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Tisato F, Marzano C, Porchia M, Pellei M, Santini C. Copper in diseases and treatments, and copper-based anticancer strategies. Med Res Rev 2010; 30:708-49. [PMID: 19626597 DOI: 10.1002/med.20174] [Citation(s) in RCA: 177] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Copper is found in all living organisms and is a crucial trace element in redox chemistry, growth and development. It is important for the function of several enzymes and proteins involved in energy metabolism, respiration, and DNA synthesis, notably cytochrome oxidase, superoxide dismutase, ascorbate oxidase, and tyrosinase. The major functions of copper-biological molecules involve oxidation-reduction reactions in which they react directly with molecular oxygen to produce free radicals. Therefore, copper requires tightly regulated homeostatic mechanisms to ensure adequate supplies without any toxic effects. Overload or deficiency of copper is associated, respectively, with Wilson disease (WD) and Menkes disease (MD), which are of genetic origin. Researches on Menkes and Wilson disorders have provided useful insights in the field of copper homeostasis and in particular into the understanding of intracellular trafficking and distribution of copper at molecular levels. Therapies based on metal supplementation with copper histidine or removal of copper excess by means of specific copper chelators are currently effective in treating MD and WD, respectively. Copper chelation therapy is now attracting much attention for the investigation and treatment of various neurodegenerative disorders such as Alzheimer, Parkinson and CreutzfeldtJakob. An excess of copper appears to be an essential co-factor for angiogenesis. Moreover, elevated levels of copper have been found in many types of human cancers, including prostate, breast, colon, lung, and brain. On these basis, the employment of copper chelators has been reported to be of therapeutic value in the treatment of several types of cancers as anti-angiogenic molecules. More recently, mixtures of copper chelators with copper salts have been found to act as efficient proteasome inhibitors and apoptosis inducers, specifically in cancer cells. Moreover, following the worldwide success of platinum(II) compounds in cancer chemotherapy, several families of individual copper complexes have been studied as potential antitumor agents. These investigations, revealing the occurrence of mechanisms of action quite different from platinum drugs, head toward the development of new anticancer metallodrugs with improved specificity and decreased toxic side effects.
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Kaler SG, Holmes CS, Goldstein DS, Tang J, Godwin SC, Donsante A, Liew CJ, Sato S, Patronas N. Neonatal diagnosis and treatment of Menkes disease. N Engl J Med 2008; 358:605-14. [PMID: 18256395 PMCID: PMC3477514 DOI: 10.1056/nejmoa070613] [Citation(s) in RCA: 171] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Menkes disease is a fatal neurodegenerative disorder of infancy caused by diverse mutations in a copper-transport gene, ATP7A. Early treatment with copper injections may prevent death and illness, but presymptomatic detection is hindered by the inadequate sensitivity and specificity of diagnostic tests. Exploiting the deficiency of a copper enzyme, dopamine-beta-hydroxylase, we prospectively evaluated the diagnostic usefulness of plasma neurochemical levels, assessed the clinical effect of early detection, and investigated the molecular bases for treatment outcomes. METHODS Between May 1997 and July 2005, we measured plasma dopamine, norepinephrine, dihydroxyphenylacetic acid, and dihydroxyphenylglycol in 81 infants at risk. In 12 newborns who met the eligibility criteria and began copper-replacement therapy within 22 days after birth, we tracked survival and neurodevelopment longitudinally for 1.5 to 8 years. We characterized ATP7A mutations using yeast complementation, reverse-transcriptase-polymerase-chain-reaction analysis, and immunohistochemical analysis. RESULTS Of 81 infants at risk, 46 had abnormal neurochemical findings indicating low dopamine-beta-hydroxylase activity. On the basis of longitudinal follow-up, patients were classified as affected or unaffected by Menkes disease, and the neurochemical profiles were shown to have high sensitivity and specificity for detecting disease. Among 12 newborns with positive screening tests who were treated early with copper, survival at a median follow-up of 4.6 years was 92%, as compared with 13% at a median follow-up of 1.8 years for a historical control group of 15 late-diagnosis and late-treatment patients. Two of the 12 patients had normal neurodevelopment and brain myelination; 1 of these patients had a mutation that complemented a Saccharomyces cerevisiae copper-transport mutation, indicating partial ATPase activity, and the other had a mutation that allowed some correct ATP7A splicing. CONCLUSIONS Neonatal diagnosis of Menkes disease by plasma neurochemical measurements and early treatment with copper may improve clinical outcomes. Affected newborns who have mutations that do not completely abrogate ATP7A function may be especially responsive to early copper treatment. (ClinicalTrials.gov number, NCT00001262.)
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Affiliation(s)
- Stephen G. Kaler
- Unit on Pediatric Genetics, Program in Molecular Medicine, National Institute of Child Health and Human Development (S.G.K., J.T., S.C.G., A.D.), the Clinical Neurocardiology Section (C.S.H., D.S.G.), and the Electroencephalography Section (C.J.L., S.S.), National Institute of Neurological Disorders and Stroke, and the Imaging Sciences Program, Mark O. Hatfield Clinical Center (N.P.) — all at the National Institutes of Health, Bethesda, MD. Address reprint requests to Dr. Kaler at the National Institute of Child Health and Human Development, National Institutes of Health, Bldg. 10, Rm. 5-2571, 10 Center Dr., MSC 1832, Bethesda, MD 20892-1832, or at
| | - Courtney S. Holmes
- Unit on Pediatric Genetics, Program in Molecular Medicine, National Institute of Child Health and Human Development (S.G.K., J.T., S.C.G., A.D.), the Clinical Neurocardiology Section (C.S.H., D.S.G.), and the Electroencephalography Section (C.J.L., S.S.), National Institute of Neurological Disorders and Stroke, and the Imaging Sciences Program, Mark O. Hatfield Clinical Center (N.P.) — all at the National Institutes of Health, Bethesda, MD. Address reprint requests to Dr. Kaler at the National Institute of Child Health and Human Development, National Institutes of Health, Bldg. 10, Rm. 5-2571, 10 Center Dr., MSC 1832, Bethesda, MD 20892-1832, or at
| | - David S. Goldstein
- Unit on Pediatric Genetics, Program in Molecular Medicine, National Institute of Child Health and Human Development (S.G.K., J.T., S.C.G., A.D.), the Clinical Neurocardiology Section (C.S.H., D.S.G.), and the Electroencephalography Section (C.J.L., S.S.), National Institute of Neurological Disorders and Stroke, and the Imaging Sciences Program, Mark O. Hatfield Clinical Center (N.P.) — all at the National Institutes of Health, Bethesda, MD. Address reprint requests to Dr. Kaler at the National Institute of Child Health and Human Development, National Institutes of Health, Bldg. 10, Rm. 5-2571, 10 Center Dr., MSC 1832, Bethesda, MD 20892-1832, or at
| | - Jingrong Tang
- Unit on Pediatric Genetics, Program in Molecular Medicine, National Institute of Child Health and Human Development (S.G.K., J.T., S.C.G., A.D.), the Clinical Neurocardiology Section (C.S.H., D.S.G.), and the Electroencephalography Section (C.J.L., S.S.), National Institute of Neurological Disorders and Stroke, and the Imaging Sciences Program, Mark O. Hatfield Clinical Center (N.P.) — all at the National Institutes of Health, Bethesda, MD. Address reprint requests to Dr. Kaler at the National Institute of Child Health and Human Development, National Institutes of Health, Bldg. 10, Rm. 5-2571, 10 Center Dr., MSC 1832, Bethesda, MD 20892-1832, or at
| | - Sarah C. Godwin
- Unit on Pediatric Genetics, Program in Molecular Medicine, National Institute of Child Health and Human Development (S.G.K., J.T., S.C.G., A.D.), the Clinical Neurocardiology Section (C.S.H., D.S.G.), and the Electroencephalography Section (C.J.L., S.S.), National Institute of Neurological Disorders and Stroke, and the Imaging Sciences Program, Mark O. Hatfield Clinical Center (N.P.) — all at the National Institutes of Health, Bethesda, MD. Address reprint requests to Dr. Kaler at the National Institute of Child Health and Human Development, National Institutes of Health, Bldg. 10, Rm. 5-2571, 10 Center Dr., MSC 1832, Bethesda, MD 20892-1832, or at
| | - Anthony Donsante
- Unit on Pediatric Genetics, Program in Molecular Medicine, National Institute of Child Health and Human Development (S.G.K., J.T., S.C.G., A.D.), the Clinical Neurocardiology Section (C.S.H., D.S.G.), and the Electroencephalography Section (C.J.L., S.S.), National Institute of Neurological Disorders and Stroke, and the Imaging Sciences Program, Mark O. Hatfield Clinical Center (N.P.) — all at the National Institutes of Health, Bethesda, MD. Address reprint requests to Dr. Kaler at the National Institute of Child Health and Human Development, National Institutes of Health, Bldg. 10, Rm. 5-2571, 10 Center Dr., MSC 1832, Bethesda, MD 20892-1832, or at
| | - Clarissa J. Liew
- Unit on Pediatric Genetics, Program in Molecular Medicine, National Institute of Child Health and Human Development (S.G.K., J.T., S.C.G., A.D.), the Clinical Neurocardiology Section (C.S.H., D.S.G.), and the Electroencephalography Section (C.J.L., S.S.), National Institute of Neurological Disorders and Stroke, and the Imaging Sciences Program, Mark O. Hatfield Clinical Center (N.P.) — all at the National Institutes of Health, Bethesda, MD. Address reprint requests to Dr. Kaler at the National Institute of Child Health and Human Development, National Institutes of Health, Bldg. 10, Rm. 5-2571, 10 Center Dr., MSC 1832, Bethesda, MD 20892-1832, or at
| | - Susumu Sato
- Unit on Pediatric Genetics, Program in Molecular Medicine, National Institute of Child Health and Human Development (S.G.K., J.T., S.C.G., A.D.), the Clinical Neurocardiology Section (C.S.H., D.S.G.), and the Electroencephalography Section (C.J.L., S.S.), National Institute of Neurological Disorders and Stroke, and the Imaging Sciences Program, Mark O. Hatfield Clinical Center (N.P.) — all at the National Institutes of Health, Bethesda, MD. Address reprint requests to Dr. Kaler at the National Institute of Child Health and Human Development, National Institutes of Health, Bldg. 10, Rm. 5-2571, 10 Center Dr., MSC 1832, Bethesda, MD 20892-1832, or at
| | - Nicholas Patronas
- Unit on Pediatric Genetics, Program in Molecular Medicine, National Institute of Child Health and Human Development (S.G.K., J.T., S.C.G., A.D.), the Clinical Neurocardiology Section (C.S.H., D.S.G.), and the Electroencephalography Section (C.J.L., S.S.), National Institute of Neurological Disorders and Stroke, and the Imaging Sciences Program, Mark O. Hatfield Clinical Center (N.P.) — all at the National Institutes of Health, Bethesda, MD. Address reprint requests to Dr. Kaler at the National Institute of Child Health and Human Development, National Institutes of Health, Bldg. 10, Rm. 5-2571, 10 Center Dr., MSC 1832, Bethesda, MD 20892-1832, or at
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