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Yin X, Cicali B, Rodriguez-Vera L, Lukacova V, Cristofoletti R, Schmidt S. Applying Physiologically Based Pharmacokinetic Modeling to Interpret Carbamazepine's Nonlinear Pharmacokinetics and Its Induction Potential on Cytochrome P450 3A4 and Cytochrome P450 2C9 Enzymes. Pharmaceutics 2024; 16:737. [PMID: 38931859 PMCID: PMC11206836 DOI: 10.3390/pharmaceutics16060737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024] Open
Abstract
Carbamazepine (CBZ) is commonly prescribed for epilepsy and frequently used in polypharmacy. However, concerns arise regarding its ability to induce the metabolism of other drugs, including itself, potentially leading to the undertreatment of co-administered drugs. Additionally, CBZ exhibits nonlinear pharmacokinetics (PK), but the root causes have not been fully studied. This study aims to investigate the mechanisms behind CBZ's nonlinear PK and its induction potential on CYP3A4 and CYP2C9 enzymes. To achieve this, we developed and validated a physiologically based pharmacokinetic (PBPK) parent-metabolite model of CBZ and its active metabolite Carbamazepine-10,11-epoxide in GastroPlus®. The model was utilized for Drug-Drug Interaction (DDI) prediction with CYP3A4 and CYP2C9 victim drugs and to further explore the underlying mechanisms behind CBZ's nonlinear PK. The model accurately recapitulated CBZ plasma PK. Good DDI performance was demonstrated by the prediction of CBZ DDIs with quinidine, dolutegravir, phenytoin, and tolbutamide; however, with midazolam, the predicted/observed DDI AUClast ratio was 0.49 (slightly outside of the two-fold range). CBZ's nonlinear PK can be attributed to its nonlinear metabolism caused by autoinduction, as well as nonlinear absorption due to poor solubility. In further applications, the model can help understand DDI potential when CBZ serves as a CYP3A4 and CYP2C9 inducer.
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Affiliation(s)
- Xuefen Yin
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL 32827, USA; (X.Y.); (B.C.); (L.R.-V.)
| | - Brian Cicali
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL 32827, USA; (X.Y.); (B.C.); (L.R.-V.)
| | - Leyanis Rodriguez-Vera
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL 32827, USA; (X.Y.); (B.C.); (L.R.-V.)
| | | | - Rodrigo Cristofoletti
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL 32827, USA; (X.Y.); (B.C.); (L.R.-V.)
| | - Stephan Schmidt
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Orlando, FL 32827, USA; (X.Y.); (B.C.); (L.R.-V.)
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2
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Bose C, Kshirsagar S, Vijayan M, Kumar S, Singh SP, Hindle A, Reddy PH. The role of RLIP76 in oxidative stress and mitochondrial dysfunction: Evidence based on autopsy brains from Alzheimer's disease patients. Biochim Biophys Acta Mol Basis Dis 2024; 1870:166932. [PMID: 37926360 DOI: 10.1016/j.bbadis.2023.166932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023]
Abstract
Several converging lines of evidence from our group support a potential role of RLIP76 (AKA Rlip) in neurodegenerative disorders, including Alzheimer's Disease (AD). However, the role of Rlip in Alzheimer's and other neurodegenerative diseases is not well understood. The purpose of the present study is to determine the role of Rlip in the brains of AD patients and control subjects. To achieve our goals, we used frozen tissues and formalin-fixed paraffin-embedded postmortem brains from AD patients of different Braak stages and age-matched control subjects. Our immunohistology and immunoblotting blotting analysis revealed that expression of Rlip protein gradually and significantly decreased (p = 0.0001) with AD progression, being lowest in Braak stage IV-V. Rlip was colocalized with Amyloid beta (Aβ) and phosphorylated tau (p-Tau) as observed by IHC staining and co-immunoprecipitation studies. Lipid peroxidation (4-HNE generation) and H2O2 production were significantly higher (p = 0.004 and 0.0001 respectively) in AD patients compared to controls, and this was accompanied by lower ATP production in AD (p = 0.0009). Oxidative DNA damage was measured by 8-Hydroxyguanosine (8-OHdG) in tissue lysates by ELISA and COMET assay. AD 8-OHdG levels were significantly higher (p = 0.0001) compared to controls. COMET assay was performed in brain cells, isolated from frozen postmortem samples. The control samples showed minimal DNA in comets representing few DNA strand breaks (<20 %), (score-0-1). However, the AD group showed an average of 50 % to 65 % of DNA in comet tails (score-4-5) indicating numerous DNA strand breaks. The difference between the two groups was significant (p = 0.001), as analyzed by Open Comet by ImageJ. Elevated DNA damage was further examined by western blot analysis for phosphorylated histone variant H2AX (γH2AX). Induction of γH2AX was very significant (p < 0.0001) and confirmed the presence of double-strand breaks in DNA. Overall, our results indicate an important role for Rlip in maintaining neuronal health and homeostasis by suppressing cellular oxidative stress and DNA damage. Based on our findings, we cautiously conclude that Rlip is a promising therapeutic target for Alzheimer's disease.
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Affiliation(s)
- Chhanda Bose
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Sudhir Kshirsagar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Murali Vijayan
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Subodh Kumar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Center of Emphasis in Neuroscience, Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA
| | - Sharda P Singh
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Ashly Hindle
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Pharmacology & Neuroscience Department, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Neurology Department, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Speech, Language and Hearing Sciences Departments, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Public Health Department, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Nutritional Sciences Department, Texas Tech University, Lubbock, TX, USA; Medicine Department, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
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3
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Boughrara W, Chentouf A. The ABCB1, ABCC2 and RALBP1 polymorphisms are associated with carbamazepine response in epileptic patient: a systematic review. Acta Neurol Belg 2022; 122:871-880. [PMID: 35325436 DOI: 10.1007/s13760-022-01920-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/07/2022] [Indexed: 11/30/2022]
Abstract
Despite a dramatic increase in treatment options over the past 30 years, Carbamazepine (CBZ) is still considered the standard of care and the most prescribed initial treatment for focal epilepsy. Hence, the identification of genetic biomarkers that influence the response, resistance and toxicity to CBZ remains a challenge. Several research studies have looked into this to highlight the polymorphisms responsible for the variability in the response to CBZ in patients with epilepsy. The aim of this review is to compare the different results published in the literature The systematic review included thirty-nine studies (2005-2021), Meta-analyses were performed on more than twelve polymorphisms in three genes (ABCB1, ABCC2, RALBP1) involved in CBZ cell transport. The current challenges are to identify other new biomarkers of antiepileptic drugs that can only materialize with large-scale collaborative research efforts.
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Affiliation(s)
- Wefa Boughrara
- École Supérieure en Sciences Biologiques d'Oran (ESSBO), BP 1042, Saim Mohamed 31003, Oran, Algeria.
- Service de Cytogénétique et de Biologie Moléculaire de l'Etablissement Hospitalo-Universitaire d'Oran, Oran, Algeria.
- Cité Emir Abdelkader (EX INESSMO) Oran, 31000, Oran, Algeria.
| | - Amina Chentouf
- Service de Neurologie, Centre Hospitalo-Universitaire d'Oran, Oran, Algeria
- Laboratoire de Recherche ACCIPED, Faculté de Médecine, Université Oran1, Oran, Algeria
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4
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Yang QY, Hu YH, Guo HL, Xia Y, Zhang Y, Fang WR, Li YM, Xu J, Chen F, Wang YR, Wang TF. Vincristine-Induced Peripheral Neuropathy in Childhood Acute Lymphoblastic Leukemia: Genetic Variation as a Potential Risk Factor. Front Pharmacol 2021; 12:771487. [PMID: 34955843 PMCID: PMC8696478 DOI: 10.3389/fphar.2021.771487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/24/2021] [Indexed: 11/25/2022] Open
Abstract
Vincristine (VCR) is the first-line chemotherapeutic medication often co-administered with other drugs to treat childhood acute lymphoblastic leukemia. Dose-dependent neurotoxicity is the main factor restricting VCR’s clinical application. VCR-induced peripheral neuropathy (VIPN) sometimes results in dose reduction or omission, leading to clinical complications or affecting the patient’s quality of life. With regard to the genetic basis of drug responses, preemptive pharmacogenomic testing and simultaneous blood level monitoring could be helpful for the transformation of various findings into individualized therapies. In this review, we discussed the potential associations between genetic variants in genes contributing to the pharmacokinetics/pharmacodynamics of VCR and VIPN incidence and severity in patients with acute lymphoblastic leukemia. Of note, genetic variants in the CEP72 gene have great potential to be translated into clinical practice. Such a genetic biomarker may help clinicians diagnose VIPN earlier. Besides, genetic variants in other genes, such as CYP3A5, ABCB1, ABCC1, ABCC2, TTPA, ACTG1, CAPG, SYNE2, SLC5A7, COCH, and MRPL47, have been reported to be associated with the VIPN, but more evidence is needed to validate the findings in the future. In fact, a variety of complex factors jointly determine the VIPN. In implementing precision medicine, the combination of genetic, environmental, and personal variables, along with therapeutic drug monitoring, will allow for a better understanding of the mechanisms of VIPN, improving the effectiveness of VCR treatment, reducing adverse reactions, and improving patients’ quality of life.
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Affiliation(s)
- Qing-Yan Yang
- Pharmaceutical Sciences Research Center, Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China.,School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Ya-Hui Hu
- Pharmaceutical Sciences Research Center, Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Hong-Li Guo
- Pharmaceutical Sciences Research Center, Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ying Xia
- Pharmaceutical Sciences Research Center, Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yong Zhang
- Pharmaceutical Sciences Research Center, Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Wei-Rong Fang
- School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Yun-Man Li
- School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jing Xu
- Pharmaceutical Sciences Research Center, Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Feng Chen
- Pharmaceutical Sciences Research Center, Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yong-Ren Wang
- Department of Hematology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Teng-Fei Wang
- Department of Pharmacology, Addiction Science and Toxicology, University of Tennessee Health Science Center, Memphis, TN, United States
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5
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Pharmacogenetics of Drug-Resistant Epilepsy (Review of Literature). Int J Mol Sci 2021; 22:ijms222111696. [PMID: 34769124 PMCID: PMC8584095 DOI: 10.3390/ijms222111696] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 12/17/2022] Open
Abstract
Pharmacogenomic studies in epilepsy are justified by the high prevalence rate of this disease and the high cost of its treatment, frequent drug resistance, different response to the drug, the possibility of using reliable methods to assess the control of seizures and side effects of antiepileptic drugs. Candidate genes encode proteins involved in pharmacokinetic processes (drug transporters, metabolizing enzymes), pharmacodynamic processes (receptors, ion channels, enzymes, regulatory proteins, secondary messengers) and drug hypersensitivity (immune factors). This article provides an overview of the literature on the influence of genetic factors on treatment in epilepsy.
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6
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Fricke-Galindo I, Jung-Cook H, Martínez-Juárez IE, Monroy-Jaramillo N, Ortega-Vázquez A, Rojas-Tomé IS, Dorado P, Peñas-Lledó E, Llerena A, López-López M. Relevance of NR1I2 variants on carbamazepine therapy in Mexican Mestizos with epilepsy at a tertiary-care hospital. Pharmacogenomics 2021; 22:983-996. [PMID: 34612084 DOI: 10.2217/pgs-2021-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We evaluated the potential influence of genetic (CYP3A5, EPHX1, NR1I2, HNF4A, ABCC2, RALBP1, SCN1A, SCN2A and GABRA1) and nongenetic factors on carbamazepine (CBZ) response, adverse drug reactions and CBZ plasma concentrations in 126 Mexican Mestizos (MM) with epilepsy. Subjects & methods: Patients were genotyped for 27 variants using TaqMan® assays. Results: CBZ response was associated with NR1I2 variants and lamotrigine cotreatment. CBZ-induced adverse drug reactions were related to antiepileptic polytherapy and SCN1A rs2298771/rs3812718 haplotype. CBZ plasma concentrations were influenced by NR1I2-rs2276707 and -rs3814058, and by phenytoin cotreatment. CBZ daily dose was also influenced by NR1I2-rs3814055 and EPHX1-rs1051740. Conclusion: Interindividual variability in CBZ treatment was partly explained by NR1I2, EPHX1 and SCN1A variants, as well as antiepileptic cotreatment in MM with epilepsy.
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Affiliation(s)
- Ingrid Fricke-Galindo
- Metropolitan Autonomous University, Campus Xochimilco, Calzada del Hueso 1100, Villa Quietud, 04960, Coyoacán, Mexico City, Mexico
| | - Helgi Jung-Cook
- National Institute of Neurology & Neurosurgery, Manuel Velasco Suárez, Insurgentes Sur 3877, La Fama, 14269, Tlalpan, Mexico City, Mexico.,National Autonomous University of Mexico, Mexico City, Mexico, Av. Universidad 3000, C.U., 04510, Coyoacán, Mexico City, Mexico
| | - Iris E Martínez-Juárez
- National Institute of Neurology & Neurosurgery, Manuel Velasco Suárez, Insurgentes Sur 3877, La Fama, 14269, Tlalpan, Mexico City, Mexico
| | - Nancy Monroy-Jaramillo
- National Institute of Neurology & Neurosurgery, Manuel Velasco Suárez, Insurgentes Sur 3877, La Fama, 14269, Tlalpan, Mexico City, Mexico
| | - Alberto Ortega-Vázquez
- Metropolitan Autonomous University, Campus Xochimilco, Calzada del Hueso 1100, Villa Quietud, 04960, Coyoacán, Mexico City, Mexico
| | - Irma S Rojas-Tomé
- National Institute of Neurology & Neurosurgery, Manuel Velasco Suárez, Insurgentes Sur 3877, La Fama, 14269, Tlalpan, Mexico City, Mexico
| | - Pedro Dorado
- Biosanitary Research Institute, INUBE Extremadura University, Avda. de Elvas, Badajoz, 06006, Spain.,Department of Medical-Surgery Therapeutics, University of Extremadura, Avda. Virgen del Puerto, Plasencia, 10600, Spain
| | - Eva Peñas-Lledó
- Biosanitary Research Institute, INUBE Extremadura University, Avda. de Elvas, Badajoz, 06006, Spain.,Faculty of Medicine, University of Extremadura, Av. de Elvas, s/n, Badajoz, 06006, Spain
| | - Adrián Llerena
- Biosanitary Research Institute, INUBE Extremadura University, Avda. de Elvas, Badajoz, 06006, Spain.,Faculty of Medicine, University of Extremadura, Av. de Elvas, s/n, Badajoz, 06006, Spain.,CICAB Clinical Research Center, Extremadura University Hospital, Campus Universitario, Av. de Elvas, s/n, Badajoz, 06080, Spain
| | - Marisol López-López
- Metropolitan Autonomous University, Campus Xochimilco, Calzada del Hueso 1100, Villa Quietud, 04960, Coyoacán, Mexico City, Mexico
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7
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Bruxel EM, do Canto AM, Bruno DCF, Geraldis JC, Lopes-Cendes I. Multi-omic strategies applied to the study of pharmacoresistance in mesial temporal lobe epilepsy. Epilepsia Open 2021; 7 Suppl 1:S94-S120. [PMID: 34486831 PMCID: PMC9340306 DOI: 10.1002/epi4.12536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 12/19/2022] Open
Abstract
Mesial temporal lobe epilepsy (MTLE) is the most common type of focal epilepsy in adults, and hippocampal sclerosis (HS) is a frequent histopathological feature in patients with MTLE. Pharmacoresistance is present in at least one-third of patients with MTLE with HS (MTLE+HS). Several hypotheses have been proposed to explain the mechanisms of pharmacoresistance in epilepsy, including the effect of genetic and molecular factors. In recent years, the increased knowledge generated by high-throughput omic technologies has significantly improved the power of molecular genetic studies to discover new mechanisms leading to disease and response to treatment. In this review, we present and discuss the contribution of different omic modalities to understand the basic mechanisms determining pharmacoresistance in patients with MTLE+HS. We provide an overview and a critical discussion of the findings, limitations, new approaches, and future directions of these studies to improve the understanding of pharmacoresistance in MTLE+HS. However, it is important to point out that, as with other complex traits, pharmacoresistance to anti-seizure medications is likely a multifactorial condition in which gene-gene and gene-environment interactions play an important role. Thus, studies using multidimensional approaches are more likely to unravel these intricate biological processes.
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Affiliation(s)
- Estela M Bruxel
- Departments of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Amanda M do Canto
- Departments of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Danielle C F Bruno
- Departments of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Jaqueline C Geraldis
- Departments of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Iscia Lopes-Cendes
- Departments of Translational Medicine, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.,Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
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8
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Mir-pharmacogenetics of Vincristine and peripheral neurotoxicity in childhood B-cell acute lymphoblastic leukemia. THE PHARMACOGENOMICS JOURNAL 2017; 18:704-712. [PMID: 29282364 DOI: 10.1038/s41397-017-0003-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 07/11/2017] [Accepted: 09/18/2017] [Indexed: 12/17/2022]
Abstract
Vincristine (VCR), an important component of childhood acute lymphoblastic leukemia (ALL) therapy, can cause sensory and motor neurotoxicity. This neurotoxicity could lead to dose reduction or treatment discontinuation, which could in turn reduce survival. In this line, several studies associated peripheral neurotoxicity and polymorphisms in genes involved in pharmacokinetics (PK) and pharmacodynamics (PD) of VCR. Nowadays, it is well known that these genes are regulated by microRNAs (miRNAs) and SNPs in miRNAs could modify their levels or function. Therefore, the aim of this study was to determine whether SNPs in miRNAs could be associated with VCR-induced neurotoxicity. To achieve this aim, we analyzed all the SNPs in miRNAs (minor allele frequency (MAF) ≥ 0.01) which could regulate VCR-related genes in a large cohort of Spanish children with B-cell precursor ALL (B-ALL) homogeneously treated with LAL/SHOP protocols. We identified the A allele of rs12402181 in the seed region of miR-3117-3p, that could affect the binding with ABCC1 and RALBP1 gene, and C allele of rs7896283 in pre-mature sequence of miR-4481, which could be involved in peripheral nerve regeneration, significantly associated with VCR-induced neurotoxicity. These findings point out the possible involvement of two SNPs in miRNA associated with VCR-related neurotoxicity.
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9
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New insights into Vinca alkaloids resistance mechanism and circumvention in lung cancer. Biomed Pharmacother 2017; 96:659-666. [DOI: 10.1016/j.biopha.2017.10.041] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 10/08/2017] [Accepted: 10/09/2017] [Indexed: 12/22/2022] Open
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10
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Yasir M, Sara UVS, Chauhan I, Gaur PK, Singh AP, Puri D. Solid lipid nanoparticles for nose to brain delivery of donepezil: formulation, optimization by Box–Behnken design, in vitro and in vivo evaluation. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2017. [DOI: 10.1080/21691401.2017.1394872] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Mohd Yasir
- Department of Pharmacy, Uttarakhand Technical University, Dehradun, India
- I.T.S. College of Pharmacy, Ghaziabad, India
| | | | - Iti Chauhan
- I.T.S. College of Pharmacy, Ghaziabad, India
| | | | | | - Dinesh Puri
- I.T.S. College of Pharmacy, Ghaziabad, India
| | - Ameeduzzafar
- College of Pharmacy, Aljouf University, Sakaka, Saudi Arabia
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11
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Bennani-Baiti B, Toegel S, Viernstein H, Urban E, Noe CR, Bennani-Baiti IM. Inflammation Modulates RLIP76/RALBP1 Electrophile-Glutathione Conjugate Transporter and Housekeeping Genes in Human Blood-Brain Barrier Endothelial Cells. PLoS One 2015; 10:e0139101. [PMID: 26406496 PMCID: PMC4583384 DOI: 10.1371/journal.pone.0139101] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 09/09/2015] [Indexed: 12/22/2022] Open
Abstract
Endothelial cells are often present at inflammation sites. This is the case of endothelial cells of the blood-brain barrier (BBB) of patients afflicted with neurodegenerative disorders such as Alzheimer's, Parkinson's, or multiple sclerosis, as well as in cases of bacterial meningitis, trauma, or tumor-associated ischemia. Inflammation is a known modulator of gene expression through the activation of transcription factors, mostly NF-κB. RLIP76 (a.k.a. RALBP1), an ATP-dependent transporter of electrophile-glutathione conjugates, modulates BBB permeability through the regulation of tight junction function, cell adhesion, and exocytosis. Genes and pathways regulated by RLIP76 are transcriptional targets of tumor necrosis factor alpha (TNF-α) pro-inflammatory molecule, suggesting that RLIP76 may also be an inflammation target. To assess the effects of TNF-α on RLIP76, we faced the problem of choosing reference genes impervious to TNF-α. Since such genes were not known in human BBB endothelial cells, we subjected these to TNF-α, and measured by quantitative RT-PCR the expression of housekeeping genes commonly used as reference genes. We find most to be modulated, and analysis of several inflammation datasets as well as a metaanalysis of more than 5000 human tissue samples encompassing more than 300 cell types and diseases show that no single housekeeping gene may be used as a reference gene. Using three different algorithms, however, we uncovered a reference geneset impervious to TNF-α, and show for the first time that RLIP76 expression is induced by TNF-α and follows the induction kinetics of inflammation markers, suggesting that inflammation can influence RLIP76 expression at the BBB. We also show that MRP1 (a.k.a. ABCC1), another electrophile-glutathione transporter, is not modulated in the same cells and conditions, indicating that RLIP76 regulation by TNF-α is not a general property of glutathione transporters. The reference geneset uncovered herein should aid in future gene expression studies in inflammatory conditions of the BBB.
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Affiliation(s)
- Barbara Bennani-Baiti
- Department for Medicinal Chemistry, Institute of Pharmaceutical Chemistry, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
- Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital (AKH), Medical University of Vienna, Waehringer-Guertel 18–20, 1090 Vienna, Austria
| | - Stefan Toegel
- Karl Chiari Lab for Orthopaedic Biology, Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | - Helmut Viernstein
- Department of Pharmaceutical Technology and Biopharmaceutics, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
| | - Ernst Urban
- Department for Medicinal Chemistry, Institute of Pharmaceutical Chemistry, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
| | - Christian R. Noe
- Department for Medicinal Chemistry, Institute of Pharmaceutical Chemistry, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
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12
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Sharma AK, Rani E, Waheed A, Rajput SK. Pharmacoresistant Epilepsy: A Current Update on Non-Conventional Pharmacological and Non-Pharmacological Interventions. J Epilepsy Res 2015; 5:1-8. [PMID: 26157666 PMCID: PMC4494988 DOI: 10.14581/jer.15001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 04/24/2015] [Indexed: 11/12/2022] Open
Abstract
Uncontrolled seizure or epilepsy is intricately related with an increase risk of pharmacoresistant epilepsy. The failure to achieve seizure control with the first or second drug trial of an anticonvulsant medication given at the appropriate daily dosage is termed as pharmacoresistance, despite the fact that these drugs possess different modes of action. It is one of the devastating neurological disorders act as major culprit of mortality in developed as well as developing countries with towering prevalence. Indeed, the presence of several anti-epileptic drug including carbamazepine, phenytoin, valproate, gabapentin etc. But no promising therapeutic remedies available to manage pharmacoresistance in the present clinical scenario. Hence, utility of alternative strategies in management of resistance epilepsy is increased which further possible by continuing developing of promising therapeutic interventions to manage this insidious condition adequately. Strategies include add on therapy with adenosine, verapamil etc or ketogenic diet, vagus nerve stimulation, focal cooling or standard drugs in combinations have shown some promising results. In this review we will shed light on the current pharmacological and non pharmacological mediator with their potential pleiotropic action on pharmacoresistant epilepsy.
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Affiliation(s)
- Arun Kumar Sharma
- Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh-201313, India
| | - Ekta Rani
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab-140401, India
| | - Abdul Waheed
- Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh-201313, India
| | - Satyendra K Rajput
- Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh-201313, India
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13
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Emich-Widera E, Likus W, Kazek B, Sieroń AL, Urbanek K. Polymorphism of ABCB1/MDR1 C3435T in children and adolescents with partial epilepsy is due to different criteria for drug resistance - preliminary results. Med Sci Monit 2014; 20:1654-61. [PMID: 25223475 PMCID: PMC4173802 DOI: 10.12659/msm.890633] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background The diagnosis of “drug resistance” in epilepsy can be defined and interpreted in various ways. This may be due to discrepant definitions of drug resistance to pharmacotherapy. The aim of our study was to investigate the relationship between C3435T polymorphism of the MDR1 gene and drug resistance in epilepsy with the consideration of 4 different criteria for qualification to groups sensitive and resistant to applied pharmacotherapy. Material/Methods Evaluation of C3435T polymorphism of MDR1/ABCB1 gene was conducted on a group of 82 white children and young adolescents up to 18 years old. While qualifying the patients to the group of sensitive or drug resistant, the following 4 definitions of drug resistance were applied: the ILAE’s, Appleton’s, Siddiqui’s, and Berg’s. Results A detailed analysis of genotypes of the MDR1 gene did not show any significant discrepancies between the groups of patients resistant and sensitive to antiepileptic drugs (AEDs) in 4 consecutive comparisons taking into consideration various criteria of sensitivity and resistance to pharmacotherapy. Conclusions The obtained results clearly confirm the lack of a connection between the occurrence of drug-resistant epilepsy and C435T polymorphism of the MDR1 gene irrespective of the definition of drug resistance applied to the patient.
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Affiliation(s)
- Ewa Emich-Widera
- Department of Neuropediatrics, School of Medicine, Medical University of Silesia, Katowice, Poland
| | - Wirginia Likus
- Department of Human Anatomy, School of Medicine, Medical University of Silesia, Katowice, Poland
| | - Beata Kazek
- Department of Neuropediatrics, School of Medicine, Medical University of Silesia, Katowice, Poland
| | - Aleksander L Sieroń
- Department of General and Molecular Biology and Genetics, School of Medicine, Medical University of Silesia, Katowice, Poland
| | - Ksymena Urbanek
- Department of General and Molecular Biology and Genetics, School of Medicine, Medical University of Silesia, Katowice, Poland
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14
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Kaneko S, Yoshida S, Kanai K, Yasui-Furukori N, Iwasa H. Development of individualized medicine for epilepsy based on genetic information. Expert Rev Clin Pharmacol 2014; 1:661-81. [DOI: 10.1586/17512433.1.5.661] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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15
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Kumar M, Kakkar V, Mishra AK, Chuttani K, Kaur IP. Intranasal delivery of streptomycin sulfate (STRS) loaded solid lipid nanoparticles to brain and blood. Int J Pharm 2014; 461:223-33. [DOI: 10.1016/j.ijpharm.2013.11.038] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 11/08/2013] [Accepted: 11/18/2013] [Indexed: 11/30/2022]
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16
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Jaramillo NM, Galindo IF, Vázquez AO, Cook HJ, LLerena A, López ML. Pharmacogenetic potential biomarkers for carbamazepine adverse drug reactions and clinical response. ACTA ACUST UNITED AC 2014; 29:67-79. [DOI: 10.1515/dmdi-2013-0046] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/18/2013] [Indexed: 11/15/2022]
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17
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Chockalingam S, Ghosh SS. Amelioration of cancer stem cells in macrophage colony stimulating factor-expressing U87MG-human glioblastoma upon 5-fluorouracil therapy. PLoS One 2013; 8:e83877. [PMID: 24391839 PMCID: PMC3877109 DOI: 10.1371/journal.pone.0083877] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 11/08/2013] [Indexed: 12/31/2022] Open
Abstract
Macrophage colony stimulating factor (MCSF) regulates growth, proliferation and differentiation of haematopoietic cell lineages. Many cancers are known to secrete high level of MCSF, which recruit macrophages into the tumour micro-environment, supporting tumour growth. Herein, we report the cloning of MCSF and subsequent generation of U87MG expressing MCSF stable cell line (U87-MCSF). Cytotoxicity of anti-cancer drug 5-fluorouracil (5-FU) was evaluated on both U87MG and U87-MCSF cells. Interestingly, the proliferation of U87-MCSF cells was less (p<0.001) than that of U87MG cells alone, after treatment with 5-FU. Significant decrease in expression levels of cyclin E and A2 quantified by real time PCR analysis corroborated the reduced proliferation of 5-FU treated U87-MCSF cells. However, JC-1 staining did not reveal any apoptosis upon 5-FU treatment. Notch-1 upregulation induced a possible epithelial-mesenchymal transition in U87-MCSF cells, which accounted for an increase in the proportion of CD24high/CD44less cancer stem cells in U87-MCSF cells after 5-FU treatment. The elevated resistance of U87-MCSF cells towards 5-FU was due to the increase in the expressions (10.2 and 6 fold) of ABCB1 and mdm2, respectively. Furthermore, increase in expressions of ABCG1, mdm2 and CD24 was also observed in U87MG cells after prolonged incubation with 5-FU. Our studies provided mechanistic insights into drug resistance of U87MG cells and also described the pivotal role played by MCSF in augmenting the resistance of U87MG cells to 5-FU.
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Affiliation(s)
- S. Chockalingam
- Department of Biotechnology, Indian Institute of Technology Guwahati, Guwahati, Assam, India
| | - Siddhartha Sankar Ghosh
- Department of Biotechnology, Indian Institute of Technology Guwahati, Guwahati, Assam, India
- Centre for Nanotechnology, Indian Institute of Technology Guwahati, Guwahati, Assam, India
- * E-mail:
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18
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Abstract
Approximately 30% of epileptic patients remain untreated, in spite of trials with maximum tolerable doses of more than one drug. The RalA binding protein 1 (RALBP1/RLIP76), a multifunctional, anti-apoptot-ic, multidrug transporter protein, has been proposed as being responsible for the drug resistance mechanism in epilepsy. We have investigated polymorphic differences in the coding regions and exonintron boundaries of the RLIP76 gene, between 146 refractory and 155 non refractory epileptic patients in Turkey, using denaturing high performance liquid chromatography (HPLC) and sequencing analysis techniques. We have detected the following sequence variants: c.160-4G>A, c.187C>G, c.1562-38G>A, c.1670+107G>A, c.1670+93G>A, c.1670+96G>A, c.1670+100C>T, c.1670+130C>T, c.1670+131G>C, c.1670+140 G>C, and found no statistically significant correlation between allele frequencies and drug response status. We conclude that sequence variants of this gene are not involved in drug resistance in epilepsy.
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19
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CYP3A5*3 and C3435T MDR1 polymorphisms in prognostication of drug-resistant epilepsy in children and adolescents. BIOMED RESEARCH INTERNATIONAL 2013; 2013:526837. [PMID: 23984379 PMCID: PMC3747339 DOI: 10.1155/2013/526837] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 06/25/2013] [Indexed: 01/13/2023]
Abstract
Drug-resistant epilepsies still remain one of the most profound problems of contemporary epileptology. Several mechanisms of drug resistance are possible; among them, genetic factors have a prominent place. Much importance is attached to genes, which encode enzymes that metabolize antiepileptic drugs CYP 3A, which belong to the family of cytochromes P450 and the genome of multidrug resistance, such as multidrug resistance 1 (MDR1) that expresses P-glycoprotein (P-gp), a drug transporter protein. The aim of the study was to assess the relation between polymorphism of gene CYP3A5 and polymorphism C3435T of MDR1 gene with the occurrence of focal, drug-resistant epilepsy in children and youths up to 18 years of age. The study comprised 85 patients, and their age range was from 33 months to 18 years of age, suffering from epilepsy, partly responding well to treatment, partly drug resistant. The polymorphism of both genes has been analysed using the PCR-RFLP method. The study failed to corroborate association between polymorphism CYP3A5∗3 and C3435T polymorphism in MDR1 gene and pharmacoresistant epilepsy. The results of our research do not confirm the prognostic value of the polymorphisms examined in the prognostication of drug resistance in epilepsies.
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20
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Bae YS, Chung W, Han K, Park KY, Kim H, Kim E, Kim MH. Down-regulation of RalBP1 expression reduces seizure threshold and synaptic inhibition in mice. Biochem Biophys Res Commun 2013; 433:175-80. [PMID: 23485460 DOI: 10.1016/j.bbrc.2013.02.056] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 02/11/2013] [Indexed: 10/27/2022]
Abstract
Idiopathic epilepsy is characterized by seizures without a clear etiology and is believed to have a strong genetic component but exhibits a complex inheritance pattern. Genetic factors seem to confer a low seizure threshold to susceptible individuals and thereby enhance epileptogenesis. However, the identity of susceptibility genes and the mechanisms regulating seizure threshold are still poorly understood. Here, we describe that reduced expression of RalBP1, a downstream effector of the small GTPases RalA and RalB, lowers the seizure threshold in mice. The intraperitoneal injection of the chemoconvulsant pentylenetetrazol induced more severe seizures in RalBP1 hypomorphic mice than in their wild-type littermates. The reduction of RalBP1 in the brain has no effect on neuronal excitability, but does decrease the inhibitory synaptic transmission onto CA1 pyramidal neurons. This impaired synaptic inhibition was associated with the loss of GABAergic interneurons in the CA1 subfield of the hippocampus. The present study identifies RalBP1 as a gene regulating the seizure threshold in mice and provides direct evidence for the role of RalBP1 in synaptic inhibition in vivo.
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Affiliation(s)
- Young-Soo Bae
- Department of Physiology, Seoul National University College of Medicine, Seoul 110-799, Republic of Korea
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21
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Wang Q, Qian J, Wang J, Luo C, Chen J, Hu G, Lu Y. Knockdown of RLIP76 expression by RNA interference inhibits invasion, induces cell cycle arrest, and increases chemosensitivity to the anticancer drug temozolomide in glioma cells. J Neurooncol 2013; 112:73-82. [DOI: 10.1007/s11060-013-1045-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 01/01/2013] [Indexed: 11/29/2022]
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Deo AK, Theil FP, Nicolas JM. Confounding Parameters in Preclinical Assessment of Blood–Brain Barrier Permeation: An Overview With Emphasis on Species Differences and Effect of Disease States. Mol Pharm 2013; 10:1581-95. [DOI: 10.1021/mp300570z] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Anand K. Deo
- UCB Pharma S.A., Chemin du Foriest, B-1420 Braine-l’Alleud,
Belgium
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23
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Aronica E, Sisodiya SM, Gorter JA. Cerebral expression of drug transporters in epilepsy. Adv Drug Deliv Rev 2012; 64:919-29. [PMID: 22138133 DOI: 10.1016/j.addr.2011.11.008] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Revised: 10/03/2011] [Accepted: 11/20/2011] [Indexed: 12/26/2022]
Abstract
Over-expression of drug efflux transporters at the level of the blood-brain barrier (BBB) has been proposed as a mechanism responsible for multidrug resistance. Drug transporters in epileptogenic tissue are not only expressed in endothelial cells at the BBB, but also in other brain parenchymal cells, such as astrocytes, microglia and neurons, suggesting a complex cell type-specific regulation under pathological conditions associated with epilepsy. This review focuses on the cerebral expression patterns of several classes of well-known membrane drug transporters such as P-glycoprotein (Pgp), and multidrug resistance-associated proteins (MRPs) in the epileptogenic brain. Both experimental and clinical evidence of epilepsy-associated cerebral drug transporter regulation and the possible mechanisms underlying drug transporter regulation are discussed. Knowledge of the cerebral expression patterns of drug transporters in normal and epileptogenic brain will provide relevant information to guide strategies attempting to overcome drug resistance by targeting specific transporters.
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Affiliation(s)
- Eleonora Aronica
- Department of (Neuro) Pathology, Academic Medical Center, University of Amsterdam, The Netherlands.
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25
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Matarrese P, Colasanti T, Ascione B, Margutti P, Franconi F, Alessandri C, Conti F, Riccieri V, Rosano G, Ortona E, Malorni W. Gender disparity in susceptibility to oxidative stress and apoptosis induced by autoantibodies specific to RLIP76 in vascular cells. Antioxid Redox Signal 2011; 15:2825-36. [PMID: 21671802 DOI: 10.1089/ars.2011.3942] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIM Ral-binding protein 1 (RLIP76) is a cell surface protein that catalyzes the extrusion from the cell of reduced glutathione (GSH) conjugates. We recently demonstrated the presence of serum antibodies to RLIP76 (aaRLIP76) in patients with immune-mediated diseases characterized by vascular dysfunction. The aim of this work was to analyze the possible implication of gender in this issue, investigating the effects of aaRLIP76 in rat vascular smooth muscle cells and human endothelial cells from males and females. RESULTS We observed that, after aaRLIP76 treatment, vascular cells from females showed a significantly higher susceptibility to the disturbance of intracellular redox balance, in terms of H(2)O(2) and O(2)(*) production, 4-hydroxy-t-2,3-nonenal and GSH levels, C-Jun NH2 kinase signaling activation, and apoptosis in comparison with cells from males. Interestingly, under mild oxidative stress (H(2)O(2) 30 μm for 30 min), these sex-associated differences became significantly more pronounced. Experiments carried out in the presence of sex hormones in the culture medium clearly suggested that estrogens could significantly increase the susceptibility of cells from females to the effects of aaRLIP76, whereas cells from males appeared unaffected. INNOVATION These results open a new perspective in the gender-dependent pathogenic mechanisms of autoimmune diseases characterized by vascular dysfunction. CONCLUSIONS Altogether these results suggest that the impairment of RLIP76 by aaRLIP76 can play a role in the damage of vascular cells from females, contributing to the gender-associated pathogenesis of immune-mediated vascular diseases.
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Affiliation(s)
- Paola Matarrese
- Dipartimento del Farmaco, Istituto Superiore di Sanità, Rome, Italy
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26
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Ghosh C, Puvenna V, Gonzalez-Martinez J, Janigro D, Marchi N. Blood-brain barrier P450 enzymes and multidrug transporters in drug resistance: a synergistic role in neurological diseases. Curr Drug Metab 2011; 12:742-9. [PMID: 21568937 PMCID: PMC4874186 DOI: 10.2174/138920011798357051] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Revised: 03/24/2011] [Accepted: 03/25/2011] [Indexed: 11/22/2022]
Abstract
Drug penetration into the central nervous system (CNS) is controlled by the blood-brain barrier (BBB). Even though a number of strategies to circumvent the BBB and to improve drug access have been developed, drug resistance in CNS diseases remains an unmet clinical problem. We here review the mechanisms by which a healthy or pathological BBB influences drug distribution in the brain, with emphasis on the role of P450 metabolic enzymes and multi-drug transporter (MDT) proteins. In addition to the classic hepatic and gut biotransformation pathways, CNS expression of P450 enzymes may bear pharmacokinetic and pharmacodynamic significance exerting a metabolic activity and transforming parent drugs into specific products. We propose these mechanisms to play a major role in CNS drug resistant pathologies including refractory forms of epilepsy. Changes in the cerebrovascular hemodynamic conditions can affect expression of P450 enzymes and MDT proteins. This should be taken into account when developing in vitro experimental approaches to reproduce the physiological or pathological properties of the BBB. Finally, a link between P450 and MDT expression in the diseased brain and cell survival is discussed.
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Affiliation(s)
- Chaitali Ghosh
- Department of Cell Biology, Cerebrovascular Research, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH 44195
| | - Vikram Puvenna
- Department of Cell Biology, Cerebrovascular Research, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH 44195
| | - Jorge Gonzalez-Martinez
- Department of Neurosurgery, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH 44195
- Epilepsy Center, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH 44195
| | - Damir Janigro
- Department of Cell Biology, Cerebrovascular Research, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH 44195
- Department of Neurosurgery, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH 44195
| | - Nicola Marchi
- Department of Cell Biology, Cerebrovascular Research, 9500 Euclid Avenue, Cleveland Clinic, Cleveland, OH 44195
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27
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Kesavan R, Kukreti R, Adithan C. Genetic polymorphism of drug refractory epilepsy. Indian J Med Res 2011; 134:253-5. [PMID: 21985806 PMCID: PMC3193704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- R. Kesavan
- Center for Advanced Research in Pharmacogenomics, Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry 605 006, India
| | - Ritushree Kukreti
- Genomics & Molecular Medicine, Institute of Genomics & Integrative Biology, Mall Road, Delhi 110 007, India
| | - C. Adithan
- Center for Advanced Research in Pharmacogenomics, Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry 605 006, India,For correspondence:
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Das A, Balan S, Banerjee M, Radhakrishnan K. Drug resistance in epilepsy and the ABCB1 gene: The clinical perspective. INDIAN JOURNAL OF HUMAN GENETICS 2011; 17 Suppl 1:S12-21. [PMID: 21747582 PMCID: PMC3125047 DOI: 10.4103/0971-6866.80353] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Multidrug resistance is one of the most serious problems in the treatment of epilepsy that is likely to have a complex genetic and acquired basis. Various experimental data support the hypothesis that over-expression of antiepileptic drug (AED) transporters may play a pivotal role in drug resistance. Hyyt
6however, key questions concerning their functionality remain unanswered. The idea that P-glycoprotein, encoded by the ABCB1 gene, might mediate at least part of the drug resistance was met with both enthusiasm and skepticism. As in oncology, initial optimism has been clouded subsequently by conflicting results. The first study reporting a positive association between genetic variation in the P-glycoprotein and multidrug-resistant epilepsy was published in 2003. Since then, several other genetic association studies have attempted to verify this result. However, taken overall, the role of P-glycoprotein in drug resistance in epilepsy still remains uncertain. We intend to critically review the inherent problems associated with epilepsy pharmacogenetic studies in general and with ABCB1 polymorphisms studies in particular. The lessons learnt from the ABCB1 studies can help us to guide future association genetics studies to investigate AED resistance, and thereby taking us closer to the cherished dream of personalized AED therapy.
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Affiliation(s)
- Abhijit Das
- R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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Uchida Y, Ohtsuki S, Katsukura Y, Ikeda C, Suzuki T, Kamiie J, Terasaki T. Quantitative targeted absolute proteomics of human blood-brain barrier transporters and receptors. J Neurochem 2011; 117:333-45. [PMID: 21291474 DOI: 10.1111/j.1471-4159.2011.07208.x] [Citation(s) in RCA: 579] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
We have obtained, for the first time, a quantitative protein expression profile of membrane transporters and receptors in human brain microvessels, that is, the blood-brain barrier (BBB). Brain microvessels were isolated from brain cortexes of seven males (16-77 years old) and protein expression of 114 membrane proteins was determined by means of a liquid chromatography-tandem mass spectrometric quantification method using recently established in-silico peptide selection criteria. Among drug transporters, breast cancer resistance protein showed the most abundant protein expression (8.14 fmol/μg protein), and its expression level was 1.85-fold greater in humans than in mice. By contrast, the expression level of P-glycoprotein in humans (6.06 fmol/μg protein) was 2.33-fold smaller than that of mdr1a in mice. The organic anion transporters reported in rodent BBB, that is, multidrug resistance-associated protein, organic anion transporter and organic anion-transporting polypeptide family members, were under limit of quantification in humans, except multidrug resistance-associated protein 4 (0.195 fmol/μg protein). Among detected transporters and receptors for endogenous substances, the glucose transporter 1 level was similar to that of mouse, while the L-type amino acid transporter 1 level was fivefold smaller than that of mouse. These findings should be useful for understanding human BBB function and its differences from that in mouse.
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Affiliation(s)
- Yasuo Uchida
- Graduate School of Pharmaceutical Sciences, Tohoku University, Japan
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30
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Ghosh C, Gonzalez-Martinez J, Hossain M, Cucullo L, Fazio V, Janigro D, Marchi N. Pattern of P450 expression at the human blood-brain barrier: roles of epileptic condition and laminar flow. Epilepsia 2010; 51:1408-17. [PMID: 20074231 PMCID: PMC3386640 DOI: 10.1111/j.1528-1167.2009.02428.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE P450 enzymes (CYPs) play a major role in hepatic drug metabolism. It is unclear whether these enzymes are functionally expressed by the diseased human blood-brain barrier (BBB) and are involved in local drug metabolism or response. We have evaluated the cerebrovascular CYP expression and function, hypothesizing possible implication in drug-resistant epilepsy. METHODS CYP P450 transcript levels were assessed by cDNA microarray in primary endothelial cultures established from a cohort of brain resections (n = 12, drug-resistant epilepsy EPI-EC and aneurism domes ANE-EC). A human brain endothelial cell line (HBMEC) and non-brain endothelial cell line (HUVEC) were used as controls. The effect of exposure to shear stress on CYP expression was evaluated. Results were confirmed by Western blot and immunohistochemistry on brain specimens. Endothelial drug metabolism was assessed by high performance liquid chromatography (HPLC-UV). RESULTS cDNA microarray showed the presence of CYP enzymes in isolated human primary brain endothelial cells. Using EPI-EC and HBMEC we found that CYP mRNA levels were significantly affected by exposure to shear stress. CYP3A4 protein was overexpressed in EPI-EC (290 ± 30%) compared to HBMEC and further upregulated by shear stress exposure. CYP3A4 was increased in the vascular compartment at regions of reactive gliosis in the drug-resistant epileptic brain. Metabolism of carbamazepine was significantly elevated in EPI-EC compared to HBMEC. DISCUSSION These results support the hypothesis of local drug metabolism at the diseased BBB. The direct association between BBB CYP enzymes and the drug-resistant phenotype needs to be further investigated.
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Affiliation(s)
- Chaitali Ghosh
- Department of Cerebrovascular Research, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Neurological Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Cell Biology, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
| | | | - Mohammed Hossain
- Department of Cerebrovascular Research, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Neurological Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Cell Biology, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
| | - Luca Cucullo
- Department of Cerebrovascular Research, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Neurological Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Cell Biology, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
| | - Vincent Fazio
- Department of Cerebrovascular Research, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Neurological Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Cell Biology, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
| | - Damir Janigro
- Department of Cerebrovascular Research, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Neurological Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Cell Biology, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Molecular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
| | - Nicola Marchi
- Department of Cerebrovascular Research, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Neurological Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
- Department of Cell Biology, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A
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Fernandes C, Soni U, Patravale V. Nano-interventions for neurodegenerative disorders. Pharmacol Res 2010; 62:166-78. [PMID: 20153429 DOI: 10.1016/j.phrs.2010.02.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Revised: 02/03/2010] [Accepted: 02/03/2010] [Indexed: 01/17/2023]
Abstract
With an increase in lifespan and changing population demographics, the incidence of central nervous system (CNS) diseases is expected to increase significantly in the 21st century. Contrary to common belief, it is recognized that neurodegenerative diseases may be multisystemic in nature and this presents numerous difficulties for the potential treatment of these disorders. This review focuses on applications in the nano-delivery of therapeutic agents across the blood-brain barrier. We explore various types of nanoparticles, ranging from polymerics to liposomes. A brief discussion of the pharmacokinetic parameters and specific targeting strategies of these nanoparticles follows, presenting suggestions for the mechanisms of cellular and intracellular uptake and possible toxicity considerations of nanoparticles.
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Affiliation(s)
- Clara Fernandes
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology (Autonomous), Matunga, Mumbai 400 019, Maharashtra, India
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33
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RLIP76: a versatile transporter and an emerging target for cancer therapy. Biochem Pharmacol 2010; 79:1699-705. [PMID: 20097178 DOI: 10.1016/j.bcp.2010.01.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Revised: 01/13/2010] [Accepted: 01/14/2010] [Indexed: 01/29/2023]
Abstract
In the last few years, extensive research has been made to elucidate the functional significance of RLIP76. The resulting novel breakthroughs have helped us understand its transport and signaling functions. RLIP76 is a ubiquitously expressed, key stress-defensive, anti-apoptotic, multi-functional protein that transports glutathione-conjugates of electrophilic compounds, thus controlling the intracellular concentration of pro-apoptotic oxidized lipid byproducts and other xenobiotics such as chemotherapeutic agents. These properties place RLIP76 at a very important position in the hierarchy of the stress defense mechanism adopted by the cell. Selective over-expression of RLIP76 in malignant cells of diverse origin is one of the possible mechanisms by which these cells overcome chemotherapy and radiation induced oxidative damage. RLIP76 has also been shown to be an effective transporter of many conventional chemotherapeutic drugs. Such transport, if inhibited, can lead to increased cellular accumulation of drugs which in turn translates to enhanced drug sensitivity. Recent studies have shown that inhibition and/or depletion of RLIP76 by antibodies, siRNA, or antisense can lead to drastic and sustained regression of lung, kidney, melanoma, colon, and prostate cancer xenografts with no observed recurrence of tumors. All these findings converge on the fact that such inhibition/depletion of RLIP76 can be used clinically to terminate cancer growth and progression. In the present review, we will discuss the role of RLIP76 as a multi-drug transporter, its involvement in cancer, and the prospects of using RLIP76 inhibition as an emerging treatment for cancer.
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Pierzchała K. Padaczka oporna na leczenie – epidemiologia i aktualny stan badań. Neurol Neurochir Pol 2010; 44:285-90. [DOI: 10.1016/s0028-3843(14)60043-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Colabufo NA, Berardi F, Cantore M, Contino M, Inglese C, Niso M, Perrone R. Perspectives of P-Glycoprotein Modulating Agents in Oncology and Neurodegenerative Diseases: Pharmaceutical, Biological, and Diagnostic Potentials. J Med Chem 2009; 53:1883-97. [DOI: 10.1021/jm900743c] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Nicola Antonio Colabufo
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
| | - Francesco Berardi
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
| | - Mariangela Cantore
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
| | - Marialessandra Contino
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
| | - Carmela Inglese
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
| | - Mauro Niso
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
| | - Roberto Perrone
- Dipartimento Farmacochimico, Universitá degli Studi di Bari, Facoltá di Farmacia, Via Orabona 4, 70125, Bari, Italy
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Tian L, Chen L, Yang T, Zhang Q, Zhou D. RNAi inhibits Coriaria lactone-induced MDR1b overexpression in rat brain microvascular endothelial cells. J Mol Neurosci 2009; 39:284-93. [PMID: 19357816 DOI: 10.1007/s12031-009-9198-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2008] [Accepted: 03/16/2009] [Indexed: 02/05/2023]
Abstract
P-glyprotein (multidrug resistance gene 1, MDR1) was the first isolated and most extensively investigated refractory epilepsy-related drug-resistant protein. Coriaria lactone (CL) can induce P-glyprotein expression of brain capillary and astrocytes in vivo. We established the primary rat brain microvascular endothelial cell (BMECs) models overexpressing P-glycoprotein induced by CL successfully and infected them with adenovirus vector, which carry small interfering RNA (siRNA) designed to target MDR1b. MDR1b mRNA levels and P-glyprotein expression in experimental group decreased significantly 72 h after infection, and the fluorescence intensity of rhodamine within the cells of experimental group increased significantly. So, CL can induce P-glyprotein overexpression in BMECs in vitro, and siRNA can effectively inhibit expression of P-glyprotein and decrease its "pumping out" function. This may offer a new method and rationale for studying the mechanism of refractory epilepsy and relevant gene therapy.
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Affiliation(s)
- Linyu Tian
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic China
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Awasthi YC, Chaudhary P, Vatsyayan R, Sharma A, Awasthi S, Sharma R. Physiological and pharmacological significance of glutathione-conjugate transport. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2009; 12:540-551. [PMID: 20183533 DOI: 10.1080/10937400903358975] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Transport of the glutathione conjugates (GS-E) of electrophilic compounds generated during biotransformation of drugs and environmental pollutants is central to the mechanisms of defense against oxidative/electrophilic stress. In recent years emphasis has been placed on ATP-binding cassette (ABC) transport proteins in the transport of GS-E and their involvement in the detoxification mechanisms, including drug resistance. Recent studies, however, suggested that the majority of GS-E transport in human and rodent cells is mediated by a non-ABC, multifunctional stress-response protein, RLIP76 or RalBP1 (ral-binding GTPase activating protein 1), which also functions as an effector in the Ral-Ras-Rho signaling pathway. In this review, after briefly describing the major discoveries in the field of glutathione (GSH)-conjugate transport, recent findings are presented on the role of RLIP76 in ATP-dependent transport of GS-E, and the relevance of this transport process to the mechanisms of toxicity of xenobiotics, radiation, and endogenous electrophilic toxicants is described. Furthermore, recent studies suggesting a link between RLIP76 mediated GS-E transport and cell cycle signaling are presented.
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Affiliation(s)
- Yogesh C Awasthi
- Department of Molecular Biology and Immunology, University of North Texas Health Science Center, Fort Worth, Texas 76107, USA.
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Eyal S, Hsiao P, Unadkat JD. Drug interactions at the blood-brain barrier: fact or fantasy? Pharmacol Ther 2009; 123:80-104. [PMID: 19393264 DOI: 10.1016/j.pharmthera.2009.03.017] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Accepted: 03/20/2009] [Indexed: 12/24/2022]
Abstract
There is considerable interest in the therapeutic and adverse outcomes of drug interactions at the blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier (BCSFB). These include altered efficacy of drugs used in the treatment of CNS disorders, such as AIDS dementia and malignant tumors, and enhanced neurotoxicity of drugs that normally penetrate poorly into the brain. BBB- and BCSFB-mediated interactions are possible because these interfaces are not only passive anatomical barriers, but are also dynamic in that they express a variety of influx and efflux transporters and drug metabolizing enzymes. Based on studies in rodents, it has been widely postulated that efflux transporters play an important role at the human BBB in terms of drug delivery. Furthermore, it is assumed that chemical inhibition of transporters or their genetic ablation in rodents is predictive of the magnitude of interaction to be expected at the human BBB. However, studies in humans challenge this well-established paradigm and claim that such drug interactions will be lesser in magnitude but yet may be clinically significant. This review focuses on current known mechanisms of drug interactions at the blood-brain and blood-CSF barriers and the potential impact of such interactions in humans. We also explore whether such drug interactions can be predicted from preclinical studies. Defining the mechanisms and the impact of drug-drug interactions at the BBB is important for improving efficacy of drugs used in the treatment of CNS disorders while minimizing their toxicity as well as minimizing neurotoxicity of non-CNS drugs.
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Affiliation(s)
- Sara Eyal
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, Washington 98195, USA
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Löscher W, Klotz U, Zimprich F, Schmidt D. The clinical impact of pharmacogenetics on the treatment of epilepsy. Epilepsia 2009; 50:1-23. [DOI: 10.1111/j.1528-1167.2008.01716.x] [Citation(s) in RCA: 186] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Liefaard LC, Ploeger BA, Molthoff CFM, de Jong HWAM, Dijkstra J, van der Weerd L, Lammertsma AA, Danhof M, Voskuyl RA. Changes in GABAAreceptor properties in amygdala kindled animals: In vivo studies using [11C]flumazenil and positron emission tomography. Epilepsia 2009; 50:88-98. [DOI: 10.1111/j.1528-1167.2008.01763.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Awasthi S, Singhal SS, Awasthi YC, Martin B, Woo JH, Cunningham CC, Frankel AE. RLIP76 and Cancer. Clin Cancer Res 2008; 14:4372-7. [PMID: 18628450 DOI: 10.1158/1078-0432.ccr-08-0145] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
RLIP76 is a multifunctional membrane protein that transports glutathione conjugates of electrophilic compounds and other xenobiotics including chemotherapy agents out of cells. The protein is overexpressed in lung carcinomas, ovarian carcinomas, and melanomas. The protein also binds Ral and participates in mitotic spindle function, clathrin-dependent endocytosis, and triggers GTPase-activating protein activity. It is found throughout the cell, in membrane, cytosol, and the nucleus, and is known to shift between these compartments in response to stress. Loss of RLIP76 by antibody or antisense therapy is associated with increased sensitivity to radiation and chemotherapy. Conversely, liposomally delivered RLIP may treat poisoning and wounds.
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Affiliation(s)
- Sanjay Awasthi
- Department of Molecular Biology and Immunology, University of North Texas Health Science Center, Fort Worth, Texas, USA
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Hildebrandt M, Amann K, Schröder R, Pieper T, Kolodziejczyk D, Holthausen H, Buchfelder M, Stefan H, Blumcke I. White matter angiopathy is common in pediatric patients with intractable focal epilepsies. Epilepsia 2008; 49:804-15. [DOI: 10.1111/j.1528-1167.2007.01514.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
BACKGROUND Despite the currently available armamentarium of antiepileptic drugs, seizures are not adequately controlled in about one-third of epileptic patients. The mechanisms of antiepileptic drug resistance are multiple and not fully clarified. METHODS We conducted a literature search in PubMed and the Cochrane Library databases with the terms: "Drug Resistance" [MeSH] and "Epilepsy" [MeSH], LIMITS added to PubMed in the last 5 years, only items with abstracts, English, Spanish, Humans. REVIEW SUMMARY It is currently known that membrane transporter proteins are increased in brain tissue of refractory epileptic patients and in animal models of epilepsy and that overexpression of these transporters and their inhibition are correlated with a reduction and an increase, respectively, of epileptic drugs in epileptic tissue (pharmacokinetic hypothesis). It has also been shown that alterations in voltage-gated sodium channels and GABAA receptors are responsible for resistance to some epileptic drugs. These changes may be constitutional (genetically determined) or acquired (as a consequence of the seizures themselves or disease progression) and may seem alone or combined with each other (pharmacodynamic hypothesis). Associations have been shown between certain genetic polymorphisms and resistance to epileptic drugs, and although they have not been replicated by all authors, they constitute a very attractive line of research. More detailed knowledge of these molecular mechanisms will probably lead to the development of new strategies for pharmacological treatment of epilepsy.
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Abstract
Epilepsy is the most common serious chronic neurological disorder. Treatment consists mainly of antiepileptic drugs (AEDs), with more than 15 different molecules available. However, AED treatment is often problematic because of unpredictability of drug response, adverse drug reactions and optimal dosing in individual patients. Moreover, up to one in three patients with epilepsy are refractory to currently available AEDs. Pharmacogenetic studies explore the contribution of genetic variants to interindividual differences in drug response. An increasing number of pharmacogenetic association studies in epilepsy are being reported. Nevertheless, at present only one association is firmly established, namely that of the HLA-B*1502 allele with severe cutaneous adverse drug reactions on carbamazepine therapy in the Han Chinese population. It is likely that large collaborations looking at multiple genes encoding entire drug pathways, or even the entire human genome, together with new pharmacogenetic strategies will result in the discovery of other genetic variants involved in AED response. Although several challenges remain, it is hoped that, ultimately, these findings will lead to the development of predictive tests, resulting in a more efficacious and safer AED treatment, and to the development of new AEDs with novel mechanisms of action, particularly aimed at patients with drug-refractory epilepsy.
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Affiliation(s)
- Chantal Depondt
- Université Libre de Bruxelles, Service de Neurologie, Hôpital Erasme, 808 Route de Lennik, 1070 Bruxelles, Belgium.
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Leschziner GD, Jorgensen AL, Andrew T, Williamson PR, Marson AG, Coffey AJ, Middleditch C, Balding DJ, Rogers J, Bentley DR, Chadwick D, Johnson MR, Pirmohamed M. The association between polymorphisms in RLIP76 and drug response in epilepsy. Pharmacogenomics 2008; 8:1715-22. [PMID: 18086001 DOI: 10.2217/14622416.8.12.1715] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Approximately 30% of patients with epilepsy are resistant to treatment with anti-epileptic drugs (AEDs). The ABC drug transporter proteins are hypothesized to mediate drug resistance in epilepsy. More recently, a non-ABC putative transporter, RLIP76, has also been proposed to be involved in the mechanism of pharmacoresistance. One previous association study of six polymorphisms in RLIP76 failed to find any association with drug resistance in a retrospective cohort of epilepsy patients. We aimed to look for an association with outcomes reflecting drug response in a larger prospective cohort, with gene-wide coverage. PATIENTS AND METHODS We investigated the role of common polymorphisms in RLIP76 in epilepsy pharmacoresistance by genotyping 23 common RLIP76 polymorphisms in a prospective cohort of 503 epilepsy patients, from the standard and new anti-epileptic drugs (SANAD) prospective study of new and old AEDs. A total of 13 of these were tested for association with four outcomes reflecting response to drugs: time to first seizure, time to 12-month remission, time to withdrawal due to inadequate seizure control, and time to withdrawal due to unacceptable adverse drug events. RESULTS No significant associations, allowing for multiple testing, were found in the whole cohort. There was also no effect in a subgroup of patients on carbamazepine, which is thought to be a RLIP76 substrate, although two polymorphisms were associated with time to first seizure (p = 0.007). DISCUSSION We failed to demonstrate any association between RLIP76 polymorphisms and four different measures of drug response in the larger cohort, but a subgroup analysis of patients receiving carbamazepine suggested an association that should be investigated further. CONCLUSIONS Our data suggest that common variants in RLIP76 are unlikely to contribute to epilepsy drug response.
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Affiliation(s)
- Guy D Leschziner
- Imperial College London, Division of Neuroscience, Charing Cross Campus, Room 10E07, St Dunstan's Road, London W6 8RF, UK.
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Jiang W, Du B, Chi Z, Ma L, Wang S, Zhang X, Wu W, Wang X, Xu G, Guo C. Preliminary explorations of the role of mitochondrial proteins in refractory epilepsy: some findings from comparative proteomics. J Neurosci Res 2008; 85:3160-70. [PMID: 17893921 DOI: 10.1002/jnr.21384] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Approximately 20-30% of patients with epilepsy continue to have seizures despite carefully monitored treatment with antiepileptic drugs. The mechanisms that underlie why some patients are responsive and others prove resistant to antiepileptic drugs are poorly understood. Increasing evidence supports a role for altered mitochondrial function in the pathogenesis of epilepsy. To gain greater molecular insight in the pathogenesis of intractable epilepsy, we undertook a global analysis of protein expressions in a pharmacoresistant epileptic model selected by phenytoin in electrical amygdala-kindled rats by using two-dimensional gel electrophoresis coupled with matrix-assisted laser desorption/ionization time of flight (MALDI-TOF-TOF). We identified five increased proteins and 14 decreased proteins including voltage-dependent anion channel 1 (VDAC1) with a 2.82-fold increased level (P < 0.05) and voltage-dependent anion channel 2 (VDAC2) with a 3.97-fold decreased level (P < 0.05) in hippocampus of pharmacoresistant rats. The increased VDAC1 and decreased VDAC2 were confirmed by Western blot analysis and immunohistochemistry. Vascular mitochondria and apoptosis neurons were observed through electron microscopy. Energy contents, the adenine nucleotides, were measured by high-performance liquid chromatography (HPLC). The correlation analyses were carried out between VDAC and the energy charge. These findings indicate that the increase of VDAC1 and the decrease of VDAC2 play an important role during the process and provide new molecular evidence in understanding mechanism of refractory epilepsy.
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Affiliation(s)
- WenJing Jiang
- Department of Cadre Healthcare, Qilu Hospital of Shandong University, Jinan, China
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Autoantibodies to the C-terminal subunit of RLIP76 induce oxidative stress and endothelial cell apoptosis in immune-mediated vascular diseases and atherosclerosis. Blood 2007; 111:4559-70. [PMID: 17993611 DOI: 10.1182/blood-2007-05-092825] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Although detection of autoantibodies in the peripheral blood from patients with immune-mediated endothelial dysfunctions has so far failed to provide tools of diagnostic or pathogenetic value, putative bioindicators include anti-endothelial cell antibodies, a heterogeneous family of antibodies that react with autoantigens expressed by endothelial cells. In this study, to identify endothelial autoantigens involved in the autoimmune processes causing endothelial damage, we screened a human microvascular endothelial cell cDNA library with sera from patients with Behçet's disease. We identified antibodies to the C-terminus of Ral binding protein1 (RLIP76), a protein that catalyzes the ATP-dependent transport of glutathione (GSH) conjugates including GSH-4-hydroxy-t-2,3-nonenal, in the serum of a significant percentage of patients with various diseases characterized by immune-mediated endothelial dysfunction, including Behçet disease, systemic sclerosis, systemic lupus erythematosus and carotid atherosclerosis. These autoantibodies increased intracellular levels of 4-hydroxy-t-2,3-nonenal, decreased levels of GSH and activated C-Jun NH2 Kinase signaling (JNK), thus inducing oxidative stress-mediated endothelial cell apoptosis. The dietary antioxidant alpha-tocopherol counteracted endothelial cell demise. These findings suggest that autoantibodies to RLIP76 play a pathogenetic role in immune-mediated vascular diseases and represent a valuable peripheral blood bioindicator of atherosclerosis and immune-mediated vascular diseases.
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Edafiogho IO, Kombian SB, Ananthalakshmi KVV, Salama NN, Eddington ND, Wilson TL, Alexander MS, Jackson PL, Hanson CD, Scott KR. Enaminones: Exploring Additional Therapeutic Activities. J Pharm Sci 2007; 96:2509-31. [PMID: 17621683 DOI: 10.1002/jps.20967] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Enaminones, enamines of beta-dicarbonyl compounds, have been known for many years. Their early use has been relegated to serving as synthetic intermediates in organic synthesis and of late, in pharmaceutical development. Recently, the therapeutic potential of these entities has been realized. This review provides the background and current research in this area with emphasis of these agents as potential anticonvulsants, their proposed mechanisms of action, and as potential modulators of multidrug resistance (MDR).
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 1/antagonists & inhibitors
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism
- Amines/chemical synthesis
- Amines/metabolism
- Amines/pharmacology
- Amines/therapeutic use
- Animals
- Anticonvulsants/chemical synthesis
- Anticonvulsants/metabolism
- Anticonvulsants/pharmacology
- Anticonvulsants/therapeutic use
- Blood-Brain Barrier/metabolism
- Crystallography, X-Ray
- Drug Resistance, Multiple/drug effects
- Drug Resistance, Multiple/genetics
- Epilepsy/drug therapy
- Epilepsy/genetics
- Epilepsy/metabolism
- Excitatory Postsynaptic Potentials/drug effects
- Humans
- Models, Chemical
- Molecular Structure
- Neurons/drug effects
- Neurons/metabolism
- Polymorphism, Single Nucleotide
- Quantitative Structure-Activity Relationship
- Synaptic Transmission/drug effects
- gamma-Aminobutyric Acid/metabolism
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Affiliation(s)
- Ivan O Edafiogho
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait
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Abstract
Multidrug resistance is one of the most serious problems in the treatment of epilepsy and is likely to have a complex genetic and environmental basis. Various experimental data support the hypothesis that overexpression of antiepileptic drug transporters may be important. However, key questions concerning their functionality remain unanswered. The first study reporting a positive association--between genetic variation in a putative antiepileptic drug transporter (P-glycoprotein, encoded by ABCB1) and multidrug resistant epilepsy was published in 2003. Since then, several other association genetics studies have sought to confirm this result, but, taken overall, do not support a major role for this polymorphism. Lessons learnt from the ABCB1 studies can help guide future association genetics studies, both for multidrug resistance in epilepsy, and for other epilepsy phenotypes.
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Affiliation(s)
- Sarah K Tate
- University College London, Department of Clinical and Experimental Epilepsy, Institute of Neurology, Queen Square, London, UK
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