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Kontoghiorghes GJ. The Puzzle of Aspirin and Iron Deficiency: The Vital Missing Link of the Iron-Chelating Metabolites. Int J Mol Sci 2024; 25:5150. [PMID: 38791185 PMCID: PMC11121054 DOI: 10.3390/ijms25105150] [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: 04/02/2024] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Acetylsalicylic acid or aspirin is the most commonly used drug in the world and is taken daily by millions of people. There is increasing evidence that chronic administration of low-dose aspirin of about 75-100 mg/day can cause iron deficiency anaemia (IDA) in the absence of major gastric bleeding; this is found in a large number of about 20% otherwise healthy elderly (>65 years) individuals. The mechanisms of the cause of IDA in this category of individuals are still largely unknown. Evidence is presented suggesting that a likely cause of IDA in this category of aspirin users is the chelation activity and increased excretion of iron caused by aspirin chelating metabolites (ACMs). It is estimated that 90% of oral aspirin is metabolized into about 70% of the ACMs salicyluric acid, salicylic acid, 2,5-dihydroxybenzoic acid, and 2,3-dihydroxybenzoic acid. All ACMs have a high affinity for binding iron and ability to mobilize iron from different iron pools, causing an overall net increase in iron excretion and altering iron balance. Interestingly, 2,3-dihydroxybenzoic acid has been previously tested in iron-loaded thalassaemia patients, leading to substantial increases in iron excretion. The daily administration of low-dose aspirin for long-term periods is likely to enhance the overall iron excretion in small increments each time due to the combined iron mobilization effect of the ACM. In particular, IDA is likely to occur mainly in populations such as elderly vegetarian adults with meals low in iron content. Furthermore, IDA may be exacerbated by the combinations of ACM with other dietary components, which can prevent iron absorption and enhance iron excretion. Overall, aspirin is acting as a chelating pro-drug similar to dexrazoxane, and the ACM as combination chelation therapy. Iron balance, pharmacological, and other studies on the interaction of iron and aspirin, as well as ACM, are likely to shed more light on the mechanism of IDA. Similar mechanisms of iron chelation through ACM may also be implicated in patient improvements observed in cancer, neurodegenerative, and other disease categories when treated long-term with daily aspirin. In particular, the role of aspirin and ACM in iron metabolism and free radical pathology includes ferroptosis, and may identify other missing links in the therapeutic effects of aspirin in many more diseases. It is suggested that aspirin is the first non-chelating drug described to cause IDA through its ACM metabolites. The therapeutic, pharmacological, toxicological and other implications of aspirin are incomplete without taking into consideration the iron binding and other effects of the ACM.
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Affiliation(s)
- George J Kontoghiorghes
- Postgraduate Research Institute of Science, Technology, Environment and Medicine, Limassol 3021, Cyprus
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Mîrza CM, Mîrza TV, Odagiu ACM, Uifălean A, But AE, Pârvu AE, Bulboacă AE. Phytochemical Analysis and Antioxidant Effects of Prunella vulgaris in Experimental Acute Inflammation. Int J Mol Sci 2024; 25:4843. [PMID: 38732062 PMCID: PMC11084636 DOI: 10.3390/ijms25094843] [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: 03/18/2024] [Revised: 04/24/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
Prunella vulgaris (PV) is one of the most commonly used nutraceuticals as it has been proven to have anti-inflammatory and antioxidant properties. The aim of this study was to evaluate the phytochemical composition of PV and its in vivo antioxidant properties. A phytochemical analysis measuring the total phenolic content (TPC), the identification of phenolic compounds by HPLC-DAD-ESI, and the evaluation of the in vitro antioxidant activity by the DPPH assay of the extract were performed. The antioxidant effects on inflammation induced by turpentine oil were experimentally tested in rats. Seven groups with six animals each were used: a control group, the experimental inflammation treatment group, the experimental inflammation and diclofenac sodium (DS) treatment group, and four groups with their inflammation treated using different dilutions of the extract. Serum redox balance was assessed based on total oxidative status (TOS), nitric oxide (NO), malondialdehyde (MDA), total antioxidant capacity (TAC), total thiols, and an oxidative stress index (OSI) contents. The TPC was 0.28 mg gallic acid equivalents (GAE)/mL extract, while specific representatives were represented by caffeic acid, p-coumaric acid, dihydroxybenzoic acid, gentisic acid, protocatechuic acid, rosmarinic acid, vanillic acid, apigenin-glucuronide, hesperidin, kaempferol-glucuronide. The highest amount (370.45 μg/mL) was reported for hesperidin, which is a phenolic compound belonging to the flavanone subclass. The antioxidant activity of the extracts, determined using the DPPH assay, was 27.52 mmol Trolox/mL extract. The PV treatment reduced the oxidative stress by lowering the TOS, OSI, NO, and MDA and by increasing the TAC and thiols. In acute inflammation, treatment with the PV extract reduced oxidative stress, with lower concentrations being more efficient and having a better effect than DS.
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Affiliation(s)
- Camelia-Manuela Mîrza
- Department of Morpho-Functional Sciences, Discipline of Pathophysiology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.-M.M.); (A.U.); (A.E.B.); (A.E.P.); (A.-E.B.)
| | - Tudor-Valentin Mîrza
- Department of Epidemiology of Communicable Diseases, National Institute of Public Health—Regional Centre of Public Health, 400376 Cluj-Napoca, Romania
| | - Antonia Cristina Maria Odagiu
- Department of Environmental Engineering and Protection, Faculty of Agriculture, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania
| | - Ana Uifălean
- Department of Morpho-Functional Sciences, Discipline of Pathophysiology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.-M.M.); (A.U.); (A.E.B.); (A.E.P.); (A.-E.B.)
| | - Anca Elena But
- Department of Morpho-Functional Sciences, Discipline of Pathophysiology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.-M.M.); (A.U.); (A.E.B.); (A.E.P.); (A.-E.B.)
| | - Alina Elena Pârvu
- Department of Morpho-Functional Sciences, Discipline of Pathophysiology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.-M.M.); (A.U.); (A.E.B.); (A.E.P.); (A.-E.B.)
| | - Adriana-Elena Bulboacă
- Department of Morpho-Functional Sciences, Discipline of Pathophysiology, Iuliu Haţieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.-M.M.); (A.U.); (A.E.B.); (A.E.P.); (A.-E.B.)
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Rubira L, Donzé C, Fouillet J, Algudo B, Kotzki PO, Deshayes E, Fersing C. [ 68Ga]Ga-FAPI-46 synthesis on a GAIA® module system: Thorough study of the automated radiolabeling reaction conditions. Appl Radiat Isot 2024; 206:111211. [PMID: 38309117 DOI: 10.1016/j.apradiso.2024.111211] [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: 10/20/2023] [Revised: 01/19/2024] [Accepted: 01/25/2024] [Indexed: 02/05/2024]
Abstract
The influence of several parameters involved in the 68Ga radiolabeling of FAPI-46 was studied at the scale of the automated reaction. Among the buffers tested, HEPES 0.3 M pH 4 allowed both high radiochemical purity (RCP) and radiochemical yield (RCY), without prepurification of 68Ga but after final purification of [68Ga]Ga-FAPI-46 on a C18 cartridge. A longer reaction time did not show significant benefit on the RCP, while higher loads of FAPI-46 and gentisic acid as anti-radiolysis compound allowed better RCY.
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Affiliation(s)
- Léa Rubira
- Nuclear medicine department, Institut régional du Cancer de Montpellier (ICM), Univ. Montpellier, Montpellier, France
| | - Charlotte Donzé
- Nuclear medicine department, Institut régional du Cancer de Montpellier (ICM), Univ. Montpellier, Montpellier, France
| | - Juliette Fouillet
- Nuclear medicine department, Institut régional du Cancer de Montpellier (ICM), Univ. Montpellier, Montpellier, France
| | - Benjamin Algudo
- Nuclear medicine department, Institut régional du Cancer de Montpellier (ICM), Univ. Montpellier, Montpellier, France
| | - Pierre Olivier Kotzki
- Nuclear medicine department, Institut régional du Cancer de Montpellier (ICM), Univ. Montpellier, Montpellier, France; Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194, Univ. Montpellier, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
| | - Emmanuel Deshayes
- Nuclear medicine department, Institut régional du Cancer de Montpellier (ICM), Univ. Montpellier, Montpellier, France; Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194, Univ. Montpellier, Institut régional du Cancer de Montpellier (ICM), Montpellier, France
| | - Cyril Fersing
- Nuclear medicine department, Institut régional du Cancer de Montpellier (ICM), Univ. Montpellier, Montpellier, France; IBMM, Univ Montpellier, CNRS, ENSCM, Montpellier, France.
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Larenkov A, Mitrofanov I, Pavlenko E, Rakhimov M. Radiolysis-Associated Decrease in Radiochemical Purity of 177Lu-Radiopharmaceuticals and Comparison of the Effectiveness of Selected Quenchers against This Process. Molecules 2023; 28:molecules28041884. [PMID: 36838872 PMCID: PMC9967390 DOI: 10.3390/molecules28041884] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
The radiolytic degradation of vector molecules is a major factor affecting the shelf life of therapeutic radiopharmaceuticals. The development of time-stable dosage forms of radiopharmaceuticals is the key to their successful implementation in clinical practice. Using [177Lu]Lu-PSMA-617 molecule as an example, the time dependence of the change in radiochemical purity (RCP, %) under radiolysis conditions was studied. The dependence of [177Lu]Lu-PSMA-617 radiolysis on parameters such as time, radionuclide activity, buffer agent concentration, precursor amount, and preparation volume was evaluated. It was shown that the absorbed dose was the dominant factor influencing the RCP. The RCP value is inversely proportional to the absorbed dose in the [177Lu]Lu-PSMA-617 preparation and has an exponential dependence. The lutetium-177 dose factor ψ (Gy·mL·MBq-1) and PSMA-617 concentration-dependent dose constant κ (Gy-1) were evaluated for absorbed dose estimation via computer modeling, chemical dosimetry, and radiochemical purity monitoring under various conditions. The further refinement and application of the dependencies found can be useful for predicting the RCP value at the stage of optimizing the composition of the finished dosage form of therapeutic radiopharmaceuticals. The influence of the buffer agent (sodium acetate) concentration on [177Lu]Lu-PSMA-617 radiolytic degradation was shown and should be considered both when developing a dosage form, and when comparing the results of independent studies. The effectiveness of the addition of various stabilizing agents, such as DMSA, cysteine, gentisic acid, vanillin, methionine, adenine, dobesilic acid, thymine, uracil, nicotinamide, meglumine, and mannitol, in suppressing the effects of radiolysis was evaluated.
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Bartoli F, Elsinga P, Nazario LR, Zana A, Galbiati A, Millul J, Migliorini F, Cazzamalli S, Neri D, Slart RHJA, Erba PA. Automated Radiosynthesis, Preliminary In Vitro/In Vivo Characterization of OncoFAP-Based Radiopharmaceuticals for Cancer Imaging and Therapy. Pharmaceuticals (Basel) 2022; 15:ph15080958. [PMID: 36015106 PMCID: PMC9416253 DOI: 10.3390/ph15080958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 12/10/2022] Open
Abstract
FAP-targeted radiopharmaceuticals represent a breakthrough in cancer imaging and a viable option for therapeutic applications. OncoFAP is an ultra-high-affinity ligand of FAP with a dissociation constant of 680 pM. OncoFAP has been recently discovered and clinically validated for PET imaging procedures in patients with solid malignancies. While more and more clinical validation is becoming available, the need for scalable and robust procedures for the preparation of this new class of radiopharmaceuticals continues to increase. In this article, we present the development of automated radiolabeling procedures for the preparation of OncoFAP-based radiopharmaceuticals for cancer imaging and therapy. A new series of [68Ga]Ga-OncoFAP, [177Lu]Lu-OncoFAP and [18F]AlF-OncoFAP was produced with high radiochemical yields. Chemical and biochemical characterization after radiolabeling confirmed its excellent stability, retention of high affinity for FAP and absence of radiolysis by-products. The in vivo biodistribution of [18F]AlF-NOTA-OncoFAP, a candidate for PET imaging procedures in patients, was assessed in mice bearing FAP-positive solid tumors. The product showed rapid accumulation in solid tumors, with an average of 6.6% ID/g one hour after systemic administration and excellent tumor-to-healthy organs ratio. We have developed simple, quick, safe and robust synthetic procedures for the preparation of theranostic OncoFAP-compounds based on Gallium-68, Lutetium-177 and Fluorine-18 using the commercially available FASTlab synthesis module.
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Affiliation(s)
- Francesco Bartoli
- Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine and Surgery, University of Pisa and Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy;
| | - Philip Elsinga
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands; (P.E.); (L.R.N.); (R.H.J.A.S.)
| | - Luiza Reali Nazario
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands; (P.E.); (L.R.N.); (R.H.J.A.S.)
| | - Aureliano Zana
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Switzerland; (A.Z.); (A.G.); (J.M.); (F.M.); (S.C.)
| | - Andrea Galbiati
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Switzerland; (A.Z.); (A.G.); (J.M.); (F.M.); (S.C.)
| | - Jacopo Millul
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Switzerland; (A.Z.); (A.G.); (J.M.); (F.M.); (S.C.)
| | - Francesca Migliorini
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Switzerland; (A.Z.); (A.G.); (J.M.); (F.M.); (S.C.)
| | - Samuele Cazzamalli
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Switzerland; (A.Z.); (A.G.); (J.M.); (F.M.); (S.C.)
| | - Dario Neri
- Department of Chemistry and Applied Biosciences, Swiss Federal Institute of Technology, CH-8093 Zurich, Switzerland;
- Philogen S.p.A., 53100 Siena, Italy
| | - Riemer H. J. A. Slart
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands; (P.E.); (L.R.N.); (R.H.J.A.S.)
- Biomedical Photonic Imaging Group, Faculty of Science and Technology, University of Twente, 7522 NB Enschede, The Netherlands
| | - Paola Anna Erba
- Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine and Surgery, University of Pisa and Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy;
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands; (P.E.); (L.R.N.); (R.H.J.A.S.)
- Correspondence:
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