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1.
Br J Pharmacol ; 177(18): 4193-4208, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32548889

RESUMO

BACKGROUND AND PURPOSE: Irinotecan, used in colorectal cancer therapy, is metabolized by glucuronidation involving different UDP-glucuronosyltransferase (UGT)1A isoforms leading to facilitated elimination from the body. Individuals homozygous for the genetic variants UGT1A1*28 (Gilbert syndrome) and UGT1A7*3 are more susceptible to irinotecan side effects, severe diarrhoea and leukopenia. The aim of this study was to investigate the protective effects and active constituents of coffee during irinotecan therapy using humanized transgenic (htg)UGT1A-WT and htgUGT1A-SNP (carry UGT1A1*28 and UGT1A7*3 polymorphisms) mice. EXPERIMENTAL APPROACH: HtgUGT1A mice were pretreated with coffee or caffeic acid (CA) + caffeic acid phenylethyl ester (CAPE) and injected with irinotecan. The effects of coffee and CA + CAPE were investigated using reporter gene assays, immunoblot, TaqMan-PCR, siRNA analyses and blood counts. KEY RESULTS: Only the combination of the two coffee ingredients, CA and CAPE, mediates protective effects of coffee in a model of irinotecan toxicity by activation of UGT1A genes. Coffee and CA + CAPE significantly increased UGT1A expression and activity along with SN-38 glucuronide excretion in irinotecan-injected htgUGT1A mice, resulting in significant improvement of leukopenia, intestinal oxidative stress and inflammation. CONCLUSION AND IMPLICATIONS: In this study, we identify the compounds responsible for mediating the previously reported coffee-induced activation of UGT1A gene expression. CA and CAPE represent key factors for the protective properties of coffee which are capable of reducing irinotecan toxicity, exerting antioxidant and protective effects. Provided that CA + CAPE do not affect irinotecan efficacy, they might represent a novel strategy for the treatment of irinotecan toxicity.


Assuntos
Ácidos Cafeicos , Café , Irinotecano , Leucopenia , Estresse Oxidativo , Animais , Ácidos Cafeicos/farmacologia , Camptotecina/toxicidade , Ésteres , Glucuronosiltransferase/genética , Glucuronosiltransferase/metabolismo , Irinotecano/toxicidade , Leucopenia/induzido quimicamente , Leucopenia/prevenção & controle , Camundongos
2.
Chem Commun (Camb) ; 55(73): 10892-10895, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31436766

RESUMO

Bifunctional supramolecular prodrug vesicles have been successfully constructed based on the complexation between a glutathione (GSH)-responsive prodrug guest molecule (DNS-CPT) and a water-soluble pillar[5]arene (WP5) for cancer diagnosis and therapy. Under the microenvironment of cancer cells with high GSH concentration, 7-ethyl-10-hydroxycamptothecin (SN-38) with strong yellow fluorescence can be efficiently released from the prodrug DNS-CPT for drug location and cancer therapy.


Assuntos
Antineoplásicos/uso terapêutico , Camptotecina/análogos & derivados , Camptotecina/uso terapêutico , Portadores de Fármacos/química , Compostos Macrocíclicos/química , Pró-Fármacos/uso terapêutico , Animais , Antineoplásicos/síntese química , Antineoplásicos/farmacologia , Antineoplásicos/toxicidade , Apoptose/efeitos dos fármacos , Camptotecina/farmacologia , Camptotecina/toxicidade , Linhagem Celular Tumoral , Portadores de Fármacos/síntese química , Liberação Controlada de Fármacos , Feminino , Glutationa/química , Humanos , Compostos Macrocíclicos/síntese química , Camundongos , Camundongos Endogâmicos BALB C , Células NIH 3T3 , Nanopartículas/química , Tamanho da Partícula , Pró-Fármacos/síntese química , Pró-Fármacos/farmacologia , Pró-Fármacos/toxicidade , Solubilidade , Água , Ensaios Antitumorais Modelo de Xenoenxerto
3.
Toxicol Appl Pharmacol ; 327: 71-79, 2017 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-28454924

RESUMO

Irinotecan-based regimens are commonly used for treatment of colorectal cancer, which is limited by mucositis and non-alcoholic steatohepatitis (NASH). Silymarin (SIL) prevents fatty liver disease in the clinical setting and in models of liver damage induced chemically. This study investigated the possible effect of SIL on irinotecan (IRI)-induced NASH. Swiss female mice were injected with saline (SAL 5ml/kg i.p.), IRI (50mg/kg i.p.), SIL (150mg/kg p.o.) or IRI (50mg/kg i.p.)+(SIL 1.5, 15 or 150mg/kg p.o.) thrice/week/7weeks. On the seventh week, blood samples were collected for transaminases assay and livers were collected for histopathology, measurement of the total lipids, malondyadehyde (MDA), non-protein sulfhydryl groups (NPSH), cytokines (IL-1ß, IL 6 and IL-10), 3-nitrotyrosine (N-Tyr) and toll-like receptor 4 (TLR4) immunoexpression, quantification of NF-kB, α-smooth muscle actin (α-SMA), and Escherichia coli 16S rRNA gene (RRS) expression. IRI increased liver transaminases, neutrophil infiltration, lipid accumulation, MDA, IL-1ß and IL-6 levels, N-Tyr and TLR4 immunostaining, NF-kB, α-SMA expression and RRS versus the SAL group (p<0.05). Additionally, SIL (1.5mg/kg) improved these parameters (p<0.05), except neutrophil infiltration and RSS versus the IRI group. Furthermore, the SIL (15mg/kg) only improved the inflammatory parameters, the expression of α-SMA and RRS versus the IRI group (p<0.05). The higher dose of SIL (150mg/kg) was even more deleterious than the intermediate dose. Therefore, silymarin showed a dual effect on liver damage induced by IRI. Hepatoprotection seems to involve the inhibition of oxidative stress and protein nitrosylation, preventing activation of hepatic fibrosis mechanisms.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Antineoplásicos Fitogênicos/toxicidade , Camptotecina/análogos & derivados , Hepatopatia Gordurosa não Alcoólica/induzido quimicamente , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Silimarina/uso terapêutico , Animais , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/patologia , Biomarcadores/metabolismo , Camptotecina/toxicidade , Citocinas/metabolismo , Feminino , Irinotecano , Metabolismo dos Lipídeos/efeitos dos fármacos , Fígado/microbiologia , Fígado/patologia , Testes de Função Hepática , Camundongos , Infiltração de Neutrófilos , Hepatopatia Gordurosa não Alcoólica/patologia , Estresse Oxidativo/efeitos dos fármacos , Compostos de Sulfidrila/metabolismo
4.
Bioorg Med Chem Lett ; 27(4): 701-707, 2017 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-28073672

RESUMO

20-(S)-Camptothecin (CPT) is a natural alkaloid extracted from the bark of Camptotheca acuminata (Chinese happy tree). It acts as a DNA topoisomerase 1 poison with an interesting antitumor activity and its use is limited by low stability and solubility and unpredictable drug-drug interactions. Since the late 20th century, it has been widely used in cancer therapy and, since extraction yields from plant tissues are very low, various synthetic routes have been developed to satisfy the increase in demand for CPT. Moreover, SAR studies have allowed for the development of more potent CPT analogues topotecan and irinotecan. Unfortunately, resistance has already occurred in several tumour lines. Additional studies are needed to better understand the relationship between substituents and resistance, its clinical relevance and the impact of related gene polymorphism. One of the latest research approaches focuses on modifying the delivery mode to improve tumour cell uptake and reduce toxicity.


Assuntos
Antineoplásicos Fitogênicos/química , Camptotecina/análogos & derivados , Medicina Tradicional , Antineoplásicos Fitogênicos/uso terapêutico , Antineoplásicos Fitogênicos/toxicidade , Apoptose/efeitos dos fármacos , Camptotheca/química , Camptotheca/metabolismo , Camptotecina/uso terapêutico , Camptotecina/toxicidade , DNA Topoisomerases Tipo I/química , DNA Topoisomerases Tipo I/metabolismo , Humanos , Neoplasias/tratamento farmacológico , Relação Estrutura-Atividade
5.
J Tradit Chin Med ; 37(1): 35-42, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-29956901

RESUMO

OBJECTIVE: To evaluate the efficacy of Shengjiangxiexin decoction (SXD), prepared with a formula from Traditional Chinese Medicine (TCM), in reducing irinotecan-induced hematological and gastrointestinal toxicities in patients with UDP-glucuronosyltransferase (UGT)1A1*28 and UGT1A1*6 polymorphisms. METHODS: This clinical trial included 115 patients receiving irinotecan combined with 5-fluorouracil plus l-leucovorin (FOLFIRI) treatment. All patients consented to UGT1A1*28 and *6 gene polymorphism detection prior to chemotherapy. SXD were administered from 1 day prior to chemotherapy to 6 day post chemotherapy. Chemotherapy induced adverse reactions (neutropenia, diarrhea, nausea, vomiting, anorexia and infection) were recorded, and short-term effect of chemotherapy was evaluated regularly. RESULTS: A total of 50 patients had *1/*1 wild genotype, 58 patients had single allele variants with genotype *1/*6 or *1/*28 , and 7 patients had two alleles variants with genotype *6/*6, *28/*28 or *6/* 28. In *1/*6 or *1/*28 patients (high risk group), 9 patients (15.5% ) developed Ⅰ-Ⅱ grade diarrhea and no patient developed severe diarrhea; neutropenia occurred in 19 patients (32.8%) and only 3 patients (8.6% ) developed sever neutropenia. There were no significant differences in any toxic effects (neutropenia, diarrhea, nausea, vomiting, anorexia or infection) between *6 or *28 variant patients (high risk group) and wild type patients. No sever toxicity was found in high risk two alleles variants patients (*6/*6, *6/*28 or *28/*28). No significant differences were observed between UGT1A1*6/*28 polymorphisms and clinical response of chemotherapy. CONCLUSION: SXD could significantly reduce irinotecan-induced hematological and gastrointestinal toxicities in UGT1A1*28 or *6 variant patients (high risk group), while this treatment didn't affect clinical response of chemotherapy.


Assuntos
Antineoplásicos/toxicidade , Camptotecina/análogos & derivados , Medicamentos de Ervas Chinesas/administração & dosagem , Glucuronosiltransferase/genética , Neoplasias/tratamento farmacológico , Polimorfismo Genético , Adolescente , Adulto , Idoso , Antineoplásicos/uso terapêutico , Camptotecina/uso terapêutico , Camptotecina/toxicidade , Diarreia/tratamento farmacológico , Diarreia/etiologia , Feminino , Fluoruracila/uso terapêutico , Fluoruracila/toxicidade , Humanos , Irinotecano , Masculino , Pessoa de Meia-Idade , Náusea/tratamento farmacológico , Náusea/etiologia , Neutropenia/tratamento farmacológico , Neutropenia/etiologia , Resultado do Tratamento , Vômito/tratamento farmacológico , Vômito/etiologia , Adulto Jovem
6.
Biol Pharm Bull ; 39(11): 1839-1845, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27803455

RESUMO

This study evaluated the influence of Styrax camporum stems hydroalcoholic extract (SCHE) and of chemical markers of the genus, egonol (EG) and homoegonol (HE), on DNA damage induced in V79 cells by mutagens with different mechanisms of action. These natural products were combined with different mutagens [methyl methanesulfonate (MMS), hydrogen peroxide (H2O2), (S)-(+)-camptothecin (CPT), and etoposide (VP-16)] to evaluate the modulatory effect on DNA damage. The results showed that SCHE was genotoxic at the highest concentration tested (60 µg/mL). Treatment with EG or HE alone induced no genotoxic effect, while genotoxic activity was observed when the two compounds were combined. The SCHE extract was able to reduce the frequency of micronuclei induced by H2O2 and VP-16. Similar results were observed when the cell cultures were treated with EG and/or HE plus VP-16. In contrast, the highest concentration (40 µg/mL) SCHE potentiated DNA damage induced by VP-16. Neolignan EG alone or combined with HE also potentiated H2O2-induced genotoxicity. However, these natural products did not influence the frequency of DNA damage induced by MMS or CPT. Therefore, the influence of SCHE and of chemical markers (EG and HE) of the genus on the induction of DNA damage depends on the concentration tested and on the mutagen used.


Assuntos
Anisóis/farmacologia , Benzofuranos/farmacologia , Dano ao DNA/efeitos dos fármacos , Mutagênicos/toxicidade , Extratos Vegetais/farmacologia , Styrax , Animais , Anisóis/toxicidade , Benzofuranos/toxicidade , Camptotecina/toxicidade , Linhagem Celular , Ensaio Cometa , Cricetulus , Etoposídeo/toxicidade , Peróxido de Hidrogênio/toxicidade , Metanossulfonato de Metila/toxicidade , Testes para Micronúcleos , Extratos Vegetais/toxicidade
7.
Drug Metab Dispos ; 44(1): 1-7, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26526067

RESUMO

Gastrointestinal toxicity, such as late-onset diarrhea, is a significant concern in irinotecan hydrochloride (CPT-11)-containing regimens. Prophylaxis of late-onset diarrhea has been reported with use of Japanese traditional (Kampo) medicine containing baicalin and with the antibiotic cefixime, and this has been explained in terms of inhibition of bacterial deconjugation of SN-38-glucuronide since unconjugated SN-38 (active metabolite of CPT-11) is responsible for the gastrointestinal toxicity. It is also prerequisite for SN-38 to be accumulated in intestinal tissues to exert toxicity. Based on the fact that liver-specific organic anion transporting polypeptide (OATP)1B1, a member of the same family as OATP2B1, is known to be involved in hepatic transport of SN-38, we hypothesized that intestinal transporter OATP2B1 contributes to the accumulation of SN-38 in gastrointestinal tissues, and its inhibition would help prevent associated toxicity. We found that uptake of SN-38 by OATP2B1-expressing Xenopus oocytes was significantly higher than that by control oocytes. OATP2B1-mediated uptake of SN-38 was saturable, pH dependent, and decreased in the presence of baicalin, cefixime, or fruit juices such as apple juice. In vivo gastrointestinal toxicity of SN-38 in mice caused by oral administration for consecutive 5 days was prevented by coingestion of apple juice. Thus, OATP2B1 contributes to the uptake of SN-38 by intestinal tissues, triggering gastrointestinal toxicity. So, in addition to the reported inhibition of bacterial ß-glucuronidase by cefixime or baicalin, inhibition of OATP2B1 may also contribute to prevention of gastrointestinal toxicity. Apple juice may be helpful for prophylaxis of late-onset diarrhea observed in CPT-11 therapy without disturbance of the intestinal microflora.


Assuntos
Antineoplásicos/toxicidade , Camptotecina/análogos & derivados , Diarreia/induzido quimicamente , Absorção Intestinal , Intestinos/efeitos dos fármacos , Transportadores de Ânions Orgânicos/metabolismo , Administração Oral , Animais , Antineoplásicos/administração & dosagem , Antineoplásicos/metabolismo , Bactérias/efeitos dos fármacos , Bactérias/enzimologia , Proteínas de Bactérias/antagonistas & inibidores , Proteínas de Bactérias/metabolismo , Camptotecina/administração & dosagem , Camptotecina/metabolismo , Camptotecina/toxicidade , Cefixima/farmacologia , Diarreia/metabolismo , Diarreia/microbiologia , Diarreia/prevenção & controle , Inibidores Enzimáticos/farmacologia , Feminino , Flavonoides/farmacologia , Interações Alimento-Droga , Sucos de Frutas e Vegetais , Microbioma Gastrointestinal , Técnicas de Transferência de Genes , Glucuronidase/antagonistas & inibidores , Glucuronidase/metabolismo , Concentração de Íons de Hidrogênio , Mucosa Intestinal/metabolismo , Intestinos/microbiologia , Irinotecano , Cinética , Malus , Camundongos Endogâmicos C57BL , Oócitos , Transportadores de Ânions Orgânicos/genética , Xenopus laevis
8.
Phytother Res ; 28(10): 1577-80, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24842785

RESUMO

The present study aims to investigate the influence of irinotecan's toxicity by the biotransformation of glucoaurantio-obtusin to aurantio-obtusin. Intraperitoneal administration (i.p.) of 100 mg/kg aurantio-obtusin significantly increased the toxicity of irinotecan, but the i.p. administration of 100 mg/kg glucoaurantio-obtusin showed negligible influence towards irinotecan's toxicity. Furthermore, the mechanism was explained through determining the inhibition potential of glucoaurantio-obtusin and aurantio-obtusin towards the glucuronidation metabolism of SN-38 that has been regarded to be the major active product responsible for the toxicity of irinotecan. The results showed that aurantio-obtusin exhibited strong competitive inhibition towards the glucuronidation of SN-38, but negligible inhibition potential of glucoaurantio-obtusin towards SN-38 glucuronidation was observed. These results showed that biotransformation of glucoaurantio-obtusin towards aurantio-obtusin increased the toxicity of irinotecan through increased inhibition of SN-38 glucuronidation.


Assuntos
Antraquinonas/metabolismo , Antineoplásicos Fitogênicos/toxicidade , Camptotecina/análogos & derivados , Animais , Biotransformação , Camptotecina/toxicidade , Irinotecano , Masculino , Camundongos da Linhagem 129
9.
PLoS One ; 9(1): e83644, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24454707

RESUMO

CPT-11 is a drug used as chemotherapy for colorectal cancer. CPT-11 causes toxic side-effects in patients. CPT-11 toxicity has been attributed to the activity of intestinal microbiota, however, intestinal microbiota may also have protective effects in CP!-11 chemotherapy. This study aimed to elucidate mechanisms through which microbiota and dietary fibres could modify host health. Rats bearing a Ward colon carcinoma were treated with a two-cycle CPT-11/5-fluorouracil therapy recapitulating clinical therapy of colorectal cancer. Animals were fed with a semi-purified diet or a semi-purified diet was supplemented with non-digestible carbohydrates (isomalto-oligosaccharides, resistant starch, fructo-oligosaccharides, or inulin) in 3 independent experiments. Changes in intestinal microbiota, bacteria translocating to mesenteric lymphnodes, cecal GUD activity, and cecal SCFA production, and the intestinal concentration of CPT-11 and its metabolites were analysed. Non-digestible carbohydrates significantly influenced feed intake, body weight and other indicators of animal health. The identification of translocating bacteria and their quantification in cecal microbiota indicated that overgrowth of the intestine by opportunistic pathogens was not a major contributor to CPT-11 toxicity. Remarkably, fecal GUD activity positively correlated to body weight and feed intake but negatively correlated to cecal SN-38 concentrations and IL1-ß. The reduction in CPT-11 toxicity by non-digestible carbohydrates did not correlate to stimulation of specific bacterial taxa. However, cecal butyrate concentrations and feed intake were highly correlated. The protective role of intestinal butyrate production was substantiated by a positive correlation of the host expression of MCT1 (monocarboxylate transporter 1) with body weight as well as a positive correlation of the abundance of bacterial butyryl-CoA gene with cecal butyrate concentrations. These correlations support the interpretation that the influence of dietary fibre on CPT-11 toxicity is partially mediated by an increased cecal production of butyrate.


Assuntos
Camptotecina/análogos & derivados , Fibras na Dieta/farmacologia , Intestinos/efeitos dos fármacos , Intestinos/microbiologia , Microbiota/efeitos dos fármacos , Animais , Butiratos/metabolismo , Camptotecina/toxicidade , Ceco/efeitos dos fármacos , Ceco/enzimologia , Ácidos Graxos/biossíntese , Feminino , Glucuronidase/metabolismo , Humanos , Mucosa Intestinal/metabolismo , Irinotecano , Ratos
10.
Surg Today ; 42(1): 60-7, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22068671

RESUMO

PURPOSE: The key anticancer agent, CPT-11 (irinotecan hydrochloride), induces severe diarrhea clinically. We investigated the effect of a Kampo medicine, Dai-kenchu-to (DKT), on CPT-11-induced intestinal injuries in rats. METHODS: Twenty-four male Wistar rats were divided into three groups: a control group; a CPT-11 group, given CPT-11 150 mg/kg intraperitoneally for 2 days; and a DKT group, given DKT 300 mg/kg orally for 5 days with CPT-11 150 mg/kg intraperitoneally on days 4 and 5. The rats were killed on day 6. RESULTS: Interleukin (IL)-1ß, IL-12, interferon (IFN)-γ, and tumor necrosis factor-α expression in the small intestine of the CPT-11 group was significantly higher than that of the control group. Interleukin-1ß and IFN-γ expression was improved significantly by DKT (P < 0.05). The number and height of jejuna villi, injury score, and apoptosis index in the CPT-11 group were improved significantly by DKT (P < 0.05). CONCLUSIONS: DKT suppressed CPT-11 induced inflammatory cytokines and apoptosis in the intestinal mucosa and maintained the mucosal integrity.


Assuntos
Camptotecina/análogos & derivados , Diarreia/prevenção & controle , Intestino Delgado/efeitos dos fármacos , Intestino Delgado/metabolismo , Medicina Kampo , Extratos Vegetais , Animais , Apoptose , Camptotecina/toxicidade , Diarreia/induzido quimicamente , Marcação In Situ das Extremidades Cortadas , Interferon gama/metabolismo , Interleucina-12/metabolismo , Interleucina-1beta/metabolismo , Irinotecano , Masculino , Panax , Ratos , Ratos Wistar , Reação em Cadeia da Polimerase em Tempo Real , Fator de Necrose Tumoral alfa/metabolismo , Zanthoxylum , Zingiberaceae
11.
Oncol Rep ; 25(2): 347-52, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21165573

RESUMO

Camptothecin (CPT), a topoisomerase I inhibitor, forms a cleavable complex with topoisomerase I and single-stranded DNA. When this complex meets a replication fork, the collision generates irreversible double-strand breaks, thereby inducing apoptosis. Based on the mechanism of action, we hypothesized that cycling cells would be more sensitive to CPT than non-cycling cells and that cells stimulated to undergo DNA synthesis would be sensitized to CPT. The study focused on the association between CPT-induced DNA strand breaks and apoptotic cell death, because the induction of DNA strand breaks is indispensable for cytotoxicity. We used the Comet assay to quantitate DNA strand breaks and Annexin V positivity to determine the level of cytotoxicity. Normal lymphocytes were used as a model for quiescent cells. First, the cultured leukemic cell line CCRF-CEM was treated with CPT. CEM cells were sensitive to CPT, and the amount of CPT-induced DNA strand breaks was concentration- and time-dependent. The increase in DNA strand breaks appeared to be correlated to a subsequent increase in apoptosis. When normal lymphocytes were treated with CPT, DNA strand breaks quickly disappeared, and the subsequent induction of apoptosis was minimal. However, when normal lymphocytes were stimulated to undergo DNA synthesis, the lymphocytes were sensitized to CPT with increased DNA strand breaks and enhanced apoptosis. Again, the extent of DNA strand breaks was associated with the magnitude of cytotoxicity. Thus, CPT was cytotoxic to stimulated normal lymphocytes in the context of DNA synthesis.


Assuntos
Camptotecina/farmacologia , Citotoxinas/farmacologia , Quebras de DNA/efeitos dos fármacos , DNA de Cadeia Simples/metabolismo , Linfócitos/efeitos dos fármacos , Antineoplásicos Fitogênicos/farmacologia , Apoptose/efeitos dos fármacos , Apoptose/fisiologia , Camptotecina/toxicidade , Células Cultivadas , Ensaio Cometa , DNA de Cadeia Simples/efeitos dos fármacos , Relação Dose-Resposta a Droga , Avaliação Pré-Clínica de Medicamentos , Humanos , Ativação Linfocitária/efeitos dos fármacos , Linfócitos/imunologia , Linfócitos/metabolismo , Linfócitos/fisiologia , Regulação para Cima/efeitos dos fármacos
12.
Onkologie ; 33(12): 684-90, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21124039

RESUMO

BACKGROUND: This prospective observational study in typical community-based outpatient clinics evaluated the efficacy and toxicity of weekly and biweekly irinotecan-based chemotherapies and their compatibility depending on age. METHODS: 601 patients with advanced or metastatic colorectal cancer receiving first-, second-, or third-line irinotecan-based therapy were regularly analyzed for response and toxicity until the end of therapy. RESULTS: The median age was 65 (28-87) years, approximately one-third of the patients were ≥70 years old. Of all patients, 405 were treated weekly and 68 biweekly. Median overall survival (OS) for first-line therapy was 26.5 months for the <70-year-old patients and 19.4 months for the ≥70-year-old patients. Toxicities were moderate in all groups. Tumor growth control rates (TCR) and median time to progression (TTP) were marginally better for patients <70 years old. Median TTP was 9.9 months in first-line therapy, 9.8 months after adjuvant therapy, 7.7 months in second-line, and 6.4 months in third-line therapy. CONCLUSIONS: Toxicity and response data from this observational study clearly confirm the positive results from previous clinical studies and show a slight ad-vantage in efficacy for the <70-year-old patients.


Assuntos
Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Camptotecina/análogos & derivados , Neoplasias Colorretais/tratamento farmacológico , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/toxicidade , Camptotecina/administração & dosagem , Camptotecina/toxicidade , Quimioterapia Adjuvante , Ensaios Clínicos como Assunto , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Terapia Combinada , Progressão da Doença , Esquema de Medicação , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Feminino , Fluoruracila/administração & dosagem , Fluoruracila/toxicidade , Humanos , Irinotecano , Leucovorina/administração & dosagem , Leucovorina/toxicidade , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Compostos Organoplatínicos/administração & dosagem , Compostos Organoplatínicos/toxicidade , Estudos Prospectivos , Taxa de Sobrevida , Resultado do Tratamento , Carga Tumoral
14.
Science ; 330(6005): 831-5, 2010 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-21051639

RESUMO

The dose-limiting side effect of the common colon cancer chemotherapeutic CPT-11 is severe diarrhea caused by symbiotic bacterial ß-glucuronidases that reactivate the drug in the gut. We sought to target these enzymes without killing the commensal bacteria essential for human health. Potent bacterial ß-glucuronidase inhibitors were identified by high-throughput screening and shown to have no effect on the orthologous mammalian enzyme. Crystal structures established that selectivity was based on a loop unique to bacterial ß-glucuronidases. Inhibitors were highly effective against the enzyme target in living aerobic and anaerobic bacteria, but did not kill the bacteria or harm mammalian cells. Finally, oral administration of an inhibitor protected mice from CPT-11-induced toxicity. Thus, drugs may be designed to inhibit undesirable enzyme activities in essential microbial symbiotes to enhance chemotherapeutic efficacy.


Assuntos
Antineoplásicos Fitogênicos/toxicidade , Camptotecina/análogos & derivados , Inibidores Enzimáticos/farmacologia , Glucuronidase/antagonistas & inibidores , Glucuronidase/farmacologia , Animais , Antineoplásicos Fitogênicos/metabolismo , Bactérias Anaeróbias/efeitos dos fármacos , Camptotecina/metabolismo , Camptotecina/toxicidade , Linhagem Celular Tumoral , Colo/efeitos dos fármacos , Colo/microbiologia , Colo/patologia , Cristalografia por Raios X , Diarreia/prevenção & controle , Avaliação Pré-Clínica de Medicamentos , Inibidores Enzimáticos/química , Inibidores Enzimáticos/metabolismo , Escherichia coli/enzimologia , Proteínas de Escherichia coli/antagonistas & inibidores , Proteínas de Escherichia coli/química , Proteínas de Escherichia coli/isolamento & purificação , Proteínas de Escherichia coli/metabolismo , Feminino , Glucuronidase/química , Glucuronidase/isolamento & purificação , Glucuronidase/metabolismo , Humanos , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/microbiologia , Mucosa Intestinal/patologia , Irinotecano , Camundongos , Camundongos Endogâmicos BALB C , Modelos Moleculares , Pró-Fármacos/metabolismo , Pró-Fármacos/toxicidade , Conformação Proteica
15.
Sci Transl Med ; 2(45): 45ra59, 2010 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-20720216

RESUMO

PHY906, a four-herb Chinese medicine formula first described 1800 years ago, decreases gastrointestinal toxicity induced by the chemotherapeutic drug CPT-11 (irinotecan), as shown in a phase I/II clinical study. Similarly, in a murine colon 38 allograft model, PHY906 increased the antitumor activity of CPT-11 while decreasing animal weight loss caused by CPT-11. Here, we have further examined the effect of PHY906 on the intestinal toxicity caused by CPT-11 in mice. PHY906 did not protect against the initial DNA damage and apoptosis triggered by CPT-11 in the intestine, but by 4 days after CPT-11 treatment, PHY906 had restored the intestinal epithelium by promoting the regeneration of intestinal progenitor or stem cells and several Wnt signaling components. PHY906 also potentiated Wnt3a activity in human embryonic kidney-293 cells. Furthermore, PHY906 exhibited anti-inflammatory effects in mice by decreasing the infiltration of neutrophils or macrophages, tumor necrosis factor-alpha expression in the intestine, and proinflammatory cytokine concentrations in plasma. Chemical constituents of PHY906 potently inhibited nuclear factor kappaB, cyclooxygenase-2, and inducible nitric oxide synthase. Our results show that the herbal medicine PHY906 can counteract the toxicity of CPT-11 via several mechanisms that act simultaneously.


Assuntos
Antineoplásicos Fitogênicos/toxicidade , Camptotecina/análogos & derivados , Medicamentos de Ervas Chinesas/farmacologia , Trato Gastrointestinal/efeitos dos fármacos , Trato Gastrointestinal/patologia , Medicina Tradicional Chinesa , Animais , Antineoplásicos Fitogênicos/efeitos adversos , Apoptose/efeitos dos fármacos , Biomarcadores Tumorais/metabolismo , Bromodesoxiuridina/metabolismo , Camptotecina/efeitos adversos , Camptotecina/toxicidade , Proliferação de Células/efeitos dos fármacos , Dano ao DNA , Trato Gastrointestinal/fisiopatologia , Glucuronidase/metabolismo , Humanos , Inflamação/patologia , Irinotecano , Camundongos , Antígeno Nuclear de Célula em Proliferação/metabolismo , Recuperação de Função Fisiológica/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Células-Tronco/efeitos dos fármacos , Células-Tronco/metabolismo , Transplante Homólogo , Redução de Peso/efeitos dos fármacos , Proteínas Wnt/metabolismo , Proteína Wnt3 , Proteína Wnt3A , beta Catenina/metabolismo
16.
J Pharm Pharmacol ; 62(8): 973-84, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20663031

RESUMO

OBJECTIVES: Intestinal toxicity and low levels of systemic drug exposure are among the major problems associated with tumour therapy. We have developed poly (ethylene oxide)-poly (propylene oxide)-poly (ethylene oxide) (PEO-PPO-PEO) micelles loaded with irinotecan hydrochloride (CPT-11) hoping to decrease CPT-11-induced intestinal toxicity while increasing its systemic exposure. In addition, we have investigated the potential involvement of breast cancer resistance protein (BCRP) in biliary excretion, pharmacokinetics, and intestinal toxicity of CPT-11. METHODS: PEO-PPO-PEO micelles were prepared using PEO(20)-PPO(70)-PEO(20) and lecithin. The effect of PEO-PPO-PEO micelles on BCRP-mediated cellular accumulation and transport efflux of CPT-11 was evaluated in MDCKII/BCRP cells. The biliary excretion, intestinal damage, and pharmacokinetic study of CPT-11-loaded PEO-PPO-PEO micelles were investigated in rats. KEY FINDINGS: The obtained micelles could effectively inhibit BCRP-mediated CPT-11 efflux in MDCKII/BCRP cells, and significantly decrease the drug biliary excretion in rats. Moreover, intestinal toxicity, assessed by microscopic examination of pathological damage, was ameliorated in rats injected with PEO-PPO-PEO micelles compared with rats injected with CPT-11 alone. Treatment with PEO-PPO-PEO micelles resulted in prolonged circulation time in blood and increased bioavailability of CPT-11 and SN-38 (7-ethyl-10-hydroxycamptothecin). CONCLUSIONS: PEO-PPO-PEO micelles were identified as promising carriers able to reduce intestinal toxicity and increase antitumour therapeutic effect of CPT-11. The study indicated a potential involvement of BCRP in CPT-11 pharmacokinetics and CPT-11-induced intestinal toxicity.


Assuntos
Transportadores de Cassetes de Ligação de ATP/metabolismo , Antineoplásicos Fitogênicos/farmacocinética , Antineoplásicos Fitogênicos/toxicidade , Camptotecina/análogos & derivados , Portadores de Fármacos , Intestinos/efeitos dos fármacos , Polietilenoglicóis/química , Propilenoglicóis/química , Membro 2 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Transportadores de Cassetes de Ligação de ATP/antagonistas & inibidores , Transportadores de Cassetes de Ligação de ATP/genética , Animais , Antineoplásicos Fitogênicos/administração & dosagem , Antineoplásicos Fitogênicos/química , Bile/metabolismo , Disponibilidade Biológica , Transporte Biológico , Biotransformação , Camptotecina/administração & dosagem , Camptotecina/química , Camptotecina/farmacocinética , Camptotecina/toxicidade , Linhagem Celular , Química Farmacêutica , Cães , Composição de Medicamentos , Células Epiteliais/metabolismo , Injeções Intravenosas , Mucosa Intestinal/metabolismo , Intestinos/patologia , Irinotecano , Lecitinas/química , Masculino , Micelas , Novobiocina/farmacologia , Ratos , Ratos Sprague-Dawley , Transfecção
17.
Med Oncol ; 27(4): 1346-58, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20013318

RESUMO

Despite the excellent chemotherapeutic effect of irinotecan, its cytotoxicity and genotoxicity in normal cells remains a major problem in chemotherapy. This study was carried out to find whether propolis preparations and related flavonoids (quercetin, naringin) might enhance irinotecan-induced cytotoxicity to tumor cells in mice bearing Ehrlich ascites tumors (EAT) while protecting normal blood, liver, and kidney cells. The preparation of propolis and their flavonoids were given to mice intraperitoneally at a dose of 100 mg kg(-1) body weight for three consecutive days before the ip injection of EAT cells (2×10(6)). Irinotecan was administered ip at dose of 50 mg kg(-1) on days 3, 4, and 5 after tumor cell inoculation. The combination treatment resulted in substantial inhibition of the growth of EAT cells as well as treatment with quercetin or irinotecan alone, whereas other treatment by itself showed little effect. However, when mice were pre-treated with test components prior to irinotecan, the frequencies of irinotecan-induced micronuclei (MN) was decreased but in mice bearing tumor QU and EEP increased number of micronucleated cells. Propolis preparation and related flavonoids were found to exhibit an important immunomodulatory effect and could decrease irinotecan-induced toxic and genotoxic effects to normal cells without effecting irinotecan cytotoxicity in EAT cells.


Assuntos
Antineoplásicos Fitogênicos/toxicidade , Camptotecina/análogos & derivados , Carcinoma de Ehrlich/tratamento farmacológico , Flavonoides/uso terapêutico , Fatores Imunológicos/uso terapêutico , Fenóis/uso terapêutico , Própole/uso terapêutico , Animais , Células Sanguíneas , Camptotecina/toxicidade , Carcinoma de Ehrlich/imunologia , Carcinoma de Ehrlich/patologia , Células Cultivadas , Injeções Intraperitoneais , Irinotecano , Rim/citologia , Rim/efeitos dos fármacos , Fígado/citologia , Fígado/efeitos dos fármacos , Macrófagos Peritoneais/citologia , Macrófagos Peritoneais/efeitos dos fármacos , Masculino , Camundongos , Testes para Micronúcleos
18.
Toxicol In Vitro ; 24(2): 417-24, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19853651

RESUMO

Many patients being treated for cancer use dietary supplements, particularly antioxidants, in the hope of reducing the toxicity of chemotherapy or radiotherapy. However, clinicians should advise their patients against using antioxidant dietary supplements during chemotherapy. Irinotecan (CPT-11) is a common chemotherapeutic agent, but it causes side effects, including genotoxicity with damages the DNA of blood cells. The aim of this work was to evaluate the modulating effect of A, C and E vitamins on genotoxic activity of irinotecan (CPT-11) and to analyse the efficacy of DNA repair in lymphocytes of both patients with diagnosed colorectal carcinoma and healthy individuals in vitro. In healthy donors' cells CPT-11 did not exert a strong, genotoxic effect, both in the presence of vitamins and without them. In turn, a statistically significant increase of DNA migration in the comet tails was noted in patients' lymphocytes. The presence of vitamins A, C and E in incubation solutions acted synergistically, increasing the level of DNA lesions in cells caused by the exposure of the material on tested irinotecan concentrations. Analysis of the efficacy of DNA repair, performed after 2h of postincubation, showed the decrease of DNA percentage in comet tails in all experimental samples.


Assuntos
Ácido Ascórbico/farmacologia , Camptotecina/análogos & derivados , Linfócitos/efeitos dos fármacos , Vitamina A/farmacologia , Vitamina E/farmacologia , Adulto , Antineoplásicos Fitogênicos/toxicidade , Camptotecina/toxicidade , Ensaio Cometa , Dano ao DNA , Reparo do DNA , Feminino , Humanos , Irinotecano , Masculino , Pessoa de Meia-Idade , Mutagênicos
19.
Zhongguo Zhong Yao Za Zhi ; 34(23): 3092-5, 2009 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-20222431

RESUMO

OBJECTIVE: To study the effect of allicin on human colon cancer cell line LoVo and the combined effect of allicin and CPT-11 on this cancer cell line. METHOD: The LoVo cells were cultured in vitro and treated with allicin in different concentrations. MTT assay was used to test dynamically the cell growth inhibiting effect. Apoptosis induction (Annexin-V-FITC/PI) and modulation of DNA cell cycle were measured by flow cytometry. The change of cytotoxicity of CPT-11 after combination of allicin at the concentration of 4.0, 8.0 mg x L(-1) were investigated. RESULT: Allicin had inhibitive effect on growth of LoVo cells in a dose and time dependent manner, with IC50 value of 32.23, 10.74, 6.58 mg x L(-1) at 24 h, 48 h and 72 h, respectively. The apoptosis rate of LoVo cells increased progressively as the cells were treated with increasing concentration of allicin in 24 h, while the apoptosis rate achieved peak value when the cells were treated with allicin at the concentration of 8 mg x L(-1) in 48 h. The result indicated the low concentrations of allicin (< 4 mg x L(-1)) lead to G2/M cell cycle arrest, and higer concentrations ( > 4 mg x L(-1)) exert G1 + G2/M cell cycle arrest in 24 h. Compared with single use of CPT-11, the combined use of CPT-11 and allicin (4.0, 8.0 mg x L(-1), respectively) showed increasing cytotoxicity on the LoVo cells, with IC50 of 24 h decreasing from 47.5 to 7.4 and 7.2 mg x L(-1), respectively. CONCLUSION: Allicin has significant anti-proliferation effect on human colon cancer cell line LoVo by induction of apoptosis and arrestment of cell cycle and can enhance the cytotoxicity of CPT-11 on the colon cancer LoVo cell.


Assuntos
Antineoplásicos Fitogênicos/toxicidade , Camptotecina/análogos & derivados , Neoplasias do Colo/fisiopatologia , Ácidos Sulfínicos/farmacologia , Apoptose/efeitos dos fármacos , Camptotecina/toxicidade , Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Neoplasias do Colo/tratamento farmacológico , Dissulfetos , Humanos , Irinotecano , Modelos Biológicos
20.
Hum Genet ; 123(6): 643-53, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18504617

RESUMO

RECQ helicase protein-like 4 (RECQL4) is a member of the human RECQ family of DNA helicases. Two-thirds of patients with Rothmund-Thomson syndrome (RTS) carry biallelic inactivating mutations in the RECQL4 gene. RTS is an autosomal recessive disorder characterized by poikiloderma, sparse hair, small stature, skeletal abnormalities, cataracts, and an increased risk of cancer. Mutations in two other RECQ helicases, BLM and WRN, are responsible for the cancer predisposition conditions Bloom and Werner syndromes, respectively. Previous studies have shown that BLM and WRN-deficient cells demonstrate increased sensitivity to hydroxyurea (HU), camptothecin (CPT), and 4-nitroquinoline 1-oxide (4NQO). Little is known about the sensitivity of RECQL4-deficient cells to these and other genotoxic agents. The purpose of this study was to determine if RTS cells display any distinct cellular phenotypes in response to DNA damaging agents or replication blocks that could provide insight into the molecular function of the RECQL4 protein. Our results show that primary fibroblasts from RTS patients carrying two deleterious RECQL4 mutations, compared to wild type (WT) fibroblasts, have increased sensitivity to HU, CPT, and doxorubicin (DOX), modest sensitivity to other DNA damaging agents including ultraviolet (UV) irradiation, ionizing radiation (IR), and cisplatin (CDDP), and relative resistance to 4NQO. The RECQ family of DNA helicases has been implicated in the regulation of DNA replication, recombination, and repair. Because HU, CPT, and DOX exert their effects primarily during S phase, these results support a greater role for the RECQL4 protein in DNA replication as opposed to repair of exogenous damage.


Assuntos
Resistência a Medicamentos/genética , Fibroblastos/efeitos dos fármacos , Mutagênicos/toxicidade , RecQ Helicases/genética , Síndrome de Rothmund-Thomson/patologia , 4-Nitroquinolina-1-Óxido/toxicidade , Antineoplásicos/toxicidade , Camptotecina/toxicidade , Cisplatino/toxicidade , Dano ao DNA/efeitos dos fármacos , Dano ao DNA/genética , Replicação do DNA/efeitos dos fármacos , Replicação do DNA/genética , Doxorrubicina/toxicidade , Avaliação Pré-Clínica de Medicamentos , Fibroblastos/metabolismo , Fibroblastos/patologia , Humanos , Hidroxiureia/toxicidade , Testes de Mutagenicidade , Polimorfismo de Nucleotídeo Único , Radiação Ionizante , RecQ Helicases/metabolismo , Raios Ultravioleta
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