The effect of amphotericin B on the water and nonelectrolyte permeability of thin lipid membranes

Polyene Antibiotics Physical Chemistry and Their Effect on Lipid Membranes; Impacting Biological Processes and Medical Applications

This review examined a collection of studies regarding the molecular properties of some polyene antibiotic molecules as well as their properties in solution and in particular environmental conditions. We also looked into the proposed mechanism of action of polyenes, where membrane properties play a crucial role. Given the interest in polyene antibiotics as therapeutic agents, we looked into alternative ways of reducing their collateral toxicity, including semi-synthesis of derivatives and new formulations. We follow with studies on the role of membrane structure and, finally, recent developments regarding the most important clinical applications of these compounds.

Does Impaired Transcellular Water Transport Contribute to Net Ultrafiltration Failure during CAPD?

Objectives

To assess the contribution of transcellular water transport in net ultrafiltration failure during continuous ambulatory peritoneal dialysis (CAPD).

Design

Retrospective.

Setting

Renal Unit, Academic Medical Center, Amsterdam.

Patients

One group of 6 patients with clinical severe ultrafiltration loss and a group of 10 stable CAPD patients without ultrafiltration problems.

Intervention

In all patients, two peritoneal permeability tests were done within one week, using glucose 1.36% dialysate on one day and glucose 3.86% on the other day. Dextran 70 was used as a volume marker.

Results

The difference in net ultrafiltration between 3.86% glucose and 1.36% glucose dialysate was 569±51 mL (control) and 153±1 03 mL (poor ultrafiltration group; p < 0.005). The dialysatelplasma (DIP) concentration ratios increased in both groups with glucose 1.36%. When using 3.86% glucose, the DIP ratio decreased in the control group with a median minimum value one hour after completion of inflow. It is possible that sieving of sodium was due to transcellular water transport by crystalloid osmosis during the hypertonic dwell, as a dissociation between the transport of water and sodium is unlikely to occur in transport through the much larger intercellular pores. The DIP sodium ratio after one hour was related to the mass transfer area coefficient (MTC) of creatinine and the percentage of glucose absorption in the control group. No decrease in DIP ratio was found in the poor ultrafiltration group. This suggests impairment of transcellular water transport. No significant differences were present between both groups with regard to MTC creatinine (10.2 and 14.0 mL/min), glucose absorption (71% and 71%), effective lymphatic absorption rate (1.34 and 1.01 mL/min), and residual volume (248 and 178 mL). Only 1 patient in the ultrafiltration loss group continued with CAPD. The others had to be transferred to hemodialysis; 1 of them developed sclerosing peritonitis.

Conclusion

The sieving of sodium during CAPD may be caused by transcellular water transport. Deficient sieving as assessed by the absence of a decreased DIP ratio after one hour of a hypertonic dwell suggests impairment of transcellular water transport. This is asso ciated with severe ultrafiltration failure. It indicates that failure of transcellular water transport, possibly by glycosylation of specific proteins on the cell membrane, may be considered one of the causes of ultrafiltration failure during CAPD.

Augmentation of Peritoneal Hydraulic Permeability by Amphotericin B: Locus of Action

In normal rabbits, intraperitoneal instillation of amphotericin B increased peritoneal ultrafiltration rates without changing the osmotic gradient. Solute clearances were unaffected. When given intravenously the drug was ineffective, suggesting that amphotericin B acts on the serosal side of the vasculature or mesothelium, presumably creating channels through the membrane, thereby increasing hydraulic permeability.

Peritoneal transport rates are much lower than those of hemodialysis (I). To circumvent this deficiency, continuous peritoneal dialysis is now employed in many patients (2). Nevertheless. a segment of patients undergoing continuous ambulatory peritoneal dialysis have, or develop, inadequate transport rates for solutes, or more often for water (3). Hence, their dialyses are not efficient enough for maintenance therapy.

It is naive to consider that the peritoileum is inert like hemodialysis membranes. Accordingly, it has been observed that transport rates decrease with systemic vascular disease, or after vasoconstrictor drugs (4, 5) and increase when vasodilators are administered locally or have selective effects on the splanchnic vasculature (5 7). Also small number of studies have demonstrated that drugs, which affect membranes directly modulate peritoneal transport rates (8–10).

A preliminary evaluation of the effects of amphotericin B on peritoneal transport rates showed that osmotically induced water flux increases when the drug was given intraperitoneally (11). No direct effect on solute transport was detected and, over the range of 0.5 to 25 mg/kg, we noted no dose effect. Although amphotericin B is so large a solute that its own transmembrane transport would be slow, the site of action could not be determined with confidence from these studies. Accordingly, we undertook to compare the effects of intraperitoneal instillation with those of intravenous administration of amphotericin B in the same experimental animals.

A theory of ion permeation through membranes with fixed neutral sites

Some model membranes and biological membranes behave as if ion permeation were controlled by fixed neutral sites, i.e., by groups that are polar but lack net charge. By solving the boundary conditions and Nernst-Planck flux equations, this paper derives the expected properties of four types of membranes with fixed neutral sites: model 1, a membrane thick enough that microscopic electroneutrality is obeyed; model 2, same as model 1 but with a free-solution shunt in parallel; model 3, a membrane thin enough that microscopic electroneutrality is violated; and model 4, same as model 3 but with a free-solution shunt in parallel. The conductance-concentration relation and the current-voltage relation in symmetrical solutions are approximately linear for all four models. Partial ionic conductances are independent of each other for a thin membrane but not for a thick membrane. Sets of permeability ratios derived from conductances, dilution potentials, or biionic potentials agree with each other in a thin membrane but not in a thick membrane. The current-voltage relation in asymmetrical single-salt solutions is linear for a thick membrane but nonlinear for a thin membrane. Examples of potential and concentration profiles in a thin membrane are calculated to illustrate the meaning of space charge and the electroneutrality condition. The experimentally determined properties (by A. Cass, A. Finkelstein & V. Krespi) of thin lipid membranes containing "pores" of the anion-selective antibiotic nystatin are in reasonable agreement with model 3. Tests are suggested for deciding if a membrane of unknown structure has neutral sites, whether it is thick or thin, and whether the sites are fixed or mobile.

Transient permeability induced by alkyl derivatives of amphotericin B in lipid membranes

Individual ionic channels were shown to be formed in the brain cholesterol containing phospholipid membranes by two-sided addition of the amphotericin B alkyl derivatives. At concentrations between 10(-8) and 10(-7) M, the resulting conductance appeared to be transient. Existence of different antibiotic assemblies was justified by the kinetic analysis of the membrane conductance decline following the antibiotic washing out. In order to account for the transient characteristics of the induced conductance, it was proposed that the antibiotic oligomers incorporate into the membrane from the aqueous phase, form channels aggregating with cholesterol, and then dissociate in the bilayer into non-active degraded oligomeric or monomeric forms.

Renal water reabsorption: a physiologic retrospective in a molecular era

The cloning and sequencing of the aquaporin water channels has been an enormous advance in the biomedical sciences, as recognized by the award of the Nobel Prize to Peter Agre last year. Among many other examples, expression of aquaporin proteins in Xenopus oocytes and other heterologous expression systems has confirmed two important models of renal function: the increase in the water permeability of the collecting duct by antidiuretic hormone (ADH), and the mechanism of near isosmotic volume reabsorption by the proximal tubule. These mechanisms were the subjects of intensive investigation by numerous investigators, including Thomas E. Andreoli, who is being honored by this symposium, and who developed many of the key concepts in these areas. His early work with artificial lipid bilayer membranes and the pore-forming antibiotic amphotericin provided the rigorous foundation in experimental and conceptual modeling techniques that he later applied to physiologic and pathophysiologic mechanisms in the kidney, which are summarized in this retrospective. Dr. Andreoli and his colleagues proposed a water channel mechanism for the action of ADH, which has been confirmed by the cloning and heterologous expression of aquaporin-2. They also proposed that volume reabsorption by the proximal tubule depended on a very high hydraulic conductivity and the development of luminal hypotonicity produced by active solute reabsorption. This model has also been confirmed in mice in which aquaporin-1 expression is knocked out, resulting in a low proximal tubule water permeability that exaggerates the development of luminal hypotonicity.

Cooperative partition model of nystatin interaction with phospholipid vesicles

Nystatin is a membrane-active polyene antibiotic that is thought to kill fungal cells by forming ion-permeable channels. In this report we have investigated nystatin interaction with phosphatidylcholine liposomes of different sizes (large and small unilamellar vesicles) by time-resolved fluorescence measurements. Our data show that the fluorescence emission decay kinetics of the antibiotic interacting with gel-phase 1,2-dipalmitoyl-sn-glycero-3-phosphocholine vesicles is controlled by the mean number of membrane-bound antibiotic molecules per liposome, <A>. The transition from a monomeric to an oligomeric state of the antibiotic, which is associated with a sharp increase in nystatin mean fluorescence lifetime from approximately 7-10 to 35 ns, begins to occur at a critical concentration of 10 nystatin molecules per lipid vesicle. To gain further information about the transverse location (degree of penetration) of the membrane-bound antibiotic molecules, the spin-labeled fatty acids (5- and 16-doxyl stearic acids) were used in depth-dependent fluorescence quenching experiments. The results obtained show that monomeric nystatin is anchored at the phospholipid/water interface and suggest that nystatin oligomerization is accompanied by its insertion into the membrane. Globally, the experimental data was quantitatively described by a cooperative partition model which assumes that monomeric nystatin molecules partition into the lipid bilayer surface and reversibly assemble into aggregates of 6 +/- 2 antibiotic molecules.

Membrane permeability modeling: Kedem-Katchalsky vs a two-parameter formalism

The analysis of experiments for the purpose of determining cell membrane permeability parameters is often done using the Kedem-Katchalsky (KK) formalism (1958). In this formalism, three parameters, the hydraulic conductivity (Lp), the solute permeability (Ps), and a reflection coefficient (final sigma), are used to characterize the membrane. Sigma was introduced to characterize flux interactions when water and solute (cryoprotectant) cross the membrane through a common channel. However, the recent discovery and characterization of water channels (aquaporins) in biological membranes reveals that aquaporins are highly selective for water and do not typically cotransport cryoprotectants. In this circumstance, sigma is a superfluous parameter, as pointed out by Kedem and Katchalsky. When sigma is unneeded, a two-parameter model (2P) utilizing only Lp and Ps is sufficient, simpler to implement, and less prone to spurious results. In this paper we demonstrate that the 2P and KK formalism yield essentially the same result (Lp and Ps) when cotransporting channels are absent. This demonstration is accomplished using simulation techniques to compare the transport response of a model cell using a KK or 2P formalism. Sigma is often misunderstood, even when its use is appropriate. It is discussed extensively here and several simulations are used to illustrate and clarify its meaning. We also discuss the phenomenological nature of transport parameters in many experiments, especially when both bilayer and channel transport are present.

On the role of sterol in the formation of the amphotericin B channel

Amphotericin B is an antimycotic agent that has been studied for a long time, both because of its pharmacological action and the interest in understanding how this ionic channel works. It has been proposed that the channel is formed by a barrel of monomers, and that the presence of sterol is needed for the formation of such a barrel. As a matter of fact this need of a sterol has been used as a guiding idea in attempts to design derivatives more efficient in the discrimination of the cholesterol containing membranes, as compared to the ergosterol containing ones, henceforth diminishing the unwanted side effects in its pharmacological use. In this work we show that unitary channels that appear in a cholesterol containing membrane also appear when this membrane is free of cholesterol. We prove this to be the case for two membranes, a biological one, asolectin, and a synthetic one, DMPC. We then advance the idea that the role of sterols in the formation of the amphotericin B channel is related to the effects they have on the structure of the membrane itself, rather than to a direct involvement in the channel formation. We further look into the effect that different cholesterol concentrations in the membrane produce on the single channel properties.

Case Forum

A 39-Year -Old Man with Loss of Ultrafiltration

Osmotic flow in membrane pores of molecular size

Water transfer by osmosis through pores occurs either by viscous flow or diffusion depending on whether the driving osmolyte is able to enter the pore. Analysis of osmotic permeabilities (Pos) measured in antibiotic and cellular pore systems supports this distinction, showing that Pos approaches either the viscous value (Pf) or the diffusive value (Pd) depending on the size of the osmolyte in relation to the pore radius. Macroscopic hydrodynamics and diffusion theory, when used with drag and steric coefficients within an appropriate osmotic model, apply with remarkable accuracy to channels of molecular dimensions where water molecules cannot pass each other, without the need to postulate any special flow regimens. It becomes apparent that the true viscous to diffusive flow ratio, Pf/Pd, can be separated from the effects of tracer filing by osmotic measurements alone. It does not monotonically decrease with the pore radius but rises steeply at the smaller radii which would apply to pores in cell membranes. Consequently, the application of the theory to osmotic and diffusive flow data for the red cell predicts a pore radius of 0.2 nm in agreement with other recent measurements on isolated components of the system, showing that the viscous-diffusive distinction applies even in molecular pores.

Amphotericin B and sodium deoxycholate induced impairment of renal p-aminohippurate accumulation (PAH) and effect on lipid peroxidation in the rat kidney

The influence of amphotericin B on PAH transport as well as on lipid peroxidation in rat renal cortical slices was studied in vitro and ex vivo. In vitro, renal cortical slices were incubated with different amphotericin B (AmB) concentrations (2-60 micrograms/mL) or with the corresponding vehicle concentrations of sodium deoxycholate (NaDo) (1.64-49.2 micrograms/mL) and time dependently (15-30-60 min) with 30 micrograms/mL AmB or 24.6 micrograms/mL NaDo. Ex vivo, PAH transport of renal cortical slices was investigated following a 3-day intravenous AmB administration with 3 mg/kg per day or 2.46 mg/kg/day NaDo, respectively. In vitro AmB as well as NaDo decreased PAH transport dose and time dependently. At the highest AmB concentration of 60 micrograms/mL, PAH uptake decreased to 17.6%. The corresponding NaDo concentration (49.2 micrograms/mL) decreased PAH uptake to 33.3%. Time dependently AmB decreased PAH uptake to 25% after 60 min. NaDo caused a decrease to 69%. Administration of AmB for 3 days resulted in a PAH decline to 81%; NaDO decreased PAH uptake to 77%. In vitro as well as in vivo, AmB or its vehicle did not induce lipid peroxidation in renal cortical tissue. In summary, the results show that AmB and its vehicle, NaDo, decrease PAH uptake by renal cortical cells, reflecting a direct effect of AmB on tubular function. The impairment of the PAH transport is not due to enhanced lipid peroxidation.

Atrial natriuretic peptide has no direct effect on proximal tubule sodium and water reabsorption

Infusion of ANP has been shown to increase the urinary excretion of sodium and water. However it is still controversial in which tubular segment sodium reabsorption is inhibited. To clarify this problem we have performed in vivo and in vitro studies to examine the direct effect of ANP on rat proximal tubules. The in vivo effect of ANP has been tested by using the micropuncture technique and in particular the shrinking droplet method that allows each investigated tubule to serve as its own control. Addition of either low (10(-9) M) or high (2 x 10(-6) M) concentrations of ANP to the luminal perfusate resulted in no significant change in isotonic fluid reabsorption (Jv). The same holds when the proximal tubules were perfused on both the tubular and peritubular side, with modified Ringer solution containing 10(-9) M ANP. To examine possible in vitro effects of ANP we prepared highly purified proximal tubule suspension derived from rat renal cortex and monitored oxygen consumption (QO2) that is tightly coupled to sodium transport in this segment. Synthetic ANP, either at low (10(-9) M) or at high (10(-6) M) concentrations, did not affect basal rate of tubular respiration. Moreover the peptide hormone (10(-9) M) did not inhibit nystatin stimulated and ouabain sensitive QO2. These results indicate that the enhancement of renal sodium excretion induced by ANP is not related to a direct inhibition of sodium transport in the proximal tubule.

Nephrotoxic drugs

The nephrotoxic effects of cyclosporine, aminoglycoside antibiotics, cisplatin, amphotericin B, beta-lactam antibiotics and indomethacin are reviewed. These drugs were chosen because they are among the most frequent causes of renal injury in children. In addition, their nephrotoxicity is caused by different mechanisms. Several generalizations can be made, however. First, agents which cause tubular damage tend to be synergistic in their toxic effects. This synergism is seen when several nephrotoxic drugs are given simultaneously. In addition, the use of a nephrotoxic agent in a patient with pre-existing renal disease can result in severe tubular injury. Second, serum levels of the drug frequently fail to correlate with the degree of nephrotoxicity in individual patients. Third, early signs of renal injury can be subtle (e.g., minor changes in electrolyte excretion) or dramatic (e.g., acute renal failure). The subtle changes are particularly important, since they can be useful predictors of serious nephrotoxicity.

Amphotericin B and amphotericin B methylester: effect on brush border membrane permeability

In order to explain the nephrotoxicity of polyene antibiotics such as Amphotericin B (AM), an effect on the tubule membrane permeability has been postulated. However, studies on the action of AM have been complicated by the use of sodium deoxycholate (DOC), a membrane dissociating detergent as a solvent. Recently, a derivative, the methylester aspartate salt of Amphotericin B (AME) has been synthesized, which is highly water soluble in the absence of organic solvents. We have tested the action of AM, DOC, and AME on the sodium permeability of brush border (BBM) vesicles isolated from rat kidney cortex. It was found that both AM and AME increased the 22Na uptake as measured by a rapid filtration technique. However, a large fraction of the AM action was due to the effect of DOC on the BBM sodium permeability. We also investigated the time- and dose-dependent action of AME on 22Na and 3H-D-mannitol efflux from BBM vesicles. After 15 sec of exposure, efflux from 22Na-preloaded vesicles was unchanged in the presence of 1 microgram AME/mg protein compared to control vesicles. With 10, 50, and 100 micrograms AME/mg protein, the efflux increased 16, 25, and 35% respectively; 260 micrograms AME/mg protein did not elicit a further increment in the 22Na efflux. In the same membrane vesicles 3H-D-mannitol efflux did not change. After preincubation of the membranes for 60 min with different concentrations of AME, the 15 sec 22Na efflux increased 26% in the presence of 1 microgram/mg protein AME with no change in the 3H-D-mannitol efflux.(ABSTRACT TRUNCATED AT 250 WORDS)

The water and ionic permeability induced by polyene antibiotics across plasma membrane vesicles from Leishmania sp

An osmotic method has been used to study the effect of the polyene antibiotics amphotericin B, nystatin and candicidin on the water permeability of plasma membranes prepared from Leishmania sp. The effect of amphotericin B on the permeability of Leishmania membranes to a salt such as potassium nitrate was also investigated. A non-linear and saturable enhancement of water and salt permeability was measured with increasing polyene concentrations, which could be adjusted to Hill cooperativity equation. The antibiotic concentrations that induce at 30 degrees C half-maximal effects on the water permeability of Leishmania vesicles were 0.021 microM for candicidin, 0.21 microM for amphotericin B and 1.4 microM for nystatin. At 30 degrees C, the concentration of amphotericin B required to induce half of the maximal effect on the permeability of Leishmania vesicles to potassium nitrate was 1.8 microM. The temperature dependence for amphotericin B, nystatin and candicidin enhancement of the water permeability of Leishmania vesicles was determined by using Q10 data at 20 and 30 degrees C. The estimated activation energies at increasing polyene concentrations display the same general pattern for all three polyene antibiotics investigated, that is, a maximal positive value at about the polyene concentrations required for half-maximal effect. The significance of these results for understanding the mechanisms of action of polyene antibiotics on natural membranes is discussed.

Concentration- and time-dependence of amphotericin-B induced permeability changes across ergosterol-containing liposomes

The effect of amphotericin B on the permeability properties of liposomes prepared by reverse-phase evaporation was examined by using an osmotic method. This study has revealed that the magnitude and type of the alterations in permeability induced by amphotericin B in liposomes made of egg phosphatidylcholine and ergosterol depend not only on the amphotericin B concentration in the external aqueous solution but also on the time elapsed after mixing. Thus, low amphotericin B concentrations (from 0.2 to 1.2 microM) led to, (1) an small increment of the total extent of shrinkage of liposomes suspended in non-electrolytes such as urea or salts like KNO3, (2) an enhancement of urea and salt permeabilities at the same time scale at which volume changes were measured (ms to s), (3) a maximal blocking by tetraethylammonium of amphotericin B-induced urea permeability and (4) an enhancement of glucose permeability but only after liposomes were incubated with amphotericin B for some minutes before mixing. The high amphotericin B concentration regime (beyond 1.2 microM) led to, (1) a decrease of the total extent of shrinkage of liposomes immediately after rapid mixing of liposomes with urea solutions containing amphotericin B and (2) a 50% reduction of the tetraethylammonium blocking of amphotericin B-induced urea permeability. These results are explained by assuming that amphotericin B may form in ergosterol-containing liposomes two types of active channel differing in internal diameter.

Mechanism of anion-cation selectivity of amphotericin B channels

Zero current potential and conductance of ionic channels formed by polyene antibiotic amphotericin B in a lipid bilayer were studied in various electrolyte solutions. Nonpermeant magnesium and sulphate ions were used to independently vary the concentration of monovalent anions and cations as well as to maintain the high ionic strength of the two solutions separated by the membrane. Under certain conditions the channels select very strongly for anions over cations. They are permeable to small inorganic anions. However, in the absence of these anions the channels are practically impermeable to any cation. In the presence of a permeant anion the contribution of monovalent cations to channel conductance grows with an increase in the anion concentration. The ratio of cation-to-anion permeability coefficients is independent of the membrane potential and cation concentration, but it does depend linearly on the sum of concentrations of a permeant anion in the two solutions. These results are accounted for on the assumption that a cation can enter only an anion-occupied channel to form an ionic pair at the center of the channel. The cation is also assumed to slip past the anion and then to leave the channel for the opposite solution. This model with only few parameters can quantitatively describe the concentration dependences of conductance and zero current potential under various conditions.

Regulation of volume reabsorption by thyroid hormones in the proximal tubule of rat: minor role of luminal sodium permeability

In order to investigate whether changes in luminal membrane sodium permeability can explain the increase in isotonic fluid reabsorption (Jv) found in proximal tubules of thyroidectomized rats (TX) treated with tri-iodothyronine (T3), experiments were carried out on TX rats and TX rats treated for 3 days (TX + T3) with physiological doses (10 micrograms/kg body wt) of T3. Two sets of experiments were performed: 1) in vivo, using the micropuncture technique for the measurements of Jv; 2) in vitro, using isolated brush border membrane vesicles for the direct measurement of Na+ permeability. In micropuncture studies a 65% increase in Jv of TX rats was observed after treatment with T3. Luminal perfusion of proximal tubules of TX rats with Amphotericin B (10 micrograms/ml), to increase luminal sodium permeability, enhanced Jv only by 15%. Brush border membrane vesicles isolated from TX and TX + T3 rats showed the same sodium permeability in uptake or efflux experiments. These results were confirmed by the fact that sodium gradient dependent histidine transport into brush border membrane vesicles did not change after T3 treatment. Finally, measuring the amiloride sensitive sodium uptake, it was also found that Na+-H+ exchange was also only slightly affected by T3. These micropuncture and vesicle data indicate that the large effect of T3 on the trans-cellular sodium transport and volume reabsorption in the proximal tubule, cannot be explained by an action of T3 on the sodium entry step across the brush border membrane.

The use of micropuncture, isolated tubule, and vesicle technique in the study of the action of thyroid hormones on the proximal tubule function

In hypothyroid rats (TX), the isotonic fluid reabsorption (Jv), that is closely linked to the transepithelial sodium transport (JNa), is impaired. The administration of physiological doses (10 micrograms/kg body weight per day) of tri-iodothyronine (T3) doubles Jv in three days (TX+T3). This phenomenon could be explained by several mechanisms: a direct stimulation of Na-K-ATPase, an increase in the Na+ entry step, changes in the permeability properties of the luminal and/or basal lateral membranes. Using a kinetic microassay, Na-K-ATPase activity was measured in early (S1) and late (S2) proximal tubules segments isolated from control, TX, and TX+3T3 animals. In TX rats the enzyme activity was lower (70%) in both segments versus control rats, it remained unchanged after 3 days, and it increased after 7 days of T3 substitution. The Na+ permeability of brush border membrane (BBM) vesicles isolated from TX and TX+T3 rats was identical. However the valuation of the K+ membrane permeability by in vivo perfusion of the lumen and peritubular space of proximal tubules of TX rats, with perfusate containing the K+ ionophore valinomycin (1 microgram/ml), induced a significant increase in Jv that accounted for 40% of that elicited by T3. Taken together, the in vivo and in vitro experiments suggest that the early effect on Jv of physiological doses of T3 cannot be explained by a direct action of T3 either on the Na+ entry step across the BBM or on the Na+ exit step (i.e., the Na-K-ATPase), but rather by an increase in K+ permeability of proximal tubular cell membranes.(ABSTRACT TRUNCATED AT 250 WORDS)

Amphotericin selectively increases peritoneal ultrafiltration

Because amphotericin B is known to affect transport rates across biologic membranes, the effects of this agent on transport parameters in an animal model of peritoneal dialysis were investigated. When amphotericin B in doses ranging from 0.5 to 25 mg/kg was instilled intraperitoneally with commercial dialysis solution, diffusive clearances of phosphate and urea did not differ from control values measured in the same animals, and only a modest increase in potassium clearance was detected. Ultrafiltration due to the osmotic gradient induced by the dextrose content of the dialysis solution increased significantly to 0.31 mL/kg/min with amphotericin B, compared with control values of 0.18 mL/kg/min. The drug did not affect dextrose transport and the osmotic gradient did not differ in the two groups. Hence, the ultrafiltration coefficient was higher with amphotericin B (14 microL/kg/min/mosm), than during control dialyses (6 microL/kg/min/mosm). Increased water flux was detected at the lowest dose and there was no dose relationship over the range studied. Amphotericin B may be the type of agent that will be clinically useful in patients with reduced peritoneal ultrafiltration capacity, and safer analogues should be explored.

Single-length and double-length channels formed by nystatin in lipid bilayer membranes

Nystatin forms two types of channels in sterol-containing planar bilayer membranes. One type is formed when it is added to only one side of the membrane; the other is formed when it is added to both sides of the membrane. The relative permeability of these channels to nonelectrolytes (urea and glycerol) is identical. The sensitivity of membranes to the one-sided action of nystatin is critically dependent on their thickness; in particular, membranes made from monoglycerides with more than 18 carbon atoms in their acyl chain are insensitive to nystatin's one-sided action. These data are consistent with a model in which the two types of channels formed by nystatin have essentially identical structures, except that the channel formed by its two-sided action is twice the length of that formed by its one-sided action, because it is a tail-to-tail dimer of the latter.

The relationship between adjuvant and mitogenic effects of amphotericin methyl ester

The antifungal polyene amphotericin B (AmB) and its methyl ester derivative (AME) both show potent murine immunostimulant as well as B-cell activating effects. Under certain experimental conditions, AME is a much more potent polyclonal B-cell activator (PBA) than AmB. Notable features of the murine B-cell stimulation induced by AME include: (i) High concentrations of AME (50-100 microgram/ml) are required and even at this level exhibit little or no spleen cell toxicity. (ii) Several lines of evidence suggest that the B-cell activating properties of AME are not involved in the cellular mechanism of adjuvant activity in vivo. (iii) There is a strong correlation between the magnitude of the in vitro PBA effects and the in vivo adjuvant effects of AME in a survey of different mouse strains. This evidence suggests that there is genetic control of the murine lymphoid cell-stimulatory effects of AME and that a small number of genes determines the responsive phenotype.

Effects of amphotericin B and its methyl ester on plasma membranes of Candida albicans and erythrocytes as examined by freeze-fracture electron microscopy

Freeze-fracture electron microscopy of the plasma membranes of Candida albicans yeast cells and red blood cells treated with amphotericin methyl ester and amphotericin B showed that amphotericin B (50 micrograms ml-1) caused extreme aggregation of intramembranous particles on the protoplasmic fracture face of the C. albicans membrane, and a marked reduction of the density of intramembranous particles. On the other hand, the rearrangement of intramembranous particles induced by amphotericin methyl ester (50 micrograms ml-1) produced elevations of the particle-free membrane domains toward the outside of the cells, so that the particles were aggregated in linear furrows surrounding these elevations on the protoplasmic fracture face, and the corresponding ridges on the exoplasmic fracture face. The density of intramembranous particles was greatly reduced on the protoplasmic fracture face. Both polyenes produced only small changes in the erythrocyte membranes at the same concentration. These results suggest that amphotericin methyl ester affects the ergosterol-containing membranes more than amphotericin B, and that ergosterol has a higher sensitivity for these two polyene antibiotics than cholesterol.

Permeability characteristics of muscle membrane

Unidirectional flux rates of saturated fatty acids, saturated alcohols, and bile acids were measured in an intact rat diaphragm preparation. The logarithm of the permeability coefficients for fatty acids containing from five to ten carbon atoms was a linear function of the number of carbon atoms in the fatty acid chain. Incremental free energies of solution were +336 cal x mol-1 for the addition of a hydroxyl group and -258 cal x mol(-1) for the addition of a methylene group. These incremental free energies were similar to those obtained by other investigators in other animal tissues, and our data suggest a structural similarity between membranes in different tissues and in different species. The muscle membrane exhibited anomalously high permeabilities for fatty acids containing less than five carbon atoms. Since muscle lacks tight junctions, this result suggest that small non-electrolytes traverse polar regions or aqueous pores within the cellular membrane.

Mechanism of blockage of amphotericin B channels in a lipid bilayer

A number of organic compounds (non-electrolytes, tetraalkylammonia, etc.) with a molecular size of 6--8 angstrom decrease the conductance of ionic channels formed in the lipid bilayer by a polyene antibiotic amphotericin B. It is suggested that these compounds, upon entering the channel, block the passage of inorganic ions. The extent of conductance blockage by organic ions depends on the membrane potential and electrolyte concentration. In the presence of ionic blockers, for instance tetraethylammonium, amphotericin B-containing membranes assume some properties characteristic of excitable membranes, i.e. the current-voltage characteristic acquires the negative resistance region, and in response to a potential step activation followed by inactivation of conductance is observed. It is shown that the potential dependence of the blockage is due to interaction inside the channel of the blocker ion with penetrating ions, by a mechanism similar to that described by Armstrong ((1979) Q. Rev. Biophys. 7, 179--210) for blockage of squid axon potassium channels by ammonium derivatives.

Hypertonic cryohemolysis: ionophore and pH effects

Human erythrocytes suspended at 37 degrees C in hypertonic solution of either electrolytes or nonelectrolytes undergo hemolysis when the temperature is lowered toward 0 degrees C (Green, F.A., Jung, C.Y. 1977 J. Membrane Biol. 33:249). In the present studies this hypertonic cryohemolysis was profoundly affected by the pH of incubation, and was completely abolished at ph 5. In hypertonic NaCl, there was an apparent pH optimum at 6--6.5. In hypertonic sucrose, on the other hand, hemolysis increased progressively with increasing pH between 6 and 9. Amphotericin B inhibited hypertonic cryohemolysis in NaCl or KCl solution. No inhibiting effect of amphotericin B was observed when hypertonicity was due to sodium sulfate or sucrose. Valinomycin also inhibited hypertonic cryohemolysis in KCl, but did not affect the process in NaCl or sucrose solution. SITS (4-acetamido-4'-isothiocyanostilbene-2,2'-disulfonate) and phloretin interfered with this valinomycin effect, whereas phlorizin did not. These results indicate that dissipation of an osmotic gradient across membranes may be responsible for the inhibition of the hemolysis by these inophores. Iso-osmotic cell shrinkage induced by valinomycin in 150 mM NaCl solution did not result in cryohemolysis.

Properties of amphotericin B channels in a lipid bilayer

Properties of individual ionic channels formed by polyene antibiotic Amphotericin B were studied on brain phospholipid membranes containing cholesterol. The ionic channels have a closed state and an open one (with conductance of about 6.5 pS in 2 M KCl). The conductance value of an open channel is independent of cholesterol concentration in the membrane of pH in the range from 3.5 to 8.0. The voltage-current characteristics of a single channel are superlinear. Zero current potential value in the case of different KCl concentrations in the two solutions indicates preferential but not ideal anionic selectivity of a single channel. Channel conductivity grows as the electrolyte concentration is increased and tends to a limiting value at high concentrations. A simple model having only one site for an ion was shown to represent satisfactorily an open channel behaviour under different conditions. An individual ionic channel performs a large number of transitions between the open and closed states during its life-time of several minutes. Rate constants of these transitions depend on the kind and concentration of salt in aqueous solutions. The switching system functioning is not influenced by an ion situated inside the pore.

Aggregation-dependent changes in susceptibility of Dictyostelium discoideum to amphotericin B

In this study, the polyene antibiotic amphotericin B was used to induce changes in permeability and viability of the eucaryotic microorganism Dictyostelium discoideum. The results show that as the cells progress from the growth phase through stationary phase to eventual aggregation, they become increasingly resistant to both permeability changes and lysis. Plasma membranes were prepared from cells harvested at exponential growth, stationary phase, and the aggregation-competent stage, and both the neutral lipid and phospholipid content were determined. An increase in the neutral lipid and a decrease in the phospholipid were observed as the cells progressed from growth into aggregation, with the overall result that the phospholipid-sterol ratio decreased during this period. The extent of amphotericin B binding by cells from the different stages was also determined. Aggregation cells exhibited a small but significant increase in binding compared to cells from either of the other two stages. The permeability changes produced by the drug were measured as a function of temperature. Exponentially growing cells showed a marked temperature dependence for the drug effect, whereas aggregating cells did not. Rates of inactivation by the drug were also determined over a range of temperatures. With exponentially growing cells, the rate of inactivation was temperature dependent, whereas with aggregating cells it was not. Finally, drug binding for both growing and aggregating cells was temperature dependent. Thus, no binding was observed for cells of either type at 4 degrees C. This finding suggests that the differences in the temperature dependence of the permeability changes and inactivation between the cells involve parameters other than drug binding.

The electrical properties and active ion transport across the urinary bladder of the urodele, Amphiuma means

1. The electrical properties and the active transport processes of the isolated urinary bladder of the urodele, Amphiuma means, were studied by mounting this tissue as a flat sheet between two halves of a lucite chamber. The mean transepithelial potential difference was 70-2 +/- 2-3 mV (serosa positive), the mean short-circuit current was 10-9 +/- 0-5 micrionA/mg of dry weight and the mean transepithelial d.c. resistance was 6540 +/- 374 omega mg of dry weight. 2. The short-circuit current (Isc) accounted for 92% of the net 22Na+ flux from the mucosa to the serosa. The difference resulted from a transport of 36Cl- in the same direction as sodium. 3. The active sodium transport exhibited typical saturation kinetics, having a Km of 15-4 m-equiv/l. and approaching zero order at 60-70 m-equiv/l. The transepithelial potential difference increased linearly with the log of the mucosal sodium concentration at a rate of 50-3 mV per tenfold concentration change. 4. In the absence of the major anions (HCO3- and Cl-) from the bathing solutions, the electrical properties and the sodium influx decreased to less than 40% of their control values. The presence of only one of these two anions in the serosal bathing solution was sufficient to maintain these parameters. 5. Amiloride (10(-5)M) and ouabain (10(-6)M) inhibited the sodium transport 97% and 85% respectively. Amphotericin B (10(-6)M) stimulated the sodium transport 47%. Furosemide (10(-3)M) inhibited the chloride transport 43%. The sodium transport was insensitive to the action of two enurohypophyseal peptides tested, lysine-vasotocin and pitocin.

Nonelectrolyte diffusion across lipid bilayer systems

The permeability coefficients of a homologous series of amides from formamide through valeramide have been measured in spherical bilayers prepared by the method described by Jung. They do not depend directly on the water:ether partition coefficient which increases regularly with chain length. Instead there is a minimum at acetamide. This has been ascribed to the effect of steric hindrance on diffusion within the bilayer which increases with solute molar volume. This factor is of the same magnitude, though opposite in sign to the effect of lipid solubility, thus accounting for the minimum. The resistance to passage across the interface has been compared to the resistance to diffusion within the membrane. As the solute chain length increases the interface becomes more important, until for valeramide it comprises about 90% of the total resistance. Interface resistance is also important in urea permeation, causing urea to permeate much more slowly than an amide of comparable size, after allowance is made for the difference in the water:ether partition coefficient. Amide permeation coefficients have been compared with relative liposome permeation data measured by the rate of liposome swelling. The ratios of the two measures of permeation vary between 3 and 16 for the homologous amides. The apparent enthalpy of liposome permeation has been measured and found to be in the neighborhood of 12 kcal mol-1 essentially independent of chain length. Comparison of the bilayer permeability coefficients with those of red cells shows that red cell permeation by the lipophilic solutes resembles that of the bilayers, whereas permeation by the hydrophilic solutes differs significantly.