Presence andex vivoformation of acridone in blood of patients routinely treated with carbamazepine: exploration of the 9-acridinecarboxaldehyde pathway

Assessing developmental toxicity and non-CYP mediated biotransformation of two anti-epileptics and their human metabolites in zebrafish embryos and larvae

Zebrafish embryo-based assays are a promising alternative for animal testing to screen new compounds for developmental toxicity. However, recent studies in zebrafish embryos showed an immature intrinsic cytochrome P450 (CYP)-mediated biotransformation capacity, as most CYPs were only active at the end of the organogenesis period. Data on other phase I enzymes involved in the biotransformation of xenobiotics in zebrafish embryos is limited. This information is pivotal for proteratogens needing bioactivation to exert their teratogenic potential. Therefore, this study aimed to investigate whether carbamazepine (CBZ) and levetiracetam (LTC), two anti-epileptic drugs that require bioactivation to exert their teratogenic potential, are biotransformed into non-CYP mediated metabolites in the zebrafish embryo and whether one or more of these metabolites cause developmental toxicity in this species. In the first step, zebrafish embryos were exposed to LTC and CBZ and their non-CYP mediated human metabolites, etiracetam carboxylic acid (ECA) and 9-acridine carboxaldehyde (9ACA), acridine (AI), and acridone (AO), respectively, from 5.25 to 120 hpf and morphologically evaluated. Next, the uptake of all compounds and the formation of the metabolites were assessed using LC-MS methods. As LTC and ECA were, respectively, poorly or not taken up by zebrafish larvae during the exposure experiments, we could not determine if LTC and ECA are teratogenic. However, biotransformation of LTC into ECA was observed at 24 hpf and 120 hpf, which indicates that the special type of B-esterase is already active at 24 hpf. CBZ and its three metabolites were teratogenic, as a significant increase in malformed embryos was observed for all of them. All three metabolites were more potent teratogens than CBZ, with AI being the most potent, followed by 9ACA and AO. The myeloperoxidase (MPO) homologue is already active at 24 hpf, as CBZ was biotransformed into 9ACA and AO in 24 hpf zebrafish embryos, and into 9ACA in 120 hpf larvae. Moreover, 9ACA was also found to be biotransformed into AI and AO, and AI into AO. As such, one or more of these metabolites probably contribute to the teratogenic effects observed in zebrafish larvae after exposure to CBZ.

Prospects on coupling UV/H2O2 with activated sludge or a fungal treatment for the removal of pharmaceutically active compounds in real hospital wastewater

Conventional active sludge (AS) process at municipal centralized wastewater treatment facilities may exhibit little pharmaceuticals (PhACs) removal efficiencies when treating hospital wastewater (HWW). Therefore, a dedicated efficient wastewater treatment at the source point is recommended. In this sense, advanced oxidation processes (AOPs) and fungal treatment (FG) have evidenced promising results in degrading PhACs. The coupling of the AOP based on UV/H₂O₂ treatment with biological treatment (AS or FG) treating a real non-sterile HWW, was evaluated in this work. In addition, a coagulation-flocculation pretreatment was applied to improve the efficiency of all approaches. Twenty-two PhACs were detected in raw HWW, which were effectively removed (93-95%) with the combination of any of the biological treatment followed by UV/H₂O₂ treatment. Similar removal results (94%) were obtained when placing UV/H₂O₂ treatment before FG, while a lower removal (83%) was obtained in the combination of UV/H₂O₂ followed by AS. However, the latest was the only treatment combination that achieved a decrease in the toxicity of water. Moreover, deconjugation of conjugated PhACs has been suggested for ofloxacin and lorazepam after AS treatment, and for ketoprofen after fungal treatment. Monitoring of carbamazepine and its transformation products along the treatment allowed to identify the same carbamazepine degradation pathway in UV/H₂O₂ and AS treatments, unlike fungal treatment, which followed another degradation route.

Carbamazepine removal from wastewater and the degradation mechanism in a submerged forward osmotic membrane bioreactor

A submerged forward osmotic membrane bioreactor (FOMBR) was used to reveal the removal and degradation mechanism of carbamazepine (CBZ) from wastewater. The results showed that the removal mechanism consisted of the rejection of the forward osmotic (FO) membrane and biodegradation of the activated sludge. The removal efficiencies of COD, NH₄⁺-N, and CBZ by the FOMBR were approximately 94.77%-97.45%, 93.56%-99.28%, and 88.20%-94.45%, respectively. Moreover, the COD and NH₄⁺-N removal efficiencies were positively correlated with the increased CBZ concentrations. The results of the soluble microbial products (SMP) and extracellular polymeric substances (EPS) tests illustrated that the membrane fouling potential of EPS may be higher than that of SMP. According to the identified 14 degradation products, oxidation, hydroxylation, and decarboxylation were defined as the primary CBZ degradation mechanism. In addition, the RNA results showed that Delftia could be the characteristic bacteria in the CBZ degradation process.

Radiolysis of carbamazepine by electron beam: Roles of transient reactive species and biotoxicity of final reaction solutions on rotifer Philodina sp

Electron beam (EB) has proven to be an effective advanced oxidation reduction process (AORP) to degrade the psychiatric drug carbamazepine (CBZ); however, the degradation mechanism and the toxicity of the final reaction solutions to aquatic microorganisms needed further investigation. In this study, CBZ was eventually degraded and even mineralized by EB treatment, where the degradation of CBZ followed the pseudo-first-order kinetics with R² > 0.98. Acidic conditions, presence of an additional oxidant (2.5 mmol L^-1 H₂O₂), and O₂/air-saturated conditions improved the degradation efficiency of CBZ, as well as the radiation chemical yield (G-value defined as the efficiency of the irradiation process). Concentrations of transient reactive species (TRS) caused by EB were quantified under different conditions at doses of 0.956 and 3.17 kGy, and the apparent quantum yield of CBZ degradation was in the order of OH > H > e_aq^-. However, the contribution of these species to CBZ degradation was in the order of OH > e_aq^- >H due to the generation of only a small amount of H. Findings regarding the changes of in CBZ degradation intermediates, short-chain fatty acids (SCFAs), and total organic carbon showed that CBZ can gradually be mineralized into CO₂/CO₃^2-, H₂O, and NH₃/NH₄⁺ by the EB process. Additionally, an excellent rotifer survival rate after 5-day culturing in the reaction solutions resulting from 5-kGy treatment indicated that EB can be a safe AORP to mineralize CBZ in solution. These findings provide scientific proof for the EB being an effective AORP for removal of psychiatric drugs from aqueous solutions, laying the foundation for future remediation research.

Carbamazepine is degraded by the bacterial strain Labrys portucalensis F11

The occurrence of pharmaceuticals in the environment is a topic of concern. Carbamazepine (CBZ) is a widespread antiepileptic drug and due to its physical-chemical characteristics minimal removal is achieved in conventional water treatments, and thus has been suggested as a molecular marker of wastewater contamination in surface water and groundwater. The present study reports the biotransformation of CBZ by the bacterial strain Labrys portucalensis F11. When supplied as a sole carbon source, a 95.4% biotransformation of 42.69 μM CBZ was achieved in 30 days. In co-metabolism with acetate, complete biotransformation was attained at a faster rate. Following a target approach, the detection and identification of 14 intermediary metabolites was achieved through UPLC-QTOF/MS/MS. Biotransformation of CBZ by the bacterial strain is mostly based on oxidation, loss of -CHNO group and ketone formation reactions; a biotransformation pathway with two routes is proposed. The toxicity of untreated and treated CBZ solutions was assessed using Vibrio Fischeri and Lepidium sativum acute toxicity tests and Toxi-Chromo Test. The presence of CBZ and/or its degradations products in solution resulted in moderate toxic effect on Vibrio Fischeri, whereas the other organisms were not affected. To the best of our knowledge this is the first report that proposes the metabolic degradation pathway of CBZ by a single bacterial strain.

The first-line antiepileptic drug carbamazepine: Reaction with biologically relevant free radicals

Carbamazepine (CBZ) is one of the most widely used antiepileptic drugs by both adults and children. Despite its widespread use, CBZ is associated with central nervous system toxicity and severe hypersensitivity reactions, which raise concerns about its chronic use. While the precise mechanisms of CBZ-induced adverse events are still unclear, metabolic activation to the epoxide (CBZ-EP) has been thought to play a significant role. This work reports first-hand evidence that CBZ reacts readily with biologically relevant thiyl radicals with no need for bioactivation. Using liquid chromatography coupled with high resolution mass spectrometry, multiple products from direct reaction of CBZ with glutathione (GSH) and N-acetyl-L-cysteine (NAC) were unequivocally identified, including the same product obtained upon ring-opening of CBZ-EP. The product profile is complex and consistent with radical-mediated mechanisms. Importantly, side products and adducts compatible with this non-enzymatic pathway were identified in liver extracts from CBZ-treated Wistar rats. The reaction of CBZ with GSH and NAC is more extensive in the presence of oxygen. Taking into consideration that GSH conjugation is, in general, a detoxification pathway, these results suggest that under hyperoxia/oxidative stress conditions the bioavailability of the parent drug may be compromised. Additionally, this non-enzymatic process can be anticipated to play, at least in part, a role in the onset of CBZ-induced adverse reactions due to the concomitant generation of reactive oxygen species. Therefore, the search for causal relationships between the formation of non-enzymatically-driven CBZ products and the occurrence of CBZ-induced adverse events in human patients merits further research, aiming the translation of basic mechanistic findings into a clinical context that may ultimately lead to a safer CBZ prescription.

Photochemistry of 9-acridinecarboxaldehyde in aqueous media

Dark and photolysis reactions in solution were investigated for 9-acridinecarboxaldehyde (ACL). ACL reacts in the dark at T = 20 °C and pH = 7.0 in an air saturated solution to the main product 9-acridinecarboxylic acid (ACA) and to the minor product 9-acridinemethanol (ACM) with a lifetime of τ = 4.3 days. The dissociation constant of the base ACLH+ was determined to be pKa ± σ = 4.38 ± 0.04. The photolysis of ACL was investigated using a polychromatic Xe-light source. The quantum yield in aqueous solution at T = 20 °C in a concentration range of c0(ACL) = 0.18-16.6 μM for pH > pKa and for nitrogen, air and oxygen aerated solutions was found to be Φ ± σ = (0.015 ± 0.003) mol/mol, independent from concentration. The quantum yield of ACLH+, i.e. for pH ≪ pKa, is by a factor of 2 higher (Φ = 0.029 mol/mol). Quantum yields in methanol and isopropanol are slightly lower compared to water and in acetone lower by about a factor of 20. In acetonitrile ACL was found to be practically photostable. Minimum lifetimes in sunlight for a measurement on September 5, 2017 were in the range of τ = 5-10 minutes. The diurnal photolysis of ACL in sunlight was satisfactory explained using the mean quantum yield, the absorption spectrum and photon fluxes with suitable corrections for cloudiness and the dimensions of the setup. For low concentrations ACR is formed with a yield of practically 100% in the photolysis reaction. However, with increasing concentration of ACL yields of ACR decrease and yields of ACA increase. 9(10H)-Acridinone and ACM were always detected as minor products with yields below 2%. 9-Methylacridine was never detected in any reaction of ACL. Strong indications are presented of a photolysis reaction of ACL in a river located in Lower Saxony (Germany) with a corresponding equimolar formation of ACR. ACL is therefore a direct precursor of ACR in natural surface water.

Metabolism of carbamazepine in plant roots and endophytic rhizobacteria isolated from Phragmites australis

Carbamazepine (CBZ) is a pharmaceutical frequently categorized as a recalcitrant pollutant in the aquatic environment. Endophytic bacteria previously isolated from reed plants have shown the ability to promote growth of their host and to contribute to CBZ metabolism. In this work, a horseradish (Armoracia rusticana) hairy root (HR) culture has been used as a plant model to study the interactions between roots and endophytic bacteria in response to CBZ exposure. HRs could remove up to 5% of the initial CBZ concentration when they were grown in spiked Murashige and Skoog (MS) medium. Higher removal rates were observed when HRs were inoculated with the endophytic bacteria Rhizobium radiobacter (21%) and Diaphorobacter nitroreducens (10%). Transformation products resulting from CBZ degradation were identified using liquid chromatography-ultra high-resolution quadrupole time of flight mass spectrometry (LC-UHR-QTOF-MS). CBZ metabolism could be divided in four pathways. Metabolites involving GSH conjugation and 2,3-dihydroxylation, as well as acridine related compounds are described in plants for the first time. This study presents strong evidence that xenobiotic metabolism and degradation pathways in plants can be modulated by the interaction with their endophytic community. Hence it points to plausible applications for the elimination of recalcitrant compounds such as CBZ from wastewater in CWs.

Transformation Pathways of the Recalcitrant Pharmaceutical Compound Carbamazepine by the White-Rot Fungus Pleurotus ostreatus: Effects of Growth Conditions

The widely used anticonvulsant pharmaceutical carbamazepine is recalcitrant in many environmental niches and thus poses a challenge in wastewater treatment. We followed the decomposition of carbamazepine by the white-rot fungus Pleurotus ostreatus in liquid culture compared to solid-state fermentation on lignocellulosic substrate where different enzymatic systems are active. Carbamazepine metabolites were identified using liquid chromatography-high-resolution mass spectrometry (LC-Q-TOF-MS). In liquid culture, carbamazepine was only transformed to 10,11-epoxy carbamazepine and 10,11-dihydroxy carbamazepine as a dead-end product. During solid-state fermentation, carbamazepine metabolism resulted in the generation of an additional 22 transformation products, some of which are toxic. Under solid-state-fermentation conditions, 10,11-epoxy carbamazepine was further metabolized via acridine and 10,11-dihydroxy carbamazepine pathways. The latter was further metabolized via five subpathways. When (14)C-carbonyl-labeled carbamazepine was used as the substrate, (14)C-CO2 release amounted to 17.4% of the initial radioactivity after 63 days of incubation. The proposed pathways were validated using metabolites (10,11-epoxy carbamazepine, 10,11-dihydroxy carbamazepine, and acridine) as primary substrates and following their fate at different time points. This work highlights the effect of growth conditions on the transformation pathways of xenobiotics. A better understanding of the fate of pollutants during bioremediation treatments is important for establishment of such technologies.