplitude of excitatory postsynaptic potentials (EPSP) recorded intracellularly in the afferent fibers. Streptomycin also blocked the excitatory action produced by KA and QA; increasing concentrations of streptomycin produced a rightward shift in the concentration-response curves for both KA and QA. This action persisted even in a high Mg2+ (10 mM), low Ca2+ (0.09 mM) Ringer solution, indicating its postsynaptic nature. These results show that streptomycin might be a non-selective excitatory amino acid (EAA) receptor antagonist.

Analgesic effects of centrally administered aminoglycoside antibiotics in mice

The possible analgesic effects of i.c.v. administration of several aminoglycoside antibiotics were evaluated in mice using hot plate and tail flick tests. Neomycin (10-80 micrograms/mouse), gentamicin (40-160 micrograms/mouse) and kanamycin (80-320 micrograms/mouse) produced dose-dependent increases in the latencies to forepaw licking and jumping in hot plate test. These drugs also produced dose-dependent increases in the percentage of animals showing analgesia in tail flick test. The order of potency of these aminoglycoside antibiotics in both tests was neomycin greater than gentamicin greater than kanamycin, which is exactly the same order that these drugs show as N-type calcium channel blockers. Bearing in mind this fact and the well known analgesic activity of several drugs which decrease neuronal calcium availability, we suggest that the mechanism of aminoglycoside-induced antinociception may be related to the capacity of these antibiotics to block N-type calcium channels and decrease neuronal calcium availability.

Effect of acidic phospholipids on the activity of lysosomal phospholipases and on their inhibition induced by aminoglycoside antibiotics--II. Conformational analysis

In a companion paper (Mingeot-Leclercq et al. Biochem Pharmacol 40: 489-497, 1990), we showed that the inhibitory potency of gentamicin on the activity of lysosomal phospholipases, measured towards phosphatidylcholine included in negatively-charged liposomes, is markedly influenced by the nature of the acidic phospholipid used (phosphatidylinositol, phosphatidylserine, phosphatidic acid), whereas the binding of the drug to the three types of liposomes is similar. This result challenged previous conclusions pointing to a key role exerted by drug binding to phospholipid membranes and presumably charge neutralization, for phospholipases inhibition (Carlier et al. Antimicrob Agents Chemother, 23: 440-449, 1983; Mingeot-Leclercq et al., Biochem Pharmacol 37:591-599, 1988). Conformational analysis of mixed monolayers of gentamicin and each of the three acid phospholipids shows that gentamicin systematically adopts an orientation largely parallel to the hydrophobic-hydrophilic interface, but that (i) the energies of interaction are largely different (phosphatidylinositol greater than phosphatidylserine greater than phosphatidic acid), and (ii) the apparent accessibility of the bound drug to water varies in an inverse relation with the energies of interaction. Amikacin, a semisynthetic derivative of kanamycin A with a lower inhibitory potential towards phospholipases than gentamicin in the three types of liposomes used, also showed similar differences in energies of interaction and accessibility to water, but constantly exhibited an orientation perpendicular to the hydrophobic-hydrophilic interface. We conclude that impairment of lysosomal phospholipase activities towards phosphatidylcholine included in negatively-charged membranes by aminoglycoside antibiotics is indeed dependent upon drug binding to the bilayer, but is also modulated by (i) the nature of the acidic phospholipid, which influences the energy of interaction and the accessibility of the drug with respect to the hydrophilic phase, and (ii) the orientation of the drug, which it itself related to its chemical structure. Inasmuch as phospholipases inhibition is related to aminoglycoside nephrotoxicity, these findings may help in better defining the molecular determinants and mechanisms responsible for this adverse effect.

Effect of acidic phospholipids on the activity of lysosomal phospholipases and on their inhibition by aminoglycoside antibiotics--I. Biochemical analysis

Aminoglycoside antibiotics accumulate in lysosomes of kidney and cultured cells and cause an impairment of phospholipid catabolism which is considered to be an early and significant step in the development of their toxicity. Using liposomes, wer previously demonstrated that the activity of lysosomal phospholipases A1 and A2 towards phosphatidylcholine was markedly enhanced by the inclusion of phosphatidylinositol in the bilayer, and that gentamicin impaired this activity by binding to phosphatidylinositol. Since gentamicin-induced inhibition was inversely related to the amount of phosphatidylinositol included in the liposomes, we proposed that gentamicin impairs activity of phospholipases by decreasing the quantity of available negative charges carried by the bilayer surface (Mingeot-Leclercq et al., Biochem Pharmacol 37: 591-599, 1988). We now extend these observations to phosphatidylserine and phosphatidic acid, and compare the inhibition caused by gentamicin, amikacin and streptomycin towards lysosomal phospholipases on the hydrolysis of phosphatidylcholine in the presence of each of these acidic phospholipids. Inclusion of phosphatidic acid in liposomes, and, to a lesser extent, phosphatidylserine, caused a larger increase in phospholipases activity than phosphatidylinositol. In parallel, the three aminoglycosides tested were found less inhibitory towards phospholipases activity measured on phosphatidic acid-or phosphatidylserine-containing liposomes than was previously observed with phosphatidylinositol, even though equilibrium dialysis experiments failed to demonstrate significant difference in binding parameters of the drug towards each of these liposomes populations. Yet, as for phosphatidylinositol-containing liposomes, the inhibition was inversely related to the amount of phosphatidic acid or phosphatidylserine included in the bilayer and the inhibitory potency of the three drugs was consistently gentamicin greater than amikacin greater than streptomycin with the three types of negatively-charged liposomes used. We conclude that impairment of lysosomal phospholipases activity towards phosphatidylcholine included in negatively-charged membranes by aminoglycoside antibiotics is dependent upon drug binding to the bilayer, but that it is modulated by the nature of the acidic phospholipid that binds the drug as well as by that of the drug itself. A companion paper (Mingeot-Leclercq et al., Biochem Pharmacol 40: 499-506, 1990) will examine by computer-aided conformational analysis the parameters (drug-phospholipid energy of interaction, position of the drug in a monolayer and its accessibility to the aqueous phase) which may be important for these effects.

Increased levels of protein- and lipid-bound sialic acids in the renal cortex of rats injected with low doses of gentamicin

Administration of the aminoglycoside antibiotic, gentamicin, even at therapeutic doses, causes renal lysosomal phospholipidosis. We now report that protein- and lipid-bound sialic acid levels are increased significantly in a time-dependent fashion in the renal cortex of rats injected with gentamicin (10 mg/kg body wt. per day) for 4-10 days and a significant relationship could be observed between these two parameters. This elevation was not due to tissue regeneration, since it was not observed in cisplatin-treated animals.

Differentiation between negative inotropic drugs by means of potentiated post-rest contractions in guinea-pig heart

1. It was tested using isolated guinea-pig atria whether negative inotropic drugs could be differentiated by measuring force under both equilibrium conditions and after a rest period leading to potentiated beats. 2. A drug believed to interfere with sarcoplasmic reticular function, ryanodine, preferentially suppressed potentiated beats, whereas the calcium antagonists gallopamil and felodipine selectively depressed force under continuous stimulation. 3. Gentamicin and doxorubicin also exerted characteristic effects on the two force parameters, the former resembling calcium antagonists, the latter ryanodine. 4. The method used is suitable for a descriptive classification of negative inotropic drugs, possibly according to their cellular mode of action.

Model of gentamicin-induced nephrotoxicity and its amelioration by calcium and thyroxine

The exact mechanism of gentamicin-induced acute renal failure is presently unknown; various mechanisms have been proposed but there is no proposed commonality between them. In animals, dietary calcium loading and L-thyroxine administration have been shown to ameliorate toxicity, with again no common process. A mechanism of competitive displacement of calcium and other cations from anionic phospholipids at the plasma and organelle membrane level, resulting in a decrease in Na+ -K+ ATPase, adenylate cyclase, mitochondrial function and ATP production, protein synthesis, solute reabsorption and overall cellular function is proposed. A further proposal is dietary calcium loading and thyroxine (which increases intracellular calcium) reverse gentamicin-induced acute renal failure by increasing the calcium and solute flux, thereby competitively inhibiting the primary lesion: anionic phospholipid binding.

Comparison of the effects of calcium and the calcium channel stimulant Bay k 8644 on neomycin-induced neuromuscular blockade

The effects of calcium and the calcium channel stimulant Bay k 8644 on neomycin-induced neuromuscular blockade were evaluated using rat phrenic nerve-hemidiaphragm preparations in vitro. neomycin showed maximum potency in inducing neuromuscular blockade when the calcium concentration in the bath was 1 mM. Higher calcium concentrations (1.5, 2 and 4 mM) produced a gradual decrease in neomycin potency, manifested as a progressive shift to the right of neomycin concentration-response curves. Bay k 8644 (0.1 and 1 microM) did not significantly modify indirectly elicited diaphragm contractions per se, nor did it antagonize neomycin-induced neuromuscular blockade. A higher concentration of Bay k 8644 (10 microM) antagonized indirectly elicited contractions. In conclusion, our results show that Bay k 8644, at concentrations causing calcium channel stimulation at the cardiac and vascular level, did not exert stimulant effects in a nerve-skeletal muscle preparation, suggesting that its action may be tissue-selective to a certain degree.

Comparison between the activities of cationic amphiphilic drugs to affect phospholipid-membranes and to depress cardiac function

The activity of cationic amphiphilic compounds to affect artificial phospholipid-membranes was compared with the membrane-stabilizing cardiodepressant potency of the drugs. The twenty-one investigated catamphiphilic compounds belonged to various pharmacological groups including antiarrhythmic, local anaesthetic, beta-blocking, antimalarial, and psychoactive drugs. The perturbing action of the drugs on phospholipid-membranes was evaluated by determining the drug-effect on the temperature of the phase-transition from the gel to the liquid crystalline state in liposomes of dipalmitoylphosphatidic acid by means of differential scanning calorimetry. The ability to interact with the polar headgroups of phospholipid-membranes was measured by recording the effects of the cationic compounds on the binding of 45Ca2+ to monomolecular layers of phosphatidylserine. The cardiodepressant action was observed in Langendorff-preparations of guinea-pig hearts. The drug-effect on excitability was indicated by the elevation of the threshold-intensity of 50 Hz alternating current to induce ventricular arrhythmia. For the sake of comparison, the negative chronotropic and inotropic effects were evaluated. There was only a moderate correlation found between the activities of the drugs to reduce the transition temperature and to inhibit 45Ca2+ -binding (r = 0.69). This result probably reflects that both methods look upon different consequences of the drug-phospholipid interaction. The membrane-stabilizing, anti-excitatory potency corresponded favourably with the ability of the drugs to affect the phospholipids. Almost 80% of the variance between the anti-excitatory potencies could be accounted for by the drug-phospholipid interactions. The negative chronotropic and inotropic effects accompanying the anti-excitatory actions were similar for most of the drugs. The results of the study are compatible with the hypothesis that the interaction with phospholipid-membranes is a major determinant of the membrane-stabilizing cardiodepressant potency of cationic amphiphilic drugs.

The influence of pH on the cardiac depressant action of tobramycin

Tobramycin, like other aminoglycoside antibiotics, is a basic compound which causes a reduction of cardiac contractile force and inhibits the inotropic action of calcium. Its antagonistic action towards calcium had been analysed at different pH values of the solution bathing the rat left atrium. The isometric tension of the electrically driven atrium (4 Hz, 2 ms, supramaximal voltage) in response to cumulative increase in the bath calcium concentration (2.0 to 32.0 mM) was measured in the absence and in the presence of 2.0 x 10(-5) M tobramycin. The increase in pH from 6.6 to 8.2, which decreased the ionization of tobramycin, reduced the cardiac depression. Similar experiments were carried with other cardiac depressants. Thus, the effect of methoxyverapamil (3.5 x 10(-7) M), also a basic compound, was increased at higher values of pH; the acidic pentobarbitone (4 x 10(-5)M) was less effective at more alkaline pH; the cardiac depression of the non-electrolyte ethanol (2 x 10(-4)M) was practically the same over the pH range studied. The time for equilibrium of the antagonism was small for tobramycin, moreover, its antagonism could only be fully reversed by an increase in extracellular calcium. These results suggest a competitive type of antagonism, between the ionized fraction of tobramycin and calcium, for superficial sites of the sarcolemma. The effect of methoxyverapamil, pentobarbitone and ethanol seems to occur at a more internal site of the cardiac cell since the unionized form of the drug is the most active.

Ultrastructural, physico-chemical and conformational study of the interactions of gentamicin and bis(beta-diethylaminoethylether) hexestrol with negatively-charged phospholipid layers

Aminoglycoside antibiotics such as gentamicin, which are fully hydrophilic, and cationic amphiphilic drugs such as bis(beta-diethylaminoethylether)hexestrol (DEH), are both known to inhibit lysosomal phospholipases and induce phospholipidosis. This enzymatic inhibition is probably related to the neutralization of the surface negative charges on which the lysosomal phospholipases A1 and A2 are dependent to express fully their activities (Mingeot-Leclerq et al., Biochem Pharmacol 37: 591-599, 1988). Using negatively charged liposomes, we show by 31P NMR spectroscopy that both gentamicin and DEH cause a significant restriction in the phosphate head mobility and, in sonicated vesicles, the appearance of larger bilayer structures. Both DEH and gentamicin increased the apparent size of sonicated negatively charged liposomes (but not of neutral liposomes) as measured by quasi-elastic light scattering spectroscopy. Examination of replicas from freeze-etched samples, however, revealed that gentamicin caused aggregation of liposomes, whereas DEH induced their fusion and the formation of intramembranous roundly shaped structures. Only DEH caused a significant decrease of the fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene, a fluorescent lipid-soluble probe. In addition, DEH, but not gentamicin, interfered with the bilayer to hexagonal phase transition occurring in dioleoyl- and dielaidoylphosphatidylethanolamine liposomes upon warming, and caused the appearance of an isotropic signal suggestive of the formation of inverted micelles. In computer-aided conformational analysis of the molecules at a simulated air-water interface, gentamicin was shown to display a largely-open crescent shape. When surrounded by phosphatidylinositol molecules, it remained as such at the interface which it locally mis-shaped, establishing close contact with the negatively charged phospho groups. In contrast, DEH could be oriented perpendicularly to the interface, with its two cationic groups associated with the phospho groups, and its phenyl- and diethylethandiyl moieties deeply inserted between and interacting with the aliphatic chains. Thus, although both agents cause lysosomal phospholipases inhibition, the differences in their interactions with negatively-charged bilayers is likely to result in a different organization of the phospholipids accumulated in vivo, which could lead to different toxicities.

Blockage of the transduction channels of hair cells in the bullfrog's sacculus by aminoglycoside antibiotics

The action of aminoglycoside antibiotics on transduction by hair cells was investigated in isolated preparations of the bullfrog's sacculus. Bath application of aminoglycosides produced a reversible blockage of extracellularly recorded responses to displacements of the otolithic membrane. The half-blocking concentrations for various drugs were in the range 2-95 microM. The effect of dihydrostreptomycin on the receptor currents of individual hair cells was studied under two-electrode, voltage-clamp conditions. Iontophoretic application of drug to the apical cellular surface caused a reduction of the receptor current within 20 ms; the reduction was reversible within 1 s. The effect was most striking at holding potentials more negative than -60 mV and was relieved by depolarization. The effect of intracellular aminoglycosides was investigated in cells voltage-clamped with the tight-seal, whole-cell technique. Gentamicin and dihydrostreptomycin, at concentrations near 100 microM, did not block transduction under these conditions. The acute, reversible blocking effect of aminoglycosides therefore occurs from the extracellular membrane surface. The results are consistent with aminoglycosides' plugging the poorly ion-selective transduction channels of hair cells.

The effect of gentamicin on the biophysical properties of phosphatidic acid liposomes is influenced by the O-C = O group of the lipid

We previously reported that gentamicin binds to liposomes composed of anionic phospholipids and depresses glycerol permeability and raises the activation energy for glycerol permeation in these liposomes. We postulated that these changes in the glycerol permeability and in the activation energy (Ea) for glycerol permeation were due to hydrogen bonding between O-C = O groups in the hydrogen belt and one or more amino groups of gentamicin. To test this hypothesis, we examined the effects of gentamicin on the membrane surface potential, the glycerol permeability coefficient (p), the Ea for glycerol permeation, and the aggregation of liposomes composed of 1:1 phosphatidylcholine (PC) and phosphatidic acid with the acyl chains of phosphatidic acid in either an ester (PA) or an ether (PA*) linkage. Gentamicin depressed the membrane surface electrostatic potential, measured by the partitioning of methylene blue between the bulk solution and the liposomal membrane, to an equivalent degree in PC-PA and PC-PA* liposomes, which indicates that substitution of the ether for the ester linkage did not interfere with the electrostatic interaction between the cationic drug and the negatively charged phosphate head group. Gentamicin caused a temperature-dependent decrease of p and raised Ea for glycerol permeation from 17.7 +/- 0.3 to 21.6 +/- 0.4 kcal/mol in PC-PA liposomes but had little or no effect on these parameters in PC-PA* liposomes. In contrast, gentamicin induced a significantly greater degree of aggregation of PC-PA* liposomes compared to that of PC-PA liposomes.(ABSTRACT TRUNCATED AT 250 WORDS)

Gentamicin causes the fast depression of action potential and contraction in cultured cardiocytes

The short-term cardiotoxic effects of gentamicin were studied on electrical and mechanical activities in cultures of ventricular confluent cardiocytes of rats. Application of gentamicin to the bath lowered the spontaneous action potential firing rate which was restored when the external calcium was elevated. Fast local application and withdrawal of drugs to non-pacemaker cells allowed effect/dose curves to be made. Such application of 200 nmol gentamicin (approximated concentration: 0.8 x 10(-3)-8.0 x 10(-3) M) lowered the contraction amplitude by 50% and the action potential overshoot by 20% while the action potential duration and maximum diastolic potential remained unchanged. Gentamicin withdrawal was followed by a rapid (half time = 5 s) and complete restoration of contraction. Verapamil, Mn2+, EDTA and La3+ also diminished contraction and overshoot but their effects were reversed 28, 25, 6 and 1.5 times more slowly, respectively. Gentamicin, like La3+, could act extracellularly, probably by competing with calcium ions for some external membrane site.

Neomycin inhibits the calcium current of Paramecium

The duration of high-K+ stimulated backward swimming is a commonly used bioassay for estimating the amplitude of the inward calcium current of Paramecium. Electrophysiological analysis confirmed that concentrations of neomycin which decreased the duration of stimulated backward swimming also reduced the isolated inward calcium current. Other polycations were also effective in this bioassay and their effectiveness was correlated with the number of their positive charges. Paramecium is therefore a convenient model system for studying the effects of compounds such as neomycin on calcium currents as well as their mechanisms of action.

Biochemical mechanism of aminoglycoside-induced inhibition of phosphatidylcholine hydrolysis by lysosomal phospholipases

Aminoglycosides such as gentamicin are hydrophilic, polycationic drugs which bind to negatively-charged phospholipid bilayers, inhibit the activities of the lysosomal enzymes involved in the degradation of the major phospholipids and cause, in kidney in vivo or in cultured cells, a lysosomal phospholipidosis. In the present study, we show that the hydrolysis of phosphatidylcholine induced in liposomes by lysosomal extracts at pH 5.4 in vitro is critically dependent on the negative charges carried by the bilayer. This hydrolysis, which is predominantly carried on by phospholipases A1 and A2, markedly increases when the phosphatidylinositol content is raised from 10 to 30% of the total phospholipids, i.e. in a range found in natural membranes. Addition of gentamicin decreases the activity of these enzymes in a non-competitive fashion, but the effect is inversely proportional to the amount of phosphatidylinositol present in the bilayer. Gentamicin and bis(beta-diethylaminoethylether)hexestrol (DEH), a cationic amphiphile which also binds to phospholipid bilayers, are equipotent inhibitors when added to negatively-charged liposomes at equinormal concentrations. Although direct aminoglycoside-enzyme interactions cannot be excluded, these results strongly suggest that gentamicin impairs the activities of the lysosomal phospholipases towards phosphatidylcholine by decreasing the available negative charges required for optimal activity.

Opposite effects of amines on lymphocyte- and monocyte-mediated ADCC

The effect of different amines on antibody-dependent cellular cytotoxicity (ADCC) activity of human mononuclear cells was tested. Whereas monocyte cytotoxic capacity was significantly stimulated in the presence of methylamine (MA), dansylcadaverine (DC) and glycine ethylester (GEE), lymphocyte ADCC was markedly suppressed by these agents. The pharmacological actions of these compounds in our system are not related to their ability to inhibit transglutaminase (TGase) enzymes, since tertiary amines such as sarcosine ethylester (SEE) and chloroquine (CQ) elicited identical responses to MA, DC and GEE. The calmodulin (CAM) inhibitors trifluoperazine (TFP) and the more specific N-(6-aminohexyl)-5-chloro-1-naphtalene sulfonamide (W-7) [Hidaka, Sasaki, Tanaka, Endo, Ohno, Fujii & Nagata (1981) Proc. natn. Acad. Sci. U.S.A., 78, 4353-4357] mimicked the effects of amines on ADCC, suggesting the possibility that a CAM-regulated process might be involved in the functional changes provoked by amines on ADCC. Finally, binding of 125I-immune complexes to the effector cells in the presence of amines showed lack of correlation between alterations in ADCC capacity and Fc gamma R expression.

Effects of neomycin on calcium channel currents in clonal GH3 pituitary cells

Membrane Ca currents were recorded from voltage-clamped clonal (GH3) pituitary cells under conditions where currents through Na and K channels were abolished. Two Ca currents, with distinct kinetics and voltage dependence for activation and inactivation, were identified. Neomycin, an aminoglycoside polycation, inhibited both the "transient" (ICa,t) and the "slowly-inactivating" (ICa,s) Ca currents in a dose-dependent manner (100-1,000 microM). The blockade was reversible and ICa,s was more sensitive to neomycin than ICa,t. The inhibition of ICa,s was frequency and time-independent, and was not affected by changes in the holding membrane potential (-35 to -100 mV). Neomycin did not affect the voltage dependence for inactivation of ICa,t. The blockade of both Ca currents by neomycin is ascribed to the general property of aminoglycosides to compete with, and displace Ca ions from membrane binding sites that determine the currents and selectivity of Ca channels. Because comparable concentrations of neomycin were required for blocking the currents conveyed by Ca or, in the absence of external divalent cations, by Na ions through the slowly-inactivating Ca channels, we suggest that the neomycin binding sites are distinct from the high-affinity transition sites within the Ca channel path.

Binding of propranolol and gentamicin to small unilamellar phospholipid vesicles. Contribution of ionic and hydrophobic forces

Binding of propranolol and gentamicin to small unilamellar phospholipid vesicles having different surface charges was studied at pH 4.4 using an ultra-centrifugation method, and the results were analyzed by an equation describing the Langmuir adsorption isotherms. Gentamicin, a polycationic drug, bound to negatively-charged small unilamellar vesicles composed of 60% phosphatidylcholine and 40% of either phosphatidylinositol, phosphatidylglycerol or phosphatidylserine in a manner consistent with a single class of binding sites but did not bind at all to small unilamellar vesicles of phosphatidylcholine alone. In contrast, propranolol bound readily to both neutral and negatively-charged liposomes in a manner consistent with two types of binding sites. Based on the binding parameters calculated from replots, it is suggested that the high-affinity site is probably at the surface of the liposome and that ionic forces are primarily responsible for this binding. The low-affinity, high-capacity binding site for propranolol was demonstrated with both neutral and negatively-charged liposomes and appeared to be independent of the surface charge. Gentamicin, which is not hydrophobic, did not bind to the low-affinity site. It is hypothesized that hydrophobic interactions are the driving force for propranolol binding to the low-affinity site which may be the interior of the lipid bilayer.

Functional-morphologic correlations in assessing renal toxicity

Evaluation of the correlation of functional and morphologic assessments of renal toxicity are obviously important to the toxicologic pathologist. All clinical assessments of the nephrotoxicity of drugs are based on renal function tests while preclinical assessments involve functional and/or morphologic assessments in laboratory animals. However, there are considerable concerns about the sensitivity of the tests available to monitor renal function. In an attempt to assess the relative sensitivity of functional and morphologic indicators of nephrotoxicity, three data bases were examined for their ability to rank the nephrotoxicity of the three most widely used aminoglycosides. The functional data base was comprised of reported comparative clinical trial data and the morphologic data base was composed of preclinical studies available in the literature which used morphology as the basis of comparison. A third data base involved biochemical or mechanistic comparisons of aminoglycosides and represented data that was not based on clinical function test results or morphologic analysis. When these three data bases were compared, it was obvious that clinical function tests could not discriminate between the nephrotoxic liability of the three aminoglycosides. The preclinical renal morphology data base and the biochemical mechanistic data base both clearly discriminated the drugs one from another and ranked the three aminoglycosides in the same order. Several conclusions were suggested by these results. Comparisons of the nephrotoxic potentials of drugs in patients utilizing available renal function tests may be inconclusive primarily because clinical renal function tests are insensitive. Comparisons of the nephrotoxic liabilities of drugs in laboratory animals utilizing morphologic assessments of renal tissue damage may be the best comparison available.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of aminoglycoside antibiotics on bound calcium and contraction in guinea-pig atria

We studied the effect of three aminoglycoside antibiotics which have been shown to replace Ca from lipid monolayers on the superficially bound Ca of isolated beating left atria from guinea-pigs. The cellular Ca content was determined by means of 45Ca after having attained complete exchange. The antibiotics dibekacin, sisomicin, and gentamicin, all reduced the cellular Ca content by 10-20% in a dose-dependent manner. The loss of superficially bound Ca was accompanied by a decline of the contractile force by 40-90%. It is concluded that in isolated atrial muscle it is the amount of Ca bound to the outer surface of the cardiac plasmalemma, rather than the extracellular Ca2+ concentration, that determines contraction height.

Interaction of streptomycin and streptomycylamine derivatives with negatively charged lipid layers. Correlation between binding, conformation of complexes and inhibition of lysosomal phospholipase activities

Aminoglycoside antibiotics induce a lysosomal phospholipidosis in kidney proximal tubules after conventional therapy in animals and man. We have previously demonstrated that these drugs bind to negatively charged phospholipid bilayers at acid pH and inhibit the activity of lysosomal acid phospholipases in vitro and in vivo. A combined biochemical and conformational study [Brasseur et al., Biochem. Pharmac. 33, 629 (1984)] showed major and consistent differences between 6 aminoglycosides in current clinical use with respect to the stability of the complexes they form with phosphatidylinositol, their inhibitory potency towards the activity of lysosomal phospholipases and their current toxicity ranking (e.g. gentamicin greater than amikacin greater than streptomycin). In the present study we have extended this approach to experimental derivatives of streptomycin. The derivatives examined were: dihydrostreptomycin, dideguanyldihydrostreptomycin, streptomycylamine, dideguanylstreptomycylamine, N-butyl- and N-benzyl-dideguanylstreptomycylamine. These compounds were examined for (i) their binding to negatively charged liposomes, measured by gel permeation on Sepharose 4B; (ii) their interactions with phosphatidylinositol assessed by semi-empirical conformational analysis and (iii) their inhibitory effect on the activities of lysosomal phospholipases towards phosphatidylcholine present in negatively charged liposomes. Streptomycin and gentamicin were also used as reference compounds with low and high affinity (and inhibitory potency), respectively. Our observations can be summarized as follows: (i) the replacement of the aldehyde in the streptose ring by a methylamino group strikingly changes the conformation of the molecule, allowing a better interaction with phosphatidylinositol. Thus, streptomycylamine binds much more tightly to phospholipid bilayers and shows a higher inhibitory potency towards phospholipase activity, as compared to streptomycin. The conformational analysis shows, however, that this effect is only partially due to the additional cationic charge carried by streptomycylamine. Other modifications of the streptomycin molecule, such as the replacement of the guanidinium groups by aminogroups or the addition of hydrophobic moieties (butyl or benzyl groups) to the streptose do not markedly further strengthen the interactions of the molecule with phosphatidylinositol. (ii) Even though some derivatives (e.g. dideguanylstreptomycylamine) bind as tightly to phospholipids as gentamicin, they remain much less inhibitory towards lysosomal phospholipases.(ABSTRACT TRUNCATED AT 400 WORDS)

Induction of methotrexate release from rat hepatocytes in suspension by alpha-adrenergic agents: involvement of calcium and metabolic energy

Hepatocytes in suspension which have accumulated [3H]methotrexate release the antifolate compound into the medium upon exposure to alpha-adrenergic agents. In the presence of metabolic poisons, such as sodium azide, dinitrophenol, or dicumarol, the release of methotrexate is attenuated, indicating that integrity of the cellular metabolic apparatus is required for response to the hormonal stimulus. In the presence of millimolar concentrations of the organic acid, probenecid, release of cellular methotrexate may be reduced (1 mM probenecid) or eliminated (2 mM probenecid), suggesting the involvement of a "membrane carrier." Microtubule poisons such as vincristine, vinblastine, and griseofulvin do not modify epinephrine + isobutyl methyl xanthine (IBMX)-induced release of methotrexate. The involvement of calcium in release of methotrexate from the hepatocyte is substantiated by a dose-dependent response to the calcium ionophore, A23187, in the presence of calcium, with a lack of response in the absence of calcium. These effects of A23187 are not related to inhibition of methotrexate influx. Other putative "calcium antagonists" such as tetracaine, neomycin sulfate, and 3,4,5-trimethoxybenzoic acid [8-(diethylamino)octyl ester], do not interfere with epinephrine + IBMX-induced release of [3H]methotrexate, suggesting that these agents may not be effective probes of calcium flux in the liver cell.

Interaction of gentamicin and spermine with bilayer membranes containing negatively charged phospholipids

We measured the electrophoretic mobility of multilamellar phospholipid vesicles, the 31P NMR spectra of both sonicated and multilamellar vesicles, and the conductance of planar bilayer membranes to study the binding of spermine and gentamicin to membranes. Spermine and gentamicin do not bind significantly to the zwitterionic lipid phosphatidylcholine. We measured the concentrations of gentamicin and spermine that reverse the charge on vesicles formed from a mixture of phosphatidylcholine and either phosphatidylserine or phosphatidylinositol. From these measurements, we determined that the intrinsic association constants of the cations with these negative lipids are all about 10 M-1. This value is orders of magnitude lower than the apparent binding constants reported in the literature by other groups because the negative electrostatic surface potential of the membranes and the resultant accumulation of these cations in the aqueous diffuse double layer adjacent to the membranes have not been explicitly considered in previous studies. Our main conclusion is that the Gouy-Chapman-Stern theory of the aqueous diffuse double layer can describe surprisingly well the interaction of gentamicin and spermine with bilayer membranes formed in a 0.1 M NaCl solution if the negative phospholipids constitute less than 50% of the membrane. Thus, the theory should be useful for describing the interactions of these cations with the bilayer component of biological membranes, which typically contain less than 50% negative lipids. For example, our results support the suggestion of Sastrasinh et al. [Sastrasinh, M., Krauss, T. C., Weinberg, J. M., & Humes, H. D. (1982) J. Pharmacol. Exp. Ther. 222, 350-358] that phosphatidylinositol is the major binding site for gentamicin in renal brush border membranes.

Characterization of aminoglycoside-lipid interactions and development of a refined model for ototoxicity testing

Aminoglycoside interactions with various phospholipids were measured in three model systems and compared with the ototoxicities of the drugs: (a) competition for [14C]neomycin binding; (b) competition for 45Ca2+ binding; and (c) effect on surface pressure of monomolecular lipid films. The efficacies of the antibiotics in displacing neomycin from phosphatidylserine, phosphatidylinositol or phosphatidylinositol bisphosphate were netilmicin greater than neomycin greater than or equal to gentamicin; the efficacies in displacing calcium from phosphatidylinositol, phosphatidylinositol phosphate or phosphatidylinositol bisphosphate were netilmicin greater than gentamicin greater than neomycin much greater than kanamycin greater than spectinomycin. Neither measure correlated well with the ototoxicities of the drugs which were quantitated at equimolar drug concentrations in cochlear perfusions: neomycin greater than gentamicin greater than or equal to tobramycin greater than netilmicin greater than or equal to amikacin. When monomolecular films of phosphatidylcholine with phosphatidylserine, cardiolipin, phosphatidylinositol, or phosphatidylinositol phosphate or bisphosphate were challenged with neomycin, the phosphatidylinositol bisphosphate film showed a unique dose-dependent increase in surface pressure while the others showed a decrease or no significant effect. The abilities of aminoglycosides to increase the surface pressure of a film of phosphatidylcholine:phosphatidylinositol bisphosphate (1:1 molar ratio) in the presence of 3 mM CaCl2 correlated well with their toxicities. Non-ototoxic cations increased the film pressure or left it unaffected. The results confirm the unique interactions between aminoglycosides and phosphatidylinositol bisphosphate as a possible basis of a mechanism of toxicity and development of a drug-screening system.

Interactions of aminoglycoside antibiotics with negatively charged lipid layers. Biochemical and conformational studies

Previous studies [Laurent et al., Biochem. Pharmac. 31, 3861 (1982)] have demonstrated that aminoglycoside antibiotics bind to negatively charged phospholipid bilayers and inhibit the activity of lysosomal phospholipases. This inhibition also occurs in vivo in animal and man. It is considered to be an early and significant step in the development of aminoglycoside-induced nephrotoxicity. The binding of 6 aminoglycosides in current clinical use (dibekacin, gentamicin, tobramycin, kanamycin A, amikacin and streptomycin) to phosphatidylinositol has been studied by gel filtration technique and by conformational analysis. Variation of the phosphatidylinositol content from 0 to 27% of total phospholipids causes a cooperative increase in aminoglycoside binding. At fixed phosphatidylinositol concentration, the binding of the different aminoglycosides is related to the number of aminogroups carried by the drug (viz., gentamicin greater than kanamycin A greater than streptomycin) and is largely, but not entirely dependent upon electrostatic interactions. Conformational analysis of the interaction of aminoglycosides with phosphatidylinositol monolayers was made by a step-wise computation approach. We first have taken into account the Vander Waals, torsional and electrostatic energies and we have calculated the hydrophobic and hydrophilic centers of each molecule. Assembly was then computed by successive association of one molecule of drug and up to 4 molecules of phosphatidylinositol. The calculated interaction energies varied from -8.5 kcal/mol (gentamicin) to -4.9 kcal/mol (amikacin) and -3.9 kcal/mol (streptomycin).(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of exogenous amines on mammalian cells, with particular reference to membrane flow

We have reviewed the evidence that amines accumulate in intracellular vesicles of low pH, such as lysosomes and endosomes. There is consequent elevation of intravesicular pH, and inhibition of receptor-ligand dissociation often results from this pH change. We have argued that the capacity for fusion of such vesicles is also reduced by the high pH. We suggest that the variety of effects of amines on membrane flow and macromolecular transport we describe are at least partly due to such reduced fusion (Figs. 1 and 2). We propose that an internal low pH may facilitate heterologous vesicle-vesicle and vesicle-plasma membrane fusion. There is some evidence that clathrin can accelerate phospholipid vesicle fusion in vitro at low pH (Blumenthal et al., 1983) but no direct evidence on the role of intravesicular pH. This idea is consistent not only with the preceding discussion, but also with the fact that the intracellular membrane-bound compartments least involved in fusion events (e.g. mitochondria) are of neutral or alkaline internal pH. Membrane fusion is certainly required for the formation of vesicles at the periphery of the Golgi apparatus, and possibly earlier in the transport and processing of biosynthetic products in the Golgi (Bergeron et al., 1982). Thus the accumulation of amines in the Golgi may be responsible for several effects on the flow of macromolecules along their translocation pathways. The status of the plasma membrane in this view is complex. It might be argued that the pH dictating the fusion step in endocytosis is that of the extracellular fluid, in which case the inhibitory effects of amines on this process are not explained. However, the rapidity of acidification of the newly formed endocytic vesicles allows the possibility that plasma membrane invaginations might temporarily sequester areas which are of lower pH than that of the bulk extracellular fluid even before fusion, since the proton pumping enzyme(s) are probably present on the plasma membrane. Were this the case, then an acid pH could again be a factor determining membrane fusion at the plasma membrane. The inhibition of endocytosis by weak bases thus may again reflect elevation of pH in a sequestered compartment. From the data on the dependence of response on the concentration of amines, we anticipate that most responses involving membrane flow will be biphasic, with inhibitory effects at low amine concentration, giving way to stimulatory ones at higher concentrations. We suggest that the reported dichotomy between different amines in intracellular membrane fusion systems (D'Arcy Hart, 1982) may result from this concentration dependence.(ABSTRACT TRUNCATED AT 400 WORDS)

Calcium is a competitive inhibitor of gentamicin-renal membrane binding interactions and dietary calcium supplementation protects against gentamicin nephrotoxicity

The divalent cations, Ca++ and Mg++, are known to competitively inhibit a large number of aminoglycoside-membrane interactions, so that Ca++ prevents both the neurotoxic and ototoxic effects of these antibiotics acutely in vitro. Since gentamicin-induced plasma and subcellular membrane damage appear to be critical pathogenetic events in gentamicin nephrotoxicity, Ca++ may play a similar protective role in gentamicin-induced acute renal failure. To test this possibility in vivo, rats (group 2) were given a 4% calcium (in the form of CaCO3) supplemented diet to increase delivery of Ca++ to the kidney and administered single daily subcutaneous injections of gentamicin, 100 mg/kg, for 10 d. Compared with a simultaneously studied group (group 1) of rats receiving identical gentamicin dosages and normal diets, Ca++ supplementation ameliorated gentamicin-induced acute renal failure. After 10 doses of gentamicin, blood-urea nitrogen values in group 1 averaged 213 +/- 15 (SE) and 25 +/- 3 (P less than 0.001) in group 2. The progressive decline in renal excretory function, as measured by BUN, in group 1 animals was accompanied by simultaneous declines in renal cortical mitochondrial function and elevations in renal cortex and mitochondrial Ca++ content, quantitative indices of the degree of renal tubular cell injury. Oral Ca++ loading markedly attenuated these gentamicin-induced derangements. After eight and 10 doses of gentamicin, mitochondria isolated from the renal cortex of group 2 rats had significantly higher rates of respiration supported by pyruvate-malate, succinate and N,N,N',N'-tetramethyl-p-phenyldiamine-ascorbate, higher rates of dinitrophenol-uncoupled respiration and greater acceptor control ratios than those measured in mitochondria isolated from the renal cortex of group 1 animals. Similarly, after 8 and 10 doses, renal cortex and renal cortical mitochondrial Ca++ content of group 2 was significantly lower than values observed in group 1. Thus, dietary calcium supplementation significantly protected against gentamicin-induced renal tubular cell injury and, consequently, gentamicin-induced acute renal failure. The mechanism for this protective effect of Ca++ may relate to the manner in which this polycationic antibiotic interacts with anionic sites, primarily the acidic phospholipids of renal membranes. In this regard, Ca++ was found to be a competitive inhibitor both of 125I-gentamicin binding to renal brush border membranes, the initial site of interaction between gentamicin and renal proximal tubule cells, with a composite inhibition constant (Ki) of 12 mM and of 125I-gentamicin binding to phosphatidic acid, an important membrane acidic phosph

Gentamicin-induced hypercalciuria in the rat

A study was made of the effects of gentamicin (40 mg/kg/day for 7 days) on the excretion of sodium, potassium, calcium and magnesium in the urine of rats. Volume of urine, protein excretion and the urinary activities of the enzymes alanine aminopeptidase, lactate dehydrogenase and N-acetyl-beta-glucosaminidase were also monitored. There were no significant changes in the excretion of sodium or potassium and the excretion of magnesium was too variable to permit a meaningful interpretation of changes in its excretion. Significant changes occurred in the excretion of calcium and protein and in the 24 hr urine osmolarity. The earliest of these changes, on day 4, was an increase in calcium excretion (P less than 0.01) which progressed until the drug was stopped and persisted throughout the 5 follow-up days. The increase in protein excretion was significant (P less than 0.01) by day 5 and the decrease in osmolarity (P less than 0.01) by day 6. These changes were preceded, on day 1, by a significant (P less than 0.001) rise in the activities in urine of all three enzymes. This early enzymuria suggests that considerable perturbation of cell integrity occurred before the increase in calcium excretion. Further studies are required to elucidate what role, if any, the loss of calcium plays in the genesis of tubular cell injury.