Effects of acetylsalicylic acid on serum protein binding and metabolism of tryptophan in man

Unravelling and Quantifying the "NMR-Invisible" Metabolites Interacting with Human Serum Albumin by Binding Competition and T2 Relaxation-Based Decomposition Analysis

Quantitative profiling of low-molecular-weight metabolites (LMWMs) by ¹H NMR is routinely used in high-throughput serum metabolomics. First, the protein background is attenuated using a T2 filter; then, the LMWM signals are resolved by line-shape fitting. However, protein-binding modifies the motional properties of LMWM, and their signal partially attenuates with the T2 filter, along with the protein background. Consequently, the quantified LMWM signals do not reflect the total concentration in serum but the nonbinding part. Here we present a novel strategy based on binding competition to promote the release of the "NMR-invisible" metabolites from serum proteins and achieve quantifications closer to total concentrations. The study focuses on five clinically relevant amino acids with different binding properties (valine, isoleucine, leucine, tyrosine, and phenylalanine). We analyzed their binding affinity to human serum albumin (HSA) in serum mimic samples and promoted the release of their bound fraction by TSP titration. Furthermore, we used a novel combination of pseudo-2D CPMG and multivariate curve resolution analysis, allowing the separation of LMWM and protein signals and providing LMWM quantifications corrected for transverse relaxation effects. We found that TSP concentrations larger than 3 mM released most of the bound fraction and validated these findings in real serum/plasma samples.

Plasma free tryptophan revisited: what you need to know and do before measuring it

Plasma free tryptophan (Trp) is an important peripheral parameter widely used by psychopharmacologists to assess Trp entry into the brain for cerebral serotonin synthesis, although, along with total Trp, it can give much more information on Trp metabolism and disposition. Plasma free Trp is, however, a labile parameter easily influenced by a great many modulators, including fasting, food intake, many prescribed and over the counter medications, consumption of alcoholic and of common hot beverages, illicit drug use, some hormones, exercise and mild stressors. Interpretation of changes in plasma free Trp requires appropriate preparation of ultrafiltrates from freshly isolated plasma or serum, accurate analytical methodology and awareness of the multitude of physiological and pharmacological modulators of its concentration. This article highlights these points and makes recommendations aimed at avoiding pitfalls in studies involving this parameter.

Epidemiology of risk factors for age-related cataract

Epidemiologic studies on risk factors for cataract have progressed significantly over the last decade. Age-related cataract is a multifactorial disease, and different risk factors seem to play a role for different cataract types. Cortical and posterior subcapsular cataracts appear to be most closely related to environmental stresses such as ultraviolet exposure, diabetes, and drug ingestion. Nuclear cataracts appear to be associated with smoking. Alcohol use seems to be associated with all cataract types. Consistent evidence also suggests that the prevalence of all cataract types is lower among those with higher education. Most of the current data support a role for antioxidants associated with decreased rates of all cataract types, but further studies are needed. More data are needed to establish the association, if any, of diarrhea, blood pressure, and use of allopurinol and phenothiazines with senile cataracts.

Drugs designed to maintain the transparence of the ocular lens

Research into the biological basis of lens transparency has demonstrated the implication of lens sugar stress in the diabetic cataract whereas senile cataract is the result of natural degeneration which is enhanced by various external factors such as cosmic and ionizing rays, or oxidative processes. Drugs have been developed which are aimed at being effective on lens pathological physiology and metabolism, concurrently. Such molecules: aldose reductase inhibitors (ARIs: sorbinil, AD-5467, CT-112 and imirestat), acetyl salicylic acid (ASA), salicylate (SA) and sodium monomethyl trisilanol orthohydroxybenzoate (SMB, a prodrug for salicylate) have undergone pharmacodynamic, pharmacokinetic and/or clinical studies which are presented here. ARIs have shown efficacy in slowing down and preventing the progression of experimental sugar cataracts; sorbinil can partially reverse the very early morphological signs of sugar cataract. Sorbinil and imirestat have also demonstrated anti-oxidant properties. ARIs administration (per os or by topical instillation) generally results in lens levels compatible with concentrations that are efficient on biochemical mechanisms of cataract formation. However, at the present time, clinical evaluations are in progress and as yet, there is no confirmation of their efficacy in man. ASA and SA can prevent various mechanisms of lens protein denaturation; they inhibit AR and prevent, in vitro, the formation of some pigments found in the aged cataractous lens. Extrapolation of the ASA ocular pharmacokinetics results in animal to man, suggest that ASA administration per os could result in efficacious levels in the lens. This is also sustained by the observation of a reduced frequency of cataracts in ASA treated diabetic rheumatoid arthritis patients. SMB pharmacokinetic studies have shown small but persistent levels of the active principle in the lens. They suggest that the capsule slows down SA diffusion into the lens and that, on the contrary, lens epithelium facilitates its penetration. Preliminary results of pharmacodynamic studies are given.

How does displacement of albumin-bound tryptophan cause sustained increases in the free tryptophan concentration in plasma and 5-hydroxytryptamine synthesis in brain?

Models of tryptophan catabolism and binding to serum albumin are presented to explain the observed effect of displacement of tryptophan from albumin on the concentrations of free and bound tryptophan and on the rate of 5-hydroxytryptamine (5-HT) synthesis from tryptophan in the brain. A rapid rate of dissociation of tryptophan from albumin (compared to the transit time of tryptophan through the liver) and a large fractional extraction of the free pool of tryptophan during passage through the liver are shown to be necessary factors in determining the effects observed. Because of the low fractional extraction of free tryptophan in the brain, the synthesis of 5-HT will be dependent only upon the free pool of tryptophan. Dissociation of tryptophan from albumin only causes a sustained increase in 5-HT synthesis in the brain because of the effect that this dissociation has on hepatic tryptophan catabolism and thereby on the free pool of tryptophan.

Serum tryptophan and cataract

Total serum tryptophan concentrations were measured in 74 cataractous patients and 124 controls. No significant differences were observed in the mean values for the cataractous and normal subjects, 11.4 +/- 2.6 and 11.3 +/- 2.2 micrograms/ml respectively, or in the range of values, 7.4-17.1 and 7.3-17.4 micrograms/ml respectively. These results do not support previous reports that serum tryptophan is elevated in cataractous subjects.

Chemically induced renal papillary necrosis and upper urothelial carcinoma. Part 1

In the past, renal papillary necrosis (RPN) has been commonly associated with long-term abusive analgesic intake, but over recent years a wide variety of industrially and therapeutically used chemicals have been shown to induce this lesion experimentally or in man. Destruction of the renal papilla may result in: (1) secondary degenerative cortical changes which precede chronic renal failure or (2) a rapidly metastasizing upper urothelial carcinoma, which has a very poor prognosis. This article will briefly review the published data on the morphology, function, and biochemistry of the normal renal medulla and the pathology associated with RPN, together with the secondary changes which give rise to cortical degeneration or epithelial carcinoma. It will then examine in detail those chemicals which have been reported to cause RPN in an attempt to delineate structure-activity relationships. Finally, the many different theories that have been proposed to explain the pathophysiology of RPN will be examined and an hypothesis will be put forward to explain the primary pathogenesis of the lesion and its secondary consequences.

Chemically induced renal papillary necrosis and upper urothelial carcinoma. Part 2

In the past, renal papillary necrosis (RPN) has been commonly associated with long-term abusive analgesic intake, but over recent years a wide variety of industrially and therapeutically used chemicals have been shown to induce this lesion experimentally or in man. Destruction of the renal papilla may result in: (1) secondary degenerative cortical changes which precede chronic renal failure or (2) a rapidly metastasizing upper urothelial carcinoma, which has a very poor prognosis. This article will briefly review the published data on the morphology, function, and biochemistry of the normal renal medulla and the pathology associated with RPN, together with the secondary changes which give rise to cortical degeneration or epithelial carcinoma. It will then examine in detail those chemicals which have been reported to cause RPN in an attempt to delineate structure-activity relationships. Finally, the many different theories that have been proposed to explain the pathophysiology of RPN will be examined and an hypothesis will be put forward to explain the primary pathogenesis of the lesion and its secondary consequences.

Overview of the current attempts toward the medical treatment of cataract

A variety of agents are currently available that claim to either prevent, delay, or reverse cataracts associated with aging (senile cataracts), radiation, or diabetes and galactosemia (sugar cataracts). Senile cataract therapy includes formulation containing inorganic salts, nutritional supplements, natural product extracts, sulfhydryl, and sulfonic acid containing compounds and miscellaneous redox and nonsteroidal anti-inflammatory compounds. Agents associated with the treatment of radiation cataracts include anti oxidants and free radial scavengers. Aldose reductase inhibitors have been effective in the prevention of sugar cataracts. A summary of these agents and their potential ocular effects are presented.

Propranolol and acetylsalicylic acid in migraine prophylaxis. Double-blind crossover study

The aim of this double-blind crossover study was to compare the prophylactic effect of acetylsalicylic acid (ASA) with that of propranolol (PRP) in the treatment of migraine. Plasma concentrations of the two drugs were measured in order to investigate a possible relationship to the clinical effect. Compared to the pretreatment period, PRP and ASA reduced migraine index, frequency, duration, severity of attacks and headache days. Due to the limited number of patients, our results should be cautiously interpreted, however relevant the clinical improvement seemed. Improvement of migraine index was not related to different plasma levels of the two drugs.

Mechanisms of elevation of rat brain tryptophan concentration by various doses of salicylate

1 The roles of inhibition of liver tryptophan pyrrolase activity and of displacement of tryptophan from its binding sites on serum proteins have been investigated in relation to the increase in rat brain tryptophan concentration after administration of various doses of sodium salicylate. 2 The elevation of brain tryptophan concentration by sodium salicylate (0.5 mg/kg) was caused by inhibition of liver pyrrolase activity, whereas that by doses of the drug of 50 mg/kg and above was achieved mainly by tryptophan displacement. Both tryptophan displacement of pyrrolase inhibition caused the increase in brain tryptophan concentration by sodium salicylate at 10 mg/kg. 3 The smallest dose of salicylate capable of displacing serum-protein-bound tryptophan was 2.5 mg/kg.

Aspirin effect on cataract formation in patients with rheumatoid arthritis alone or combined with diabetes

The prevalence of cataracts is significantly lower in patients with rheumatoid arthritis receiving aspirin (mean of 2,700 mgs daily for an average of 10.4 years) as compared to the matched population not receiving aspirin. Similarly, fewer cataracts were found among a population with diabetes and rheumatoid arthritis receiving aspirin (mean of 2,340 mgs daily for an average of 8.8 years) as compared to the matched population on no aspirin. The effects of aspirin on cataract formation may result from 1) lowering of plasma tryptophan levels and increased excretion of tryptophan metabolites, 2) inhibition of aldose reductase and sorbitol formation in the diabetic lens, 3) inhibition of tryptophan or kynurenine binding to lens protein.

5-OH-Tryptophane in migraine: clinical and neurophysiological considerations

The clinical effects of the protracted treatment with 5-OH Tryptophane (5-HTP) of some patients with chronic migraine are compared with other patients with acetylsalicylic acid. The pain threshold was neurophysiologically determined in migraneous on patients whose response to 5-HTP therapy was specially good. The results with 5-HTP can be accounted for by an action of the substance on the serotonin turnover with activation of the serotoninergic antinociceptive system.

Aspirin and human sleep

Two groups of 8 females were given either 3 X 600 mg aspirin or placebo daily for 4 days, double blind. With aspirin, slow wave sleep was significantly decreased and stage 2 sleep significantly increased. Aspirin also significantly disrupted intra-subject night-to-night continuity of several sleep stages during drug and recovery nights.

The analysis of free tryptophan in human blood with the Ultrafiltrator: a comparison with other methods

Recently, the Ultrafiltrator has been described, in the literature, which allows the ultrafiltration of small molecules in minute blood samples under anaerobic conditions with filters of any pore size. This apparatus has been tested for the separation of free tryptophan in heparinised and EDTA-plasma and in whole blood. At the same time, free tryptophan has been analysed after ultrafiltration with CF-50 A and CF-25 membrane cones (Centriflo). The results obtained by these two techniques are compared. Finally, a comprehensive review of other methods reported in the literature, concerning the isolation of free tryptophan, is presented.

Plasma free and total tryptophan during the oestrus cycle, in ovariectomized and in male rats

Plasma free tryptophan was higher during prooestrus and early oestrus than at metoestrus or in ovariectomized or male rats. In contrast, total tryptophan was higher in ovariectomized and male rats than at any time in cycling females.

The effect of tryptophan and a tryptophan/5-hydroxytryptophan combination on indoles in the brains of rats fed a tryptophan deficient diet

Rats maintained on a tryptophan deficient diet had reduced brain and serum tryptophan and brain 5-hydroxyindolacetic acid levels compared to controls. 5-Hydroxytryptophan and L-tryptophan administered to these deficient rats in a combination (5:95) produced a greater elevation of indolamines and tryptophan in the brain than either amino acid alone. In rats maintained on a normal diet the urinary output of 3-hydroxykynurenine was considerably reduced by treatment with the combination of amino acids as compared to tryptophan treatment. 5-Hydroxytryptophan reduced the induction of kynurenine synthesis in the liver produced by tryptophan, implying that it is capable of inhibiting the enzyme tryptophan pyrrolase in vivo. It is suggested that the possession by 5-hydroxytryptophan of tryptophan pyrrolase inhibitory properties may make the administration of the combination a better treatment of depressed patients exhibiting an indolamine deficit than either amino acid alone.

Benzodiazepines: specific competitors for the binding of L-tryptophan to human serum albumin

By means of the gel filtration technique, the effect of nine benzodiazepine derivatives on the binding of L-tryptophan to human serum albumin was investigated. Using equimolar tryptophan and benzodiazepine concentrations, all benzodiazepines with binding constants higher than 10(4) (M(-1), displace L-tryptophan from its binding site to a high degree. The mechanism of the displacement was characterized as a competition for a common binding site. Some of the benzodiazepines displace L-tryptophan to a greater extent than salicylic acid. The benzostereospecific binding to human serum albumin. This study shows that there is only one binding site on the human serum albumin molecule, which binds tryptophan and the benzodiazepines in a highly stereospecific manner. Therefore it is concluded that the benzodiazepines and L-tryptophan must have similarities in their molecular structure, so that both can bind to the common binding site in such specific manner. These considerations are discussed in regard to the known influence of benzodiazepine derivatives on the L-tryptophan metabolism in brain. A direct involvement of the reported displacement in the pharmacological actions of the drugs seems not to be relevant because of their small therapeutical plasma levels.

Oral contraceptives and vitamins: a review

The literature concerning the influence of estrogen-containing oral contraceptives on vitamins is reviewed. The appearance of an elevated plasma concentration of vitamin A is probably without clinical importance, while there seems to be a clear connection between disturbances of vitamin B6 metabolism and mental symptoms. Low levels of folic acid and vitamin B12 have also been noted. Despite this, it is very rare that hematologic abnormalities develop during hormonal contraception. A reduced concentration of vitamin C in plasma and blood corpuscles has been reported. The clinical significance of these alterations is unknown.