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Kontoghiorghes GJ. Drug Selection and Posology, Optimal Therapies and Risk/Benefit Assessment in Medicine: The Paradigm of Iron-Chelating Drugs. Int J Mol Sci 2023; 24:16749. [PMID: 38069073 PMCID: PMC10706143 DOI: 10.3390/ijms242316749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/19/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
The design of clinical protocols and the selection of drugs with appropriate posology are critical parameters for therapeutic outcomes. Optimal therapeutic protocols could ideally be designed in all diseases including for millions of patients affected by excess iron deposition (EID) toxicity based on personalised medicine parameters, as well as many variations and limitations. EID is an adverse prognostic factor for all diseases and especially for millions of chronically red-blood-cell-transfused patients. Differences in iron chelation therapy posology cause disappointing results in neurodegenerative diseases at low doses, but lifesaving outcomes in thalassemia major (TM) when using higher doses. In particular, the transformation of TM from a fatal to a chronic disease has been achieved using effective doses of oral deferiprone (L1), which improved compliance and cleared excess toxic iron from the heart associated with increased mortality in TM. Furthermore, effective L1 and L1/deferoxamine combination posology resulted in the complete elimination of EID and the maintenance of normal iron store levels in TM. The selection of effective chelation protocols has been monitored by MRI T2* diagnosis for EID levels in different organs. Millions of other iron-loaded patients with sickle cell anemia, myelodysplasia and haemopoietic stem cell transplantation, or non-iron-loaded categories with EID in different organs could also benefit from such chelation therapy advances. Drawbacks of chelation therapy include drug toxicity in some patients and also the wide use of suboptimal chelation protocols, resulting in ineffective therapies. Drug metabolic effects, and interactions with other metals, drugs and dietary molecules also affected iron chelation therapy. Drug selection and the identification of effective or optimal dose protocols are essential for positive therapeutic outcomes in the use of chelating drugs in TM and other iron-loaded and non-iron-loaded conditions, as well as general iron toxicity.
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Affiliation(s)
- George J Kontoghiorghes
- Postgraduate Research Institute of Science, Technology, Environment and Medicine, Limassol 3021, Cyprus
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2
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San-Martín-Martínez D, Serrano-Lemus D, Cornejo V, Gajardo AIJ, Rodrigo R. Pharmacological Basis for Abrogating Myocardial Reperfusion Injury Through a Multi-Target Combined Antioxidant Therapy. Clin Pharmacokinet 2022; 61:1203-1218. [DOI: 10.1007/s40262-022-01151-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
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Targeting Pro-Oxidant Iron with Deferoxamine as a Treatment for Ischemic Stroke: Safety and Optimal Dose Selection in a Randomized Clinical Trial. Antioxidants (Basel) 2021; 10:antiox10081270. [PMID: 34439518 PMCID: PMC8389327 DOI: 10.3390/antiox10081270] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 12/24/2022] Open
Abstract
A role of iron as a target to prevent stroke-induced neurodegeneration has been recently revisited due to new evidence showing that ferroptosis inhibitors are protective in experimental ischemic stroke and might be therapeutic in other neurodegenerative brain pathologies. Ferroptosis is a new form of programmed cell death attributed to an overwhelming lipidic peroxidation due to excessive free iron and reactive oxygen species (ROS). This study aims to evaluate the safety and tolerability and to explore the therapeutic efficacy of the iron chelator and antioxidant deferoxamine mesylate (DFO) in ischemic stroke patients. Administration of placebo or a single DFO bolus followed by a 72 h continuous infusion of three escalating doses was initiated during the tPA infusion, and the impact on blood transferrin iron was determined. Primary endpoint was safety and tolerability, and secondary endpoint was good clinical outcome (clinicalTrials.gov NCT00777140). DFO was found safe as adverse effects were not different between placebo and DFO arms. DFO (40-60 mg/Kg/day) reduced the iron saturation of blood transferrin. A trend to efficacy was observed in patients with moderate-severe ischemic stroke (NIHSS > 7) treated with DFO 40-60 mg/Kg/day. A good outcome was observed at day 90 in 31% of placebo vs. 50-58% of the 40-60 mg/Kg/day DFO-treated patients.
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4
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Moussa RS, Park KC, Kovacevic Z, Richardson DR. Ironing out the role of the cyclin-dependent kinase inhibitor, p21 in cancer: Novel iron chelating agents to target p21 expression and activity. Free Radic Biol Med 2019; 133:276-294. [PMID: 29572098 DOI: 10.1016/j.freeradbiomed.2018.03.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/02/2018] [Accepted: 03/14/2018] [Indexed: 12/12/2022]
Abstract
Iron (Fe) has become an important target for the development of anti-cancer therapeutics with a number of Fe chelators entering human clinical trials for advanced and resistant cancer. An important aspect of the activity of these compounds is their multiple molecular targets, including those that play roles in arresting the cell cycle, such as the cyclin-dependent kinase inhibitor, p21. At present, the exact mechanism by which Fe chelators regulate p21 expression remains unclear. However, recent studies indicate the ability of chelators to up-regulate p21 at the mRNA level was dependent on the chelator and cell-type investigated. Analysis of the p21 promoter identified that the Sp1-3-binding site played a significant role in the activation of p21 transcription by Fe chelators. Furthermore, there was increased Sp1/ER-α and Sp1/c-Jun complex formation in melanoma cells, suggesting these complexes were involved in p21 promoter activation. Elucidating the mechanisms involved in the regulation of p21 expression in response to Fe chelator treatment in neoplastic cells will further clarify how these agents achieve their anti-tumor activity. It will also enhance our understanding of the complex roles p21 may play in neoplastic cells and lead to the development of more effective and specific anti-cancer therapies.
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Affiliation(s)
- Rayan S Moussa
- Molecular Pharmacology and Pathology Program, Discipline of Pathology and Bosch Institute, Medical Foundation Building (K25), The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Kyung Chan Park
- Molecular Pharmacology and Pathology Program, Discipline of Pathology and Bosch Institute, Medical Foundation Building (K25), The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Zaklina Kovacevic
- Molecular Pharmacology and Pathology Program, Discipline of Pathology and Bosch Institute, Medical Foundation Building (K25), The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Des R Richardson
- Molecular Pharmacology and Pathology Program, Discipline of Pathology and Bosch Institute, Medical Foundation Building (K25), The University of Sydney, Sydney, New South Wales 2006, Australia; Department of Pathology and Biological Responses, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya 466-8550, Japan.
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5
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Guo S, Liu G, Frazer DM, Liu T, You L, Xu J, Wang Y, Anderson GJ, Nie G. Polymeric Nanoparticles Enhance the Ability of Deferoxamine To Deplete Hepatic and Systemic Iron. NANO LETTERS 2018; 18:5782-5790. [PMID: 30085676 DOI: 10.1021/acs.nanolett.8b02428] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Chelators are commonly used to remove excess iron in iron-loading disorders. Deferoxamine (DFO) is an effective and safe iron chelator but an onerous parenteral administration regimen limits its routine use. To develop more effective methods for delivering iron chelators, we examined whether amphiphilic copolymer nanoparticles (NPs) could deliver DFO more efficiently. Physical characterization showed a uniform and stable preparation of DFO nanoparticles (DFO-NPs) with an average diameter of 105.3 nm. In macrophage (RAW264.7) and hepatoma (HepG2) cell lines, DFO-NPs proved more effective at depleting iron than free DFO. In wild-type mice previously loaded with iron dextran, as well as Hbb th3 /+ and Hfe -/- mice, which are predisposed to iron loading, DFO-NPs (40 mg/kg DFO; alternate days; 4 weeks) reduced hepatic iron levels by 71, 46, and 37%, respectively, whereas the equivalent values for free DFO were 53, 7, and 15%. Staining for tissue iron and urinary iron excretion confirmed these findings. Pharmacokinetic analysis showed that NP-encapsulated DFO had a much longer elimination half-life than free DFO (48.63 ± 28.80 vs 1.46 ± 0.59 h), and that DFO-NPs could be readily taken up by tissues and in particular by hepatic Kupffer cells. In vitro, DFO-NPs were less toxic to several cell lines than free DFO, and in vivo they did not elicit any specific inflammatory responses or histological changes. Our results suggest that using a nanoformulation of DFO is a valuable strategy for improving its efficiency as an iron chelator and that this could broaden its clinical use for the treatment of human iron overload disorders.
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Affiliation(s)
- Shanshan Guo
- CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience , National Center for Nanoscience and Technology , Beijing 100190 , People's Republic of China
- Iron Metabolism Laboratory , QIMR Berghofer Medical Research Institute , Brisbane , Queensland 4006 , Australia
- University of Chinese Academy of Sciences , Beijing 100049 , People's Republic of China
| | - Gang Liu
- CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience , National Center for Nanoscience and Technology , Beijing 100190 , People's Republic of China
| | - David M Frazer
- Iron Metabolism Laboratory , QIMR Berghofer Medical Research Institute , Brisbane , Queensland 4006 , Australia
| | - Tianqing Liu
- Iron Metabolism Laboratory , QIMR Berghofer Medical Research Institute , Brisbane , Queensland 4006 , Australia
| | - Linhao You
- CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience , National Center for Nanoscience and Technology , Beijing 100190 , People's Republic of China
| | - Jiaqi Xu
- CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience , National Center for Nanoscience and Technology , Beijing 100190 , People's Republic of China
- University of Chinese Academy of Sciences , Beijing 100049 , People's Republic of China
| | - Yongwei Wang
- CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience , National Center for Nanoscience and Technology , Beijing 100190 , People's Republic of China
- University of Chinese Academy of Sciences , Beijing 100049 , People's Republic of China
| | - Gregory J Anderson
- Iron Metabolism Laboratory , QIMR Berghofer Medical Research Institute , Brisbane , Queensland 4006 , Australia
| | - Guangjun Nie
- CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience , National Center for Nanoscience and Technology , Beijing 100190 , People's Republic of China
- University of Chinese Academy of Sciences , Beijing 100049 , People's Republic of China
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6
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Tyagi P, Kumar A, Gupta D, Singh H. Decorporation of Iron Metal Using Dialdehyde Cellulose-Deferoxamine Microcarrier. AAPS PharmSciTech 2017; 18:156-165. [PMID: 26912356 DOI: 10.1208/s12249-016-0499-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 02/01/2016] [Indexed: 12/18/2022] Open
Abstract
Deferoxamine iron chelator has a limited therapeutic index due to rapid clearance from blood and possesses dose-limiting toxicity. Therefore, an intravenous deferoxamine delivery system based on dialdehyde cellulose (DAC) polymer was developed and its efficacy and toxicity were tested in iron-overloaded animals. The amino groups of deferoxamine were conjugated to free aldehyde moieties of dialdehyde cellulose via Schiff base reaction to form dialdehyde cellulose-deferoxamine (DAC-DFO) conjugate and characterized by Fourier transform infrared spectrophotometer, scanning electron microscope, and X-ray diffraction. The toxicity of prepared formulation was analyzed by XTT cell viability assay and LD50 study in mice. The change in serum iron levels, after intravenous administration of formulation, was observed in iron-overloaded rats. The DAC-DFO conjugate was tagged with Tc-99m to study the blood kinetics and observe change in blood circulation time. DAC-DFO conjugate was dispersible in water at concentration ∼75 mg/ml. In vitro cytotoxicity assay and LD50 study in mice indicated significantly enhanced safety of covalently bound deferoxamine (at >1000 mg/kg body weight compared to free drug at ∼270 mg/kg dose). A preliminary scintigraphy imaging and blood clearance study, with technetium-99m, indicated prolonged circulation of conjugated DFO in rabbit blood. A single dose of formulation injected into iron overloaded animals was found to maintain the normal serum iron levels until 10 days. The polymeric conjugate was effective in maintaining normal serum iron levels until 10 days at a dose of 100 mg/kg body weight.
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7
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Wang G, Shen G, Yin T. In vitro assessment of deferoxamine on mesenchymal stromal cells from tumor and bone marrow. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2017; 49:58-64. [PMID: 27915123 DOI: 10.1016/j.etap.2016.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 11/17/2016] [Accepted: 11/20/2016] [Indexed: 06/06/2023]
Abstract
Deferoxamine (DFO), an iron chelator, is commonly used to remove excess iron from the body. DFO has also been demonstrated to have anti-tumor effect. However, there is no available report on the effect of deferoxamine on mesenchymal stromal cells (MSCs). In this study, we first isolated tumor-associated MSCs (TAMSCs) from EG-7 tumors, which were positive for CD29, CD44, CD73, CD90 and CD105. Ex vivo cultured stem cells derived from tumor and bone marrow compartment were exposed to DFO. We demonstrated that DFO had growth-arresting and apoptosis-inducing effect on TAMSCs and bone marrow MSCs (BMMSCs). DFO also influenced the expression pattern of adhesion molecule VCAM-1 on both TAMSCs and BMMSCs. Notwithstanding its widespread use, our results here warrants caution in the application of DFO, and also highlights the need for careful evaluation of the bone marrow compartment in patients receiving DFO treatment.
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Affiliation(s)
- Guoping Wang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center of Biotherapy, Chengdu 610041, PR China
| | - Guobo Shen
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center of Biotherapy, Chengdu 610041, PR China
| | - Tao Yin
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center of Biotherapy, Chengdu 610041, PR China.
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8
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Nurchi VM, Crisponi G, Lachowicz JI, Medici S, Peana M, Zoroddu MA. Chemical features of in use and in progress chelators for iron overload. J Trace Elem Med Biol 2016; 38:10-18. [PMID: 27365273 DOI: 10.1016/j.jtemb.2016.05.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 05/20/2016] [Accepted: 05/30/2016] [Indexed: 01/19/2023]
Abstract
An excessive amount of iron may become extremely toxic both for its ability to generate reactive oxygen species, and for the lack of regulatory mechanisms for iron excretion in humans. Chelation therapy has been introduced in clinical practice in the 1970's to defend thalassemia patients from the effects of iron overload and it has dramatically changed both life expectancy and quality of life. The disadvantages of the drugs in clinical use make the research for new, more suitable iron chelating agents, urgent. This review defines the requirements of an iron chelator, then points out the principal chemical features of the iron chelators in use. Finally, a survey on the last ten years of the literature relative to iron chelators is done, and the most interesting ligands are presented, with particular emphasis to those that reached clinical trials.
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Affiliation(s)
- Valeria Marina Nurchi
- Department of Chemical and Geological Sciences, University of Cagliari, Cittadella Universitaria, 09042 Monserrato-Cagliari, Italy.
| | - Guido Crisponi
- Department of Chemical and Geological Sciences, University of Cagliari, Cittadella Universitaria, 09042 Monserrato-Cagliari, Italy
| | - Joanna I Lachowicz
- Department of Chemical and Geological Sciences, University of Cagliari, Cittadella Universitaria, 09042 Monserrato-Cagliari, Italy
| | - Serenella Medici
- Department of Chemistry and Pharmacy, University of Sassari, Via Vienna 2, 07100 Sassari, Italy
| | - Massimiliano Peana
- Department of Chemistry and Pharmacy, University of Sassari, Via Vienna 2, 07100 Sassari, Italy
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9
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Affiliation(s)
- Mark D. Scott
- Center for Immunology and Microbial Disease, MC-151, Albany Medical College, Albany, NY 12208
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10
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Hayashida M, Hashioka S, Miki H, Nagahama M, Wake R, Miyaoka T, Horiguchi J. Aceruloplasminemia With Psychomotor Excitement and Neurological Sign Was Improved by Minocycline (Case Report). Medicine (Baltimore) 2016; 95:e3594. [PMID: 27175663 PMCID: PMC4902505 DOI: 10.1097/md.0000000000003594] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aceruloplasminemia is an autosomal recessive disorder of iron metabolism caused by mutations in the ceruloplasmin gene. Its prevalence is 1 in 2,000,000 people in Japan. This is a disorder of neurodegeneration with iron accumulation in the brain revealed by MRI. The iron overload induces oxidative stress and generation of reactive oxygen species, which triggers a cascade of pathological events that lead to neuronal death. Intravenous administration of an iron chelator, deferoxamine has been proposed as a method of inhibiting the accumulation of iron.The patient was a 46-year-old Japanese woman. She was diagnosed at the age of 33 years. Deferoxamine was administrated for 6 months but was discontinued due to adverse effects. On admission at the age of 46, psychomotor excitement was acute in onset. The extrapyramidal symptoms reflected iron deposition in the basal ganglia and substantia nigra in the midbrain. Ataxia and a wide-based gate reflected iron deposition in the dentate nuclei of the cerebellum. An antibiotic, minocycline at 150 mg/day successfully ameliorated the clinical symptoms.Minocycline, a second generation tetracycline, has a direct radical scavenging property due to its chemical structure. It has been reported that minocycline is similar to deferoxamine in its ability to chelate iron. Minocycline is also involved in preventing the upregulation of proinflammatory cytokines. The iron-chelating, antioxidant, and anti-inflammatory effects of minocycline were involved in this case.
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Affiliation(s)
- Maiko Hayashida
- From the Department of Psychiatry, Faculty of Medicine, Shimane University, Enyacho, Izumo, Shimane, Japan
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Saha M, Sarkar S, Sarkar B, Sharma BK, Bhattacharjee S, Tribedi P. Microbial siderophores and their potential applications: a review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:3984-99. [PMID: 25758420 DOI: 10.1007/s11356-015-4294-0] [Citation(s) in RCA: 309] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 02/27/2015] [Indexed: 05/18/2023]
Abstract
Siderophores are small organic molecules produced by microorganisms under iron-limiting conditions which enhance the uptake of iron to the microorganisms. In environment, the ferric form of iron is insoluble and inaccessible at physiological pH (7.35-7.40). Under this condition, microorganisms synthesize siderophores which have high affinity for ferric iron. These ferric iron-siderophore complexes are then transported to cytosol. In cytosol, the ferric iron gets reduced into ferrous iron and becomes accessible to microorganism. In recent times, siderophores have drawn much attention due to its potential roles in different fields. Siderophores have application in microbial ecology to enhance the growth of several unculturable microorganisms and can alter the microbial communities. In the field of agriculture, different types of siderophores promote the growth of several plant species and increase their yield by enhancing the Fe uptake to plants. Siderophores acts as a potential biocontrol agent against harmful phyto-pathogens and holds the ability to substitute hazardous pesticides. Heavy-metal-contaminated samples can be detoxified by applying siderophores, which explicate its role in bioremediation. Siderophores can detect the iron content in different environments, exhibiting its role as a biosensor. In the medical field, siderophore uses the "Trojan horse strategy" to form complexes with antibiotics and helps in the selective delivery of antibiotics to the antibiotic-resistant bacteria. Certain iron overload diseases for example sickle cell anemia can be treated with the help of siderophores. Other medical applications of siderophores include antimalarial activity, removal of transuranic elements from the body, and anticancer activity. The aim of this review is to discuss the important roles and applications of siderophores in different sectors including ecology, agriculture, bioremediation, biosensor, and medicine.
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Affiliation(s)
- Maumita Saha
- Department of Molecular Biology & Bioinformatics, Tripura University (A Central University), Suryamaninagar, Tripura, 799022, India
| | - Subhasis Sarkar
- Department of Molecular Biology & Bioinformatics, Tripura University (A Central University), Suryamaninagar, Tripura, 799022, India
| | - Biplab Sarkar
- National Institute of Abiotic Stress Management, Baramati, 413115, Pune, Maharashtra, India
| | - Bipin Kumar Sharma
- Department of Microbiology, Tripura University (A Central University), Suryamaninagar, Tripura, 799022, India
| | - Surajit Bhattacharjee
- Department of Molecular Biology & Bioinformatics, Tripura University (A Central University), Suryamaninagar, Tripura, 799022, India.
| | - Prosun Tribedi
- Department of Microbiology, Tripura University (A Central University), Suryamaninagar, Tripura, 799022, India.
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12
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Polymer antidotes for toxin sequestration. Adv Drug Deliv Rev 2015; 90:81-100. [PMID: 26026975 DOI: 10.1016/j.addr.2015.05.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 05/09/2015] [Accepted: 05/21/2015] [Indexed: 12/24/2022]
Abstract
Toxins delivered by envenomation, secreted by microorganisms, or unintentionally ingested can pose an immediate threat to life. Rapid intervention coupled with the appropriate antidote is required to mitigate the threat. Many antidotes are biological products and their cost, methods of production, potential for eliciting immunogenic responses, the time needed to generate them, and stability issues contribute to their limited availability and effectiveness. These factors exacerbate a world-wide challenge for providing treatment. In this review we evaluate a number of polymer constructs that may serve as alternative antidotes. The range of toxins investigated includes those from sources such as plants, animals and bacteria. The development of polymeric heavy metal sequestrants for use as antidotes to heavy metal poisoning faces similar challenges, thus recent findings in this area have also been included. Two general strategies have emerged for the development of polymeric antidotes. In one, the polymer acts as a scaffold for the presentation of ligands with a known affinity for the toxin. A second strategy is to generate polymers with an intrinsic affinity, and in some cases selectivity, to a range of toxins. Importantly, in vivo efficacy has been demonstrated for each of these strategies, which suggests that these approaches hold promise as an alternative to biological or small molecule based treatments.
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Badria FA, Ibrahim AS, Badria AF, Elmarakby AA. Curcumin Attenuates Iron Accumulation and Oxidative Stress in the Liver and Spleen of Chronic Iron-Overloaded Rats. PLoS One 2015; 10:e0134156. [PMID: 26230491 PMCID: PMC4521784 DOI: 10.1371/journal.pone.0134156] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 07/06/2015] [Indexed: 01/24/2023] Open
Abstract
Objectives Iron overload is now recognized as a health problem in industrialized countries, as excessive iron is highly toxic for liver and spleen. The potential use of curcumin as an iron chelator has not been clearly identified experimentally in iron overload condition. Here, we evaluate the efficacy of curcumin to alleviate iron overload-induced hepatic and splenic abnormalities and to gain insight into the underlying mechanisms. Design and Methods Three groups of male adult rats were treated as follows: control rats, rats treated with iron in a drinking water for 2 months followed by either vehicle or curcumin treatment for 2 more months. Thereafter, we studied the effects of curcumin on iron overload-induced lipid peroxidation and anti-oxidant depletion. Results Treatment of iron-overloaded rats with curcumin resulted in marked decreases in iron accumulation within liver and spleen. Iron-overloaded rats had significant increases in malonyldialdehyde (MDA), a marker of lipid peroxidation and nitric oxide (NO) in liver and spleen when compared to control group. The effects of iron overload on lipid peroxidation and NO levels were significantly reduced by the intervention treatment with curcumin (P<0.05). Furthermore, the endogenous anti-oxidant activities/levels in liver and spleen were also significantly decreased in chronic iron overload and administration of curcumin restored the decrease in the hepatic and splenic antioxidant activities/levels. Conclusion Our study suggests that curcumin may represent a new horizon in managing iron overload-induced toxicity as well as in pathological diseases characterized by hepatic iron accumulation such as thalassemia, sickle cell anemia, and myelodysplastic syndromes possibly via iron chelation, reduced oxidative stress derived lipid peroxidation and improving the body endogenous antioxidant defense mechanism.
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Affiliation(s)
- Farid A. Badria
- Department of Pharmacognosy, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
- * E-mail:
| | - Ahmed S. Ibrahim
- Department of Biochemistry and Clinical Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Adel F. Badria
- Medical Technology Center, Alexandria University, Alexandria 21526, Egypt
- Department of Mechanical and Aeronautical Engineering, University of Patras, Patras, 26500, Greece
| | - Ahmed A. Elmarakby
- Department of Oral Biology, Georgia Regents University, Augusta, Georgia, United States of America
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Fagundez DDA, Câmara DF, Salgueiro WG, Noremberg S, Luiz Puntel R, Piccoli JE, Garcia SC, da Rocha JBT, Aschner M, Ávila DS. Behavioral and dopaminergic damage induced by acute iron toxicity in Caenorhabditis elegans. Toxicol Res (Camb) 2015. [DOI: 10.1039/c4tx00120f] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Iron (Fe) exposure, results in multiple biological defects in C. elegans, including reproductive and motor impairment, which may be related to oxidative stress and neuronal damage.
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Intranasally-administered deferoxamine mitigates toxicity of 6-OHDA in a rat model of Parkinson׳s disease. Brain Res 2014; 1574:96-104. [DOI: 10.1016/j.brainres.2014.05.048] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 04/04/2014] [Accepted: 05/30/2014] [Indexed: 11/21/2022]
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16
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Nejad FK, Fatemi SJ, Sheibani V. An investigation of cobalt toxicity on blood parameters and evaluation of deferasirox and desferrioxamine chelators in removing cobalt from biological system. TOXIN REV 2013. [DOI: 10.3109/15569543.2013.853315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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17
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Liddell JR, Obando D, Liu J, Ganio G, Volitakis I, Mok SS, Crouch PJ, White AR, Codd R. Lipophilic adamantyl- or deferasirox-based conjugates of desferrioxamine B have enhanced neuroprotective capacity: implications for Parkinson disease. Free Radic Biol Med 2013; 60:147-56. [PMID: 23391576 DOI: 10.1016/j.freeradbiomed.2013.01.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Revised: 01/22/2013] [Accepted: 01/29/2013] [Indexed: 02/03/2023]
Abstract
Parkinson disease (PD) is a neurodegenerative disease characterized by death of dopaminergic neurons in the substantia nigra region of the brain. Iron content is also elevated in this region in PD and is implicated in the pathobiology of the disease. Desferrioxamine B (DFOB) is a high-affinity iron chelator and has shown efficacy in animal models of Parkinson disease. The high water solubility of DFOB, however, attenuates its ability to enter the brain. In this study, we have conjugated DFOB to derivatives of adamantane or the clinical iron chelator deferasirox to produce lipophilic compounds designed to increase the bioavailability of DFOB to brain cells. We found that the novel compounds are highly effective in preventing iron-mediated paraquat and hydrogen peroxide toxicity in neuronal-like BE2-M17 dopaminergic cells, primary neurons, and iron-loaded or glutathione-depleted primary astrocytes. The compounds also alleviated paraquat toxicity in BE2-M17 cells that express the PD-causing A30P mutation of α-synuclein. This protection was ∼66-fold more potent than DFOB alone and also more effective than other cell-permeative metal chelators, clioquinol and phenanthroline. These results demonstrate that increasing the bioavailability of DFOB through the conjugation of lipophilic fragments greatly enhances its protective capacity. These novel compounds have potential as therapeutics for the treatment of PD and other conditions of Fe dyshomeostasis.
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Affiliation(s)
- Jeffrey R Liddell
- Department of Pathology, University of Melbourne, and Mental Health Research Institute, Melbourne Brain Centre, University of Melbourne, Parkville, VIC 3010, Australia.
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Abstract
During the last 30 years, in addition to the considerable progress made in control and prevention of thalassemias(3), there have also been major advances in their symptomatic management, at least in wealthier countries where appropriate facilities are available. Remarkable improvements in survival in the severe forms of thalassemia have followed the more judicious use of blood transfusion and, in particular, the ability to manage the iron accumulation resulting from transfusion with its severe and ultimately lethal effects on endocrine and cardiac function.
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Affiliation(s)
- Nancy F Olivieri
- Hemoglobinopathy Research University Health Network, Toronto, Ontario M5G 2C4, Canada
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19
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Merlot AM, Kalinowski DS, Richardson DR. Novel chelators for cancer treatment: where are we now? Antioxid Redox Signal 2013; 18:973-1006. [PMID: 22424293 DOI: 10.1089/ars.2012.4540] [Citation(s) in RCA: 150] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
SIGNIFICANCE Under normal circumstances, cellular iron levels are tightly regulated due to the potential toxic effects of this metal ion. There is evidence that tumors possess altered iron homeostasis, which is mediated by the perturbed expression of iron-related proteins, for example, transferrin receptor 1, ferritin and ferroportin 1. The de-regulation of iron homeostasis in cancer cells reveals a particular vulnerability to iron-depletion using iron chelators. In this review, we examine the absorption of iron from the gut; its transport, metabolism, and homeostasis in mammals; and the molecular pathways involved. Additionally, evidence for alterations in iron processing in cancer are described along with the perturbations in other biologically important transition metal ions, for example, copper(II) and zinc(II). These changes can be therapeutically manipulated by the use of novel chelators that have recently been shown to be highly effective in terms of inhibiting tumor growth. RECENT ADVANCES Such chelators include those of the thiosemicarbazone class that were originally thought to target only ribonucleotide reductase, but are now known to have multiple effects, including the generation of cytotoxic radicals. CRITICAL ISSUES Several chelators have shown marked anti-tumor activity in vivo against a variety of solid tumors. An important aspect is the toxicology and the efficacy of these agents in clinical trials. FUTURE DIRECTIONS As part of the process of the clinical assessment of the new chelators, an extensive toxicological assessment in multiple animal models is essential for designing appropriate dosing protocols in humans.
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Affiliation(s)
- Angelica M Merlot
- Department of Pathology and Bosch Institute, University of Sydney, Sydney, Australia
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20
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Abstract
Iron is a redox active metal which is abundant in the Earth's crust. It has played a key role in the evolution of living systems and as such is an essential element in a wide range of biological phenomena, being critical for the function of an enormous array of enzymes, energy transduction mechanisms, and oxygen carriers. The redox nature of iron renders the metal toxic in excess and consequently all biological organisms carefully control iron levels. In this overview the mechanisms adopted by man to control body iron levels are described.Low body iron levels are related to anemia which can be treated by various forms of iron fortification and supplementation. Elevated iron levels can occur systemically or locally, each giving rise to specific symptoms. Systemic iron overload results from either the hyperabsorption of iron or regular blood transfusion and can be treated by the use of a selection of iron chelating molecules. The symptoms of many forms of neurodegeneration are associated with elevated levels of iron in certain regions of the brain and iron chelation therapy is beginning to find an application in the treatment of such diseases. Iron chelators have also been widely investigated for the treatment of cancer, tuberculosis, and malaria. In these latter studies, selective removal of iron from key enzymes or iron binding proteins is sought. Sufficient selectivity between the invading organism and the host has yet to be established for such chelators to find application in the clinic.Iron chelation for systemic iron overload and iron supplementation therapy for the treatment of various forms of anemia are now established procedures in clinical medicine. Chelation therapy may find an important role in the treatment of various neurodegenerative diseases in the near future.
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Telpoukhovskaia MA, Patrick BO, Rodríguez-Rodríguez C, Orvig C. Exploring the multifunctionality of thioflavin- and deferiprone-based molecules as acetylcholinesterase inhibitors for potential application in Alzheimer's disease. MOLECULAR BIOSYSTEMS 2013; 9:792-805. [DOI: 10.1039/c3mb25600f] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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22
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Suzuki Y, Yoshida K, Aburakawa Y, Kuroda K, Kimura T, Terada T, Kono S, Miyajima H, Yahara O. Effectiveness of oral iron chelator treatment with deferasirox in an aceruloplasminemia patient with a novel ceruloplasmin gene mutation. Intern Med 2013; 52:1527-30. [PMID: 23812204 DOI: 10.2169/internalmedicine.52.0102] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 59-year-old man presented with refractory anemia, choreoathetosis in the left upper extremity, an unsteady gait and cognitive dysfunction. The laboratory findings showed a marked decrease in ceruloplasmin. Magnetic resonance images revealed iron deposition in the brain and visceral organs. Iron accumulation was also observed in hepatocytes. Genetic analyses of the ceruloplasmin gene revealed a novel homozygous mutation of c.2185 delC in exon 12. The oral chelator deferasirox was effective in treating the left-side choreoathetosis and unsteady gait. Providing early treatment using deferasirox may be useful for preventing the progression of symptomatic neurological dysfunction.
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23
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Abstract
Aceruloplasminemia is an inherited neurodegenerative disorder involving "neurodegeneration with brain iron accumulation," which is caused by genetic defects in the ceruloplasmin gene. Ceruloplasmin is a multicopper oxidase with ferroxidase activity that oxidizes ferrous iron following its transfer to extracellular transferrin. In the central nervous system, a glycosylphosphatidylinositol-linked ceruloplasmin bound to the cell membranes was found to be the major isoform of this protein. Aceruloplasminemia is characterized by diabetes, retinal degeneration, and progressive neurological symptoms, including extrapyramidal symptoms, ataxia, and dementia. Clinical and pathological studies and investigations of cell culture and murine models revealed that there is an iron-mediated cellular radical injury caused by a marked accumulation of iron in the affected parenchymal tissues. The aim of this chapter is to provide an overview of not only the clinical features, genetic and molecular pathogenesis, and treatment of aceruloplasminemia but also the biological and physiological features of iron metabolism.
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Affiliation(s)
- Satoshi Kono
- First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
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Rodríguez-Rodríguez C, Telpoukhovskaia M, Orvig C. The art of building multifunctional metal-binding agents from basic molecular scaffolds for the potential application in neurodegenerative diseases. Coord Chem Rev 2012. [DOI: 10.1016/j.ccr.2012.03.008] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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25
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Yu Y, Suryo Rahmanto Y, Richardson DR. Bp44mT: an orally active iron chelator of the thiosemicarbazone class with potent anti-tumour efficacy. Br J Pharmacol 2012; 165:148-66. [PMID: 21658021 DOI: 10.1111/j.1476-5381.2011.01526.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND AND PURPOSE Our previous studies demonstrated that a thiosemicarbazone iron chelator (di-2-pyridylketone-4,4-dimethyl-3-thiosemicarbazone; Dp44mT) possesses potent and selective anti-cancer activity but led to cardiotoxicity at non-optimal doses. In this study, we examined the in vivo anti-tumour efficacy and tolerability of a new-generation 2-benzoylpyridine thiosemicarbazone iron chelator (2-benzoylpyridine-4,4-dimethyl-3-thiosemicarbazone; Bp44mT) administered via the oral or i.v. routes. EXPERIMENTAL APPROACH BpT chelators were tested in vitro against human lung cancer cells (DMS-53) and in vivo in DMS-53 tumour xenografts in mice. The toxicity of Bp44mT in vivo and its effects on the expression of iron-regulated molecules involved in growth and cell cycle control were investigated. KEY RESULTS Administration of Bp44mT by either route resulted in marked dose-dependent inhibition of tumour growth. When administered at 50 mg·kg(-1) via oral gavage three times per week for 23 days, the net xenograft growth was inhibited by 75%, compared with vehicle-treated mice. Toxicological examination showed reversible alterations including slight reduction of RBC count, with a decrease of liver and splenic iron levels, which confirmed iron chelation in vivo. Importantly, in contrast to Dp44mT, the chelator-treated mice did not show cardiac histological abnormalities. There was also no significant weight loss in mice, suggesting oral administration of Bp44mT was well tolerated. CONCLUSIONS AND IMPLICATIONS This is the first study to show that Bp44mT can be given orally with potent anti-tumour efficacy. Oral administration of a novel and effective chemotherapeutic agent provides the benefits of convenience for chronic dosing regimens.
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Affiliation(s)
- Y Yu
- Iron Metabolism and Chelation Program, Department of Pathology and Bosch Institute, Blackburn Building (D06), University of Sydney, Sydney, New South Wales, Australia
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26
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Lu N, Yi L, Deng Q, Li J, Gao Z, Li H. The interaction between desferrioxamine and hemin: a potential toxicological implication. Toxicol In Vitro 2012; 26:732-5. [PMID: 22445860 DOI: 10.1016/j.tiv.2012.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 03/01/2012] [Accepted: 03/07/2012] [Indexed: 10/28/2022]
Abstract
Our previous research demonstrated that iron chelating agent desferrioxamine (DFO) could promote iron donor hemin-induced protein oxidation due to the combination of DFO and hemin, but the binding constant and thermodynamic parameters of DFO-hemin interaction have not been examined before. In this study, affinity capillary electrophoresis (ACE) was applied to investigate the interaction between DFO and hemin for the first time. The binding constants of DFO-hemin were calculated to be 10(4)-10(5)M(-1) at various temperatures. The negative value of various thermodynamic parameters (ΔG, ΔS, and ΔH) suggested that the binding was spontaneous and the interaction was exothermic and entropically driven. In addition, the high binding affinity between DFO with hemin seemed to be the key factor on promoting hemin- catalyzed formation of cytotoxic radicals, such as superoxide (O(2)(-)), which was related to the potential toxicity of this drug in clinical use.
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Affiliation(s)
- Naihao Lu
- Key Laboratory of Functional Small Organic Molecule, Ministry of Education and College of Life Science, Jiangxi Normal University, Nanchang 330022, PR China
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27
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Zhou T, Ma Y, Kong X, Hider RC. Design of iron chelators with therapeutic application. Dalton Trans 2012; 41:6371-89. [DOI: 10.1039/c2dt12159j] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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28
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Hašková P, Koubková L, Vávrová A, Macková E, Hrušková K, Kovaříková P, Vávrová K, Simůnek T. Comparison of various iron chelators used in clinical practice as protecting agents against catecholamine-induced oxidative injury and cardiotoxicity. Toxicology 2011; 289:122-31. [PMID: 21864640 DOI: 10.1016/j.tox.2011.08.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Revised: 08/02/2011] [Accepted: 08/04/2011] [Indexed: 01/19/2023]
Abstract
Catecholamines are stress hormones and sympathetic neurotransmitters essential for control of cardiac function and metabolism. However, pathologically increased catecholamine levels may be cardiotoxic by mechanism that includes iron-catalyzed formation of reactive oxygen species. In this study, five iron chelators used in clinical practice were examined for their potential to protect cardiomyoblast-derived cell line H9c2 from the oxidative stress and toxicity induced by catecholamines epinephrine and isoprenaline and their oxidation products. Hydroxamate iron chelator desferrioxamine (DFO) significantly reduced oxidation of catecholamines to more toxic products and abolished redox activity of the catecholamine-iron complex at pH 7.4. However, due to its hydrophilicity and large molecule, DFO was able to protects cells only at very high and clinically unachievable concentrations. Two newer chelators, deferiprone (L1) and deferasirox (ICL670A), showed much better protective potential and were effective at one or two orders of magnitude lower concentrations as compared to DFO that were within their clinically relevant plasma levels. Ethylenediaminetetraacetic acid (EDTA), dexrazoxane (ICRF-187, clinically approved cardioprotective agent against anthracycline-induced cardiotoxicity) as well as selected beta adrenoreceptor antagonists and calcium channel blockers exerted no effect. Hence, results of the present study indicate that small, lipophilic and iron-specific chelators L1 and ICL670A can provide significant protection against the oxidative stress and cardiomyocyte damage exerted by catecholamines and/or their reactive oxidation intermediates. This potential new application of the clinically approved drugs L1 and ICL670A warrants further investigation, preferably using more complex in vivo animal models.
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Affiliation(s)
- Pavlína Hašková
- Charles University in Prague, Faculty of Pharmacy in Hradec Králové, Czech Republic
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29
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Nagoba B, Vedpathak D. Medical Applications of Siderophores. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2011. [DOI: 10.29333/ejgm/82743] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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30
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Mohammadi Z, Xie SX, Golub AL, Gehrke SH, Berkland C. Siderophore-Mimetic hydrogel for iron chelation therapy. J Appl Polym Sci 2011. [DOI: 10.1002/app.33562] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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31
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Piyamongkol S, Ma YM, Kong XL, Liu ZD, Aytemir MD, van der Helm D, Hider RC. Amido-3-hydroxypyridin-4-ones as iron(III) ligands. Chemistry 2010; 16:6374-81. [PMID: 20397153 DOI: 10.1002/chem.200902455] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The synthesis and physicochemical properties of a range of 2- and 6-amido-3-hydroxypyridin-4-ones are described. All the amido-substituted 3-hydroxypyridin-4-ones have lower pK(a) values than 1,2-dimethyl-3-hydroxypyridin-4-one (deferiprone). This is due to the inductive effect of the amido group. Furthermore, the pK(a) values of the 3-hydroxy group in 1-nonsubstituted pyridinones are dramatically lower than those of the corresponding 1-alkyl analogues, indicating that a strong hydrogen bond exists between the 2-amido function and the 3-oxygen anion, which stabilises the anion. As a result of the decreased competition with protons, the pFe(3+) values of this group of molecules are higher than that of deferiprone. The distribution coefficients of these molecules are also increased despite the lack of a hydrophobic 1-alkyl substituent and this is ascribed to the intramolecular hydrogen bond. X-ray diffraction studies confirm the existence of the intramolecular hydrogen bond.
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Affiliation(s)
- Sirivipa Piyamongkol
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200 Thailand
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32
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Bendova P, Mackova E, Haskova P, Vavrova A, Jirkovsky E, Sterba M, Popelova O, Kalinowski DS, Kovarikova P, Vavrova K, Richardson DR, Simunek T. Comparison of Clinically Used and Experimental Iron Chelators for Protection against Oxidative Stress-Induced Cellular Injury. Chem Res Toxicol 2010; 23:1105-14. [DOI: 10.1021/tx100125t] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Petra Bendova
- Faculty of Pharmacy in Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic, and Iron Metabolism and Chelation Program, Bosch Institute and Department of Pathology, University of Sydney, Sydney 2006, Australia
| | - Eliska Mackova
- Faculty of Pharmacy in Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic, and Iron Metabolism and Chelation Program, Bosch Institute and Department of Pathology, University of Sydney, Sydney 2006, Australia
| | - Pavlina Haskova
- Faculty of Pharmacy in Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic, and Iron Metabolism and Chelation Program, Bosch Institute and Department of Pathology, University of Sydney, Sydney 2006, Australia
| | - Anna Vavrova
- Faculty of Pharmacy in Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic, and Iron Metabolism and Chelation Program, Bosch Institute and Department of Pathology, University of Sydney, Sydney 2006, Australia
| | - Eduard Jirkovsky
- Faculty of Pharmacy in Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic, and Iron Metabolism and Chelation Program, Bosch Institute and Department of Pathology, University of Sydney, Sydney 2006, Australia
| | - Martin Sterba
- Faculty of Pharmacy in Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic, and Iron Metabolism and Chelation Program, Bosch Institute and Department of Pathology, University of Sydney, Sydney 2006, Australia
| | - Olga Popelova
- Faculty of Pharmacy in Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic, and Iron Metabolism and Chelation Program, Bosch Institute and Department of Pathology, University of Sydney, Sydney 2006, Australia
| | - Danuta S. Kalinowski
- Faculty of Pharmacy in Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic, and Iron Metabolism and Chelation Program, Bosch Institute and Department of Pathology, University of Sydney, Sydney 2006, Australia
| | - Petra Kovarikova
- Faculty of Pharmacy in Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic, and Iron Metabolism and Chelation Program, Bosch Institute and Department of Pathology, University of Sydney, Sydney 2006, Australia
| | - Katerina Vavrova
- Faculty of Pharmacy in Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic, and Iron Metabolism and Chelation Program, Bosch Institute and Department of Pathology, University of Sydney, Sydney 2006, Australia
| | - Des R. Richardson
- Faculty of Pharmacy in Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic, and Iron Metabolism and Chelation Program, Bosch Institute and Department of Pathology, University of Sydney, Sydney 2006, Australia
| | - Tomas Simunek
- Faculty of Pharmacy in Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Heyrovskeho 1203, 500 05 Hradec Kralove, Czech Republic, and Iron Metabolism and Chelation Program, Bosch Institute and Department of Pathology, University of Sydney, Sydney 2006, Australia
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Noulsri E, Richardson DR, Lerdwana S, Fucharoen S, Yamagishi T, Kalinowski DS, Pattanapanyasat K. Antitumor activity and mechanism of action of the iron chelator, Dp44mT, against leukemic cells. Am J Hematol 2009; 84:170-6. [PMID: 19140186 DOI: 10.1002/ajh.21350] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Iron chelators have been reported to induce apoptosis and cell cycle arrest in cancer cells. Recent studies suggest broad and selective antitumor activity of the new iron chelator, di-2-pyridylketone-4,4-dimethyl-3-thiosemicarbazone (Dp44mT; Whitnall et al., Proc Natl Acad Sci USA 2006;103:14901-14906). However, little is known concerning its effects on hematological malignancies. Using acute leukemia cells, the effect of Dp44mT on apoptosis, cell cycle, caspase-3 activation, and mitochondrial trans-membrane potential has been examined by flow cytometry. Dp44mT acted to induce a G(1)/S arrest in NB4 promyelocytic leukemia cells at low concentrations (0.5-2.5 microM), being far more effective than the clinically used chelator, desferrioxamine (DFO). Moreover, Dp44mT induced apoptosis of NB4 cells in a dose- and time-dependent manner with markedly less effect on nonproliferating cells. The apoptosis-inducing activity of Dp44mT was significantly more effective than DFO. Furthermore, this study also showed that Dp44mT had broad activity, inducing apoptosis in several types of acute leukemia and also multiple myeloma cell lines. Additional studies examining the cytotoxic mechanisms of Dp44mT showed that a reduction in the mitochondrial trans-membrane potential and caspase-3 activation could be involved in the mechanism of apoptosis. Our results suggest that Dp44mT possesses potential as an effective cytotoxic agent for the chemotherapeutic treatment of acute leukemia.
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Affiliation(s)
- Egarit Noulsri
- Office for Research and Development, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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34
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Mladĕnka P, Kalinowski DS, Hašková P, Bobrovová Z, Hrdina R, Šimůnek T, Nachtigal P, Semecký V, Vávrová J, Holečková M, Palicka V, Mazurová Y, Jansson PJ, Richardson DR. The Novel Iron Chelator, 2-Pyridylcarboxaldehyde 2-Thiophenecarboxyl Hydrazone, Reduces Catecholamine-Mediated Myocardial Toxicity. Chem Res Toxicol 2008; 22:208-17. [DOI: 10.1021/tx800331j] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Pr̆emysl Mladĕnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Danuta S. Kalinowski
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Pavlína Hašková
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Zuzana Bobrovová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Radomír Hrdina
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Tomáš Šimůnek
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Petr Nachtigal
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Vladimír Semecký
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Jaroslava Vávrová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Magdaléna Holečková
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Vladimir Palicka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Yvona Mazurová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Patric J. Jansson
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
| | - Des R. Richardson
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Department of Biochemical Sciences, Faculty of Pharmacy in Hradec Králové, Department of Biological and Medical Science, Faculty of Pharmacy in Hradec Králové, Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine in Hradec Králové, Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Czech Republic, and Iron Metabolism and Chelation Program, Bosch
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Nishio M, Endo T, Nakao S, Sato N, Koike T. Reversible cardiomyopathy due to secondary hemochromatosis with multitransfusions for severe aplastic anemia after successful non-myeloablative stem cell transplantation. Int J Cardiol 2008; 127:400-1. [PMID: 17582528 DOI: 10.1016/j.ijcard.2007.04.066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2007] [Accepted: 04/04/2007] [Indexed: 10/23/2022]
Abstract
A 30-year-old Japanese woman with acquired severe aplastic anemia (SAA), diagnosed 20 years ago, was referred to our institution for allogeneic stem cell transplantation (SCT). As an unusual case of long-standing SAA, the patient was complicated with moderate heart failure due to secondary hemochromatosis. After successful SCT using a non-myeloablative conditioning regimen, she needed no transfusion. Five years after SCT, echocardiography showed a dramatic improvement of her cardiac function. This case indicates that the cardiac function in secondary hemochromatosis could be reversed once iron overload from multitransfusions is stopped.
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Lu N, Zhang M, Li H, Gao Z. Completely Different Effects of Desferrioxamine on Hemin/Nitrite/H2O2-Induced Bovine Serum Albumin Nitration and Oxidation. Chem Res Toxicol 2008; 21:1229-34. [DOI: 10.1021/tx800013e] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hodges YK, Weinberger HD, Stephens J, Horwitz MA, Horwitz LD. Desferri-Exochelin, a lipid-soluble, hexadentate iron chelator, effectively removes tissue iron. Transl Res 2006; 148:63-71. [PMID: 16890146 DOI: 10.1016/j.trsl.2006.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2005] [Revised: 03/13/2006] [Accepted: 03/27/2006] [Indexed: 10/24/2022]
Abstract
Chronic iron-overload is damaging to the heart, liver, and other organs. Better iron chelators are needed to treat this serious medical condition. The uptake and distribution of the lipid-soluble, hexadentate iron chelator desferri-Exochelin 772SM (D-Exo) is studied and its efficacy in removing iron from tissue in rodent models is evaluated. After an intravenous bolus of tritiated D-Exo to rats, counts rapidly disappeared from the blood and rapidly appeared in 15 organs studied, usually peaking within 15 min. There was considerable uptake in the heart and liver, 2 organs especially susceptible to damage from clinical iron overload. To assess actual decreases in cardiac and hepatic iron in response to D-Exo, mice loaded with 42 mg of iron dextran (2100 mg/kg) were studied. Untreated, iron-loaded mice sacrificed 9 weeks later had a 4-fold increase in cardiac iron and a 20-fold increase in hepatic iron compared with controls that were not iron-loaded. In iron-loaded mice treated with 7 mg of D-Exo intraperitoneally (i.p.) 4 days/week for 8 weeks (total 224 mg), tissue iron, measured by atomic absorption, was reduced by 20% in the liver and 25% in the heart (P < 0.01 for each organ). During the first 8 h after a D-Exo dose, iron was excreted in the urine. Mice treated with D-Exo gained weight normally and showed no evidence of toxicity. In conclusion, in this iron-overload mouse model, D-Exo administered intravenously or i.p. rapidly diffuses into multiple organs, including the heart and liver, and effectively removes iron without apparent toxicity.
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Affiliation(s)
- Yvonne K Hodges
- Department of Cardiology, Colorado Health Sciences Center, Denver, CO 80262, USA
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Thompson KH, Barta CA, Orvig C. Metal complexes of maltol and close analogues in medicinal inorganic chemistry. Chem Soc Rev 2006; 35:545-56. [PMID: 16729148 DOI: 10.1039/b416256k] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The family of hydroxypyrones and close congeners, the hydroxypyridinones, is a particularly versatile class of ligands. The most widely investigated for medicinal applications are the 3-hydroxy-4-pyrones and the 1,2- 3,2- and 3,4-hydroxypyridinones. Key features of these ligands are: a six-membered ring, with a ring N or O atom either ortho or para to a ketone group, and two ortho exocyclic oxygen atoms. Readily functionalizable, the hydroxypyrones and hydroxypyridinones allow one to achieve a range of di- and trivalent metallocomplex stabilities and can include tissue or molecular targeting features by design. Research over the past several decades has greatly expanded the array of ligands that are the subject of this critical review. Ligand applications as diverse as iron removal or supplementation, contrast agents in imaging applications, and mobilization of undesirable excess metal ions will be surveyed herein.
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Affiliation(s)
- Katherine H Thompson
- Medicinal Inorganic Chemistry Group, Chemistry Department, University of British Columbia, Vancouver, BC, Canada V6T 1Z1.
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Hoke EM, Maylock CA, Shacter E. Desferal inhibits breast tumor growth and does not interfere with the tumoricidal activity of doxorubicin. Free Radic Biol Med 2005; 39:403-11. [PMID: 15993339 DOI: 10.1016/j.freeradbiomed.2005.03.029] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2005] [Revised: 03/08/2005] [Accepted: 03/24/2005] [Indexed: 11/16/2022]
Abstract
Desferal is a clinically approved iron chelator used to treat iron overload. Doxorubicin is an anthracycline cancer chemotherapy drug used in the treatment of breast cancer. It can undergo redox cycling in the presence of iron to produce reactive oxygen species. The oxidant-generating activity of doxorubicin is thought to be responsible for the cardiotoxic side effects of the drug, but it is unclear whether it is also required for its anti-tumor activity. To test whether an iron-chelating antioxidant would interfere with the tumor-killing activity of doxorubicin, nude mice were transplanted with xenografts of human breast cancer MDA-MB 231 cells and then treated with doxorubicin and/or desferal. Not only did desferal not interfere with the anti-tumor activity of doxorubicin, it inhibited tumor growth on its own. In vitro studies confirmed that desferal inhibits breast tumor growth. However, it did not induce apoptosis, nor did it induce cell cycle arrest. Instead, desferal caused cytostasis, apparently through iron depletion. The cytostatic activity of desferal was partially ameliorated by pretreatment with iron-saturated transferrin, and transferrin receptor expression on breast cancer cells nearly doubled after exposure to desferal. In contrast to its effect on tumor cells, desferal did not inhibit growth of normal breast epithelial cells. The data indicate that the anti-tumor activity of doxorubicin is not dependent on iron-mediated ROS production. Furthermore, desferal may have utility as an adjunctive chemotherapy due to its ability to inhibit breast tumor growth and cardiotoxic side effects without compromising the tumor-killing activity of an anthracycline chemotherapy drug.
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Affiliation(s)
- Eileen M Hoke
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20815, USA
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Tomita M, Nagira M, Haga M, Hayashi M. Clarification of the mechanism of structural change induced by reoxygenation following the induction of lipid peroxidation in Caco-2 cell monolayers. Drug Metab Pharmacokinet 2005; 17:83-91. [PMID: 15618656 DOI: 10.2133/dmpk.17.83] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Recently, we established a system for assessing ischemia/reperfusion injury, specifically the opening of tight junctions (TJ), caused by reoxygenation following the induction of lipid peroxidation by tertiary-butylhydroperoxide (t-BuOOH), using the human intestinal epithelial cell line Caco-2 in order to focus on the barrier function of the epithelium independent of the vascular compartment. In the present study, we attempted to identify factors involved in the structural changes induced by reoxygenation using 0.5 mM t-BuOOH in Caco-2 cell monolayers. Glutathione (GSH) and N-acetylcystein, a precursor of GSH, inhibited the opening of TJ evoked by reoxygenation following the induction of lipid peroxidation by 0.5 mM of t-BuOOH. Tiron, as a cell permeable superoxide anion scavenger and deferoxamine, an iron-chelating agent ameliorated the opening in a dose-dependent manner. Also, Tiron suppressed the apical-to-basal and basal-to-apical permeability of the increased Rhodamine123 by reoxygenation in a concentration-dependent manner. These results collectively suggest that superoxide anion and iron ions play an important role or contribute to structural changes such as the opening of TJ induced by reoxygenation following the induction of lipid peroxidation by 0.5 mM t-BuOOH.
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Affiliation(s)
- Mikio Tomita
- Department of Biopharmaceutics, School of Pharmacy, Tokyo University of Pharmacy and Life Science, Tokyo, Japan.
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Murray KF, Lam D, Kowdley KV. Current and future therapy in haemochromatosis and Wilson’s disease. Expert Opin Pharmacother 2005; 4:2239-51. [PMID: 14640923 DOI: 10.1517/14656566.4.12.2239] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There have been several new developments in the treatment of iron and copper overload disorders, such as haemochromatosis, thalassaemia and Wilson's disease. Clinical trials of orally administered iron chelators, both as monotherapy and in combination with deferoxamine, are in progress around the world. Several new chelators are now being introduced in clinical trials. Future therapies for iron overload may comprise of oral iron binding agents capable of preventing dietary iron absorption from the diet. The characterisation of specific iron transporters such as the divalent metallic transporter and ferroportin may hold promise for the development of 'smart' compounds capable of blocking iron transport. Several new agents are now available for the management of Wilson's disease, including trientine, zinc and tetrathiomolybdate. This review, will discuss the pathogenesis, and current and future therapies for iron and copper overload disorders.
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Affiliation(s)
- Karen F Murray
- Hepatobiliary Program, Childrens Hospital and Regional Medical Center, and University of Washington, Seattle, WA 98195, USA
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Dayani PN, Bishop MC, Black K, Zeltzer PM. Desferoxamine (DFO)--mediated iron chelation: rationale for a novel approach to therapy for brain cancer. J Neurooncol 2004; 67:367-77. [PMID: 15164994 DOI: 10.1023/b:neon.0000024238.21349.37] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Iron homeostasis is crucial to normal cell metabolism, and its deficiency or excess is associated with numerous disease states. The association of increased iron load with cancer may be due to several factors including free radical production, reduction of the body's protective mechanism to combat oxidative stress, inhibition of immune systems, inhibition of essential nutrient functions, facilitation of cancer growth, suppression of antitumor actions of macrophages, and lowering of the ratio of T4-T8 positive lymphocytes. Antiproliferative effects of desferoxamine (DFO) both in vitro and in vivo are mediated by an intracellular pool of iron that is necessary for DNA synthesis rather than prevention of iron uptake from transferrin. Several clinical studies have shown it to have antitumor activity in the treatment of neuroblastoma, leukemia, bladder carcinoma, and hepatocellular carcinoma. Human neural tumor cells are susceptible to the effects of DFO. Continued study of DFO is necessary to further elucidate its antineoplastic profile and its use as an adjunct to current chemotherapy regimens. Given the lack of satisfactory treatment of central nervous system neoplasms, DFO could serve as an important tool in the management of such cancers.
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Affiliation(s)
- Pouya N Dayani
- Northwestern University Medical School, Chicago, IL, USA
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Bartesaghi S, Trujillo M, Denicola A, Folkes L, Wardman P, Radi R. Reactions of desferrioxamine with peroxynitrite-derived carbonate and nitrogen dioxide radicals. Free Radic Biol Med 2004; 36:471-83. [PMID: 14975450 DOI: 10.1016/j.freeradbiomed.2003.10.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2003] [Revised: 09/18/2003] [Accepted: 10/15/2003] [Indexed: 11/26/2022]
Abstract
The iron chelating agent desferrioxamine inhibits peroxynitrite-mediated oxidations and attenuates nitric oxide and oxygen radical-dependent oxidative damage both in vitro and in vivo. The mechanism of protection is independent of iron chelation and has remained elusive over the past decade. Herein, stopped-flow studies revealed that desferrioxamine does not react directly with peroxynitrite. However, addition of peroxynitrite to desferrioxamine in both the absence and the presence of physiological concentrations of CO2 and under excess nitrite led to the formation of a one-electron oxidation product, the desferrioxamine nitroxide radical, consistent with desferrioxamine reacting with the peroxynitrite-derived species carbonate (CO3*-) and nitrogen dioxide (*NO2) radicals. Desferrioxamine inhibited peroxynitrite-dependent free radical-mediated processes, including tyrosine dimerization and nitration, oxyhemoglobin oxidation in the presence of CO2, and peroxynitrite plus carbonate-dependent chemiluminescence. The direct two-electron oxidation of glutathione by peroxynitrite was unaffected by desferrioxamine. The reactions of desferrioxamine with CO3*- and *NO2 were unambiguously confirmed by pulse radiolysis studies, which yielded second-order rate constants of 1.7 x 10(9) and 7.6 x 10(6) M(-1) s(-1), respectively. Desferrioxamine also reacts with tyrosyl radicals with k = 6.3 x 10(6) M(-1) s(-1). However, radical/radical combination reactions between tyrosyl radicals or of tyrosyl radical with *NO2 outcompete the reaction with desferrioxamine and computer-assisted simulations indicate that the inhibition of tyrosine oxidation can be fully explained by scavenging of the peroxynitrite-derived radicals. The results shown herein provide an alternative mechanism to account for some of the biochemical and pharmacological actions of desferrioxamine via reactions with CO3*- and *NO2 radicals.
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Affiliation(s)
- Silvina Bartesaghi
- Departamento de Bioquímica, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
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Kontoghiorghes GJ, Neocleous K, Kolnagou A. Benefits and risks of deferiprone in iron overload in Thalassaemia and other conditions: comparison of epidemiological and therapeutic aspects with deferoxamine. Drug Saf 2003; 26:553-84. [PMID: 12825969 DOI: 10.2165/00002018-200326080-00003] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Deferiprone is the only orally active iron-chelating drug to be used therapeutically in conditions of transfusional iron overload. It is an orphan drug designed and developed primarily by academic initiatives for the treatment of iron overload in thalassaemia, which is endemic in the Mediterranean, Middle East and South East Asia and is considered an orphan disease in the European Union and North America. Deferiprone has been used in several other iron or other metal imbalance conditions and has prospects of wider clinical applications. Deferiprone has high affinity for iron and interacts with almost all the iron pools at the molecular, cellular, tissue and organ levels. Doses of 50-120 mg/kg/day appear to be effective in bringing patients to negative iron balance. It increases urinary iron excretion, which mainly depends on the iron load of patients and the dose of the drug. It decreases serum ferritin levels and reduces the liver and heart iron content in the majority of chronically transfused iron loaded patients at doses >80 mg/kg/day. It is metabolised to a glucuronide conjugate and cleared through the urine in the metabolised and a non-metabolised form, usually of a 3 deferiprone: 1 iron complex, which gives the characteristic red colour urine. Peak serum levels of deferiprone are observed within 1 hour of its oral administration and clearance from blood is within 6 hours. There is variation among patients in iron excretion, the metabolism and pharmacokinetics of deferiprone. Deferiprone has been used in more than 7500 patients aged from 2-85 years in >50 countries, in some cases daily for >14 years. All the adverse effects of deferiprone are considered reversible, controllable and manageable. These include agranulocytosis with frequency of about 0.6%, neutropenia 6%, musculoskeletal and joint pains 15%, gastrointestinal complains 6% and zinc deficiency 1%. Discontinuation of the drug is recommended for patients developing agranulocytosis. Deferiprone is of similar therapeutic index to subcutaneous deferoxamine but is more effective in iron removal from the heart, which is the target organ of iron toxicity and mortality in iron-loaded thalassaemia patients. Deferiprone is much less expensive to produce than deferoxamine. Combination therapy of deferoxamine and deferiprone has been used in patients not complying with subcutaneous deferoxamine or experiencing toxicity or not excreting sufficient amounts of iron with use of either drug alone. New oral iron-chelating drugs are being developed, but even if successful these are likely to be more expensive than deferiprone and are not likely to become available in the next 5-8 years. About 25% of treated thalassaemia patients in Europe and more than 50% in India are using deferiprone. For most thalassaemia patients worldwide who are not at present receiving any form of chelation therapy the choice is between deferiprone and fatal iron toxicity.
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Affiliation(s)
- George J Kontoghiorghes
- Postgraduate Research Institute of Science, Technology, Environment and Medicine, Limassol, Cyprus.
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Buss JL, Hermes-Lima M, Ponka P. Pyridoxal isonicotinoyl hydrazone and its analogues. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2003; 509:205-29. [PMID: 12572996 DOI: 10.1007/978-1-4615-0593-8_11] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Joan L Buss
- Lady Davis Institute for Medical Research, Sir Mortimer B. Davis Jewish General Hospital and Department of Physiology, McGill University, Montreal, Quebec, Canada
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Liachenko S, Tang P, Xu Y. Deferoxamine improves early postresuscitation reperfusion after prolonged cardiac arrest in rats. J Cereb Blood Flow Metab 2003; 23:574-81. [PMID: 12771572 DOI: 10.1097/01.wcb.0000057742.00152.3f] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The no-reflow phenomenon and delayed hypoperfusion after transient cardiac arrest (CA) impede postischemic recovery. Activation of lipid peroxidation (LPO) after ischemia and reperfusion is considered one of the mechanisms responsible for such abnormalities. The present study investigates the influence of iron-dependent LPO inhibitor deferoxamine (DFO) on the cerebral perfusion after prolonged CA and resuscitation. Fourteen male Sprague-Dawley rats were subjected to 17 minutes of CA, induced by esmolol (an ultrashort-acting beta-blocker) and apnea, followed by resuscitation by retrograde intraaortic infusion of oxygenated donor blood mixed with a resuscitation cocktail inside a vertical-bore 9.4-T magnetic resonance imaging (MRI) magnet. Animals were randomized double-blindly into two groups to receive DFO or saline, respectively. Cerebral perfusion was measured by MRI continuously using the arterial spin-labeling method before, during, and after CA. All animals were successfully resuscitated in 1.36 +/- 0.04 minutes with well-controlled arrest time (17.99 +/- 0.03 minutes) in both groups. Deferoxamine significantly increased cerebral perfusion in hippocampus, thalamus, hypothalamus, and amygdala, but not in cortex, during the first 20 minutes of reperfusion. In the DFO-treated group, the neurologic deficit score was significantly better (400 +/- 30 vs. 250 +/- 47, out of 500 as the best, P < 0.05) and weight loss was significantly less (33 +/- 6 vs. 71 +/- 19 g, P < 0.05) 5 d after arrest. The finding supports the notion that early reperfusion immediately after resuscitation is important for long-term outcome and that LPO may be involved in microvascular disorders during the reperfusion, particularly in the brain after prolonged cardiac arrest and resuscitation.
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Affiliation(s)
- Serguei Liachenko
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261, U.S.A
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Buss JL, Arduini E, Shephard KC, Ponka P. Lipophilicity of analogs of pyridoxal isonicotinoyl hydrazone (PIH) determines the efflux of iron complexes and toxicity in K562 cells. Biochem Pharmacol 2003; 65:349-60. [PMID: 12527328 DOI: 10.1016/s0006-2952(02)01551-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Iron overload secondary to beta-thalassemia and other iron-loading anemias is the most serious obstacle to be overcome in the treatment of these diseases, since there is no physiological mechanism for excretion of the excess iron acquired by chronic blood transfusion. Due to the inconvenience and cost of the current iron chelation therapy, the search for an orally available iron chelator is ongoing. Pyridoxal isonicotinoyl hydrazone (PIH) and many of its analogs are effective at mobilizing iron in vivo and in vitro at doses that are not toxic. PIH analogs were approximately equally effective at binding 59Fe within K562 cells; their efficacy depended upon the kinetics of release of the iron-chelator complex from the cell, which was correlated inversely with the lipophilicity of the chelators. Addition of BSA, which has a well-characterized affinity for lipophilic species, to the extracellular medium enhanced iron-chelator efflux, such that all analogs caused 59Fe release from the cells as quickly as it was chelated; this suggests that BSA acts as an extracellular sink for the iron-chelator complexes, many of which are highly lipophilic. The toxicity of the free chelators varied over two orders of magnitude, and was correlated with the amount of intracellular 59Fe-chelator complexes, implicating the complexes in the mechanism of toxicity of the chelators. Understanding the structural features that determine the efficacy and toxicity of iron chelators in biological systems is of value in the selection of PIH analogs for in vivo examination.
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Affiliation(s)
- Joan L Buss
- Department of Physiology, McGill University, and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis Jewish General Hospital, 3755 Chemin de la Cote-Ste-Catherine, Montreal, Que., Canada H3T 1E2
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