Evidence for two forms of substructure in the cell survival curve--mechanisms and clinical consequences.

Recent laboratory studies have clearly demonstrated the presence of two types of fine structure in the radiation survival response of cultured mammalian cells: a) one type of substructure, observed at doses of a few Gy, is the result of the differential killing of subpopulations of cells of different, cell-cycle-related radiosensitivity; this substructure is strongly dependent on the cell-cycle distribution and is absent in tightly synchronized cell populations; b) the other type of substructure, found at lower doses (< 1 Gy), is expressed as a very sensitive (hypersensitive) response at very low doses followed by increased resistance as the dose increases until, by approximately 1 Gy, the response usually follows a standard linear-quadratic (LQ) function; it thus has the characteristics of a radiation-induced radioresistance and is assumed to reflect an inducible repair process. Although the linear-quadratic (LQ) model is widely used to describe the dose-effect response both in the laboratory and in the clinic, over the past 20 years there have been several reports of an anomalous departure from the simple LQ formalism, particularly at low doses. A review of these reports suggests that the observed anomalies are not so much a failure of the LQ formalism as a manifestation of the effects of the response substructure: mixed populations, a) and hypersensitivity, b) described above.

Lack of correlation between G1 arrest and radiation age-response in three synchronized human tumour cell lines.

PURPOSE: To determine radiosensitivity as a function of cell age (the age-response) in three human tumour cell lines, and investigate the dependence of the age-response on G1 arrest and on cell-age heterogeneity in synchronized cell populations. MATERIALS AND METHODS: Variation in radiosensitivity throughout the cell cycle and G1 arrest was measured in mitotically selected populations of synchronized human tumour cells. In order to examine the effects of desynchronization and cell age heterogeneity on the measured age-response, a mathematical model was developed based on an existing kinetic model of the cell cycle. The model was used to describe the age-response for mitotically selected populations of cells, which was then compared with experimentally measured age responses. RESULTS: Three different human tumour cell lines had qualitatively similar age-responses, with periods of radiosensitivity in mitosis and in late G1 phase/early S phase, and periods of radioresistance in early/mid G1 phase and late S/G2 phase. Radiosensitivity appeared to increase in G1 phase before the onset of DNA synthesis. One of the cell lines displayed a prolonged G1 arrest after irradiation in G1 phase. Model results demonstrated that the measured age-responses were consistent with a simple model in which the cell cycle was divided into four regions. Radiosensitivity was assumed to be constant within each region, and changed abruptly at the borders between regions. CONCLUSIONS: Human tumour cell lines can exhibit qualitatively similar age-responses despite having markedly different G1 checkpoint responses. This suggests that modulation of the G1 arrest response may not prove to be a useful clinical strategy because it may not lead to significant cell age specific changes in radiosensitivity. The mathematical model of the radiation response of mitotically selected synchronized cells was a useful way to quantitatively describe cell age heterogeneity in these populations, and demonstrated the important impact of this heterogeneity on measured age-responses.

Cell-age heterogeneity and deviations from the LQ model in the radiation survival responses of human tumour cells.

PURPOSE: To determine whether some of the deviations from the simple linear-quadratic (LQ) theory in the radiation dose survival responses of asynchronous cultures of human tumour cell lines are caused by the presence of cell-age specific subpopulations which all individually follow LQ theory, but have different radiosensitivities. MATERIALS AND METHODS: Human tumour cells were synchronized by mitotic selection and their survival dose responses were measured at doses from 0.05 Gy to 12 Gy, using a high-precision survival assay. These responses were compared with a kinetic model of radiation survival in synchronized cells, which assumed that age-specific populations individually obeyed the LQ theory. The cell lines used included HT-29 and A549, which have typical dose responses, and U1, which is somewhat atypical. RESULTS: In two of the three cell lines, A549 and HT-29, observed deviations from the LQ model were consistent with those expected from cell-age heterogeneity. In the third cell line, U1, survival responses could not be described by the LQ theory, even when cell-age heterogeneity was considered. CONCLUSIONS: The LQ model provided an adequate description of cell survival for two of three tumour cell lines in this study when cell-age related heterogeneity in survival responses was accounted for. However, some alternative survival models (such as the repair saturation model) provided better characterizations of the survival response of the third cell line and, in fact, gave good descriptions of survival for all three cell lines.

Radiobiology with heavy charged particles: a historical review.

Radiobiological studies using heavy charged particles followed closely the development of accelerators to produce beams of ever-increasing energy, driven primarily by the aspirations of physicists and chemists interested in the structure of matter. An impressive share of this development took place at Berkeley, beginning with the invention of the cyclotron by Ernest Lawrence in 1930. There followed a series of cyclotrons, synchrotrons and linear accelerators, culminating in the BEVALAC, which provided the first source of very heavy ions (helium to argon) to be used clinically, beginning in 1975. Other early entrants (1950's-1960's) in the clinical use of heavy ion beams (protons only) included Uppsala, Harvard/MGH and several facilities in the USSR. During the 1970's negative pi-meson (pion) beams for clinical use were developed in the US (LAMPF), Switzerland (SIN/PSI) and Canada (TRIUMF). Although the first accelerator built primarily for medical use, the Crocker Medical Cyclotron, was completed at Berkeley in 1939 (it was used primarily to produce neutron beams) it was not until 1990 that the next clearly dedicated medical heavy ion facility went into operation: the 3-gantry proton synchrotron at Loma Linda. There are several reasons for this long hiatus: the long time required to complete clinical trials; the need to develop more economic and flexible accelerators and beam handling systems; the early discouraging clinical results obtained with neutron beams at Berkeley in the 1940's, before the dose response differences for early and late effects were fully understood. During the last decade or so there has been a rapid increase in the number of proton beam facilities; heavier ion beams are so far available only at HIMAC in Japan and GSI in Germany. Earlier studies with radioactive alpha-particle sources and plant cells had already shown, by the early 1930's that high LET radiations were biologically more effective than X-rays in producing damage in eukaryotes. The increased penetration of high energy particles from accelerators made it possible to carry out in vivo radiobiological studies in animals, and the publication by Puck of the first radiation survival response for cultured mammalian cells in 1956, provided another valuable tool for radiobiological studies. One of the earliest systematic studies of the dependence of RBE (relative biological effectiveness) and OER (oxygen enhancement ratio) on LET (linear energy transfer) was that by Barendsen in the early 1960's; he irradiated cultured human kidney cells with deuterium and alpha-particles, and showed that RBE reached a maximum at an LET of 100-200 keV/micrometer, the same LET at which the OER decreased to approximately 1.0. More recent studies (Belli, Folkard, etc.) show that the RBE 'peaks' at a LET which is particle-dependent (for protons, RBE maximum is at approximately 30 keV/micrometer), indicating that LET alone does not adequately define the microscopic energy deposition and its influence on biological effect. One of the complications with heavy ion and pion beams is the increase in RBE with depth in the stopping region. Cultured cell techniques were developed to accurately map these RBE changes, which were investigated at each of the heavy ion and pion facilities, allowing physical dose profiles to be shaped to compensate for the change in biological effectiveness. With the heavier ions, RBE is also dependent on dose and on the dose fractionation scheme used. In vivo systems are the most suitable for such measurements and a variety of normal tissue and tumour end-points has been employed for such studies. A review of the published RBE values for proton beams, 1975-1997, shows very good consistency between the various centres, with average in vivo and average in vitro values falling in the range 1.11-1.18. In this article we have, due to space limitations, only been able to review a representative fraction of the extensive literature on heavy ion radiobiology. We have arbitrarily limited our discussion to mammalian systems, except for a few very early experiments of historical interest.

Low-dose radiation sensitivity and induced radioresistance to cell killing in HT-29 cells is distinct from the "adaptive response" and cannot be explained by a subpopulation of sensitive cells.

Several reports using two different improved assays of clonogenicity have indicated the presence of a hypersensitive region in the radiation survival response at low doses, followed by an increase in radioresistance, in many mammalian cell lines. Mathematical modeling of these responses has suggested that it is unlikely that this effect can be explained by the presence of a small subpopulation of sensitive cells; however, this possibility cannot be excluded solely on the basis of those results. A second explanation has been offered which hypothesizes that a radiation-induced mechanism causes an increase in cellular radioresistance. This proposal has led to speculation that the substructure observed at low doses in these cell lines is related to the adaptive response, which hypothesizes the induction of a repair mechanism after a small priming dose of radiation which can protect cells against a larger second dose given several hours later. We have investigated these proposals with a study of priming doses using human tumor HT-29 cells, which we have previously shown to exhibit low-dose hyper-radiosensitivity. Our results provide significant evidence that this effect cannot be explained by a subpopulation of sensitive cells. However, the results also suggest that the radiation-induced increase in radioresistance observed in this cell line is distinct from the adaptive response.

Substructure in the cell survival response at low radiation dose: effect of different subpopulations.

In order to obtain more accurate measurements of cell survival after low doses of radiation, we have used the cell sorter assay, in which a cell sorter is used to accurately count out the number of cells plated for colony formation. This method, combined with data averaging, permits measurements of survival with superior precision, which have revealed that there is substructure in the radiation response of asynchronously dividing Chinese hamster cells. The substructure, observed at doses of a few Gy, has features of a 2-component response, consistent with the presence of subpopulations of cells of different cell-cycle-related radiosensitivity. The absence of any substructure in the radiation response of homogeneous (tightly synchronized) cell populations lends strong support to this subpopulation explanation of the substructure. This assay has also been used on a variety of human tumour cell lines, most of which exhibited substructure similar to that of Chinese hamster cells. This paper outlines the application of the cell sorter assay to three different problems: (i) radiosensitizer mechanisms-etanidazole and RB 6145 are shown to enhance primarily the beta term and alpha term, respectively, of tumour cell kill, indicating that sensitizer efficacy may be tumour-specific and predictable from tumour response parameters; (ii) accurate measurement of Relative Biological Effectiveness (RBE) in a modulated clinical proton beam shows that the RBE is both dose- and depth-dependent; and (iii) measurements at lower doses clearly demonstrate a second order of substructure, termed the hypersensitive response, at doses < 1 Gy.

A general cavity theory.

A cavity theory is used to relate the dose deposited in the cavity (sensitive volume of the detector) to that in the surrounding medium which may be of different atomic number or composition. Burlin proposed a general cavity theory to include all cavity sizes. The Burlin theory ignores all secondary-electron scattering effects which results in large discrepancies in dose to the cavity compared with the experimental results in high atomic number media. Kearsley proposed a new general cavity theory which includes secondary-electron scattering at the cavity boundary. The Kearsley theory showed excellent agreement with experimental results for 60Co y-rays but poor correlation for 10 MV x-rays. The Kearsley theory has numerous parameters and the magnitude of the input parameters is arbitrary; therefore the dose to the cavity depends on the choice of parameters. We have developed a new cavity theory which includes secondary-electron backscattering from the medium into the cavity. The strengths of this proposed theory are that it contains few parameters and a methodical way of determining the magnitude of the parameters experimentally. the proposed theory gives better agreement with experimental results in lithium fluoride thermoluminescence dosimeters for 60Co y-rays and 10 MV x-rays in aluminium, copper and lead than do the Burlin and Kearsley cavity theories.

Hypoxic cell sensitization: low-dose intrinsic radiosensitivity is predictive for etanidazole efficacy in a panel of human tumour cell lines.

We used a cell sorter assay to evaluate the efficacy of the hypoxic cell sensitizer etanidazole over 3-4 logs of cell inactivation, with particular attention to the clinically relevant low-dose survival region. Analysis of the radiation responses in a panel of six human tumour cell lines under conditions of hypoxia and hypoxia with etanidazole revealed both a cell-line and radiation dose-dependence in the sensitizing ability of this drug. Fits of the linear-quadratic (LQ) model to the low-dose region of cell survival indicate that sensitization of hypoxic cells by etanidazole results primarily from a modification of the beta parameter. This results in selective sensitization of cell lines in which this parameter contributes significantly to cell kill (i.e. a low alpha/beta ratio) and implies that the efficacy of this drug may be tumour specific. Selective modification of beta also leads to a radiation dose-dependence of the sensitizing enhancement ratio (SER). Analysis of the alpha and beta parameters derived from fist to data at low doses of radiation, suggests that the dose-dependence of this sensitizer, and possibly others including oxygen, is cell-line dependent; cell lines exhibiting a low alpha/beta ratio (i.e. with a large shoulder) exhibit little or no SER dose dependence, while those with a high alpha/beta ratio (i.e. small shoulder) exhibit a reduced SER at low doses as compared to high doses. Furthermore, this analysis suggests that modelling of the low-dose radiation survival data under conditions of hypoxia, can be predictive for both the absolute sensitizing ability of etanidazole, and its dose dependence. Our results also indicate that measurement of the in vitro low-dose radiation survival response in a panel of human cell lines is a more effective assay for evaluating agents like etanidazole than simply high-dose measurements in rodent cell lines which have, in general, demonstrated more congruent survival responses.

Low-dose hypersensitivity and increased radioresistance in a panel of human tumor cell lines with different radiosensitivity.

It is well known that cells of human tumor cell lines display a wide range of sensitivity to radiation, at least a part of which can be attributed to different capacities to process and repair radiation damage correctly. We have examined the response to very low-dose radiation of cells of five human tumor cell lines that display varying sensitivity to radiation, using an improved assay for measurement of radiation survival. This assay improves on the precision of conventional techniques by accurately determining the numbers of cells at risk, and has allowed us to measure radiation survival to doses as low as 0.05 Gy. Because of the statistical limitations in measuring radiation survival at very low doses, extensive averaging of data was used to determine the survival response accurately. Our results show that the four most resistant cell lines exhibit a region of initial low-dose hypersensitivity. This hypersensitivity is followed by an increase in radioresistance over the dose range 0.3 to 0.7 Gy, beyond which the response is typical of that seen in most survival curves. Mathematical modeling of the responses suggests that this phenomenon is not due to a small subpopulation of sensitive cells (e.g. mitotic), but rather is a reflection of the induction of resistance in the whole cell population, or at least a significant proportion of the whole cell population. These results suggest that a dose-dependent alteration in the processing of DNA damage over the initial low-dose region of cell survival may contribute to radioresistance in some cell lines.

Substructure in the radiation survival response at low dose in cells of human tumor cell lines.

In earlier studies using asynchronously growing Chinese hamster cells, we observed substructure in the survival response at low doses. The substructure appeared to result from subpopulations of cells having different, cell cycle phase-dependent radiosensitivity. We have now applied the same flow cytometry and cell sorting technique to accurately measure the responses of cells of eight different asynchronously growing human tumor cell lines, representing a wide range in radiosensitivity. When the data were fitted with a linear-quadratic (LQ) function, most of these lines showed substructure similar to that observed in Chinese hamster cells, with the result that values of alpha and beta were dependent on the dose range used for fitting. Values of alpha describing the low-dose response were typically smaller (by as much as 2.2 times) than the alpha describing the high-dose response, while values of beta were larger at low doses. Values of alpha/beta from our measurements are in reasonable agreement with other values published recently if we fit the data for the high-dose range (excluding, for example, 0-4 Gy), which corresponds to a conventional survival response measurement. However, the values of alpha/beta describing the low-dose range were, on average, 2.8-fold smaller. The results show that the usual laboratory measurement of cell survival over 2 or 3 logs of cell killing, if fitted with a single LQ function, will yield alpha and beta values which may give a rather poor description of cell inactivation at low dose in asynchronous cells, no matter how carefully those measurements are done, unless the low-dose range is fitted separately. The contribution of killing represented by the beta coefficient at low doses was found to be surprisingly large, accounting for 40-70% of cell inactivation at 2 Gy in these cell lines. A two-population LQ model provides excellent fits to the data for most of the cell lines though, as one might expect with a five-parameter model, the best-fitting value of the various parameters is far from unique, and the values are probably not reliable indicators of the size and radiosensitivity of the different cell subpopulations. At very low dose, below 0.5-1 Gy, another order of substructure is observed: the hypersensitive response; this is described in the accompanying paper (Wouters et al., Radiat. Res. 146, 399-413, 1996).

Measurements of relative biological effectiveness of the 70 MeV proton beam at TRIUMF using Chinese hamster V79 cells and the high-precision cell sorter assay.

Measurements of relative biological effectiveness (RBE) have been made on the range-modulated 70 MeV proton beam at TRIUMF using a precise cell sorting survival assay. In this study, Chinese hamster V79-WNRE cells were suspended in medium containing liquid gelatin at 37 degrees C in irradiation tubes and the gel was allowed to solidify by cooling to 4 degrees C. Complete cell survival responses were measured at 11 positions with 2 mm spacing within a proton stopping peak width of approximately 2 cm. Survival responses after proton irradiation were compared with responses to 60Co gamma rays measured at the same time, and RBE values were determined as a function of both dose and depth. Above doses of 4 Gy, the average RBE for these cells throughout the modulated proton stopping distribution was 1.21 +/- 0.05, measured at a survival of 1%. However, we also observed that, within the spread-out Bragg peak, the RBE increased with increasing depth, from approximately 1.2 at the proximal part to > 1.3 at the distal part of the peak. At the distal edge of the stopping distribution, the RBE value increased significantly, to an extent that may be of concern when this region of the treatment volume is close to sensitive tissues. Below 4 Gy, the RBE value was also dependent on radiation dose, increasing significantly to values of approximately 1.37 and 1.56 at 2 and 1 Gy, respectively. Our results illustrate that the use of a single RBE value in different irradiation protocols can be an oversimplification, and argues for the use of "proton gray doses" rather than "gamma-ray equivalent grays."

Cytotoxic effect of RB 6145 in human tumour cell lines: dependence on hypoxia, extra- and intracellular pH and drug uptake.

Low pH and hypoxia are a common feature of many solid tumours. This study examined the effect of these two conditions on the cytotoxic properties of the bifunctional agent RB 6145, the prodrug of RSU 1069. The effect of acidic pH on RB 6145 toxicity was examined in six human tumour cell lines under hypoxic conditions and was found to have little effect in HT 29, A549, U373 and HT 144 cells. Treatment was for 1 h at 37 degrees C, pH 6.4 or 7.4. Significant potentiation of RB 6145 toxicity was observed in SiHa cells (enhancement ratio; ERpH approximately 1.6) and in U1 cells (ERpH approximately 1.4). In these two cell lines the potentiation of RB 6145 toxicity arising from hypoxia was large, with ERHyp approximately 11 and 15 in SiHa and U1 cells respectively. SiHa cells, which show a pH effect and HT 29 cells, which do not, were chosen for further comparative studies of drug uptake )nd regulation of intracellular pH. High-performance liquid chromatography (HPLC) determinations of the uptake of RB 6145 and its dervatives showed that in SiHa cells, intracellular to extracellular drug concentration ratio (Ci/Ce) at 1 h was approximately 40% higher at pH 6.4 than at pH 7.4, whereas in HT 29 cells Ci/Ce was approximately 25% lower. Under conditions of acidic extracellular pH, regulation of pH was somewhat less effective in SiHa cells, where pHi dropped to within 0.2 pH units of the extracellular pH over a 2.5 h treatment at pH 6.4. It seems likely that increased drug uptake was at least part of the basis for the observed potentiation of RB 6145 toxicity in SiHa cells. A model which would better explain the results for both cell lines might also include the possibility that low pH per se potentiates cytotoxic damage to a modest extent and that it is offset or augmented by altered uptake in HT 29 and SiHa cells respectively.

The cytotoxicity of melphalan and its relationship to pH, hypoxia and drug uptake.

In the present in vitro studies we examined the effect of hypoxia and acidic pH, two important consequences of reduced blood flow in vivo, on the cytotoxicity of melphalan treatment in Chinese hamster V79-WNRE and SiHa human tumor cells. Cells were exposed to various concentrations of melphalan for 1 hr at 37 degrees C under oxic or hypoxic conditions; pH 6.6 or 7.4, and cell survival was measured. The cytotoxicity of melphalan was potentiated by both low pH and hypoxia, in both cell lines. The overall potentiation, expressed as an enhancement ratio (ER), from both hypoxia and low pH was 3.5 in V79-WNRE and 2.9 in SiHa cells. The potentiation of cell killing produced by hypoxia alone (ERHyp) ranged from 1.4 to 1.9, and was greater in V79-WNRE than in SiHa cells. The potentiation from low pH (ERpH) was approximately 2 in both cell lines. HPLC analysis showed substantial intracellular accumulation of melphalan in both cell lines. Hypoxia and reduced pH further enhanced uptake of melphalan but this was not sufficient by itself to account for the increased potentiation of cytotoxicity observed under those conditions.

The effect of low pH and hypoxia on the cytotoxic effects of SR4233 and mitomycin C in vitro.

PURPOSE: We examined the effect of acidic pH and hypoxia on the cytotoxicity of SR4233 and mitomycin C in vitro. METHODS AND MATERIALS: The importance of tumor microenvironment to the response of solid tumors to cytotoxic treatment is well established. The bioreductive drug SR4233 has a very substantial selective toxicity for hypoxic cells. We have used both Chinese hamster and human tumor cells to investigate the influence of low pH and hypoxia on the response of cultured cells to treatment with SR4233 or mitomycin C. RESULTS: We found that low pH (6.6) had little effect on the hypoxic toxicity of SR4233; under aerobic conditions, however, low pH substantially increased the cytotoxic effects of 1 h exposure to SR4233, with drug dose enhancement ratios (ER) of 3.9 and 2.5 in V79 and HT-29 cells, respectively. In similar studies with mitomycin C, hypoxia had little effect on the cytotoxicity of mitomycin C in V79 cells, though a low pH of 6.6 enhanced the cytotoxicity under both aerobic and hypoxic conditions (ER approximately 2). In HT-29 cells, neither low pH nor hypoxia had any significant effect on mitomycin C toxicity. CONCLUSION: Low pH, like hypoxia, is a common feature of solid tumors and can be an important determinant of the cytotoxic effect of bioreductive drugs such as SR4233 and mitomycin C.

The survival of asynchronous V79 cells at low radiation doses: modeling the response of mixed cell populations.

We have observed that when a single linear-quadratic (LQ) function is used to fit the radiation survival response of an asynchronously dividing population of V79 cells, a consistent misfit occurs at low doses. The data can be better described by fitting the low-dose and high-dose ranges separately, and there is evidence of a two-component response. The most obvious explanation is that we may simply be seeing the response of subpopulations of cells of different radiosensitivity: sensitive G1-, G2- and M-phase cells and resistant S-phase cells. The cell sorting assay for cell survival which we have used in these studies may thus be providing sufficient accuracy to resolve these subpopulations, not previously seen in conventional survival measurements. An alternative explanation is that the linear-quadratic function may be inappropriate for accurate description of the radiation survival response at low dose, at least for these cells. To test this hypothesis we have used three other models to fit the data: the single-hit plus multi-target (SHMT) model and the two-parameter repair-misrepair (RMR) model both yielded inferior fits to the asynchronous survival data; the three-parameter RMR model provided an improved fit to the data. The best fit, however, was obtained using a two-population LQ model, which suggested approximately equal numbers of sensitive and resistant cells. When the survival response of tightly synchronized G1/S-phase cells was measured using the cell sorting assay, no substructure was observed. This offers strong support to the hypothesis that the substructure observed in the asynchronous survival response is due to subpopulations of cells of different, cycle-dependent radiosensitivity.

The response of a human tumor cell line to low radiation doses: evidence of enhanced sensitivity.

The survival of asynchronous, exponentially growing DU-145 human tumor cells was measured after single doses of X rays in the dose range of 0.05-4 Gy using the cell sorting assay. When the response was modeled with the linear-quadratic (LQ) equation, a good fit to the data was observed for dose levels above 1 Gy; however, a region of enhanced sensitivity was observed at doses less than this. One possible explanation of this low-dose substructure is that a small, sensitive subpopulation of cells is selectively killed at low doses. Modeling of the radiation response with a two-population LQ model suggests that for these data this explanation is unlikely. Another possibility is that the whole cell population is initially hypersensitive, becoming radioresistant as damage is sustained by the cell. Conceivably this radioprotective mechanism could act in one of two ways. The cell could move from a radiation-sensitive to a radiation-resistant state by a continuous function of dose, or alternatively, only after a sufficient accumulation of damage, i.e. a "triggering dose." Both of these possibilities have been explored in the results of fitting two "induced resistance" models.

Substructure in the radiation survival response at low dose: asynchronous and partially synchronized V79-WNRE cells.

The radiation survival response of asynchronously-dividing populations of the cell line V79-WNRE indicates substructure in the low dose region that can be better characterized by separately fitting the data within the low and high dose regions to the linear-quadratic (LQ) equation. Flow cytometry and cell sorting techniques have been used to determine the response of both asynchronous populations and synchronous populations obtained by mitotic selection with or without an additional drug block. The statistically significant substructure which is present in the radiation response of asynchronous cells is absent in G1/S cells synchronized by mitotic selection followed by hydroxyurea (or aphidicolin) accumulation at the G1/S boundary. Such G1/S populations have a radiation response that is well characterized by a single LQ expression over 3 logs of cell inactivation. In contrast, the radiation response of cells synchronized by mitotic selection alone and irradiated in early G1 shows substantial substructure when fitted to the LQ equation, reflecting some radioresistance at high dose. While this response is well described by a single hit plus multitarget equation, it is possible that the small proportion (< 5%) of interphase cells in such mitotically-selected populations may be responsible for the resistance observed at higher doses.

The effect of pH on the aerobic and hypoxic cytotoxicity of SR4233 in HT-29 cells.

We have observed that low pH can substantially potentiate the cytotoxic effect of the bioreductive drug SR4233 in aerobic HT-29 human tumour cells. No such potentiation was observed under hypoxic conditions. This pH effect might be relevant both to the therapeutic effectiveness and to the normal tissue toxicity of this new agent.

Survival at low dose in asynchronous and partially synchronized Chinese hamster V79-171 cells.

In an earlier study using cell sorting techniques to define the radiation survival response of asynchronous Chinese hamster V79-171 cells more accurately, we found evidence of substructure in the response at low dose. In the present work we have attempted to show that this substructure arises from the subpopulations of sensitive (G1, G2 phase) and resistant (late S phase) cells which are present in asynchronously dividing cultures but which are not resolved by conventional survival assays. Partially synchronized cells were produced by exposure to 1 mM hydroxyurea for 12 h and were harvested 15 min later, yielding a population of viable cells at or just beyond the G1/S-phase boundary. Parallel experiments were carried out with asynchronous cells. The average of repeated measurements of the radiation survival response of asynchronous cells again showed a significant difference (P = 0.002 to 0.009) between the alpha and beta values evaluated from the data for the low-dose range, 0-2.8 Gy, and the high-dose range, 2.8-14 Gy. For G1/S-phase cells, however, there was no significant difference between the values of alpha and beta for the low-dose and high-dose ranges (P > 0.5). The results thus support the hypothesis that the observed substructure in the asynchronous response is due to resolution of subpopulations of different radiosensitivities, and they illustrate the advantage of the cell sorter assay for accurate measurements of cell survival, particularly at low dose.

The effect of hypoxia and low pH on the cytotoxicity of chlorambucil.

Studies with mouse tumors have shown that the effectiveness of certain chemotherapeutic agents can be enhanced if they are used in appropriate combination with an anti-hypertensive drug such as hydralazine. This results in reduced tumor blood flow with, among other things, a consequent decrease in oxygenation and increase in acidity in the tumor tissue. The purpose of the present work was to determine to what extent hypoxia and low pH are involved in the mechanism of this effect for chlorambucil. V79-WNRE cells were exposed to various drug concentrations under aerobic or hypoxic conditions, pH 6.4 or 7.4. Measurements of cell survival following 1 hr exposure at 37 degrees C showed that pH 6.4 produced a large potentiation of cell killing by chlorambucil (ER = 4 approx.); hypoxia, on the other hand, had little effect. The potentiation was shown to be greatest for pH values below 7.0. HPLC measurements of drug uptake were made since it was anticipated that chlorambucil, a weak acid, might tend to accumulate in cells under conditions of low extracellular pH. It was found that at an extracellular pH of 6.4 the ratio of the intracellular (Ci) and extracellular (Ce) drug concentrations was increased 4.5 and 3.6 fold for aerobic and hypoxic conditions, respectively. This probably explains most, if not all, of the cell killing potentiation observed at low pH.