CISD3 inhibition drives cystine-deprivation induced ferroptosis

Ferroptosis, a new form of programmed cell death, not only promotes the pathological process of various human diseases, but also regulates cancer progression. Current perspectives on the underlying mechanisms remain largely unknown. Herein, we report a member of the NEET protein family, CISD3, exerts a regulatory role in cancer progression and ferroptosis both in vivo and in vitro. Pan-cancer analysis from TCGA reveals that expression of CISD3 is generally elevated in various human cancers which are consequently associated with a higher hazard ratio and poorer overall survival. Moreover, knockdown of CISD3 significantly accelerates lipid peroxidation and accentuates free iron accumulation triggered by Xc- inhibition or cystine-deprivation, thus causing ferroptotic cell death. Conversely, ectopic expression of the shRNA-resistant form of CISD3 (CISD3res) efficiently ameliorates the ferroptotic cell death. Mechanistically, CISD3 depletion presents a metabolic reprogramming toward glutaminolysis, which is required for the fuel of mitochondrial oxidative phosphorylation. Both the inhibitors of glutaminolysis and the ETC process were capable of blocking the lipid peroxidation and ferroptotic cell death in the shCISD3 cells. Besides, genetic and pharmacological activation of mitophagy can rescue the CISD3 knockdown-induced ferroptosis by eliminating the damaged mitochondria. Noteworthily, GPX4 acts downstream of CISD3 mediated ferroptosis, which fails to reverse the homeostasis of mitochondria. Collectively, the present work provides novel insights into the regulatory role of CISD3 in ferroptotic cell death and presents a potential target for advanced antitumor activity through ferroptosis.

A TAZ-ANGPTL4-NOX2 Axis Regulates Ferroptotic Cell Death and Chemoresistance in Epithelial Ovarian Cancer

Ovarian cancer is the deadliest gynecologic cancer. Despite recent advances, clinical outcomes remain poor, necessitating novel therapeutic approaches. To investigate metabolic susceptibility, we performed nutrigenetic screens on a panel of clear cell and serous ovarian cancer cells and identified cystine addiction and vulnerability to ferroptosis, a novel form of regulated cell death. Our results may have therapeutic potential, but little is known about the determinants of ferroptosis susceptibility in ovarian cancer. We found that vulnerability to ferroptosis in ovarian cancer cells is enhanced by lower cell confluency. Because the Hippo pathway effectors Yes-associated protein (YAP)/transcriptional coactivator with PDZ-binding motif (TAZ) are recognized as sensors of cell density, and TAZ is the predominant effector in the tested ovarian cancer cell lines, we investigated the role of TAZ in ferroptosis of ovarian cancer. TAZ removal confers ferroptosis resistance, while TAZS89A overexpression sensitizes cells to ferroptosis. In addition, we found that lower TAZ level in chemo-resistant recurrent ovarian cancer is responsible for reduced ferroptosis susceptibility. The integrative genomic analysis identified ANGPTL4 as a direct TAZ-regulated target gene that sensitizes ferroptosis by activating NOX2. Collectively, cell density-regulated ferroptosis in ovarian cancer is mediated by TAZ through the regulation of the ANGPTL4-NOX2 axis, suggesting therapeutic potentials for ovarian cancers and other TAZ-activated tumors. IMPLICATIONS: This study reveals that TAZ promotes ferroptosis in ovarian cancers by regulating ANGPTL4 and NOX, offering a novel therapeutic potential for ovarian tumors with TAZ activation.

Control of extracellular cysteine/cystine redox state by HT-29 cells is independent of cellular glutathione

Human cell lines regulate the redox state (E(h)) of the cysteine/cystine (Cys/CySS) couple in culture medium to approximately -80 mV, a value similar to the average E(h) for Cys/CySS in human plasma. The mechanisms involved in regulation of extracellular E(h) of Cys/CySS are not known, but GSH is released from tissues at rates proportional to tissue GSH concentration, and this released GSH could react with CySS to contribute to maintenance of this balance. The present study was undertaken to determine whether depletion of cellular GSH alters regulation of extracellular Cys/CySS E(h). Decrease of GSH in HT-29 cells by inhibiting synthesis with l-buthionine-[S,R]-sulfoximine showed no effect on the rate of reduction of extracellular CySS to achieve a stable E(h) for Cys/CySS in the culture medium. Limiting Cys and CySS in the culture medium also substantially decreased cellular GSH but resulted in no significant effect on extracellular Cys/CySS E(h). Addition of CySS to these cells showed that extracellular Cys/CySS E(h) approached -80 mV at 4 h while cellular GSH and extracellular GSH/GSSG E(h) recovered more slowly. Together, these results show that HT-29 cells have the capacity to regulate the extracellular Cys/CySS E(h) by mechanisms that are independent of cellular GSH. The results suggest that transport systems for Cys and CySS and/or membranal oxidoreductases could be more important than cellular GSH in regulation of extracellular Cys/CySS E(h).

Sulfasalazine-induced cystine starvation: potential use for prostate cancer therapy

BACKGROUND

Certain cancers depend for growth on uptake of cystine/cysteine from their environment. Here we examined advanced human prostate cancer cell lines, DU-145 and PC-3, for dependence on extracellular cystine and sensitivity to sulfasalazine (SASP), a potent inhibitor of the x(c)(-) cystine transporter.

METHODS

Cultures were evaluated for growth dependence on exogenous cystine, x(c)(-) transporter expression, response to SASP (growth and glutathione content). In vivo, effect of SASP was determined on subrenal capsule xenograft growth.

RESULTS

Cystine omission from culture medium arrested DU-145 and PC-3 cell proliferation; both cell lines expressed the x(c)(-) transporter and were growth inhibited by SASP (IC(50)s: 0.20 and 0.28 mM, respectively). SASP-induced growth inhibition was associated with vast reductions in cellular glutathione content - both effects based on cystine starvation. SASP (i.p.) markedly inhibited growth of DU-145 and PC-3 xenografts without major toxicity to hosts.

CONCLUSIONS

SASP-induced cystine/cysteine starvation leading to glutathione depletion may be useful for therapy of prostate cancers dependent on extracellular cystine.

Specificity of resistance to oxidative stress

Two clonal nerve-like cell lines derived from HT22 and PC12 have been selected for resistance to glutamate toxicity and amyloid toxicity, respectively. In the following experiments it was asked if these cell lines show cross-resistance toward amyloid beta peptide (Abeta) and glutamate as well as toward a variety of additional neurotoxins. Conversely, it was determined if inhibitors of oxytosis, a well-defined oxidative stress pathway, also protect cells from the neurotoxins. It is shown that both glutamate and amyloid resistant cells are cross resistant to most of the other toxins or toxic conditions, while inhibitors of oxytosis protect from glutathione and cystine depletion and H2O2 toxicity, but not from the toxic effects of nitric oxide, rotenone, arsenite or cisplatin. It is concluded that while there is a great deal of cross-resistance to neurotoxins, the components of the cell death pathway which has been defined for oxytosis are not used by many of the neurotoxins.

Flupirtine and retigabine prevent L-glutamate toxicity in rat pheochromocytoma PC 12 cells

Flupirtine is an analgesic drug thought to have NMDA receptor antagonistic and antiapoptotic effects. We investigated the effects of Ethyl-2-amino-6-(4-(4-fluorbenzyl)amino)-pyridine-3-carbamamic+ ++ acid, maleate (flupirtine) and the related compound N-(2-amino-4-(4-fluorobenzylamino)-phenyl)-carbamic acid, ethyl ester) (retigabine) (Desaza-flupirtine) on the toxicity of L-glutamate and L-3,4-dihydroxyphenylalanine (L-DOPA) in rat pheochromocytoma PC 12 cells in vitro. Both drugs (10 microM) markedly decreased nonreceptor-mediated necrotic cell death in PC 12 cultures treated with L-glutamate (10 mM) for 72 h. In contrast, apoptosis induced by L-DOPA (250 microM) after 48 h was not affected by either substance. While L-DOPA elicited massive generation of reactive oxygen intermediates, L-glutamate-induced cell death was accompanied by only slightly increased levels of reactive oxygen intermediates. Flupirtine and retigabine exerted anti-oxidative effects in PC 12 cultures independent of their ability to prevent cell death. Further examination of the protective action of flupirtine and retigabine against L-glutamate toxicity showed that it had no influence on monoamine oxidase (monoamine: oxygen oxidoreductase (deaminating), EC 1.4.3.4., MAO) activity. Thus, flupirtine and retigabine provided protection against cystine deprivation and L-glutamate toxicity but did not protect against L-glutamate under cystine-free conditions indicating that both compounds are sufficiently effective to compensate the oxidative stress elicited by cystine deprivation but not excessive activity of monoamine oxidase after L-glutamate treatment.

Bioactivation of cyanide to cyanate in sulfur amino acid deficiency: relevance to neurological disease in humans subsisting on cassava

Neurological disorders have been reported from parts of Africa with protein-deficient populations and attributed to cyanide (CN-) exposure from prolonged dietary use of cassava, a cyanophoric plant. Cyanide is normally metabolized to thiocyanate (SCN-) by the sulfur-dependent enzyme rhodanese. However, in protein-deficient subjects where sulfur amino acids (SAA) are low, CN may conceivably be converted to cyanate (OCN-), which is known to cause neurodegenerative disease in humans and animals. This study investigates the fate of potassium cyanide administered orally to rats maintained for up to 4 weeks on either a balanced diet (BD) or a diet lacking the SAAs, L-cystine and L-methionine. In both groups, there was a time-dependent increase in plasma cyanate, with exponential OCN- increases in SAA-deficient rats. A strongly positive linear relationship between blood CN- and plasma OCN- concentrations was observed in these animals. These data are consistent with the hypothesis that cyanate is an important mediator of chronic cyanide neurotoxicity during protein-calorie deficiency. The potential role of thiocyanate in cassava-associated konzo is discussed in relationship to the etiology of the comparable pattern of motor-system disease (spastic paraparesis) seen in lathyrism.

Dietary deficiency of cystine and methionine in rats alters thiol homeostasis required for cyanide detoxification

Nutritional status is an important factor in modulating the metabolic fate of xenobiotics. Sulfur amino acid (SAA) deficiency has been proposed as a risk factor for human neurological diseases among protein-poor populations subsisting on the cyanophoric plant cassava. Female Sprague-Dawley rats were used to develop and define a model of SAA deficiency for use in future studies examining cassava-related neurotoxicity. Rats were kept in metabolic cages for 7-21 d and fed a balanced diet (BD) of known composition or a comparable diet selectively deficient in methionine and cystine (SAA-free diet). Animals fed the SAA-free diet failed to thrive, lost body weight, excreted porphyrinic materials, and showed a steep and persistent reduction of urinary inorganic sulfate. In contrast, animals on the BD gained body weight and maintained baseline output of urinary inorganic sulfate. Urinary thiocyanate excretion did not differ between groups, but plasma thiocyanate concentrations reached double that in SAA-deficient rats. Increased plasma thiocyanate suggests mobilization of sulfur amino acids from endogenous sources. Liver glutathione and blood cyanide concentrations were similar in animals on the BD and the SAA-deficient diet. In summary, a diet free of methionine and cystine results in increased retention of inorganic sulfur as thiocyanate and a near absence of inorganic sulfur excretion in urine.

Maturation-dependent vulnerability of oligodendrocytes to oxidative stress-induced death caused by glutathione depletion

Death of oligodendrocyte (OL) precursors can be triggered in vitro by cystine deprivation, a form of oxidative stress that involves depletion of intracellular glutathione. We report here that OLs demonstrate maturation-dependent differences in survival when subjected to free radical-mediated injury induced by glutathione depletion. Using immunopanning to isolate rat preoligodendrocytes (preOLs), we generated highly enriched populations of preOLs and mature OLs under chemically defined conditions. Cystine deprivation caused a similar decrease in glutathione levels in OLs at both stages. However, preOLs were completely killed by cystine deprivation, whereas mature OLs remained viable. Although the glutathione-depleting agents buthionine sulfoximine and diethylmaleate were more potent in depleting glutathione in mature OLs, both agents were significantly more toxic to preOLs. Glutathione depletion markedly increased intracellular free radical generation in preOLs, but not in mature OLs, as indicated by oxidation of the redox-sensitive probe dihydrorhodamine 123. The antioxidants alpha-tocopherol, idebenone, and glutathione monoethylester prevented the oxidation of dihydrorhodamine in cystine-depleted preOLs and markedly protected against cell death. When the intracellular glutathione level was not manipulated, preOLs were also more vulnerable than mature OLs to exogenous free radical toxicity generated by a xanthine-xanthine oxidase system. Ultrastructural features of free radical-mediated injury in glutathione-depleted preOLs included nuclear condensation, margination of chromatin, and mitochondrial swelling. These observations indicate that preOLs are significantly more sensitive to the toxic effects of glutathione depletion and that oligodendroglial maturation is associated with decreased susceptibility to oxidative stress.

Trichothiodystrophy without associated neuroectodermal defects

Trichothiodystrophy leading to generalized trichorrhexis nodosa-like hair changes with abnormal hair breakage is described in a 4-year-old girl. A marked deficiency of sulphur and the sulphur-containing amino acid, cystine, was detected in the biochemical analysis of the hair. Further investigation of the hair showed the morphological criteria of trichothiodystrophy. Commonly related symptoms, such as mental retardation, ichthyosis and increased sensitivity to sunlight, were not present in our patient.

Role of cysteine and glutathione in signal transduction, immunopathology and cachexia

Abnormally low plasma cystine levels have been found in the late asymptomatic stage of HIV infection and several other diseases associated with progressive loss of skeletal muscle mass. The phenomenon is commonly associated with a low NK cell activity, skeletal muscle wasting or muscle fatigue and increased rates of urea production. In its extreme form, the negative nitrogen balance leads to overt cachexia and is associated with severe debilitation and psychological stress. The low NK cell activity is in most cases not life-threatening but may be disasterous in HIV infection, because it may compromise the initially stable balance between immune system and virus and trigger disease progression. This review summarizes briefly (i) the role of cysteine in the physiological regulation of body cell mass and the development of skeletal muscle wasting, and (ii) the role of glutathione in the immune system.

Adult T cell leukemia (ATL)-derived factor/human thioredoxin prevents apoptosis of lymphoid cells induced by L-cystine and glutathione depletion: possible involvement of thiol-mediated redox regulation in apoptosis caused by pro-oxidant state

Thiol compounds, such as L-cysteine and glutathione (GSH), play crucial roles in the regulation of lymphocyte proliferation. In this study, we analyzed the effect of L-cystine and GSH depletion on lymphocyte survival and investigated the regulatory roles of adult T cell leukemia (ATL)-derived factor (ADF)/human thioredoxin (hTRX) in relation to these low m.w. thiols. MT-1, MT-2, and Jurkat cells underwent apoptosis when cultured in the L-cystine- and GSH-free medium within 18 to 24 h. Dichlorofluorescin oxidation assay indicated that the apoptosis in MT-1 and MT-2 cells was preceded by an increase in the level of intracellular hydrogen peroxide (H2O2). The addition of catalase and recombinant ADF/hTRX (rADF) partially blocked the apoptosis in a dose-dependent manner. rADF has been also shown to enhance the internalization of L-cystine into MT-2 cells in a dose-dependent manner, whereas oxidized rADF or mutated rADF that has no insulin-reducing activity failed to do so. Furthermore, culture in the L-cystine- and GSH-free medium lowered the cellular GSH content of PHA blasts, which was restored dose-dependently by rADF. These data suggest that the inability to neutralize oxidative stress results in the apoptosis of lymphoid cells under L-cystine- and GSH-depleted conditions. The protective effects of rADF may be explained by direct scavenging action on H2O2 (catalase-like activity) or by indirect neutralizing effects on the pro-oxidant status through enhancing the L-cystine internalization and elevating the intracellular GSH content.

Metabolism of homocysteine, its relation to the other cellular thiols and its mechanism of cell damage in a cell culture line (human histiocytic cell line U-937)

This study shows that the intracellular concentration of homocysteine in cultured cells is kept low due to an accumulation in the medium. The intracellular level of homocysteine was decreased when its precursor, methionine, was omitted from the culture medium. Intracellular glutathione and cysteine were lowered in cystine-deficient medium. Intracellular glutathione was also lowered when copper ions were added to the culture medium. It is evident from this study that the intracellular concentration of homocysteine was not influenced by the lowered level of glutathione and/or cysteine. High amounts of homocysteine added to the medium give rise to an increase of intracellular reduced homocysteine, which participates in the transsulfuration pathway and can replace cysteine in the synthesis of glutathione. The addition of relatively high amounts of reduced homocysteine (500 mumol/l) in the presence of copper ions (100 mumol/l) to the culture medium can be directly toxic to the cells, possibly due to oxygen radicals formed by thiol auto-oxidation. Whilst the level of homocysteine in this study using short-time cell culture experiment is much higher than the mild hyperhomocysteinemia thought to be atherogenic in humans, it is conceivable that over a longer time course these levels of homocysteine could be sufficient to induce endothelial dysfunction, eventually leading to atherosclerosis.

Intermittent hair loss in a child with PIBI(D)S syndrome and trichothiodystrophy with defective DNA repair-xeroderma pigmentosum group D

We describe a girl with photosensitivity (P), ichthyosis (I), brittle hair (B), impaired intelligence (I), possibly decreased fertility (D), and short stature (S). The clinical findings fit into the PIBI(D)S syndrome and trichothiodystrophy. A remarkable and probably unique observation for this disorder was the intermittent character of the scalp hair loss during infectious periods in this patient. Easy suntanning suggested photosensitivity and prompted DNA repair studies which demonstrated reduced UV-induced DNA repair synthesis. Subsequent studies have assigned this patient to xeroderma pigmentosum group D and suggested a specific deficiency of 6-4 photoproduct repair. An unaffected child was diagnosed in the next pregnancy of the mother.

Trichothiodystrophy: report of a new case with severe nervous system impairment

The authors report a 3-year-old girl affected by trichothiodystrophy and severe nervous system involvement: the patient showed hypotonia since birth, mental retardation, and anomalies of the central nervous system consisting of partial agenesis of the corpus callosum on computed tomographic scan. ( J Child Neurol 1992;7:300-303).

HIV-induced cysteine deficiency and T-cell dysfunction--a rationale for treatment with N-acetylcysteine

Markedly decreased plasma cystine and cysteine concentrations have been found in HIV-infected patients at all stages of the disease and in SIV-infected rhesus macaques. The elevated glutamate levels found in the same patients aggravate the cysteine deficiency by inhibiting the membrane transport activity for cystine. The intact immune system appears to require a delicate balance between pro-oxidant and antioxidant conditions, maintained by a limited and well-regulated supply of cysteine. This balance is obviously disturbed in HIV infection and may contribute to the pathogenesis of AIDS.

Immature cortical neurons are uniquely sensitive to glutamate toxicity by inhibition of cystine uptake

Using the N18-RE-105 neuroblastoma X retina cell line, we previously described Ca2(+)-dependent quisqualate-type glutamate toxicity caused by the inhibition of high-affinity cystine uptake, leading to glutathione depletion and accumulation of cellular oxidants. We now demonstrate that primary cultures of rat cortical neurons (E17; 24-72 h in culture), but not glia, also degenerate when exposed to culture medium with reduced cystine or containing competitive inhibitors of cystine uptake, including glutamate. At this developmental stage, neurotoxicity did not occur as a consequence of continuous exposure to glutamate receptor subtype agonists, N-methyl-D-aspartate, kainate, or 2(RS)-amino-3-hydroxy-5-methyl-4-isoxazolepropionate. However, those that inhibited neuronal cystine uptake--quisqualate, glutamate, homocysteate, beta-N-oxalyl-L-alpha,beta-diaminopropionic acid, and ibotenate--were neurotoxic. Toxicity related to quisqualate did not correlate with the development of quisqualate-stimulated phosphatidylinositol turnover. The toxic potencies of glutamate, quisqualate, and homocysteate were inversely proportional to the concentration of cystine in the medium, suggesting that they competitively inhibit cystine uptake. Autoradiographic analysis of the cellular localization of L-[35S]cystine uptake indicated that embryonic neurons have a high-affinity transport system that is sensitive to quisqualate, whereas non-neuronal cells in the same cultures have a low-affinity system that is insensitive to quisqualate but potently blocked by D-aspartate and glutamate. Exposure to glutamate or homocysteate resulted in a time-dependent depletion of the cellular antioxidant glutathione. The centrally acting antioxidant idebenone and alpha-tocopherol completely blocked the neurotoxicity resulting from glutamate exposure. We propose that competitive inhibition of cystine transport and reduction of extracellular cystine levels result in neuronal cell death due to accumulation of cellular oxidants.

The trichothiodystrophy syndrome of Pollitt

Trichothiodystrophy, or sulphur-deficient brittle hair, is a clinical marker for a syndrome that consists primarily of cystine (and hence sulphur)-deficient brittle hair, nail dysplasia, mental and physical retardation and decreased fertility. The radiological aspects of this syndrome have received scant mention in the literature. I describe a 5-year-old boy whose skeleton exhibits axial osteosclerosis and peripheral osteopenia which is similar to two other previously described cases.

Whole-body protein turnover in chicks fed control, histidine, or methionine plus cystine-free diets

Whole-body protein turnover rates were measured in chicks fed control, histidine-free (-His), and methionine plus cystine-free (-Met, Cys) diets. After chicks were fed the experimental diets ad libitum for 7 days, they were injected with a massive dose of L-[4-3H]-phenylalanine (40 microCi/100 g body weight) and rate of protein synthesis was estimated from the incorporation of phenylalanine into protein. The rate of protein degradation was estimated as the difference between the synthesis and growth rates of protein. In chicks fed the amino acid-devoid diets, the fractional synthesis rates of protein (FSR, percent per day) were significantly lower than those in control chicks, whereas fractional degradation rates of protein (percent per day) were constant for all dietary treatments. The FSR in -Met, Cys chicks was lower than that in -His chicks and the lower FSR in -Met, Cys chicks seemed to result in more body protein loss. The RNA/protein ratio of chicks was almost the same in all treatments, but the protein synthesized per unit RNA varied depending on the dietary treatments. The lower amount of protein synthesized per unit RNA in -Met, Cys chicks was postulated to result from inhibition of protein synthesis by a shortage of available methionine associated with a higher degradation rate of methionine itself. These results indicated that different growth responses between -His and -Met, Cys chicks were primarily caused by the difference in the rates of protein synthesis.

[Activity and requirement of selected amino acids in growing female pigs. 4. Combination of protein sources with lysine, methionine/cystine and threonine limitation]

On the basis of the results of 3 previous articles on the efficiency of amino acids in single protein sources a total of 16 protein sources was tested maintaining the limitation relations of the combination partners with regard to the additivity of the efficiencies of lysine, methionine/cystine and threonine. The results of the N metabolism measurements with a total of 60 female pigs of the country breed type (30...55 kg live weight) allow the conclusion that additive relations and thus suitable correction possibilities exist for the gross amino acid content through the amino acid efficiency for the calculation of requirement and requirement meeting. The N utilization model used (GEBHARDT 1963) is in its further development confirmed as the basis of amino acid efficiency.

Activation of murine lymphocytes by 2-mercapto-ethanol and related thiol compounds and its mechanism. II. Effect of thiol compounds on the viability of the lymphocytes under a cystine-deficient culture condition

When murine lymphocytes were cultured in a cystine-deficient RPMI-1640 medium containing 10% fetal calf serum, approximately 70% of the cells died in 48 h. In the presence of 5 X 10(-4) M L-cystine, 70-80% of the lymphocytes remained viable under the same condition. The decrease of the viability was also effectively inhibited when cystine was replaced by the following thiol compounds; 2-mercaptoethanol (2-ME), dithiothreitol (DTT), cysteamine and glutathione (GSH). Oxidized DTT, an intramolecular disulfide that was resistant to the reduction by the lymphocytes, did not show a protective effect in contrast to DTT. On the other hand, 2-hydroxyethyldisulfide was readily reduced to 2-ME by the lymphocytes and improved lymphocyte viability as effectively as 2-ME. These observations suggest that thiol groups are responsible for the improvement of lymphocyte viability under a cystine-deficient condition. The viabilities of both T cells and B cells were equally improved by 2-ME. The intracellular level of GSH remained constant in the presence of cystine but dropped rapidly in its absence. 2-ME could not reverse this decrease of GSH level. These protective effects of thiol compounds on lymphocyte viability are discussed in relation to their capacities to activate murine lymphocytes.

Tissue glutathione as a cyst(e)ine reservoir during cystine depletion in growing rats

Previous data suggest that liver glutathione (GSH) serves as a cyst(e)ine reservoir in rats starved or fed cyst(e)ine-deficient diets. In the present study we investigated whether extrahepatic tissue GSH concentrations also decreased during cystine (Cys-Cys) depletion and whether excess dietary cystine increased tissue GSH and cysteine (Cys) concentrations. Five groups of growing rats (80-100 g) were fed diets containing crystalline L-amino acids differing in methionine (Met) and cystine (Cys-Cys) content for 15 days. All diets were isonitrogenous (1.3 g/100 g diet) and provided the minimum Met (0.17%) required by growing rats. Diet 1 provided 0.17% Met and 0% Cys-Cys, diet 2 (the recommended diet) provided 0.17% Met and 0.26% Cys-Cys, diet 3 provided 0.50% Met and 0% Cys-Cys, diet 4 provided 0.17% Met and 0.39% Cys-Cys and diet 5 provided 0.17% Met and 0.52% Cys-Cys. Diets 2 and 3 were isosulfurous at 3.3 mmol/100 g diet. Diets 4 and 5 provided 50 and 100%, respectively, more Cys-Cys than required when 0.17% Met was present. Animals fed diet 1 (Cys-Cys depletion) had significantly decreased (P less than 0.05) liver, muscle, spleen, heart and thymus GSH concentrations, whereas brain, small intestine and erythrocyte GSH concentrations remained unchanged. Although brain and small intestine Cys concentrations were not affected by Cys-Cys depletion, spleen, heart and liver Cys concentrations decreased significantly (P less than 0.05). Feeding Cys-Cys above the requirement level did not increase GSH and Cys concentrations of any tissue except liver where Cys levels were elevated. The data indicate that liver, muscle, spleen, heart and thymus GSH serve as Cys reservoirs during Cys-Cys depletion.

Hypotyrosinemia, hypocystinemia, and failure to retain nitrogen during total parenteral nutrition of cirrhotic patients

Six patients with gastrointestinal malabsorption and 12 with alcoholic cirrhosis received total parenteral nutrition for 4 wk. Freamine II, the source of the amino acids, is nearly devoid of cystine and tyrosine. We monitored daily nitrogen balance and other nutritional parameters and 22 plasma amino acids. Malabsorbers had a strongly positive nitrogen balance and improvements in nutritional parameters. Plasma amino acids were maintained within or above their normal fasting ranges. Eight of 12 cirrhotics resembled malabsorbing patients in terms of positive nitrogen balance, improved nutritional parameters, and plasma amino acids. In 4 cirrhotics, nitrogen balance remained negative and nutritional repletion failed to occur. Plasma cystine and tyrosine fell to below 30% of their normal fasting means. In 2 of these patients, oral supplements of cystine and tyrosine were given during the fifth week of parenteral nutrition. Plasma cystine and tyrosine were normalized, nitrogen balance became positive, and other repletion indicators demonstrated recovery. We conclude that in 4 cirrhotics, repletion was blocked by deficiencies of cystine and tyrosine, resulting from hepatic inability to synthesize cystine from methionine and tyrosine from phenylalanine.

Effect of deficiencies of single essential amino acids on nitrogen and energy utilisation in chicks

1. Diets 50% deficient in single essential amino acids were fed to chicks from day 8 to day 18 after hatching to evaluate body-weight gain, food consumption, body composition, nitrogen (N) and energy utilisation. 2. Body-weight gain was reduced most severely by deficiency of isoleucine followed in decreasing order by threonine, arginine, valine, histidine, tryptophan, methionine plus cystine, phenylalanine plus tyrosine, leucine and lysine, and possible reasons for the differences are discussed. 3. Body-weight gain and food efficiency were highly correlated with food consumption but metabolisable energy value of diets was not affected by single essential amino acid deficiencies. 4. Generally N retention (N retained/N consumed) and energy retention (energy retained/energy consumed) reflected food consumption, except for a lower N retention by chicks fed on the methionine plus cystine-deficient diet and for a lower energy retention by chicks fed on the valine deficient diet. 5. The amino acid deficient in the diet was present at very low concentration in the blood plasma.

Oxidative deterioration of the muscle proteins during nutritional muscular dystrophy in chicks

Nutritional muscular dystrophy in the chick results from the simultaneous deficiency of vitamin E and cystine. Being a biological antioxidant, vitamin E might be functional in maintaining a proper redox state of the sulfur-containing amino acid in the proteins. The analyses of protein-bound sulfhydryls and disulfides at onset of muscular dystrophy in young chicks were carried out. The ratio of disulfide to sulfhydryls increased two- to three-fold in dystrophic muscle as compared to that in the control muscle proteins. Dystrophic and normal muscle proteins also were subjected to SDS-gel electrophoresis. Proteins of low molecular weight, supposedly derived from proteolysis, were present in the gels of the dystrophic muscle and absent in those of normal muscle extracts. As a result of these studies, a chemical model has been proposed to explain the oxidative deterioration of proteins in nutritional muscular dystrophy due to vitamin E deficiency.

Plasma and urinary amino acids and selected sulfur metabolites in young men fed a diet devoid of methionine and cystine

A preliminary investigation was conducted to explore the use of plasma methionine and cystine for determining human sulfur amino acid requirements. Measurements of urinary methionine, cystine, taurine, and inorganic sulfate were included. After a 3-day control period, three young men were fed for 8 days a diet containing a purified -l-amino acid mixture, patterned after egg protein but devoid of methionine and cystine. Fasting plasma methionine and cystine levels showed little decrease during the 8-day period. Urinary cystine and taurine responses were inconsistent among the subjects. Urinary methionine and inorganic sulfate levels decreased markedly within a few days after feeding of the experimental diet, and may be useful criteria for determining human sulfur amino acid requirements.

Cystinosis. Intracellular cystine depletion by aminothiols in vitro and in vivo

Certain aminothiols rapidly deplete cultured cystinotic skin fibroblasts of their abnormally high free (nonprotein) cystine pool. The free cystine content of these cells if reduced by over 90% in 1 h with 0.1 mM cysteamine. This is more rapid than previously known methods of removing free cystine from cystinotic fibroblasts. The disulfide, cystamine, is also able to deplete cystinotic cells of free cystine. A patient with nephropathic cystinosis and end-stage renal disease was treated with cysteamine, both intravenously and orally. Both methods of administration rapidly lowered the free cystine content of the patient's peripheral leukocytes. Study of the patient's urinary sulfur excretion did not conclusively determine the effect of this therapy on the total body cystine pool. Her renal status remained at end stage after 1 mo of oral cysteamine, when an episode of grand mal seizures prompted cessation of the study. Determination of the proper place of aminothiol therapy in this disease will depend upon further clinical trial with patients whose kidney function has not deteriorated to the point of irreversible change, accompanied by careful monitoring of plasma aminothiol levels.

Studies on the changes in reduced glutathione of chick tissues during onset and regression of nutritional muscular dystrophy

Nutritional muscular dystrophy (NMD) in the chick results from a simultaneous deficiency of vitamin E and cystine. Muscle and liver of dystrophic and nondystrophic chicks were assayed for nonprotein sulfhydryl (NP-SH), reduced glutathione (GSH) and glutathione reductase. Red blood cells were assayed for NP-SH and GSH content. Glutathione peroxidase was determined in muscle, plasma and liver. Dystrophic muscle GSH was increased and at times was approximately double that of normal muscle, while liver GSH was lower in dystrophic than in normal chicks. During recovery from NMD, brought about by addition of either vitamin E or cystine to the dystrophogenic diet, muscle GSH declined and liver GSH increased to normal levels. Glutathione peroxidase was equivalent in both dystrophic and nondystrophic plasma and liver, but was significantly increased in dystrophic muscle. The mode of action of dietary cystine in preventing NMD in chicks remains unknown; it is not mediated through the role of amino acid as a component of the GSH needed for the action of glutathione peroxidase.

Role of coprophagy in masking dietary deficiencies of cystine in the rat

When a diet containing raw soybean was fed to rats, there was an increase in the synthesis of pancreatic protein, presumably exocrine protein, as evidenced by an increased uptake of [35S]cystine. There was also an increased transsulfuration of methionine sulfur as indicated by labeled sulfur transformation from methionine to cystine. This same pattern of events was produced in rats receiving a casein-containing diet when 50 mg of crystalline trypsin inhibitor was administered by gavage. However, if coprophagy was prevented, the increased uptake of [35S]cystine and [35S]methionine transsulfuration under both dietary conditions was blocked. It was found that prevention of coprophagy was without effect upon these two processes if supplementary dietary cystine was provided or if a dietary protein source with adequate cystine, i.e., heat-treated soybean, was provided. It was concluded that by practicing coprophagy, sufficient fecal cystine was being returned to the upper intestinal tract to permit some synthesis of pancreatic exocrine protein and with this stimulation of synthesis, transulfuration could proceed. This assumes that the biosynthesis of cystine is dependent upon the availability of sufficient cystine to permit active protein synthesis. In another situation where cystine requirement is high, namely, the rapidly growing rat, a limited amount of cystine was fed by providing a 12% casein diet. Either supplementary cystine or methionine was provided and it was found that both amino acids gave optimal growth in conventional rats, but when coprophagy was prevented, optimal growth was achieved only with the cystine-supplemented diet.

Cystine deficiency during dietotherapy of homocystinemia

Cystine deficiency was inadvertently produced in a boy receiving specific dietary therapy for homocystinuria. This was manifested as a loss in weight, the reappearance of significant amounts of homocystine in the plasma and urine, and the elevation of the plasma methionine level. In addition, there was a significant reduction in the level of cystine in the plasma. This reduction in plasma cystine level differentiates cystine deficiency from loss of biochemical control due to failure to keep the prescribed diet. The addition of cystine to the regime of this child, without any other dietary modification, resulted in a complete remission.