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Trancart M, Hanak AS, Dambrune C, Madi M, Voros C, Baati R, Calas AG. No-observed-adverse-effect-level (NOAEL) assessment as an optimized dose of cholinesterase reactivators for the treatment of exposure to warfare nerve agents in mice. Chem Biol Interact 2024; 392:110929. [PMID: 38417730 DOI: 10.1016/j.cbi.2024.110929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/01/2024]
Abstract
Despite the international convention on the prohibition of chemical weapons ratified in 1997, the threat of conflicts and terrorist attacks involving such weapons still exists. Among these, organophosphorus-nerve agents (OPs) inhibit cholinesterases (ChE) causing cholinergic syndrome. The reactivation of these enzymes is therefore essential to protect the poisoned people. However, these reactivating molecules, mainly named oximes, have major drawbacks with limited efficacy against some OPs and a non-negligible ChE inhibitor potential if administered at an inadequate dose, an effect that they are precisely supposed to mitigate. As a result, this project focused on assessing therapeutic efficacy, in mice, up to the NOAEL dose, the maximum dose of oxime that does not induce any observable toxic effect. NOAEL doses of HI-6 DMS, a reference oxime, and JDS364. HCl, a candidate reactivator, were assessed using dual-chamber plethysmography, with respiratory ventilation impairment as a toxicity criterion. Time-course modeling parameters and pharmacodynamic profiles, reflecting the interaction between the oxime and circulating ChE, were evaluated for treatments at their NOAEL and higher doses. Finally, the therapeutic potential against OPs poisoning was determined through the assessment of protective indices. For JDS364. HCl, the NOAEL dose corresponds to the smallest dose inducing the most significant therapeutic effect without causing any abnormality in ChE activity. In contrast, for HI-6 DMS, its therapeutic benefit was observed at doses higher than its NOAEL, leading to alterations in respiratory function. These alterations could not be directly correlated with ChE inhibition and had no adverse effects on survival. They are potentially attributed to the stimulation of non-enzymatic cholinergic targets by HI-6 DMS. Thus, the NOAEL appears to be an optimal dose for evaluating the efficacy of oximes, particularly when it can be linked to respiratory alterations effectively resulting from ChE inhibition.
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Affiliation(s)
- Marilène Trancart
- French Armed Forces Biomedical Research Institute, CBRN Defense Division, Toxicology and Chemical Risks Department, Brétigny-sur-Orge, France
| | - Anne-Sophie Hanak
- French Armed Forces Biomedical Research Institute, CBRN Defense Division, Toxicology and Chemical Risks Department, Brétigny-sur-Orge, France
| | - Chloé Dambrune
- French Armed Forces Biomedical Research Institute, CBRN Defense Division, Toxicology and Chemical Risks Department, Brétigny-sur-Orge, France; Ecole de Chimie Polymère et Matériaux ECPM, Université de Strasbourg, ICPEES UMR CNRS 7515, 25, Rue Becquerel, F-67087, Strasbourg, France
| | - Méliati Madi
- French Armed Forces Biomedical Research Institute, CBRN Defense Division, Toxicology and Chemical Risks Department, Brétigny-sur-Orge, France
| | - Camille Voros
- Ecole de Chimie Polymère et Matériaux ECPM, Université de Strasbourg, ICPEES UMR CNRS 7515, 25, Rue Becquerel, F-67087, Strasbourg, France
| | - Rachid Baati
- Ecole de Chimie Polymère et Matériaux ECPM, Université de Strasbourg, ICPEES UMR CNRS 7515, 25, Rue Becquerel, F-67087, Strasbourg, France
| | - André-Guilhem Calas
- French Armed Forces Biomedical Research Institute, CBRN Defense Division, Toxicology and Chemical Risks Department, Brétigny-sur-Orge, France.
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Váňová N, Múčková L, Kalíšková T, Lochman L, Bzonek P, Švec F. In Vitro Evaluation of Oxidative Stress Induced by Oxime Reactivators of Acetylcholinesterase in HepG2 Cells. Chem Res Toxicol 2023; 36:1912-1920. [PMID: 37950699 PMCID: PMC10731658 DOI: 10.1021/acs.chemrestox.3c00203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/13/2023]
Abstract
Oxime reactivators of acetylcholinesterase (AChE) are used as causal antidotes for intended and unintended poisoning by organophosphate nerve agents and pesticides. Despite all efforts to develop new AChE reactivators, none of these drug candidates replaced conventional clinically used oximes. In addition to the therapeutic efficacy, determining the safety profile is crucial in preclinical drug evaluation. The exact mechanism of oxime toxicity and the structure-toxicity relationship are subjects of ongoing research, with oxidative stress proposed as a possible mechanism. In the present study, we investigated four promising bispyridinium oxime AChE reactivators, K048, K074, K075, and K203, and their ability to induce oxidative stress in vitro. Cultured human hepatoma cells were exposed to oximes at concentrations corresponding to their IC50 values determined by the MTT assay after 24 h. Their potency to generate reactive oxygen species, interfere with the thiol antioxidant system, and induce lipid peroxidation was evaluated at 1, 4, and 24 h of exposure. Reactivators without a double bond in the four-carbon linker, K048 and K074, showed a greater potential to induce oxidative stress compared with K075 and K203, which contain a double bond. Unlike oximes with a three-carbon-long linker, the number of aldoxime groups attached to the pyridinium moieties does not determine the oxidative stress induction for K048, K074, K075, and K203 oximes. In conclusion, our results emphasize that the structure of oximes plays a critical role in inducing oxidative stress, and this relationship does not correlate with their cytotoxicity expressed as the IC50 value. However, it is important to note that oxidative stress cannot be disregarded as a potential contributor to the side effects associated with oximes.
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Affiliation(s)
- Nela Váňová
- Department
of Pharmaceutical Chemistry and Pharmaceutical Analysis, Faculty of
Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, Hradec
Králové 500 05, Czechia
| | - L’ubica Múčková
- Department
of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Třebešská 1575, Hradec Králové 500 02, Czechia
| | - Tereza Kalíšková
- Department
of Pharmaceutical Chemistry and Pharmaceutical Analysis, Faculty of
Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, Hradec
Králové 500 05, Czechia
| | - Lukáš Lochman
- Department
of Pharmaceutical Chemistry and Pharmaceutical Analysis, Faculty of
Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, Hradec
Králové 500 05, Czechia
| | - Petr Bzonek
- Department
of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Třebešská 1575, Hradec Králové 500 02, Czechia
| | - František Švec
- Department
of Analytical Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, Hradec
Králové 500 05, Czechia
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Karasova JZ, Kassa J, Hepnarova V, Pejchal J, Junova L, Andrys R, Malinak D, Bzonek P, Kohoutova Z, Musilek K. Toxicity, pharmacokinetics, and effectiveness of the ortho-chlorinated bispyridinium oxime, K870. Food Chem Toxicol 2022; 167:113236. [PMID: 35738326 DOI: 10.1016/j.fct.2022.113236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 05/31/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022]
Abstract
Oxime reactivators are causal antidotes for organophosphate intoxication. Herein, the toxicity, pharmacokinetics, and reactivation effectiveness of o-chlorinated bispyridinium oxime K870 are reported. Oxime K870 was found to have a safe profile at a dose of 30 mg/kg in rats. It exhibited rapid absorption and renal clearance similar to those of other charged oximes after intramuscular administration. Its isoxazole-pyridinium degradation product was identified in vivo. Although it showed some improvement in brain targeting, it was nevertheless rapidly effluxed from the central nervous system. Its reactivation effectiveness was evaluated in rats and mice intoxicated with sarin, tabun, VX, and paraoxon and compared with pralidoxime and asoxime. K870 was found to be less effective in reversing tabun poisoning compared to its parent unchlorinated oxime K203. However, K870 efficiently reactivated blood acetylcholinesterase for all tested organophosphates in rats. In addition, K870 significantly protected against intoxication by all tested organophosphates in mice. For these reasons, oxime K870 seems to have a broader reactivation spectrum against multiple organophosphates. It seems important to properly modulate the oximate forming properties (pKa) to obtain more versatile oxime reactivators.
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Affiliation(s)
- Jana Zdarova Karasova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic; Biomedical Research Center, University Hospital, Hradec Kralove, Czech Republic.
| | - Jiri Kassa
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Vendula Hepnarova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Jaroslav Pejchal
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Lucie Junova
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | - Rudolf Andrys
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - David Malinak
- Biomedical Research Center, University Hospital, Hradec Kralove, Czech Republic; Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Petr Bzonek
- Department of Toxicology and Military Pharmacy, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic; Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Zuzana Kohoutova
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Kamil Musilek
- Biomedical Research Center, University Hospital, Hradec Kralove, Czech Republic; Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic.
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Handl J, Malinak D, Capek J, Andrys R, Rousarova E, Hauschke M, Bruckova L, Cesla P, Rousar T, Musilek K. Effects of Charged Oxime Reactivators on the HK-2 Cell Line in Renal Toxicity Screening. Chem Res Toxicol 2021; 34:699-703. [PMID: 33566584 DOI: 10.1021/acs.chemrestox.0c00489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Oxime cholinesterase reactivators (oximes) are used to counteract organophosphate intoxication. Charged oximes are administered via intramuscular or intravenous injection when the majority of dose is unmetabolized and is excreted as urine. In this study, the effects of selected double charged oximes were determined in the HK-2 cell line as a model for renal toxicity screening. Some effects on dehydrogenase activity were found for obidoxime, asoxime (syn. HI-6), K027, and K203. The effects of K868 and K869 were found to be unreliable due to rapid degradation of both chlorinated oximes in the assay medium, resulting for K868 in an isoxazole-pyridinium product.
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Affiliation(s)
- Jiri Handl
- Faculty of Chemical Technology, Department of Biological and Biochemical Sciences, University of Pardubice, Studentska 573, 532 10 Pardubice, Czech Republic
| | - David Malinak
- Faculty of Science, Department of Chemistry, University of Hradec Kralove, Rokitanskeho 62, 500 03 Hradec Kralove, Czech Republic
| | - Jan Capek
- Faculty of Chemical Technology, Department of Biological and Biochemical Sciences, University of Pardubice, Studentska 573, 532 10 Pardubice, Czech Republic
| | - Rudolf Andrys
- Faculty of Science, Department of Chemistry, University of Hradec Kralove, Rokitanskeho 62, 500 03 Hradec Kralove, Czech Republic
| | - Erika Rousarova
- Faculty of Chemical Technology, Department of Biological and Biochemical Sciences, University of Pardubice, Studentska 573, 532 10 Pardubice, Czech Republic
| | - Martina Hauschke
- Faculty of Chemical Technology, Department of Biological and Biochemical Sciences, University of Pardubice, Studentska 573, 532 10 Pardubice, Czech Republic
| | - Lenka Bruckova
- Faculty of Chemical Technology, Department of Biological and Biochemical Sciences, University of Pardubice, Studentska 573, 532 10 Pardubice, Czech Republic
| | - Petr Cesla
- Department of Analytical Chemistry, Faculty of Chemical Technology, University of Pardubice, Studentska 573, 532 10 Pardubice, Czech Republic
| | - Tomas Rousar
- Faculty of Chemical Technology, Department of Biological and Biochemical Sciences, University of Pardubice, Studentska 573, 532 10 Pardubice, Czech Republic
| | - Kamil Musilek
- Faculty of Science, Department of Chemistry, University of Hradec Kralove, Rokitanskeho 62, 500 03 Hradec Kralove, Czech Republic
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Development of versatile and potent monoquaternary reactivators of acetylcholinesterase. Arch Toxicol 2021; 95:985-1001. [PMID: 33517499 DOI: 10.1007/s00204-021-02981-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/06/2021] [Indexed: 12/15/2022]
Abstract
To date, the only treatments developed for poisoning by organophosphorus compounds, the most toxic chemical weapons of mass destruction, have exhibited limited efficacy and versatility. The available causal antidotes are based on reactivation of the enzyme acetylcholinesterase (AChE), which is rapidly and pseudo-irreversibly inhibited by these agents. In this study, we developed a novel series of monoquaternary reactivators combining permanently charged moieties tethered to position 6- of 3-hydroxypyridine-2-aldoxime reactivating subunit. Highlighted representatives (21, 24, and 27; also coded as K1371, K1374, and K1375, respectively) that contained 1-phenylisoquinolinium, 7-amino-1-phenylisoquinolinium and 4-carbamoylpyridinium moieties as peripheral anionic site ligands, respectively, showed efficacy superior or comparable to that of the clinically used standards. More importantly, these reactivators exhibited wide-spectrum efficacy and were minutely investigated via determination of their reactivation kinetics in parallel with molecular dynamics simulations to study their mechanisms of reactivation of the tabun-inhibited AChE conjugate. To further confirm the potential applicability of these candidates, a mouse in vivo assay was conducted. While K1375 had the lowest acute toxicity and the most suitable pharmacokinetic profile, the oxime K1374 with delayed elimination half-life was the most effective in ameliorating the signs of tabun toxicity. Moreover, both in vitro and in vivo, the versatility of the agents was substantially superior to that of clinically used standards. Their high efficacy and broad-spectrum capability make K1374 and K1375 promising candidates that should be further investigated for their potential as nerve agents and insecticide antidotes.
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