Utility of an appropriate reporter assay: Heliotrine interferes with GAL4/upstream activation sequence-driven reporter gene systems

Reporter gene assays are widely used for the assessment of transcription factor activation following xenobiotic exposure of cells. A critical issue with such assays is the possibility of interference of test compounds with the test system, for example, by direct inhibition of the reporter enzyme. Here we show that the pyrrolizidine alkaloid heliotrine interferes with reporter signals derived from GAL4-based nuclear receptor transactivation assays by a mechanism independent of luciferase enzyme inhibition. These data highlight the necessity to conduct proper control experiments in order to avoid perturbation of reporter assays by test chemicals.

Disturbance of gene expression in primary human hepatocytes by hepatotoxic pyrrolizidine alkaloids: A whole genome transcriptome analysis

1,2-unsaturated pyrrolizidine alkaloids (PA) are plant metabolites predominantly occurring in the plant families Asteraceae and Boraginaceae. Acute and chronic PA poisoning causes severe hepatotoxicity. So far, the molecular mechanisms of PA toxicity are not well understood. To analyze its mode of action, primary human hepatocytes were exposed to a non-cytotoxic dose of 100 μM of four structurally different PA: echimidine, heliotrine, senecionine, senkirkine. Changes in mRNA expression were analyzed by a whole genome microarray. Employing cut-off values with a |fold change| of 2 and a q-value of 0.01, data analysis revealed numerous changes in gene expression. In total, 4556, 1806, 3406 and 8623 genes were regulated by echimidine, heliotrine, senecione and senkirkine, respectively. 1304 genes were identified as commonly regulated. PA affected pathways related to cell cycle regulation, cell death and cancer development. The transcription factors TP53, MYC, NFκB and NUPR1 were predicted to be activated upon PA treatment. Furthermore, gene expression data showed a considerable interference with lipid metabolism and bile acid flow. The associated transcription factors FXR, LXR, SREBF1/2, and PPARα/γ/δ were predicted to be inhibited. In conclusion, though structurally different, all four PA significantly regulated a great number of genes in common. This proposes similar molecular mechanisms, although the extent seems to differ between the analyzed PA as reflected by the potential hepatotoxicity and individual PA structure.

Structure-activity relationship in the passage of different pyrrolizidine alkaloids through the gastrointestinal barrier: ABCB1 excretes heliotrine and echimidine

SCOPE

1,2-Unsaturated pyrrolizidine alkaloids (PA) are found in plants such as Asteraceae and Boraginaceae families. Acute PA poisoning via contaminated food or feed causes severe damage to liver depending on species-specific oral bioavailability. For assessing PA bioavailability, their passage across the intestinal barrier was investigated using Caco-2 cells.

METHODS

Differentiated Caco-2 cells were exposed in transport chambers to the PA heliotrine (Hn), echimidine (Em), senecionine (Sc), and senkirkine (Sk). Cell supernatants were analyzed by LC-MS/MS.

RESULTS

PA pass Caco-2 monolayer from the apical into basolateral compartment depending on their chemical structure. Compared to the cyclic diesters Sc and Sk with a passage rate of 47% ± 4 and 40% ± 3, respectively, the transferred amount of the monoester Hn (32% ± 3) and open-chained diester Em (13% ± 2) was substantially lower. This suggested an active transport of Hn and Em. Using Madin-Darby canine kidney II/P-glycoprotein (ABCB1)-overexpressing cells, the active excretion of Hn and Em by ABCB1 from the gastrointestinal epithelium into the gut lumen was shown.

CONCLUSION

PA cross the intestinal barrier structure-dependently. The passage of the noncyclic PA Hn and Em is reduced by an ABCB1-driven efflux into the gastrointestinal lumen resulting in a decreased oral bioavailability.

Polycyclic aromatic hydrocarbons stimulate human CYP3A4 promoter activity via PXR

Metabolic activation of polycyclic aromatic hydrocarbons (PAH) is mediated mainly by cytochrome P₄₅₀ monooxygenases (CYP) CYP1A1, 1A2 and 1B1. Several PAH are known to induce these CYP via aryl hydrocarbon receptor (AhR) signaling. Recently, it was shown that the PAH benzo[a]pyrene (BaP) can induce CYP3A4 as well. The induction was suggested to be mediated by the pregnane X receptor (PXR) rather than AhR. Metabolism by CYP3A4 is only known for dihydrodiol metabolites of PAH but not for their parent compounds. In the present study, a CYP3A4 reporter gene assay, requiring the overexpression of PXR, was used to investigate whether the PAH parent compounds BaP, benzo[c]phenanthrene (BcP) and dibenzo[a,l]pyrene (DBalP) as well as their corresponding phase I metabolites, the respective dihydrodiols and diol epoxides, can induce CYP3A4 promoter activity. BaP, BcP and their dihydrodiols were found to significantly activate the CYP3A4 promoter. Moreover, activation of PXR by all four compounds was detected by using a PXR transactivation assay, supporting that PXR mediates CYP3A4 induction by PAH. Taken together, these results show that both PAH parent compounds as well as their phase I metabolites induce CYP3A4 promoter via the transcription factor PXR.

Identification and characterization of a mammalian enzyme catalyzing the asymmetric oxidative cleavage of provitamin A

In vertebrates, symmetric versus asymmetric cleavage of beta-carotene in the biosynthesis of vitamin A and its derivatives has been controversially discussed. Recently we have been able to identify a cDNA encoding a metazoan beta,beta-carotene-15,15'-dioxygenase from the fruit fly Drosophila melanogaster. This enzyme catalyzes the key step in vitamin A biosynthesis, symmetrically cleaving beta-carotene to give two molecules of retinal. Mutations in the corresponding gene are known to lead to a blind, vitamin A-deficient phenotype. Orthologs of this enzyme have very recently been found also in vertebrates and molecularly characterized. Here we report the identification of a cDNA from mouse encoding a second type of carotene dioxygenase catalyzing exclusively the asymmetric oxidative cleavage of beta-carotene at the 9',10' double bond of beta-carotene and resulting in the formation of beta-apo-10'-carotenal and beta-ionone, a substance known as a floral scent from roses, for example. Besides beta-carotene, lycopene is also oxidatively cleaved by the enzyme. The deduced amino acid sequence shares significant sequence identity with the beta,beta-carotene-15,15'-dioxygenases, and the two enzyme types have several conserved motifs. To establish its occurrence in different vertebrates, we then attempted and succeeded in cloning cDNAs encoding this new type of carotene dioxygenase from human and zebrafish as well. As regards their possible role, the apocarotenals formed by this enzyme may be the precursors for the biosynthesis of retinoic acid or exert unknown physiological effects. Thus, in contrast to Drosophila, in vertebrates both symmetric and asymmetric cleavage pathways exist for carotenes, revealing a greater complexity of carotene metabolism.

[Interstitial laser-induced coagulation of the prostate for therapy of benign hyperplasia]

Interstitial laser-induced coagulation (ILC) is a new, minimally invasive, procedure for the treatment of benign prostatic hyperplasia (BPH). It is based on the placement of special light guides in the prostatic tissue, either transurethrally or perineally. The radiation source is a Nd-YAG laser, which is active for 3 or 5 min per fiber placement, respectively, with the power reduced stepwise. The coagulation necroses caused shrink during follow-up, leading to a decrease in the obstruction. In 239 patients treated in this way the mean I-PSS-Score fell from 25.4 to 8.1 points and the quality of life index from 4.1 to 1.6, the urinary peak flow rate increased from 7.7 to 16.3 ml/s, the residual urine volume fell from 151 to 32 ml, and the mean prostate volume declined from 47.4 to 32.2 ml in the first 3 months of follow up; 9.2% of the patients required further treatment within 1 year because of persistent obstruction. The complication rate was low. Statistical analysis showed no factors allowing prediction of the outcome. ILC is an effective method with few side effects and complications, and it has a wide range of indications for all BPH patients.

[Interstitial laser coagulation of benign prostatic hyperplasia]

We report on the new method of interstitial laser coagulation for the treatment of benign prostatic hyperplasia (BPH). The procedure is based on the interstitial application of Nd:YAG laser irradiation, delivered through a new light guide system. Such light applicators coagulate constant tissue volumes in a homogeneous manner, as proven by in vitro studies in different tissues, including surgically removed prostate adenoma. The extent of the coagulation is determined by laser power and irradiation time. At 5 W, for example, and during a 10-min period, this zone reached a diameter of up to 20 mm. Temperatures generated in the process were over 100 degrees C, as measured by time/space resolution. These results were confirmed by in vivo studies in canine prostates. In the course of 7 weeks, the coagulated areas formed scars with degeneration and fibrosis, accompanied by marked shrinking. Neighbouring organs were not affected. The method was successfully transferred to clinical practice. The application of the light guides to the lateral lobes was performed percutaneously from the perineum under transrectal ultrasound guidance. The median lobe was punctured transurethrally under direct vision. Twenty-seven patients with an average age of 67.7 years were treated between July 1991 and March 1992. At the time of evaluation 15 patients had a follow-up of more than 2 months. They experienced a mean increase of peak flow rate from 6.6 to 15.2 ml/s and a mean decrease of residual volume from 206 to 38 ml. This was accompanied by a marked lessening of symptoms. The average prostate weight decreased from 63 to 44 g. Sexually active patients did not experience retrograde ejaculation.(ABSTRACT TRUNCATED AT 250 WORDS)

Fine structure of zonal changes in experimental Nd:YAG laser-induced interstitial hyperthermia

Interstitial thermotherapy using Nd:YAG-laser induced hyperthermia is a new stereotactic method for the treatment of brain tumors in poorly accessible regions. To provide a basis for the underlying tissue alterations, we have analyzed the spatial and temporal pattern of interstitial laser hyperthermia lesions in the normal rat brain by histological, immunohistochemical, and electron microscopical methods. The acute changes corresponded to the temperature gradient surrounding the laser probe and showed a distinct zonal architecture. Membrane destruction on a cellular and subcellular level appears to be of major significance in the pathogenesis of the laser lesion. The tissue reaction followed the course known for coagulation necrosis and resulted in a well-defined defect. These results, although limited by the choice of the experimental model, may be helpful in the interpretation of images obtained in future applications of interstitial thermotherapy.

Thermal effects and histologic changes from Nd:YAG laser irradiation on normal and diseased aortic tissue using a novel angioplasty catheter with a mobile optical fiber: an in vitro assessment

Although various laser angioplasty devices are currently being examined, thermal damage and perforation of the vessel wall remains the major acute complication of vascular laser recanalization. Consequently, the aim of this study was to investigate the thermal effects and histologic changes from laser irradiation (Nd:YAG, 1064 nm) on normal and diseased aortic tissue using a novel angioplasty device. During laser emission the coaxially guided optical fiber tip was positioned in reference to the end hole of the metallic capped probe as follows: (1) at the end hole (metal-cap position), (2) protruding 10 mm from that end hole (bare-fiber position), (3) withdrawn 5 mm into the metal cap's lumen (hot-tip position). In total, 96 laser impacts (25 joule: 5 W, 5 s, each) were produced on normal and atherosclerotic aorta in air through a 0.2-mm-core-diameter silica quartz fiber, with direct contact on the intimal surface of the target tissue by both the fiber and the metal cap and by either the fiber or the metal cap (n = 32 each). Tissue temperature was measured by means of special sensors positioned opposite the irradiated intimal spot in direct contact with the adventitial surface. Morphohistologic evaluation of lesions was performed and injury indexes were determined.

In vitro ablation of normal and diseased vascular tissue by a fiber-transmitted holmium laser

An in vitro study was performed to test the ablative potential of a fiber-transmitted pulsed holmium laser (2.1 microns) applied to normal vascular wall, lipomatous plaques, and calcified plaques. Different fluences per pulse of 42, 80, 205, and 315 J/cm2 were used. Ablation of normal tissue and lipomatous plaques was achieved with all power settings. Effective ablation of calcified plaques, however, occurred only after a minimum fluence of 205 J/cm2, and the effect was significantly less pronounced compared to ablation of soft lesions.

Application systems for intracorporeal laser-induced shockwave lithotripsy using the Nd:YAG Q-switched laser

For laser-induced shockwave lithotripsy, the electromagnetic energy of a laser light pulse is converted intracorporeally into the acoustic energy of a shockwave. The lithotriptor is based on a specially developed, Q-switched Nd:YAG laser whose high power light pulses (70 mJ, 25 nsec) are coupled into a flexible quartz fiber with a core diameter of 600 mum. Using focusing elements, energy densities higher than 6 x 10 5 J m -2 can be achieved, resulting in an optical breakdown in water followed by a shockwave. As a result of different absorption mechanisms, the breakdown threshold can be decreased by placing a metallic target into the laser beam. The different shockwave formations of such optomechanical transducers have been measured. First clinical applications have been performed.

[Laser angioplasty and the removal of calcified plaques. An in vitro study]

The ablative potentials of five different lasers on normal and diseased vascular tissue were tested in vitro. Post-mortem aortic specimens of normal wall, lipomatous and calcified plaques were exposed to both continuous wave lasers (argon, neodymium-YAG 1064 nm) coupled to hot-tipped or sapphire tipped fibres and pulsed lasers (Excimer 193 nm, CO2, erbium-YAG). Histomorphological changes and penetration were evaluated microscopically. Pulsed lasers of all wavelengths used were able to ablate vascular tissue of all stages including heavily calcified plaques. Thermal lasers were able to penetrate the normal wall and lipomatous plaques, but did not reach any evident reaction on calcified plaques. Thermal lasers may have only limited potentials in angioplasty, since ablation of calcified plaques is not possible.

Vascular tissue ablation by an erbium-YAG laser: a fiber-transmittable pulsed laser in the infrared range

Vascular tissue ablation by an erbium:YAG laser of 2,940 nm was tested in-vitro with the application of increasing energies from 20 to 80 mJ per pulse. Effective ablation of normal vascular tissue, lipomatous atheromas and calcified plaques was achieved. Penetration depth was considerably diminished in the presence of calcifications. The lasered craters showed smooth surfaces and were regularly shaped. The solid state erbium:YAG, which is transmittable by fluoride fibers, offers theoretical advantages for laser angioplasty.

Laser balloon angioplasty: technical realization and vascular tissue effects of a modified concept

A modified concept using a movable fiber with radial light dispersion was developed for combining mechanical balloon dilatation and intraluminal circumferential Nd-Yag laser irradiation of the arterial wall. The aims of the study were the technical feasibility and the acute and chronic vascular tissue effects of laser-assisted balloon dilatation. The carotid arteries (n = 9 dogs) and femoral arteries (n = 5 dogs) of dogs were mechanically dilated and simultaneously circumferentially irradiated through the balloon by 1,064 nm Nd-Yag laser (20-25 W). Temperature at the adventitial surface was kept constant at 50 degrees C, 60 degrees C, 70 degrees C, or 80 degrees C for either 8 or 15 seconds by a computerized feedback system for temperature control. Angiographic and histological results were available acutely, subacutely (2 days), and at 3 months. Angiographically, stable and smooth enlargement of the lumen was demonstrated acutely. At 3 months, occlusions, probably thrombotic in origin, had occurred in 5 of the carotid arteries and none of the femoral arteries. Histologically, laser-induced coagulation of the arterial wall with loss of cellular elements was demonstrated. Collagen and elastic fibers remained relatively intact. In two carotid arteries intimal proliferation was observed at the treated site. Thus, this technique appears to be technically feasible, yet further study is needed to assess its potential to reduce or repair acute vascular complications (dissections) and to reduce restenoses after percutaneous transluminal coronary angioplasty (PTCA). However, the clinical value of this technique appears to be limited in view of the thromboses and reactive proliferations observed in this preliminary study.

[Use of the thermal laser effect of laser irradiation for cardiovascular applications exemplified by the Nd:YAG laser]

Techniques of percutaneous transluminal application of laser energy for vessel recanalization have been used clinically since 1983. The commonly used Nd:YAG and argon lasers achieve ablation of atherosclerotic plaques by thermal action (vaporization). In order to reduce undesirable thermal damage in the neighborhood of the target tissue and to avoid vessel perforation, optimal irradiation parameters, modified (atraumatic) fiber tips (hot tips, sapphires), and steerable catheter systems needed to be implemented. Favorable results from peripheral application have encouraged use in the coronary circulation. More recently, coagulative tissue effects of circumferential irradiation of the vessel wall during balloon dilatation have been used for stabilization of acute and late results after mechanical balloon angioplasty. Enhancement of the differential light absorption of atherosclerotic plaque by use of biological dyes may further improve selective intravascular laser application. Intraoperative ECG-guided laser coagulation of arrhythmogenic areas of myocardium is a method for treatment of malignant arrhythmias. Transluminal non-operative application of myocardial laser photocoagulation has now been tested experimentally and shown to be safe and effective. There was no arrhythmogenicity or thermal damage of coronary arteries associated with this method. Innovative techniques such as nanosecond pulsed excimer lasers (athermal action) and development of "intelligent" lasers--which are equipped with spectroscopy-guided feedback systems for plaque recognition--have opened new perspectives and will further improve safety and efficacy of clinical laser application. However, according to current experience, the thermally acting Nd:YAG laser is an effective and versatile mode of laser therapy for selected cardiovascular indications.

Effects of Nd-YAG laser and cryosurgery on the oral mucosa in rabbits

In 32 rabbits, lesions of comparable depths were created in the oral mucosa using a Nd-YAG laser (Medilas II, 1.06 microns, MBB Co., Munich) and a cryosurgery unit (Kryo-S, Erbe Co., Hannover). Histologic specimens were examined between 1 h and up to 8 weeks following operation. The laser lesion was restricted horizontally to the laser-exposed area; the full extent of the lesion could already be seen after 1 day. Cryosurgical lesions showed their maximum extent 3 days following treatment. Wound healing processes following laser application, were accelerated compared to cryosurgical procedure.

Health technology assessment: problems and challenges

From a national perspective, the central prerequisite of the proper application of medical technology is the timely determination of efficacy, cost, safety, and societal impact. This applies to both the introduction of the new methods and the retirement of older methods that may have outlived their usefulness. Within that framework, the rapid diffusion of innovative methods of great value must be balanced against the cost of premature enthusiasm for techniques with little or no incremental diagnostic or therapeutic gain. A nongovernmental Council on Health Care Technology Assessment of the Institute of Medicine-National Academy of Sciences was established by the Congress in 1986. The Council was charged to serve as an information clearing-house, a center to promote research and education, and a stimulus to establish better methods of assessment and more prompt identification of potentially important technologies. It represents virtually all of the constituencies concerned with adequate evaluation of new and existing methods. The Council confronts the critical problems of timing, bias, the quality of primary data collection, new methods of secondary data analysis, the nature of the "laboratory" in which technology assessment is best accomplished, the "exploitative" character of technology assessment research, appropriate diffusion, and ethnical issues. The appropriate use of technology in modern health care depends on the resolution of these issues.

Comparative investigations of the effects of the neodymium:YAG laser at 1.06 microns and 1.32 microns on tissue

The beneficial deep homogeneous coagulation of neodymium (Nd):YAG laser radiation at 1.06 microns owing to low absorption and high scattering in tissue has been documented widely. For another Nd:YAG laser wavelength at 1.32 microns the absorption coefficient of water and saline is approximately ten times higher than at 1.06 microns. This results in more efficient energy conversion into heat in tissue at 1.32 microns. The extinction coefficient in blood at 1.32 microns is only one-third of that at 1.06 microns. We would expect this to result in less heat dissipation by blood and deeper penetration in tissue at 1.32 microns. Nevertheless, at this wavelength scattering also contributes to an effective, uniform distribution of the laser light in the tissue. Animal experiments have been done to examine the effect of wavelength, irradiation time, and beam geometry on tissue damage and to assess its possible clinical uses. The results imply that the 1.32 microns wavelength will produce further indications for the use of the Nd:YAG laser in surgery.

Laser-induced alteration of collagen substructure allows microsurgical tissue welding

Tissue welding is a potentially important biomedical application of laser technology. The structural alterations basic to this phenomenon were studied in experimental repair of lesions of the rat carotid artery and sciatic nerve. A modified neodymiumdoped yttrium-aluminum-garnet laser operating at a wavelength of 1.319 micrometers was used in conjunction with conventional suture techniques. Histological and fine-structural analysis revealed a homogenizing change in collagen with interdigitation of altered individual fibrils that appeared to be the structural basis of the welding effect.