Thiol-mediated incorporation of radiolabel from 1-[14C]-methyl-4-phenyl-5-nitrosoimidazole into DNA. A model for the biological activity of 5-nitroimidazoles

Trichomonas vaginalis: metronidazole and other nitroimidazole drugs are reduced by the flavin enzyme thioredoxin reductase and disrupt the cellular redox system. Implications for nitroimidazole toxicity and resistance

Infections with the microaerophilic parasite Trichomonas vaginalis are treated with the 5-nitroimidazole drug metronidazole, which is also in use against Entamoeba histolytica, Giardia intestinalis and microaerophilic/anaerobic bacteria. Here we report that in T. vaginalis the flavin enzyme thioredoxin reductase displays nitroreductase activity with nitroimidazoles, including metronidazole, and with the nitrofuran drug furazolidone. Reactive metabolites of metronidazole and other nitroimidazoles form covalent adducts with several proteins that are known or assumed to be associated with thioredoxin-mediated redox regulation, including thioredoxin reductase itself, ribonucleotide reductase, thioredoxin peroxidase and cytosolic malate dehydrogenase. Disulphide reducing activity of thioredoxin reductase was greatly diminished in extracts of metronidazole-treated cells and intracellular non-protein thiol levels were sharply decreased. We generated a highly metronidazole-resistant cell line that displayed only minimal thioredoxin reductase activity, not due to diminished expression of the enzyme but due to the lack of its FAD cofactor. Reduction of free flavins, readily observed in metronidazole-susceptible cells, was also absent in the resistant cells. On the other hand, iron-depleted T. vaginalis cells, expressing only minimal amounts of PFOR and hydrogenosomal malate dehydrogenase, remained fully susceptible to metronidazole. Thus, taken together, our data suggest a flavin-based mechanism of metronidazole activation and thereby challenge the current model of hydrogenosomal activation of nitroimidazole drugs.

DNA damage induced in HT-29 colon cancer cells by exposure to 1-methyl-2-nitrosoimidazole, a reductive metabolite of 1-methyl-2-nitroimidazole

Exposure of HT-29 colon carcinoma cells to 1-methyl-2-nitrosoimidazole (INO), a reductive metabolite of a model 2-nitroimidazole, induced concentration-dependent DNA damage detectable by conventional alkaline (single-strand breaks) and neutral (double-strand breaks) filter elution techniques. Elution of DNA from the filters under alkaline conditions was distinctly biphasic. No evidence of DNA damage was detected when cellular DNA was incubated directly with INO prior to filter elution. DNA damage was enhanced markedly in HT-29 cells incubated with buthionine sulfoximine to deplete intracellular glutathione levels prior to INO treatment. The biphasic shape of the elution profiles was not attributable to loss of labeled thymidine mononucleotides or to the formation of DNA-protein crosslinks. Rather, the data suggest the existence of two subpopulations of cells differing in sensitivity to the DNA-damaging effects of INO exposure. Based upon differential adherence, two populations of cells, differing with respect to the rate and extent of elution from the filters during alkaline elution assays, were detected, although they could not be purified sufficiently by this technique to permit biochemical characterization. The results suggest that the nitroso intermediate is either an active metabolite, or a proximate form of the ultimate DNA-reactive species, responsible for DNA damage in cells exposed to 2-nitroimidazoles under reducing conditions.

Effect of 1-methyl-2-nitrosoimidazole on intracellular thiols and calcium levels in Chinese hamster ovary cells

The cellular reduction of 2-nitroimidazoles under hypoxic conditions can lead to cell killing. One of the postulated toxic intermediates is the two-electron reduction product, the nitrosoimidazole. 1-Methyl-2-nitrosoimidazole (INO) was used as a model to study the reactivity of 2-nitrosoimidazoles with sulfhydryls. INO reacted within minutes with bovine serum albumin (BSA) in a stoichiometric fashion as measured by the loss of its characteristic absorption at 360 nm. It appeared to react specifically with the SH group of BSA as demonstrated by the loss of 5,5'-dithiobis-2- nitrobenzoic acid (DTNB) reactive groups and by the loss of INO reactivity if BSA was previously reacted with DTNB. INO also depleted glutathione (GSH) and protein sulfhydryls (Pr-SH) in Chinese hamster ovary (CHO) cells in a concentration-dependent fashion. INO at 25 microM, a non-toxic concentration in terms of cell colony-forming ability, depleted GSH to 10-20% of control levels within 5 min after treatment. Pr-SH were depleted more slowly to 60% of control levels. GSH recovered to near control levels over 3-4 hr but Pr-SH remained depressed. The recovery of GSH was blocked by buthionine sulfoximine (BSO), suggesting that the recovery was due to de novo synthesis of GSH. At a toxic concentration of INO (45 microM), GSH was again depleted to 10-20% and Pr-SH to 50% of control levels. No recovery of either was observed up to 4 hr. The effect of this extensive oxidative stress on intracellular calcium (Ca2+i) levels was monitored using 1-[2-amino-5-(6-carboxyindole-2-yl)-phenoxyl]-2- (2'-amino-5'-methylphenoxy)-ethane-N,N,N',N'-tetraacetic acid pentaacetoxy methylester (INDO-1 AM). At toxic concentrations of INO, Ca2+i increased in a sustained, non-physiological manner starting at approximately 60 min after the addition of INO. No increase in Ca2+i was observed when cells were treated with nontoxic concentrations of INO. INO toxicity may be modulated by an uncontrolled influx of Ca2+ which can trigger the activation of cellular enzymes and lead to cell death.

Enhancement of melphalan (L-PAM) toxicity by reductive metabolites of 1-methyl-2-nitroimidazole, a model nitroimidazole chemosensitizing agent

Chemosensitization of bifunctional alkylators by misonidazole (MISO) and related nitroimidazoles in vitro has been shown to require hypoxic exposures. Presumably, reductive metabolism of the nitroimidazole under hypoxic conditions results in generation of a chemosensitizing intermediate(s) in a manner analogous to that described for the hypoxic toxicity of these compounds. In an attempt to identify these intermediates, we examined the ability of reductive metabolites of a model 2-nitroimidazole compound, 1-methyl-2-nitroimidazole (INO2), to enhance the toxicity of melphalan (t-PAM) in HT-29 human colon cancer cells. INO2 was a modest chemosensitizing agent, enhancing L-PAM only under hypoxic conditions. The 2-electron reduction product, 1-methyl-2-nitrosoimidazole (INO), was a potent chemosensitizer, enhancing L-PAM toxicity at micromolar concentrations under either aerobic or hypoxic conditions. In contrast, the 4- and 6-electron reduction products, 1-methyl-2-[hydroxylamino]imidazole and 1-methyl-2-aminoimidazole, respectively, failed to modify cell kill by L-PAM even at millimolar concentration. These results suggest that nitrosoimidazoles may be the active chemosensitizing species generated upon the reductive metabolism of nitroimidazoles.