1
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Kalyanaraman H, Casteel DE, Cabriales JA, Tat J, Zhuang S, Chan A, Dretchen KL, Boss GR, Pilz RB. The Antioxidant/Nitric Oxide-Quenching Agent Cobinamide Prevents Aortic Disease in a Mouse Model of Marfan Syndrome. JACC Basic Transl Sci 2024; 9:46-62. [PMID: 38362350 PMCID: PMC10864892 DOI: 10.1016/j.jacbts.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 02/17/2024]
Abstract
Major pathologic changes in the proximal aorta underlie the life-threatening aortic aneurysms and dissections in Marfan Syndrome; current treatments delay aneurysm development without addressing the primary pathology. Because excess oxidative stress and nitric oxide/protein kinase G signaling likely contribute to the aortopathy, we hypothesized that cobinamide, a strong antioxidant that can attenuate nitric oxide signaling, could be uniquely suited to prevent aortic disease. In a well-characterized mouse model of Marfan Syndrome, cobinamide dramatically reduced elastin breaks, prevented excess collagen deposition and smooth muscle cell apoptosis, and blocked DNA, lipid, and protein oxidation and excess nitric oxide/protein kinase G signaling in the ascending aorta. Consistent with preventing pathologic changes, cobinamide diminished aortic root dilation without affecting blood pressure. Cobinamide exhibited excellent safety and pharmacokinetic profiles indicating it could be a practical treatment. We conclude that cobinamide deserves further study as a disease-modifying treatment of Marfan Syndrome.
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Affiliation(s)
- Hema Kalyanaraman
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | - Darren E. Casteel
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | - Justin A. Cabriales
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | - John Tat
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | - Shunhui Zhuang
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | - Adriano Chan
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | | | - Gerry R. Boss
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | - Renate B. Pilz
- Department of Medicine, University of California-San Diego, La Jolla, California, USA
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2
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Behymer MM, Mo H, Fujii N, Suresh V, Arzumanian AS, Chan A, Nath AK, McCain R, MacRae CA, Peterson R, Boss GR, Davisson VJ, Knipp GT. Investigating the Replacement of Carboxylates with Carboxamides to Modulate the Safety and Efficacy of Platinum(II) Thioether Cyanide Scavengers. Toxicol Sci 2023; 197:kfad119. [PMID: 37952247 PMCID: PMC10823771 DOI: 10.1093/toxsci/kfad119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Abstract
Cyanide represents a persistent threat for accidental or malicious misuse due to easy conversion into a toxic gas and access to large quantities through several industries. The high safety index of hydroxocobalamin is a cornerstone quality as a cyanide scavenger. Unfortunately, intravenous infusion of hydroxocobalamin limits the utility in a mass casualty setting. We previously reported platinum(II) [Pt(II)] complexes with trans-directing sulfur ligands as an efficacious alternative to hydroxocobalamin when delivered by a bolus intramuscular injection in mice and rabbits. Thus, to enable Pt(II) as an alternative to hydroxocobalamin, a high safety factor is needed. The objective is to maintain efficacy and mitigate the risk for nephrotoxicity. Platinum amino acid complexes with the ability to form five- or six-membered rings and possessing either carboxylates or carboxamides are evaluated in vitro for cyanide scavenging. In vivo efficacy was evaulated in the zebrafish and mice cyanide exposure models. In addition, Pt(II) complex toxicity and pharmacokinetics were evaluated in a cyanide naive Sprague-Dawley model. Doses for toxicity are escalated to 5x from the efficacious dose in mice using a body surface area adjustment. The results show the carboxamide ligands display a time and pH dependence on cyanide scavenging in vitro and efficacy in vivo. Additionally, exchanging the carboxylate for carboxamide showed reduced indications of renal injury. A pharmacokinetic analysis of the larger bidentate complexes displayed rapid absorption by intramuscular administration and having similar plasma exposure. These findings point to the importance of pH and ligand structures for methionine carboxamide complexes with Pt(II).
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Affiliation(s)
- Matthew M Behymer
- Department of Industrial and Molecular Pharmaceutics, Purdue University, West Lafayette, Indiana 47907, USA
| | - Huaping Mo
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, USA
| | - Naoaki Fujii
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, USA
| | - Vallabh Suresh
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, USA
| | - Ari S Arzumanian
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, California 92093, USA
| | - Anjali K Nath
- Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA
| | - Robyn McCain
- Purdue Translational Pharmacology CTSI Core Facility, Purdue University, West Lafayette, Indiana, USA
| | - Calum A MacRae
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts 02115, USA
| | - Randall Peterson
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, Utah 84112, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, California 92093, USA
| | - Vincent Jo Davisson
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, Indiana 47907, USA
| | - Gregory T Knipp
- Department of Industrial and Molecular Pharmaceutics, Purdue University, West Lafayette, Indiana 47907, USA
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3
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Marques HM. The inorganic chemistry of the cobalt corrinoids - an update. J Inorg Biochem 2023; 242:112154. [PMID: 36871417 DOI: 10.1016/j.jinorgbio.2023.112154] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023]
Abstract
The inorganic chemistry of the cobalt corrinoids, derivatives of vitamin B12, is reviewed, with particular emphasis on equilibrium constants for, and kinetics of, their axial ligand substitution reactions. The role the corrin ligand plays in controlling and modifying the properties of the metal ion is emphasised. Other aspects of the chemistry of these compounds, including their structure, corrinoid complexes with metals other than cobalt, the redox chemistry of the cobalt corrinoids and their chemical redox reactions, and their photochemistry are discussed. Their role as catalysts in non-biological reactions and aspects of their organometallic chemistry are briefly mentioned. Particular mention is made of the role that computational methods - and especially DFT calculations - have played in developing our understanding of the inorganic chemistry of these compounds. A brief overview of the biological chemistry of the B12-dependent enzymes is also given for the reader's convenience.
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Affiliation(s)
- Helder M Marques
- Molecular Sciences Institute, School of Chemistry, University of the Witwatersrand, Johannesburg 2050, South Africa.
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4
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Suzuki Y, Taguchi K, Okamoto W, Enoki Y, Komatsu T, Matsumoto K. Methemoglobin-albumin clusters for cyanide detoxification. Toxicol Appl Pharmacol 2023; 466:116472. [PMID: 36934860 DOI: 10.1016/j.taap.2023.116472] [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: 01/29/2023] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023]
Abstract
Sodium nitrite (NaNO2) is a universal antidote for patients with cyanide poisoning. However, its use has serious drawbacks in terms of efficacy and safety. Herein, we present a promising antidote: methemoglobin (metHb)-albumin clusters. The metHb-albumin cluster is made by a metHb core wrapped by covalently bound human serum albumin. Spectral analyses proved that the metHb-albumin clusters possessed cyanide-binding properties similar to those of naked metHb. In vitro cell experiments showed that metHb-albumin clusters prevented the cyanide-induced inhibition of cytochrome c oxidase activity, resulting in a strong cytoprotective effect. In mice subjected to cyanide poisoning, metHb-albumin clusters reduced mortality and alleviated metabolic acidosis, while maintaining the activity of cytochrome c oxidase in organs; their efficacy was better than that of NaNO2. Furthermore, the oxygen carrying capacity was maintained in poisoned mice treated with metHb-albumin clusters and was low in those treated with NaNO2. These results indicate that metHb-albumin clusters could be a more effective and safer antidote against cyanide poisoning than NaNO2.
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Affiliation(s)
- Yuto Suzuki
- Faculty of Pharmacy, Keio University, Tokyo, Japan
| | | | - Wataru Okamoto
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Yuki Enoki
- Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Teruyuki Komatsu
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
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5
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A synthetic porphyrin as an effective dual antidote against carbon monoxide and cyanide poisoning. Proc Natl Acad Sci U S A 2023; 120:e2209924120. [PMID: 36802431 PMCID: PMC9992825 DOI: 10.1073/pnas.2209924120] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Simultaneous poisoning by carbon monoxide (CO) and hydrogen cyanide is the major cause of mortality in fire gas accidents. Here, we report on the invention of an injectable antidote against CO and cyanide (CN-) mixed poisoning. The solution contains four compounds: iron(III)porphyrin (FeIIITPPS, F), two methyl-β-cyclodextrin (CD) dimers linked by pyridine (Py3CD, P) and imidazole (Im3CD, I), and a reducing agent (Na2S2O4, S). When these compounds are dissolved in saline, the solution contains two synthetic heme models including a complex of F with P (hemoCD-P) and another one of F with I (hemoCD-I), both in their iron(II) state. hemoCD-P is stable in its iron(II) state and captures CO more strongly than native hemoproteins, while hemoCD-I is readily autoxidized to its iron(III) state to scavenge CN- once injected into blood circulation. The mixed solution (hemoCD-Twins) exhibited remarkable protective effects against acute CO and CN- mixed poisoning in mice (~85% survival vs. 0% controls). In a model using rats, exposure to CO and CN- resulted in a significant decrease in heart rate and blood pressure, which were restored by hemoCD-Twins in association with decreased CO and CN- levels in blood. Pharmacokinetic data revealed a fast urinary excretion of hemoCD-Twins with an elimination half-life of 47 min. Finally, to simulate a fire accident and translate our findings to a real-life scenario, we confirmed that combustion gas from acrylic cloth caused severe toxicity to mice and that injection of hemoCD-Twins significantly improved the survival rate, leading to a rapid recovery from the physical incapacitation.
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6
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Behymer M, Mo H, Fujii N, Suresh V, Chan A, Lee J, Nath AK, Saha K, Mahon SB, Brenner M, MacRae CA, Peterson R, Boss GR, Knipp GT, Davisson VJ. Identification of Platinum(II) Sulfide Complexes Suitable as Intramuscular Cyanide Countermeasures. Chem Res Toxicol 2022; 35:1983-1996. [PMID: 36201358 PMCID: PMC9682522 DOI: 10.1021/acs.chemrestox.2c00157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The development of rapidly acting cyanide countermeasures using intramuscular injection (IM) represents an unmet medical need to mitigate toxicant exposures in mass casualty settings. Previous work established that cisplatin and other platinum(II) or platinum(IV)-based agents effectively mitigate cyanide toxicity in zebrafish. Cyanide's in vivo reaction with platinum-containing materials was proposed to reduce the risk of acute toxicities. However, cyanide antidote activity depended on a formulation of platinum-chloride salts with dimethyl sulfoxide (DMSO) followed by dilution in phosphate-buffered saline (PBS). A working hypothesis to explain the DMSO requirement is that the formation of platinum-sulfoxide complexes activates the cyanide scavenging properties of platinum. Preparations of isolated NaPtCl5-DMSO and Na (NH3)2PtCl-DMSO complexes in the absence of excess DMSO provided agents with enhanced reactivity toward cyanide in vitro and fully recapitulated in vivo cyanide rescue in zebrafish and mouse models. The enhancement of the cyanide scavenging effects of the DMSO ligand could be attributed to the activation of platinum(IV) and (II) with a sulfur ligand. Unfortunately, the efficacy of DMSO complexes was not robust when administered IM. Alternative Pt(II) materials containing sulfide and amine ligands in bidentate complexes show enhanced reactivity toward cyanide addition. The cyanide addition products yielded tetracyanoplatinate(II), translating to a stoichiometry of 1:4 Pt to each cyanide scavenger. These new agents demonstrate a robust and enhanced potency over the DMSO-containing complexes using IM administration in mouse and rabbit models of cyanide toxicity. Using the zebrafish model with these Pt(II) complexes, no acute cardiotoxicity was detected, and dose levels required to reach lethality exceeded 100 times the effective dose. Data are presented to support a general chemical design approach that can expand a new lead candidate series for developing next-generation cyanide countermeasures.
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Affiliation(s)
- Matthew
M. Behymer
- Department
of Industrial and Physical Pharmacy, Purdue
University, 575 Stadium Mall Drive, West Lafayette, Indiana47907, United States
| | - Huaping Mo
- Department
of Medicinal Chemistry and Molecular Pharmacology, Purdue University, 575
Stadium Mall Drive, West Lafayette, Indiana47907, United
States
| | - Naoaki Fujii
- Department
of Medicinal Chemistry and Molecular Pharmacology, Purdue University, 575
Stadium Mall Drive, West Lafayette, Indiana47907, United
States
| | - Vallabh Suresh
- Department
of Medicinal Chemistry and Molecular Pharmacology, Purdue University, 575
Stadium Mall Drive, West Lafayette, Indiana47907, United
States
| | - Adriano Chan
- Department
of Medicine, University of California, San Diego, California92093, United States
| | - Jangweon Lee
- Beckman
Laser Institute and Medical Clinic, Department of Medicine, University of California, Irvine, California92697, United States
| | - Anjali K. Nath
- Department
of Cardiology, Beth Israel Deaconess Medical
Center, Boston, Massachusetts02115, United States
| | - Kusumika Saha
- Division
of Cardiovascular Medicine, Brigham and
Women’s Hospital, Boston, Massachusetts02115, United States
| | - Sari B. Mahon
- Beckman
Laser Institute and Medical Clinic, Department of Medicine, University of California, Irvine, California92697, United States
| | - Matthew Brenner
- Beckman
Laser Institute and Medical Clinic, Department of Medicine, University of California, Irvine, California92697, United States
| | - Calum A. MacRae
- Division
of Cardiovascular Medicine, Brigham and
Women’s Hospital, Boston, Massachusetts02115, United States
| | - Randall Peterson
- Department
of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake
City, Utah84112, United States
| | - Gerry R. Boss
- Department
of Medicine, University of California, San Diego, California92093, United States
| | - Gregory T. Knipp
- Department
of Industrial and Physical Pharmacy, Purdue
University, 575 Stadium Mall Drive, West Lafayette, Indiana47907, United States
| | - Vincent Jo Davisson
- Department
of Medicinal Chemistry and Molecular Pharmacology, Purdue University, 575
Stadium Mall Drive, West Lafayette, Indiana47907, United
States,
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7
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Haouzi P, MacCann M, Brenner M, Mahon S, Bebarta VS, Chan A, Judenherc-Haouzi A, Tubbs N, Boss GR. Treatment of life-threatening H2S intoxication: Lessons from the trapping agent tetranitrocobinamide. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2022; 96:103998. [PMID: 36228991 DOI: 10.1016/j.etap.2022.103998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
We sought to evaluate the efficacy of trapping free hydrogen sulfide (H2S) following severe H2S intoxication. Sodium hydrosulfide solution (NaHS, 20 mg/kg) was administered intraperitoneally in 69 freely moving rats. In a first group (protocol 1), 40 rats were randomly assigned to receive saline (n = 20) or the cobalt compound tetranitrocobinamide (TNCbi) (n = 20, 75 mg/kg iv), one minute into coma, when free H2S was still present in the blood. A second group of 27 rats received TNCbi or saline, following epinephrine, 5 min into coma, when the concentration of free H2S has drastically decreased in the blood. In protocol 1, TNCbi significantly increased immediate survival (65 vs 20 %, p < 0.01) while in protocol 2, administration of TNCbi led to the same outcome as untreated animals. We hypothesize that the decreased efficacy of TNCbi with time likely reflects the rapid spontaneous disappearance of the pool of free H2S in the blood following H2S exposure.
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Affiliation(s)
- Philippe Haouzi
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University, College of Medicine, Hershey, PA, USA.
| | - Marissa MacCann
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Matthew Brenner
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA, USA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Irvine, CA, USA
| | - Sari Mahon
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA, USA
| | - Vikhyat S Bebarta
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, CO, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Annick Judenherc-Haouzi
- Heart and Vascular Institute, Department of Medicine, Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Nicole Tubbs
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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8
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Gretarsdottir J, Lambert IH, Sturup S, Suman SG. In Vitro Characterization of a Threonine-Ligated Molybdenyl-Sulfide Cluster as a Putative Cyanide Poisoning Antidote; Intracellular Distribution, Effects on Organic Osmolyte Homeostasis, and Induction of Cell Death. ACS Pharmacol Transl Sci 2022; 5:907-918. [PMID: 36268119 PMCID: PMC9578141 DOI: 10.1021/acsptsci.2c00093] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Indexed: 11/28/2022]
Abstract
Binuclear molybdenum sulfur complexes are effective for the catalytic conversion of cyanide into thiocyanate. The complexes themselves exhibit low toxicity and high aqueous solubility, which render them suitable as antidotes for cyanide poisoning. The binuclear molybdenum sulfur complex [(thr)Mo2O2(μ-S)2(S2)]- (thr - threonine) was subjected to biological studies to evaluate its cellular accumulation and mechanism of action. The cellular uptake and intracellular distribution in human alveolar (A549) cells, quantified by inductively coupled plasma mass spectrometry (ICP-MS) and cell fractionation methods, revealed the presence of the compound in cytosol, nucleus, and mitochondria. The complex exhibited limited binding to DNA, and using the expression of specific protein markers for cell fate indicated no effect on the expression of stress-sensitive channel components involved in cell volume regulation, weak inhibition of cell proliferation, no increase in apoptosis, and even a reduction in autophagy. The complex is anionic, and the sodium complex had higher solubility compared to the potassium. As the molybdenum complex possibly enters the mitochondria, it is considered as a promising remedy to limit mitochondrial cyanide poisoning following, e.g., smoke inhalation injuries.
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Affiliation(s)
| | - Ian H. Lambert
- Department
of Biology, University of Copenhagen, Universitetsparken 13, 2100 Copenhagen Ø, Denmark
| | - Stefan Sturup
- Department
of Pharmacy, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Ø, Denmark
| | - Sigridur G. Suman
- Science
Institute, University of Iceland, Dunhaga 3, 107 Reykjavik, Iceland
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9
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Bhadra S, Chan A, Hendry-Hofer TB, Boss GR, Bebarta VS, Logue BA. Analysis of bisaminotetrazole cobinamide, a next-generation antidote for cyanide, hydrogen sulfide and methanethiol poisoning, in swine plasma by liquid chromatography-tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1208:123392. [PMID: 35952445 DOI: 10.1016/j.jchromb.2022.123392] [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: 02/25/2022] [Revised: 07/07/2022] [Accepted: 07/24/2022] [Indexed: 11/29/2022]
Abstract
Cyanide, hydrogen sulfide, and methanethiol are common toxic inhalation agents that inhibit mitochondrial cytochrome c oxidase and result in cellular hypoxia, cytotoxic anoxia, apnea, respiratory failure, cardiovascular collapse, seizure and potentially death. While all are occupational gas exposure hazards that have the potential to cause mass casualties from industrial accidents or acts of terrorism, only cyanide has approved antidotes, and each of these has major limitations, including difficult administration in mass-casualty settings. While bisaminotetrazole cobinamide (Cbi(AT)2) has recently gained attention because of its efficacy in treating these metabolic poisons, there is no method available for the analysis of Cbi(AT)2 in any biological matrix. Hence, in this study, a simple and rapid liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the analysis of Cbi(AT)2 in swine plasma. The method is extremely simple, consisting of protein precipitation, separation and drying of the supernatant, reconstitution in an aqueous solvent, and LC-MS/MS analysis. The method produced an LOD of 0.3 μM with a wide dynamic range (2 - 500 μM). Inter- and intraassay accuracies (100 ± 12 % and 100 ± 19 %, respectively) were acceptable and the precision (<12 % and < 9 % relative standard deviation, respectively) was good. The developed method was used to analyze Cbi(AT)2 from treated swine and the preliminary pharmacokinetic parameters showed impressive antidotal behavior, most notably a long estimated elimination half-life (t1/2 = 37.5 h). This simple and rapid method can be used to facilitate the development of Cbi(AT)2 as a therapeutic against toxic cyanide, hydrogen sulfide and methanethiol exposure.
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Affiliation(s)
- Subrata Bhadra
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD 57007, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Tara B Hendry-Hofer
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Vikhyat S Bebarta
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Brian A Logue
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD 57007, USA.
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10
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Chang S, Tat J, China SP, Kalyanaraman H, Zhuang S, Chan A, Lai C, Radic Z, Abdel-Rahman EA, Casteel DE, Pilz RB, Ali SS, Boss GR. Cobinamide is a strong and versatile antioxidant that overcomes oxidative stress in cells, flies, and diabetic mice. PNAS NEXUS 2022; 1:pgac191. [PMID: 36276587 PMCID: PMC9578022 DOI: 10.1093/pnasnexus/pgac191] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/12/2022] [Indexed: 01/29/2023]
Abstract
Increased oxidative stress underlies a variety of diseases, including diabetes. Here, we show that the cobalamin/vitamin B12 analog cobinamide is a strong and multifaceted antioxidant, neutralizing superoxide, hydrogen peroxide, and peroxynitrite, with apparent rate constants of 1.9 × 108, 3.7 × 104, and 6.3 × 106 M-1 s-1, respectively, for cobinamide with the cobalt in the +2 oxidation state. Cobinamide with the cobalt in the +3 oxidation state yielded apparent rate constants of 1.1 × 108 and 8.0 × 102 M-1 s-1 for superoxide and hydrogen peroxide, respectively. In mammalian cells and Drosophila melanogaster, cobinamide outperformed cobalamin and two well-known antioxidants, imisopasem manganese and manganese(III)tetrakis(4-benzoic acid)porphyrin, in reducing oxidative stress as evidenced by: (i) decreased mitochondrial superoxide and return of the mitochondrial membrane potential in rotenone- and antimycin A-exposed H9c2 rat cardiomyocytes; (ii) reduced JNK phosphorylation in hydrogen-peroxide-treated H9c2 cells; (iii) increased growth in paraquat-exposed COS-7 fibroblasts; and (iv) improved survival in paraquat-treated flies. In diabetic mice, cobinamide administered in the animals' drinking water completely prevented an increase in lipid and protein oxidation, DNA damage, and fibrosis in the heart. Cobinamide is a promising new antioxidant that has potential use in diseases with heightened oxidative stress.
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Affiliation(s)
| | | | | | | | - Shunhui Zhuang
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Cassandra Lai
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Zoran Radic
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA
| | - Engy A Abdel-Rahman
- Tumor Biology Research Program, Children’s Cancer Hospital, Cairo 57357, Egypt,Pharmacology Department, Faculty of Medicine, Assuit University, Assuit 71515, Egypt
| | - Darren E Casteel
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Renate B Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
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11
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Effect of complexation between cobinamides and bovine serum albumin on their reactivity toward cyanide. REACTION KINETICS MECHANISMS AND CATALYSIS 2022. [DOI: 10.1007/s11144-022-02216-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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12
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Chan A, Lee J, Bhadra S, Bortey-Sam N, Hendry-Hofer TB, Bebarta VS, Mahon SB, Brenner M, Logue B, Pilz RB, Boss GR. Development of sodium tetrathionate as a cyanide and methanethiol antidote. Clin Toxicol (Phila) 2022; 60:332-341. [PMID: 34328378 PMCID: PMC8800944 DOI: 10.1080/15563650.2021.1953517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONTEXT Hydrogen cyanide and methanethiol are two toxic gases that inhibit mitochondrial cytochrome c oxidase. Cyanide is generated in structural fires and methanethiol is released by decaying organic matter. Current treatments for cyanide exposure do not lend themselves to treatment in the field and no treatment exists for methanethiol poisoning. Sodium tetrathionate (tetrathionate), a product of thiosulfate oxidation, could potentially serve as a cyanide antidote, and, based on its chemical structure, we hypothesized it could react with methanethiol. RESULTS We show that tetrathionate, unlike thiosulfate, reacts directly with cyanide in vitro under physiological conditions, and based on rabbit studies where we monitor cyanide poisoning in real-time, tetrathionate likely reacts directly with cyanide in vivo. We found that tetrathionate administered by intramuscular injection rescues >80% of juvenile, young adult, and old adult mice from exposure to inhaled hydrogen cyanide gas that is >80% lethal. Tetrathionate also rescued young adult rabbits from intravenously administered sodium cyanide. Tetrathionate was reasonably well-tolerated by mice and rats, yielding a therapeutic index of ∼5 in juvenile and young adult mice, and ∼3.3 in old adult mice; it was non-mutagenic in Chinese Hamster ovary cells and by the Ames bacterial test. We found by gas chromatography-mass spectrometry that both tetrathionate and thiosulfate react with methanethiol to generate dimethyldisulfide, but that tetrathionate was much more effective than thiosulfate at recovering intracellular ATP in COS-7 cells and rescuing mice from a lethal exposure to methanethiol gas. CONCLUSION We conclude that tetrathionate has the potential to be an effective antidote against cyanide and methanethiol poisoning.
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Affiliation(s)
- Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Jangwoen Lee
- Beckman Laser Institute, University of California, Irvine, Irvine, CA, USA
| | - Subrata Bhadra
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD, USA
| | - Nesta Bortey-Sam
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Vikhyat S. Bebarta
- Department of Emergency Medicine, University of Colorado, Aurora, CO, USA
| | - Sari B. Mahon
- Beckman Laser Institute, University of California, Irvine, Irvine, CA, USA
| | - Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, Irvine, CA, USA
| | - Brian Logue
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD, USA
| | - Renate B. Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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13
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Philipopoulos GP, Tat J, Chan A, Jiang J, Mukai D, Burney T, Doosty M, Mahon S, Patel HH, White CW, Brenner M, Lee J, Boss GR. Methyl mercaptan gas: mechanisms of toxicity and demonstration of the effectiveness of cobinamide as an antidote in mice and rabbits. Clin Toxicol (Phila) 2022; 60:615-622. [PMID: 34989638 PMCID: PMC9662850 DOI: 10.1080/15563650.2021.2017949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
CONTEXT Methyl mercaptan (CH3SH) is a colorless, toxic gas with potential for occupational exposure and used as a weapon of mass destruction. Inhalation at high concentrations can result in dyspnea, hypoventilation, seizures, and death. No specific methyl mercaptan antidote exists, highlighting a critical need for such an agent. Here, we investigated the mechanism of CH3SH toxicity, and rescue from CH3SH poisoning by the vitamin B12 analog cobinamide, in mammalian cells. We also developed lethal CH3SH inhalation models in mice and rabbits, and tested the efficacy of intramuscular injection of cobinamide as a CH3SH antidote. RESULTS We found that cobinamide binds to CH3SH (Kd = 84 µM), and improved growth of cells exposed to CH3SH. CH3SH reduced cellular oxygen consumption and intracellular ATP content and activated the stress protein c-Jun N-terminal kinase (JNK); cobinamide reversed these changes. A single intramuscular injection of cobinamide (20 mg/kg) rescued 6 of 6 mice exposed to a lethal dose of CH3SH gas, while all six saline-treated mice died (p = 0.0013). In rabbits exposed to CH3SH gas, 11 of 12 animals (92%) treated with two intramuscular injections of cobinamide (50 mg/kg each) survived, while only 2 of 12 animals (17%) treated with saline survived (p = 0.001). CONCLUSION We conclude that cobinamide could potentially serve as a CH3SH antidote.
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Affiliation(s)
| | - John Tat
- Department of Medicine, University of California, San Diego, CA, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, CA, USA
| | - Jingjing Jiang
- Department of Medicine, University of California, San Diego, CA, USA
| | - David Mukai
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Tanya Burney
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Melody Doosty
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Sari Mahon
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Hemal H Patel
- VA San Diego Healthcare System and Department of Anesthesiology, University of California, San Diego, CA, USA
| | - Carl W White
- Department of Pediatrics, University of Colorado, Aurora, CO, USA
| | - Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Jangwoen Lee
- Beckman Laser Institute, University of California, Irvine, CA, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, CA, USA
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14
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Suzuki Y, Taguchi K, Kure T, Enoki Y, Otagiri M, Sakai H, Matsumoto K. Long-term pharmaceutical stability of liposome-encapsulated methemoglobin as an antidote for cyanide poisoning. Int J Pharm 2021; 610:121260. [PMID: 34740759 DOI: 10.1016/j.ijpharm.2021.121260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/11/2021] [Accepted: 10/29/2021] [Indexed: 12/29/2022]
Abstract
Liposome-encapsulated methemoglobin (metHb@Lipo) has been developed as a novel antidote for cyanide poisoning. Antidotes for lethal acute poisoning should be capable of being easily stored as ready-to-use formulations without temperature restrictions. Here, we investigated the pharmaceutical stability of the metHb@Lipo suspension after one-year storage as a ready-to-use formulation at 4 °C, room temperature (23-28 °C) and 37 °C. The liposomal integrity of metHb@Lipo was observed after one year of storage at all storage temperatures with no physicochemical change or methemoglobin leakage outside the liposome. Furthermore, the encapsulated methemoglobin remained intact without aggregation, fragmentation, denaturation, or dissociation of heme. Fresh and stored metHb@Lipo were equivalent in their binding affinity against cyanide. Moreover, all one-year stored metHb@Lipo suspensions improved the mortality rates of lethal cyanide poisoning mice comparable to fresh metHb@Lipo suspension. Additionally, all stored metHb@Lipo suspensions preserved high biocompatibility, including blood compatibility and the lack of organ toxicity. In conclusion, the metHb@Lipo suspension was a pharmaceutically stable antidote for cyanide poisoning for at least one year without any temperature restrictions.
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Affiliation(s)
- Yuto Suzuki
- Faculty of Pharmacy, Keio University, Tokyo, Japan
| | | | - Tomoko Kure
- Department of Chemistry, Nara Medical University, Kashihara, Japan
| | - Yuki Enoki
- Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Masaki Otagiri
- Faculty of Pharmaceutical Sciences, Sojo University, Kumamoto, Japan; DDS Research Institute, Sojo University, Kumamoto, Japan
| | - Hiromi Sakai
- Department of Chemistry, Nara Medical University, Kashihara, Japan
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15
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Suzuki Y, Taguchi K, Kure T, Sakai H, Enoki Y, Otagiri M, Matsumoto K. Liposome-encapsulated methemoglobin as an antidote against cyanide poisoning. J Control Release 2021; 337:59-70. [PMID: 34273418 DOI: 10.1016/j.jconrel.2021.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/06/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022]
Abstract
Cyanide induces acute lethal poisoning resulting from inhibition of cytochrome c oxidase located in the complex IV (Complex IV) of mitochondria. However, current therapies for cyanide poisoning using hydroxocobalamin and nitrous acid compounds remain a clinical issue. Here, we show that liposome-encapsulated methemoglobin (metHb@Lipo), nanosized biomimetic red blood cells, replicate the antidotal mechanism of nitrous acid compounds against cyanide poisoning, achieving superior efficacy and fast action with no adverse effects. The structure of metHb@Lipo, which consists of concentrated methemoglobin in its aqueous core and a lipid membrane resembling the red blood cell membrane, provides favorable characteristics as a cyanide antidote, such as binding properties and membrane permeability. Upon cyanide exposure, metHb@Lipo maintained the mitochondrial function in PC12 cells, resulting in a cell viability comparable to treatment with nitrous acid compounds. In a mouse model of cyanide poisoning, metHb@Lipo treatment dramatically improved mortality with a rapid recovery from the symptoms of cyanide poisoning compared to treatment with nitrous acid compounds. Furthermore, metHb@Lipo also possesses satisfactory pharmacokinetic properties without long-term bioaccumulation and toxicity. Our findings showed a novel concept to develop drugs for cyanide poisoning and provide a promising possibility for biomimetic red blood cell preparations for pharmaceutical applications.
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Affiliation(s)
- Yuto Suzuki
- Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan
| | - Kazuaki Taguchi
- Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan.
| | - Tomoko Kure
- Department of Chemistry, Nara Medical University, Shijo-cho 840, Kashihara, Nara 634-8521, Japan
| | - Hiromi Sakai
- Department of Chemistry, Nara Medical University, Shijo-cho 840, Kashihara, Nara 634-8521, Japan
| | - Yuki Enoki
- Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan
| | - Masaki Otagiri
- Faculty of Pharmaceutical Sciences, Sojo University, 4-22-1 Ikeda, Nishi-ku, Kumamoto City, Kumamoto 860-0082, Japan; DDS Research Institute, Sojo University, 4-22-1 Ikeda, Nishi-ku, Kumamoto City, Kumamoto 860-0082, Japan
| | - Kazuaki Matsumoto
- Faculty of Pharmacy, Keio University, 1-5-30 Shibakoen, Minato-ku, Tokyo 105-8512, Japan
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16
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Lippner DS, Hildenberger DM, Rhoomes MO, Winborn JN, Dixon H, McDonough J, Rockwood GA. A novel aqueous dimethyl trisulfide formulation is effective at low doses against cyanide toxicity in non-anesthetized mice and rats. Clin Toxicol (Phila) 2021; 60:83-94. [PMID: 34219566 DOI: 10.1080/15563650.2021.1935991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Cyanide (CN) is a metabolic poison that is capable of intoxicating individuals through accidental or intentional means. With high concentration exposures, death can occur in minutes. In cases of mass casualty exposures, there is a need for a rapid-acting countermeasure capable of being administered in a short period of time in a pre-hospital setting to treat victims. OBJECTIVE These studies evaluate the safety and efficacy of a novel aqueous formulation of dimethyl trisulfide (DMTS) as an intramuscular (IM) CN countermeasure using non-anesthetized rodent models. METHODS Non-anesthetized rodents (mice and rats) were exposed to hydrogen cyanide (HCN) or potassium cyanide (KCN) along with immediate IM 10% DMTS treatment or vehicle treatment. Survival and other parameters, such as the time to recovery and assessment of clinical toxic signs (e.g., gasping, loss of righting reflex, convulsions, etc.), were quantified to determine the effectiveness of 10% DMTS treatment (12.5, 25, 75 mg/kg IM) compared to vehicle control treatment. A rat KCN delayed-treatment model with a 15-minute treatment delay was also utilized to simulate a real-life exposure/treatment scenario with 10% DMTS treatment. The stability of the 10% DMTS formulation was also assessed. RESULTS A 25 mg/kg IM dose of 10% DMTS exhibits potent efficacy against subcutaneous (SC) KCN challenge in both mice and rats and inhalational HCN exposure in mice. 10% DMTS treatment also shortens the time to recovery in rats using a delayed-treatment model. CONCLUSION IM treatment with 10% DMTS improves survival and clinical outcomes in non-anesthetized rodent models of acute CN toxicity. Additionally, the use of an SC KCN delayed-treatment model in rats is advised to assess the performance of a candidate CN countermeasure in a more realistic exposure/treatment scenario.
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Affiliation(s)
- D S Lippner
- Medical Toxicology Research Division, Biochemistry and Physiology Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - D M Hildenberger
- Medical Toxicology Research Division, Biochemistry and Physiology Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - M O Rhoomes
- Medical Toxicology Research Division, Biochemistry and Physiology Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - J N Winborn
- Medical Toxicology Research Division, Biochemistry and Physiology Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
| | - H Dixon
- Southwest Research Institute, San Antonio, TX, USA
| | - J McDonough
- Southwest Research Institute, San Antonio, TX, USA
| | - G A Rockwood
- Medical Toxicology Research Division, Biochemistry and Physiology Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, USA
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17
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Tinsley IC, Borner T, Swanson ML, Chepurny OG, Doebley SA, Kamat V, Sweet IR, Holz GG, Hayes MR, De Jonghe BC, Doyle RP. Synthesis, Optimization, and Biological Evaluation of Corrinated Conjugates of the GLP-1R Agonist Exendin-4. J Med Chem 2021; 64:3479-3492. [PMID: 33677970 PMCID: PMC8279408 DOI: 10.1021/acs.jmedchem.1c00185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
![]()
Corrination
is the conjugation of a corrin ring containing molecule,
such as vitamin B12 (B12) or B12 biosynthetic precursor
dicyanocobinamide (Cbi), to small molecules, peptides, or proteins
with the goal of modifying pharmacology. Recently, a corrinated GLP-1R
agonist (GLP-1RA) exendin-4 (Ex4) has been shown in vivo to have reduced penetration into the central nervous system relative
to Ex4 alone, producing a glucoregulatory GLP-1RA devoid of anorexia
and emesis. The study herein was designed to optimize the lead conjugate
for GLP-1R agonism and binding. Two specific conjugation sites were
introduced in Ex4, while also utilizing various linkers, so that it
was possible to identify Cbi conjugates of Ex4 that exhibit improved
binding and agonist activity at the GLP-1R. An optimized conjugate
(22), comparable with Ex4, was successfully screened
and subsequently assayed for insulin secretion in rat islets and in vivo in shrews for glucoregulatory and emetic behavior,
relative to Ex4.
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Affiliation(s)
- Ian C Tinsley
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, New York 13244, United States
| | - Tito Borner
- Department of Biobehavioral Health Sciences, University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania 19104, United States
| | - MacKenzie L Swanson
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, New York 13244, United States
| | - Oleg G Chepurny
- Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York 13210, United States
| | - Sarah A Doebley
- Department of Biobehavioral Health Sciences, University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania 19104, United States
| | - Varun Kamat
- Department of Medicine, University of Washington, Medicine Diabetes Institute, Seattle, Washington 98109, United States
| | - Ian R Sweet
- Department of Medicine, University of Washington, Medicine Diabetes Institute, Seattle, Washington 98109, United States
| | - George G Holz
- Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York 13210, United States
| | - Matthew R Hayes
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania 19104, United States
| | - Bart C De Jonghe
- Department of Biobehavioral Health Sciences, University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania 19104, United States
| | - Robert P Doyle
- Department of Chemistry, Syracuse University, 111 College Place, Syracuse, New York 13244, United States.,Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York 13210, United States
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18
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Hendry-Hofer TB, Ng PC, McGrath AM, Soules K, Mukai DS, Chan A, Maddry JK, White CW, Lee J, Mahon SB, Brenner M, Boss GR, Bebarta VS. Intramuscular cobinamide as an antidote to methyl mercaptan poisoning. Inhal Toxicol 2021; 33:25-32. [PMID: 33356664 PMCID: PMC8063453 DOI: 10.1080/08958378.2020.1866123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Methyl mercaptan occurs naturally in the environment and is found in a variety of occupational settings, including the oil, paper, plastics, and pesticides industries. It is a toxic gas and deaths from methyl mercaptan exposure have occurred. The Department of Homeland Security considers it a high threat chemical agent that could be used by terrorists. Unfortunately, no specific treatment exists for methyl mercaptan poisoning. METHODS We conducted a randomized trial in 12 swine comparing no treatment to intramuscular injection of the vitamin B12 analog cobinamide (2.0 mL, 12.5 mg/kg) following acute inhalation of methyl mercaptan gas. Physiological and laboratory parameters were similar in the control and cobinamide-treated groups at baseline and at the time of treatment. RESULTS All six cobinamide-treated animals survived, whereas only one of six control animals lived (17% survival) (p = 0.0043). The cobinamide-treated animals returned to a normal breathing pattern by 3.8 ± 1.1 min after treatment (mean ± SD), while all but one animal in the control group had intermittent gasping, never regaining a normal breathing pattern. Blood pressure and arterial oxygen saturation returned to baseline values within 15 minutes of cobinamide-treatment. Plasma lactate concentration increased progressively until death (10.93 ± 6.02 mmol [mean ± SD]) in control animals, and decreased toward baseline (3.79 ± 2.93 mmol [mean ± SD]) by the end of the experiment in cobinamide-treated animals. CONCLUSION We conclude that intramuscular administration of cobinamide improves survival and clinical outcomes in a large animal model of acute, high dose methyl mercaptan poisoning.
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Affiliation(s)
- Tara B. Hendry-Hofer
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Patrick C. Ng
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Brooke Army Medical Center, Ft Sam Houston, San Antonio, Texas
| | - Alison M. McGrath
- Department of Environmental Health and Safety, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kirsten Soules
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - David S. Mukai
- Beckman Laser Institute, University of California, Irvine, California
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, California
| | - Joseph K. Maddry
- 59th Medical Wing/Science & Technology, Lackland Air Force Base, Texas,San Antonio Military Medical Center, JBSA-Ft Sam Houston, San Antonio, Texas
| | - Carl W. White
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Jangwoen Lee
- Beckman Laser Institute, University of California, Irvine, California
| | - Sari B. Mahon
- Beckman Laser Institute, University of California, Irvine, California
| | - Matthew Brenner
- Beckman Laser Institute, University of California, Irvine, California
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, La Jolla, California
| | - Vikhyat S. Bebarta
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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19
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Neuromodulatory activity of trèvo on cyanide-induced neurotoxicity viz neurochemical, antioxidants, cytochrome C oxidase and p53. ADVANCES IN TRADITIONAL MEDICINE 2020. [DOI: 10.1007/s13596-020-00450-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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20
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Hendry-Hofer TB, Ng PC, McGrath AM, Mukai D, Brenner M, Mahon S, Maddry JK, Boss GR, Bebarta VS. Intramuscular aminotetrazole cobinamide as a treatment for inhaled hydrogen sulfide poisoning in a large swine model. Ann N Y Acad Sci 2020; 1479:159-167. [PMID: 32233102 DOI: 10.1111/nyas.14339] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/28/2020] [Accepted: 03/06/2020] [Indexed: 01/28/2023]
Abstract
Hydrogen sulfide (H2 S), a high-threat chemical agent, occurs naturally in a variety of settings. Despite multiple incidents of exposures and deaths, no FDA-approved antidote exists. A rapid-acting, easy to administer antidote is needed. We conducted a randomized control trial in swine comparing intramuscular administration of aminotetrazole cobinamide (2.9 mL, 18 mg/kg) to no treatment following inhalation of H2 S gas. We found that aminotetrazole cobinamide administered 2 min after the onset of respiratory depression-defined as a tidal volume of less than 3 mL/kg for 2 consecutive minutes-yielded 100% survival, while all control animals died. Respiratory depression resolved in the treatment group within 3.6 ± 1.5 min (mean ± SD) of cobinamide administration, whereas control animals had intermittent gasping until death. Blood pressure and arterial oxygen saturation (SO2 ) returned to baseline values within 5 and 10 min, respectively, of cobinamide treatment, and plasma lactate concentration decreased to less than 50% of the highest value by the end of the experiment. In control animals, plasma lactate rose continuously until death. We conclude that intramuscular aminotetrazole cobinamide is effective in a large animal, inhalational model of acute, severe H2 S poisoning.
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Affiliation(s)
- Tara B Hendry-Hofer
- Department of Emergency Medicine, School of Medicine, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado
| | - Patrick C Ng
- Department of Emergency Medicine, School of Medicine, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado.,Brooke Army Medical Center, Ft Sam Houston, San Antonio, Texas
| | - Alison M McGrath
- Department of Environmental Health and Safety, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado
| | - David Mukai
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California
| | - Matthew Brenner
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California
| | - Sari Mahon
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California
| | - Joseph K Maddry
- Brooke Army Medical Center, Ft Sam Houston, San Antonio, Texas.,59th Medical Wing/Science & Technology, Lackland Air Force Base, Lackland AFB, Texas
| | - Gerry R Boss
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Vikhyat S Bebarta
- Department of Emergency Medicine, School of Medicine, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado.,Office of the Chief Scientist, US Air Force Reserve, Joint Base San Antonio-Lackland, San Antonio, Texas
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21
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Schwaerzer GK, Kalyanaraman H, Casteel DE, Dalton ND, Gu Y, Lee S, Zhuang S, Wahwah N, Schilling JM, Patel HH, Zhang Q, Makino A, Milewicz DM, Peterson KL, Boss GR, Pilz RB. Aortic pathology from protein kinase G activation is prevented by an antioxidant vitamin B 12 analog. Nat Commun 2019; 10:3533. [PMID: 31387997 PMCID: PMC6684604 DOI: 10.1038/s41467-019-11389-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 07/11/2019] [Indexed: 01/08/2023] Open
Abstract
People heterozygous for an activating mutation in protein kinase G1 (PRKG1, p.Arg177Gln) develop thoracic aortic aneurysms and dissections (TAAD) as young adults. Here we report that mice heterozygous for the mutation have a three-fold increase in basal protein kinase G (PKG) activity, and develop age-dependent aortic dilation. Prkg1R177Q/+ aortas show increased smooth muscle cell apoptosis, elastin fiber breaks, and oxidative stress compared to aortas from wild type littermates. Transverse aortic constriction (TAC)—to increase wall stress in the ascending aorta—induces severe aortic pathology and mortality from aortic rupture in young mutant mice. The free radical-neutralizing vitamin B12-analog cobinamide completely prevents age-related aortic wall degeneration, and the unrelated anti-oxidant N-acetylcysteine ameliorates TAC-induced pathology. Thus, increased basal PKG activity induces oxidative stress in the aorta, raising concern about the widespread clinical use of PKG-activating drugs. Cobinamide could be a treatment for aortic aneurysms where oxidative stress contributes to the disease, including Marfan syndrome. Individuals carrying a gain-of-function mutation in PKG1 develop thoracic aortic aneurysms and dissections. Here Schwaerzer et al. show that mice carrying the same mutation recapitulate the human disease, and find that treatment with anti-oxidants including cobinamide, a vitamin B12 analog, prevents disease progression.
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Affiliation(s)
- Gerburg K Schwaerzer
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Hema Kalyanaraman
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Darren E Casteel
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Nancy D Dalton
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Yusu Gu
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Seunghoe Lee
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Shunhui Zhuang
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Nisreen Wahwah
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Jan M Schilling
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, 92093, USA
| | - Hemal H Patel
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, 92093, USA
| | - Qian Zhang
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Ayako Makino
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Dianna M Milewicz
- Division of Medical Genetics and Cardiology, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Kirk L Peterson
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Gerry R Boss
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Renate B Pilz
- Department of Medicine, University of California San Diego, La Jolla, CA, 92093, USA.
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Petrikovics I, Kiss L, Chou CE, Ebrahimpour A, Kovács K, Kiss M, Logue B, Chan A, Manage ABW, Budai M, Boss GR, Rockwood GA. Antidotal efficacies of the cyanide antidote candidate dimethyl trisulfide alone and in combination with cobinamide derivatives. Toxicol Mech Methods 2019; 29:438-444. [DOI: 10.1080/15376516.2019.1585504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Ilona Petrikovics
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Lóránd Kiss
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Ching-En Chou
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Afshin Ebrahimpour
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Kristóf Kovács
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Márton Kiss
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Brian Logue
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, CA, USA
| | - Ananda B. W. Manage
- Department of Mathematics and Statistics, Sam Houston State University, Huntsville, TX, USA
| | - Marianna Budai
- Department of Chemistry, Sam Houston State University, Huntsville, TX, USA
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, CA, USA
| | - Gary A. Rockwood
- US Army Medical Research Institute of Chemical Defense, APG, MD, USA
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Rice NC, Rauscher NA, Wilkins WL, Lippner DS, Rockwood GA, Myers TM. Behavioural and physiological assessments of dimethyl trisulfide treatment for acute oral sodium cyanide poisoning. Basic Clin Pharmacol Toxicol 2019; 125:289-303. [DOI: 10.1111/bcpt.13220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/01/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Nathaniel C. Rice
- United States Army Medical Research Institute of Chemical Defense Aberdeen Proving Ground Maryland
| | - Noah A. Rauscher
- United States Army Medical Research Institute of Chemical Defense Aberdeen Proving Ground Maryland
| | - William L. Wilkins
- United States Army Medical Research Institute of Chemical Defense Aberdeen Proving Ground Maryland
| | - Dennean S. Lippner
- United States Army Medical Research Institute of Chemical Defense Aberdeen Proving Ground Maryland
| | - Gary A. Rockwood
- United States Army Medical Research Institute of Chemical Defense Aberdeen Proving Ground Maryland
| | - Todd M. Myers
- United States Army Medical Research Institute of Chemical Defense Aberdeen Proving Ground Maryland
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Ng PC, Hendry-Hofer TB, Garrett N, Brenner M, Mahon SB, Maddry JK, Haouzi P, Boss GR, Gibbons TF, Araña AA, Bebarta VS. Intramuscular cobinamide versus saline for treatment of severe hydrogen sulfide toxicity in swine. Clin Toxicol (Phila) 2018; 57:189-196. [PMID: 30430872 DOI: 10.1080/15563650.2018.1504955] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Hydrogen sulfide (H2S) is found in petroleum, natural gas, and decaying organic matter. Terrorist groups have attempted to use it in enclosed spaces as a chemical weapon. Mass casualty scenarios have occurred from industrial accidents and release from oil field sites. There is no FDA approved antidote for sulfide poisoning. We have previously reported that intravenous cobinamide is effective for sulfide poisoning. A rapid-acting antidote that is easy to administer intramuscularly (IM) would be ideal for use in a prehospital setting. In this study, we assessed survival in sulfide-poisoned swine treated with IM cobinamide. METHODS Eleven swine (45-55 kg) were anesthetized, intubated, and instrumented with continuous femoral and pulmonary artery pressure monitoring. After stabilization, anesthesia was adjusted such that animals ventilated spontaneously with a FiO2 of 0.21. Sodium hydrosulfide (NaHS, 8 mg/mL) was infused intravenously at 0.9 mg/kg.min until apnea or severe hypotension. Animals were randomly assigned to receive cobinamide (4 mg/kg), or no treatment at the apnea/hypotension trigger. The NaHS infusion rate was sustained for 1.5 min post trigger, decreased to 0.2 mg/kg.min for 10 min, and then discontinued. RESULTS The amount of NaHS required to produce apnea or hypotension was not statistically different in both groups (cobinamide: 9.0 mg/kg ±6.1; saline: 5.9 mg/kg ±5.5; mean difference: -3.1, 95% CI: -11.3, 5.0). All of the cobinamide treated animals survived (5/5), none of the control (0/6) animals survived (p < .01). Mean time to return to spontaneous ventilation in the cobinamide treated animals was 3.2 (±1.1) min. Time to return to baseline systolic blood pressure (±5%) in cobinamide-treated animals was 5 min. CONCLUSION Intramuscular cobinamide was effective in improving survival in this large swine model of severe hydrogen sulfide toxicity.
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Affiliation(s)
- Patrick C Ng
- a Rocky Mountain Poison and Drug Center , Denver Health and Hospital Authority , Denver , CO , USA
| | - Tara B Hendry-Hofer
- b Department of Emergency Medicine , University of Colorado, School of Medicine , Aurora , CO , USA
| | - Norma Garrett
- c Medical Toxicology and the Department of Emergency Medicine , San Antonio Military Medical Center , San Antonio , TX , USA
| | - Matthew Brenner
- d Beckman Laser Institute , University of California, Irvine , Irvine , CA , USA
| | - Sari B Mahon
- d Beckman Laser Institute , University of California, Irvine , Irvine , CA , USA
| | - Joseph K Maddry
- e USAF En Route Care Research Center , US Army Institute of Surgical Research , San Antonio , TX , USA
| | - Philippe Haouzi
- f Division of Pulmonary and Critical Care Medicine , Pennsylvania State University, College of Medicine , Hershey , PA , USA
| | - Gerry R Boss
- g Department of Medicine , University of California, San Diego , La Jolla , CA , USA
| | - Thomas F Gibbons
- h Laboratory Services Branch , Clinical Research Division, Wilford Hall Ambulatory Surgical Center , San Antonio , TX , USA
| | - Allyson A Araña
- e USAF En Route Care Research Center , US Army Institute of Surgical Research , San Antonio , TX , USA
| | - Vikhyat S Bebarta
- b Department of Emergency Medicine , University of Colorado, School of Medicine , Aurora , CO , USA
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Kaur H, Singh P. Rationally designed molecules for resurgence of cyanide mitigated cytochrome c oxidase activity. Bioorg Chem 2018; 82:229-240. [PMID: 30391853 DOI: 10.1016/j.bioorg.2018.10.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 10/19/2018] [Accepted: 10/22/2018] [Indexed: 11/26/2022]
Abstract
Cytochrome c oxidase (CcOX) containing binuclear heme a3-Cu B centre (BNC) mechanises the process of electron transfer in the last phase of cellular respiration. The molecular modelling based structural analysis of CcOX - heme a3-Cu B complex was performed and the disturbance to this complex under cyanide poisoning conditions was investigated. Taking into consideration the results of molecular docking studies, new chemical entities were developed for clipping cyanide from the enzyme and restoring its normal function. It was found that the molecules obtained by combining syringaldehyde, oxindole and chrysin moieties bearing propyl/butyl spacing groups occupy the BNC region and effectively remove cyanide bound to the enzyme. The binding constant of compound 2 with CN- was 2.3 × 105 M-1 and its ED50 for restoring the cyanide bound CcOX activity in 10 min was 16 µM. The compound interacted with CN- over the pH range 5-10. The comparison of the loss of enzymatic activity in the presence of CN- and resumption of enzymatic activity by compound 2 mediated removal of CN- indicated the efficacy of the compound as antidote of cyanide.
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Affiliation(s)
- Harpreet Kaur
- Department of Chemistry, UGC Sponsored Centre for Advanced Studies, Guru Nanak Dev University, Amritsar 143005, India
| | - Palwinder Singh
- Department of Chemistry, UGC Sponsored Centre for Advanced Studies, Guru Nanak Dev University, Amritsar 143005, India.
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Singh P, Kaur H, Singh H. Rationally Designed Circularly Arranged Sextuple Molecule with Dimethoxyphenolic Tentacles for Ample Hunting of Cyanide. ACS OMEGA 2018; 3:8003-8008. [PMID: 31458938 PMCID: PMC6644536 DOI: 10.1021/acsomega.8b01155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 07/04/2018] [Indexed: 06/10/2023]
Abstract
Herein, we report the design, synthesis, and cyanide-scavenging behavior of circularly arranged sextuple molecule 4. The six syringaldehyde units carrying equal number of dimethoxyphenolic moieties projecting at the periphery make the molecule highly efficient for cleaning up cyanide from the aqueous solution. The stoichiometric data 1:6 showed that six units of cyanide interact with one unit of compound 4. The association constant of the compound for cyanide was 2.5 × 104 M-1, and its detection limit for cyanide was 10 nM. The compound was also found to remove cyanide bound to cytochrome c oxidase.
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Affiliation(s)
- Palwinder Singh
- E-mail: . Phone: 91-183-2258802
ext. 3278. Fax: 91-183-2258819 (P.S.)
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Identification of specific metabolic pathways as druggable targets regulating the sensitivity to cyanide poisoning. PLoS One 2018; 13:e0193889. [PMID: 29879736 PMCID: PMC5991913 DOI: 10.1371/journal.pone.0193889] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 02/20/2018] [Indexed: 11/19/2022] Open
Abstract
Cyanide is a potent toxic agent, and the few available antidotes are not amenable to rapid deployment in mass exposures. As a result, there are ongoing efforts to exploit different animal models to identify novel countermeasures. We have created a pipeline that combines high-throughput screening in zebrafish with subsequent validation in two mammalian small animal models as well as a porcine large animal model. We found that zebrafish embryos in the first 3 days post fertilization (dpf) are highly resistant to cyanide, becoming progressively more sensitive thereafter. Unbiased analysis of gene expression in response to several hours of ultimately lethal doses of cyanide in both 1 and 7 dpf zebrafish revealed modest changes in iron-related proteins associated with the age-dependent cyanide resistance. Metabolomics measurements demonstrated significant age-dependent differences in energy metabolism during cyanide exposure which prompted us to test modulators of the tricarboxylic acid cycle and related metabolic processes as potential antidotes. In cyanide-sensitive 7 dpf larvae, we identified several such compounds that offer significant protection against cyanide toxicity. Modulators of the pyruvate dehydrogenase complex, as well as the small molecule sodium glyoxylate, consistently protected against cyanide toxicity in 7 dpf zebrafish larvae. Together, our results indicate that the resistance of zebrafish embryos to cyanide toxicity during early development is related to an altered regulation of cellular metabolism, which we propose may be exploited as a potential target for the development of novel antidotes against cyanide poisoning.
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Anantharam P, Whitley EM, Mahama B, Kim DS, Sarkar S, Santana C, Chan A, Kanthasamy AG, Kanthasamy A, Boss GR, Rumbeiha WK. Cobinamide is effective for treatment of hydrogen sulfide-induced neurological sequelae in a mouse model. Ann N Y Acad Sci 2017; 1408:61-78. [PMID: 29239480 PMCID: PMC5734662 DOI: 10.1111/nyas.13559] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/16/2017] [Accepted: 10/30/2017] [Indexed: 12/21/2022]
Abstract
Hydrogen sulfide (H2 S) is a highly neurotoxic gas. Acute exposure can lead to neurological sequelae among survivors. A drug for treating neurological sequelae in survivors of acute H2 S intoxication is needed. Using a novel mouse model we evaluated the efficacy of cobinamide (Cob) for increasing survival of, and reducing neurological sequalae in, mice exposed to sublethal doses of H2 S. There were two objectives: (1) to determine the dose-response efficacy of Cob and (2) to determine the effective therapeutic time window of Cob. To explore objective 1, mice were injected intramuscularly with Cob at 0, 50, or 100 mg/kg at 2 min after H2 S exposure. For objective 2, mice were injected intramuscularly with 100 mg/kg Cob at 2, 15, and 30 min after H2 S exposure. For both objectives, mice were exposed to 765 ppm of H2 S gas. Cob significantly reduced H2 S-induced lethality in a dose-dependent manner (P < 0.05). Cob-treated mice exhibited significantly fewer seizures and knockdowns compared with the H2 S-exposed group. Cob also reversed H2 S-induced weight loss, behavioral deficits, neurochemical changes, cytochrome c oxidase enzyme inhibition, and neurodegeneration in a dose- and time-dependent manner (P < 0.01). Overall, these findings show that Cob increases survival and is neuroprotective in a mouse model of H2 S-induced neurological sequelae.
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Affiliation(s)
- Poojya Anantharam
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa
| | | | - Belinda Mahama
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa
| | - Dong-Suk Kim
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa
| | - Souvarish Sarkar
- Department of Biomedical Sciences, Iowa State University, Ames, Iowa
| | - Cristina Santana
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa
| | - Adriano Chan
- Department of Biomedical Sciences, Iowa State University, Ames, Iowa
| | | | - Arthi Kanthasamy
- Department of Biomedical Sciences, Iowa State University, Ames, Iowa
| | - Gerry R. Boss
- Department of Medicine, University of California, San Diego, San Diego, California
| | - Wilson K. Rumbeiha
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, Iowa
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Bebarta VS, Garrett N, Brenner M, Mahon SB, Maddry JK, Boudreau S, Castaneda M, Boss GR. Efficacy of Intravenous Cobinamide Versus Hydroxocobalamin or Saline for Treatment of Severe Hydrogen Sulfide Toxicity in a Swine (Sus scrofa) Model. Acad Emerg Med 2017; 24:1088-1098. [PMID: 28472554 DOI: 10.1111/acem.13213] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/22/2017] [Accepted: 04/27/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Hydrogen sulfide (H2 S) is a potentially deadly gas that naturally occurs in petroleum and natural gas. The Occupational Health and Safety Administration cites H2 S as a leading cause of workplace gas inhalation deaths. Mass casualties of H2 S toxicity may be caused by exposure from industrial accidents or release from oil field sites. H2 S is also an attractive terrorism tool because of its high toxicity and ease with which it can be produced. Several potential antidotes have been proposed for hydrogen sulfide poisoning but none have been completely successful. OBJECTIVE The objective was to compare treatment response assessed by the time to spontaneous ventilation among groups of swine with acute H2 S-induced apnea treated with intravenous (IV) cobinamide (4 mg/kg in 0.8 mL of 225 mmol/L solution), IV hydroxocobalamin (4 mg/kg in 5 mL of saline), or saline alone. METHODS Twenty-four swine (45-55 kg) were anesthetized, intubated, and instrumented with continuous femoral and pulmonary artery pressure monitoring. After stabilization, anesthesia was adjusted such that animals would spontaneously ventilate with an FiO2 of 0.21. Sodium hydrosulfide (NaHS; concentration of 8 mg/mL) was begun at 1 mg/kg/min until apnea was confirmed for 20 seconds by capnography. This infusion rate was sustained for 1.5 minutes postapnea and then decreased to a maintenance rate for the remainder of the study to replicate sustained clinical exposure. Animals were randomly assigned to receive cobinamide (4 mg/kg), hydroxocobalamin (4 mg/kg), or saline and monitored for 60 minutes beginning 1 minute postapnea. G* power analysis using the Z-test determined that equal group sizes of eight animals were needed to achieve a power of 80% in detecting a 50% difference in return to spontaneous ventilations at α = 0.05. RESULTS There were no significant differences in baseline variables. Moreover, there were no significant differences in the mg/kg dose of NaHS (5.6 mg/kg; p = 0.45) required to produce apnea. Whereas all of the cobinamide-treated animals survived (8/8), none of the control (0/8) or hydroxocobalamin (0/8)-treated animals survived. Mean (±SD) time to spontaneous ventilation in the cobinamide-treated animals was 3.2 (±1.1) minutes. CONCLUSIONS Cobinamide successfully rescued the severely NaHS-poisoned swine from apnea in the absence of assisted ventilation.
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Affiliation(s)
- Vikhyat S. Bebarta
- Department of Emergency Medicine; University of Colorado Denver-Anschutz Medical Campus; Aurora CO
| | - Normalynn Garrett
- CREST Research Program; Department of Emergency Medicine; San Antonio Military Medical Center; San Antonio TX
| | - Matthew Brenner
- Beckman Laser Institute and Medical Clinic; University of California at Irvine; Irvine CA
| | - Sari B Mahon
- Beckman Laser Institute and Medical Clinic; University of California at Irvine; Irvine CA
| | - Joseph K. Maddry
- Air Force En Route Care Research Center; San Antonio TX
- CREST Research Program; Department of Emergency Medicine; San Antonio Military Medical Center; San Antonio TX
| | - Susan Boudreau
- CREST Research Program; Department of Emergency Medicine; San Antonio Military Medical Center; San Antonio TX
| | - Maria Castaneda
- CREST Research Program; Department of Emergency Medicine; San Antonio Military Medical Center; San Antonio TX
| | - Gerry R. Boss
- Department of Medicine; University of California at San Diego; La Jolla CA
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Summerhill EM, Hoyle GW, Jordt SE, Jugg BJ, Martin JG, Matalon S, Patterson SE, Prezant DJ, Sciuto AM, Svendsen ER, White CW, Veress LA. An Official American Thoracic Society Workshop Report: Chemical Inhalational Disasters. Biology of Lung Injury, Development of Novel Therapeutics, and Medical Preparedness. Ann Am Thorac Soc 2017; 14:1060-1072. [PMID: 28418689 PMCID: PMC5529138 DOI: 10.1513/annalsats.201704-297ws] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This report is based on the proceedings from the Inhalational Lung Injury Workshop jointly sponsored by the American Thoracic Society (ATS) and the National Institutes of Health (NIH) Countermeasures Against Chemical Threats (CounterACT) program on May 21, 2013, in Philadelphia, Pennsylvania. The CounterACT program facilitates research leading to the development of new and improved medical countermeasures for chemical threat agents. The workshop was initiated by the Terrorism and Inhalational Disasters Section of the Environmental, Occupational, and Population Health Assembly of the ATS. Participants included both domestic and international experts in the field, as well as representatives from U.S. governmental funding agencies. The meeting objectives were to (1) provide a forum to review the evidence supporting current standard medical therapies, (2) present updates on our understanding of the epidemiology and underlying pathophysiology of inhalational lung injuries, (3) discuss innovative investigative approaches to further delineating mechanisms of lung injury and identifying new specific therapeutic targets, (4) present promising novel medical countermeasures, (5) facilitate collaborative research efforts, and (6) identify challenges and future directions in the ongoing development, manufacture, and distribution of effective and specific medical countermeasures. Specific inhalational toxins discussed included irritants/pulmonary toxicants (chlorine gas, bromine, and phosgene), vesicants (sulfur mustard), chemical asphyxiants (cyanide), particulates (World Trade Center dust), and respirable nerve agents.
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Nath AK, Shi X, Harrison DL, Morningstar JE, Mahon S, Chan A, Sips P, Lee J, MacRae CA, Boss GR, Brenner M, Gerszten RE, Peterson RT. Cisplatin Analogs Confer Protection against Cyanide Poisoning. Cell Chem Biol 2017; 24:565-575.e4. [PMID: 28416275 DOI: 10.1016/j.chembiol.2017.03.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 01/19/2017] [Accepted: 03/16/2017] [Indexed: 02/04/2023]
Abstract
Cisplatin holds an illustrious position in the history of chemistry most notably for its role in the virtual cure of testicular cancer. Here we describe a role for this small molecule in cyanide detoxification in vivo. Cyanide kills organisms as diverse as insects, fish, and humans within seconds to hours. Current antidotes exhibit limited efficacy and are not amenable to mass distribution requiring the development of new classes of antidotes. The binding affinity of the cyanide anion for the positively charged metal platinum is known to create an extremely stable complex in vitro. We therefore screened a panel of diverse cisplatin analogs and identified compounds that conferred protection from cyanide poisoning in zebrafish, mice, and rabbits. Cumulatively, this discovery pipeline begins to establish the characteristics of platinum ligands that influence their solubility, toxicity, and efficacy, and provides proof of concept that platinum-based complexes are effective antidotes for cyanide poisoning.
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Affiliation(s)
- Anjali K Nath
- Division of Cardiology, Department of Medicine, Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA 02129, USA; Department of Systems Biology, Harvard Medical School, Boston, MA 02215, USA; Broad Institute, Cambridge, MA 02142, USA.
| | - Xu Shi
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Devin L Harrison
- Division of Cardiology, Department of Medicine, Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA 02129, USA; Department of Systems Biology, Harvard Medical School, Boston, MA 02215, USA
| | - Jordan E Morningstar
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Sari Mahon
- Department of Medicine, Beckman Laser Institute, University of California, Irvine, CA 92697, USA
| | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Patrick Sips
- Division of Cardiology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Jangwoen Lee
- Department of Medicine, Beckman Laser Institute, University of California, Irvine, CA 92697, USA
| | - Calum A MacRae
- Broad Institute, Cambridge, MA 02142, USA; Division of Cardiology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Matthew Brenner
- Department of Medicine, Beckman Laser Institute, University of California, Irvine, CA 92697, USA
| | - Robert E Gerszten
- Broad Institute, Cambridge, MA 02142, USA; Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Randall T Peterson
- Division of Cardiology, Department of Medicine, Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA 02129, USA; Department of Systems Biology, Harvard Medical School, Boston, MA 02215, USA; Broad Institute, Cambridge, MA 02142, USA.
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Bebarta VS, Brittain M, Chan A, Garrett N, Yoon D, Burney T, Mukai D, Babin M, Pilz RB, Mahon SB, Brenner M, Boss GR. Sodium Nitrite and Sodium Thiosulfate Are Effective Against Acute Cyanide Poisoning When Administered by Intramuscular Injection. Ann Emerg Med 2016; 69:718-725.e4. [PMID: 28041825 DOI: 10.1016/j.annemergmed.2016.09.034] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/16/2016] [Accepted: 09/22/2016] [Indexed: 11/29/2022]
Abstract
STUDY OBJECTIVE The 2 antidotes for acute cyanide poisoning in the United States must be administered by intravenous injection. In the out-of-hospital setting, intravenous injection is not practical, particularly for mass casualties, and intramuscular injection would be preferred. The purpose of this study is to determine whether sodium nitrite and sodium thiosulfate are effective cyanide antidotes when administered by intramuscular injection. METHODS We used a randomized, nonblinded, parallel-group study design in 3 mammalian models: cyanide gas inhalation in mice, with treatment postexposure; intravenous sodium cyanide infusion in rabbits, with severe hypotension as the trigger for treatment; and intravenous potassium cyanide infusion in pigs, with apnea as the trigger for treatment. The drugs were administered by intramuscular injection, and all 3 models were lethal in the absence of therapy. RESULTS We found that sodium nitrite and sodium thiosulfate individually rescued 100% of the mice, and that the combination of the 2 drugs rescued 73% of the rabbits and 80% of the pigs. In all 3 species, survival in treated animals was significantly better than in control animals (log rank test, P<.05). In the pigs, the drugs attenuated an increase in the plasma lactate concentration within 5 minutes postantidote injection (difference: plasma lactate, saline solution-treated versus nitrite- or thiosulfate-treated 1.76 [95% confidence interval 1.25 to 2.27]). CONCLUSION We conclude that sodium nitrite and sodium thiosulfate administered by intramuscular injection are effective against severe cyanide poisoning in 3 clinically relevant animal models of out-of-hospital emergency care.
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Affiliation(s)
- Vikhyat S Bebarta
- Department of Emergency Medicine, University of Colorado, School of Medicine, Aurora, CO
| | | | - Adriano Chan
- Department of Medicine, University of California, San Diego, La Jolla, CA
| | - Norma Garrett
- Medical Toxicology and the Department of Emergency Medicine, San Antonio Military Medical Center/59 MDW, San Antonio, TX
| | - David Yoon
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA
| | - Tanya Burney
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA
| | - David Mukai
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA
| | | | - Renate B Pilz
- Department of Medicine, University of California, San Diego, La Jolla, CA
| | - Sari B Mahon
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA
| | - Matthew Brenner
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, CA
| | - Gerry R Boss
- Department of Medicine, University of California, San Diego, La Jolla, CA
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The Vitamin B 12 Analog Cobinamide Is an Effective Antidote for Oral Cyanide Poisoning. J Med Toxicol 2016; 12:370-379. [PMID: 27631586 DOI: 10.1007/s13181-016-0566-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/31/2016] [Accepted: 06/14/2016] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Cyanide is a major chemical threat, and cyanide ingestion carries a higher risk for a supra-lethal dose exposure compared to inhalation but provides an opportunity for effective treatment due to a longer treatment window and a gastrointestinal cyanide reservoir that could be neutralized prior to systemic absorption. We hypothesized that orally administered cobinamide may function as a high-binding affinity scavenger and that gastric alkalinization would reduce cyanide absorption and concurrently increase cobinamide binding, further enhancing antidote effectiveness. METHODS Thirty New Zealand white rabbits were divided into five groups and were given a lethal dose of oral cyanide poisoning (50 mg). The survival time of animals was monitored with oral cyanide alone, oral cyanide with gastric alkalinization with oral sodium bicarbonate buffer (500 mg), and in combination with either aquohydroxocobinamide or dinitrocobinamide (250 mM). Red blood cell cyanide concentration, plasma cobinamide, and thiocyanate concentrations were measured from blood samples. RESULTS In cyanide ingested animals, oral sodium bicarbonate alone significantly prolonged survival time to 20.3 ± 8.6 min compared to 10.5 ± 4.3 min in saline-treated controls, but did not lead to overall survival. Aquohydroxocobinamide and dinitrocobinamide increased survival time to 64 ± 41 (p < 0.05) and 75 ± 16.4 min (p < 0.001), respectively. Compared to aquohydroxocobinamide, dinitrocobinamide showed greater systemic absorption and reduced blood pressure. Dinitrocobinamide also markedly increased the red blood cell cyanide concentration. Under all conditions, the plasma thiocyanate concentration gradually increased with time. CONCLUSION This study demonstrates a promising new approach to treat high-dose cyanide ingestion, with gastric alkalinization alone and in combination with oral cobinamide for treating a supra-lethal dose of orally administered cyanide in rabbits.
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Simultaneous determination of 3-mercaptopyruvate and cobinamide in plasma by liquid chromatography–tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2016; 1008:181-188. [DOI: 10.1016/j.jchromb.2015.11.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 11/16/2015] [Accepted: 11/17/2015] [Indexed: 11/22/2022]
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Zelder F. Recent trends in the development of vitamin B12 derivatives for medicinal applications. Chem Commun (Camb) 2015; 51:14004-17. [PMID: 26287029 DOI: 10.1039/c5cc04843e] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This Feature Article highlights recent developments in the field of vitamin B12 derivatives for medicinal applications. The following topics are emphasized: (1) the development of aquacorrinoids for cyanide detection and detoxification, (2) the use of vitamin B12 conjugates and (3) antivitamins B12 for therapy and diagnosis, and (4) the design of corrinoids as activators of soluble guanylyl cyclase (sGC).
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Affiliation(s)
- Felix Zelder
- Department of Chemistry, University of Zürich, Winterthurerstr. 190, CH-8057 Zürich, Switzerland.
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Decellularized skeletal muscle as an in vitro model for studying drug-extracellular matrix interactions. Biomaterials 2015; 64:108-14. [PMID: 26125502 DOI: 10.1016/j.biomaterials.2015.06.033] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 06/12/2015] [Accepted: 06/18/2015] [Indexed: 01/16/2023]
Abstract
Several factors can affect drug absorption after intramuscular (IM) injection: drug solubility, drug transport across cell membranes, and drug metabolism at the injection site. We found that potential interactions between the drug and the extracellular matrix (ECM) at the injection site can also affect the rate of absorption post-injection. Using decellularized skeletal muscle, we developed a simple method to model drug absorption after IM injection, and showed that the nature of the drug-ECM interaction could be investigated by adding compounds that alter binding. We validated the model using the vitamin B12 analog cobinamide with different bound ligands. Cobinamide is being developed as an IM injectable treatment for cyanide poisoning, and we found that the in vitro binding data correlated with previously published in vivo drug absorption in animals. Commercially available ECM products, such as collagen and GelTrex, did not recapitulate drug binding behavior. While decellularized ECM has been widely studied in fields such as tissue engineering, this work establishes a novel use of skeletal muscle ECM as a potential in vitro model to study drug-ECM interactions during drug development.
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