Extracellular Na+ and initiation of DNA synthesis: role of intracellular pH and K+.

Initiation of DNA synthesis in confluent quiescent 3T3 cell cultures stimulated by epidermal growth factor (EGF), vasopressin, and insulin was abolished by removing extracellular Na+. The inhibition was reversible, time- and Na+-concentration-dependent, and not due to an effect on binding or internalization of 125I-EGF. Stimulation by combinations of other growth factors with different mechanisms of action was also affected by decreasing extracellular Na+, but with different half-maximal Na+ concentrations. When choline was used as an osmotic substitute for Na+, the decrease in DNA synthesis was correlated with the decrease in intracellular K+. In contrast, when sucrose was used there was stimulation of the Na+-K+ pump and maintenance of intracellular K+ that resulted in a somewhat higher rate of DNA synthesis at lowered extracellular Na+ compared to choline. Mitogenesis induced by epidermal growth factor, vasopressin, and insulin led to cytoplasmic alkalinization as determined by an increase in uptake of the weak acid 5,5-dimethyloxazolidine-2,4-dione. Experimental decrease in extracellular Na+ blocked this cellular alkalinization. Therefore, under some conditions the supply of extracellular Na+ may limit cellular proliferation because of a reduction in the provision of Na+ to the Na+/H+ antiport and resultant failure of alkalinization. We conclude that Na+ flux and its effect on intracellular K and pH has a major role in the complex system that regulates proliferation.

Fluidity properties and liquid composition of erythrocyte membranes in Chediak-Higashi syndrome.

We have earlier shown through electron spin resonance (ESR) studies of leukocytes that membranes of cells from both Chediak-Higashi syndrome (CHS) mice and humans have abnormally high fluidity. We have extended our studied to erythrocytes. Erythrocytes were labeled with the nitroxide-substituted analogue of stearic acid, 2-(3-carboxypropyl)-4,4-dimethyl-2-tridecyl-3-oxazolidinyloxyl, and ESR spectra were obtained. Order parameter, S, at 23 degrees C, was 0.661 and 0.653 for erythrocytes of normal and CHS mice (P less than 0.001). S was 0.684 for normal human erythrocytes and 0.675 (P less than 0.001) for CHS erythrocytes at 25 degrees C. Because S varies inversely to fluidity, these results indicate that CHS erythrocytes tend to have higher fluidity than normal. In vitro treatment of both mice and human CHS erythrocytes with 10 mM ascorbate returned their membrane fluidity to normal. We prepared erythrocyte ghosts and extracted them with CHCl3:CH3OH (2:1). Gas-liquid chromatography analysis showed a greater number of unsaturated fatty acids for CHS. The average number of double bonds detected in fatty acids for mice on a standard diet was 1.77 for normal and 2.02 for CHS (P less than 0.04); comparison of human erythrocytes from one normal control and one CHS patient showed a similar trend. Our results suggest that an increased proportion of unsaturated fatty acids may contribute to increased fluidity of CHS erythrocytes. Our observation that both leukocytes and erythrocytes of CHS have abnormal fluidity indicates that CHS pathophysiology may relate to a general membrane disorder.

New granulocyte antigens demonstrated by microgranulocytotoxicity assay.

Although granulocyte transfusions and bone marrow transplantation are becoming common clinical modalities, our knowledge of surface nonerythroid, nonlymphoid, non-HLA hematopoetic antigens remains very incomplete. Accordingly, we have systematically screened sera from recipients of multiple granulocyte and whole blood transfusions, and immunoneutropenic patients for antibodies directed primarily at granulocytes. The initial screens demonstrated that >50% of the sera from the above sources contained non-HLA cytotoxic and/or agglutinating antibodies. Preliminary clustering indicated seven possible new specificities detected by microgranulocytotoxicity. Calculations for Hardy-Weinberg goodness of fit based on a study of 98 unrelated donors plus informative families established that 5 of these were alleles of a single new locus termed Human Granulocyte Antigen (HGA)-3a, b, c, d, and e. Absorptions indicated that these antigens were present on mature granulocytes but absent from platelets, lymphocytes, monocytes, and myeloid precursors. A single antigen of another separate locus, HGA-1, was also identified. Absorptions revealed a quite different distribution for HGA-1 than HGA-3, this antigen being detected on monocytes and myeloblasts as well as on mature granulocytes. Independent segregation of the three loci from HLA, from the NA-NB and the 5a-5b antigens, and from themselves was confirmed in informative families.Finally, it seems likely that other antigens will be identified because several other sera that react with both monocytes and granulocytes have been detected.

Effect of dietary fat saturation on survival of mice with L1210 leukemia.

We examined L1210 murine leukemia growth rate and survival of host male DBA/2J mice fed a diet rich in either polyunsaturated fat (16% sunflower oil) or saturated fat (16% coconut oil). The survival of mice that received transplants of L1210 leukemia cells was longer among the animals that had ingested a diet rich in the saturated fat as compared to those fed the more unsaturated fat. In duplicate experiments, the mean survivals of mice fed coconut oil were 200.9 +/- 1.6 and 202.5 +/- 3.4 hours compared to 188.7 +/- 5.3 and 187.6 +/- 3.5 hours for those fed sunflower oil. Tumor growth rate or the rate of DNA synthesis by the leukemia cells did not differ between the two experimental groups. Therefore, the alteration in survival was apparently due to an effect of the diets on the responses of the hosts rather than their effect on tumor size or growth rate.

Biological and therapeutic potential of membrane lipid modification in tumors.

The membrane fatty acid composition of cancer cells can be modified either in culture or during growth in animals without disrupting basic membrane or cellular integrity. Only fatty acids are affected; no changes occur in membrane cholesterol, phospholipid, or protein content. There are changes in membrane physical properties and certain cellular functions, including carrier-mediated transport, receptor binding, ion channels, and eicosanoid production. Fatty acid modification also can enhance the sensitivity of the cells to hyperthermia and Adriamycin. This technique provides a new approach to understanding the membrane properties of neoplastic cells. Membrane fatty acid modification also may be of potential value as a therapeutic approach designed to augment the cytotoxicity of other antineoplastic therapies.

Membrane lipid free radicals produced from L1210 murine leukemia cells by photofrin photosensitization: an electron paramagnetic resonance spin trapping study.

We have detected membrane lipid-derived free radicals from neoplastic cells subjected to Photofrin photosensitization. The presence of the prooxidants iron or iron plus ascorbate in the L1210 cell system increased the intensity of the spin-trapped lipid radical electron paramagnetic resonance spectra and correspondingly decreased cell survival. In addition, raising the proportion of unsaturated lipids in the cell membranes by supplementation of the growth medium with docosahexaenoic acid increased lipid radical formation and decreased cell survival when the L1210 cells were subjected to Photofrin and light. These data educe the hypothesis that the extent of radical generation as well as the efficacy of photodynamic therapy can be increased when prooxidant conditions, which enhance free radical processes, are present in conjunction with photosensitizers that target membrane lipids.

Increased generation of lipid-derived and ascorbate free radicals by L1210 cells exposed to the ether lipid edelfosine.

Using the spin trap alpha-(4-pyridyl-1-oxide)-N-tert-butylnitrone, we have detected a lipid-derived carbon-centered free radical generated from intact L1210 lymphoblastic leukemia cells that were exposed to 1-O-octadecyl-2-O-methyl-rac-glycero-3-phosphocholine (edelfosine or ET-18-OCH3) and oxidative stress. The spectral characteristics, including hyperfine splitting constants of aN = 15.61G and aH = 2.65G, were consistent with the spin trapping of an alkyl radical. Radical detection required iron and prior enrichment of cellular components with the polyunsaturated fatty acid docosahexaenoic acid; unmodified cells failed to generate detectable free radical. Ascorbate further enhanced radical generation. The detection of lipid-derived free radicals when intact cells are exposed to edelfosine provides further evidence that oxidative stress may play an important role in the cytotoxic mechanism of this class of anticancer drug.

Membrane peroxidative damage enhancement by the ether lipid class of antineoplastic agents.

The ether lipid antineoplastic agents have no known interaction with DNA, but rather they appear to target membranes. The primary mechanism of action is unknown but effects on membrane biology are documented. We have studied the effect of two ether lipids on membrane lipids and examined the hypothesis that membrane peroxidative damage may be involved in their mechanism of action. With the use of cells having membranes enriched in polyunsaturated fatty acids of the omega-3 family of fatty acids, we have demonstrated that the prototypical ether lipid 1-O-octadecyl-2-O-methyl-rac-glycero-3-phosphocholine and a thioether lipid analogue, 1-O-hexadecylmercapto-2-methoxymethyl-rac-glycero-3-phosphocholine , increase membrane lipid peroxidation and cytotoxicity in a time- and drug concentration-dependent manner. The oxidative cofactors Fe2+ and ascorbic acid were required. The pattern of cell death did not fully correspond to the peroxidation, since cofactors were required for peroxidation but not cytotoxicity. However, the rate of decrease in cell viability after exposure to the drug and cofactors corresponded to the peroxidation rate. In addition, when L1210 cells modified with the monounsaturated fatty acid oleic acid or unmodified cells were used, there was no ether lipid-enhanced peroxidation, and the cells were significantly less sensitive to the drug, with or without cofactors. The lipid-soluble antioxidant vitamin E inhibited 1-O-octadecyl-2-O-methyl-rac-glycero-3-phosphocholine peroxidation and cytotoxicity in a concentration-dependent manner in the presence of cofactors but not consistently without them. Depletion of cellular glutathione content of L1210 cells using L-buthionine-(SR)-sulfoximine resulted in 40% augmentation of cofactor-facilitated cytotoxicity of 1-O-octadecyl-2-O-methyl-rac-glycero-3-phosphocholine and a borderline effect on peroxidation. Another ether lipid, the thio compound 1-O-hexadecylmercapto-2-methoxymethyl-rac-glycero-3-phosphocholine , enhanced peroxidation in the presence of cofactors with kinetics corresponding to those of cytotoxicity. In the presence of ether lipid and cofactors the intensity of ascorbate free radical increased, consistent with oxidative stress. We conclude that the ether lipids stimulate membrane lipid peroxidation in a time- and drug concentration-dependent manner in the presence of oxidative cofactors. Even though peroxidation may not fully explain the cytotoxic effect of the ether lipid class of anticancer drugs, this observation provides further information on the nature of the membrane damage induced by the drugs. Since the ether lipids generate no known free radical intermediates directly, this suggests that membrane damage indirectly results in a process involving a peroxidative reaction.

Effect of cellular fatty acid alteration on adriamycin sensitivity in cultured L1210 murine leukemia cells.

We have investigated the effect of cellular fatty acid alteration on Adriamycin cytotoxicity using the L1210 lymphoblastic leukemia cell line. Cells growing in Roswell Park Memorial Institute Medium 1640 with 5% fetal bovine serum were modified with respect to fatty acid composition by supplementing their growth medium with 32 microM docosahexaenoic acid (22:6) or oleic acid (18:1). A soft agar clonogenic assay was then used to assess survival following incubation with Adriamycin. When exposed to the drug at a concentration of 0.4 microM, cells grown in the 22:6-supplemented medium were more sensitive (min of drug treatment required to reduce survival by 63% on the exponential portion of the survival curve, 64.9 +/- 4.2 min) to the cytotoxic effects of Adriamycin than cells grown in unsupplemented medium (min of drug treatment required to reduce survival by 63% on the exponential part of the survival curve, 106 +/- 9.7 min) (p less than 0.005). Cytotoxicity of L1210 cells grown in 18:1-supplemented medium was similar to that of cells grown in unsupplemented medium (min of drug treatment required to reduce survival by 63% on the exponential part of the survival curve, 126.6 +/- 9.1 min). The heightened sensitivity to Adriamycin of cells whose medium contained 22:6 increased as the concentration of fatty acid used to supplement the growth medium was increased. The cytotoxicity was also a function of the concentration of Adriamycin from 0.1 to 1.6 microM. When compared to cells grown in unsupplemented medium, those grown in 22:6-supplemented medium contained 3- to 4-fold more polyunsaturated fatty acids in their phospholipids, with a resultant doubling in the mean number of double bonds per fatty acid molecule. These data demonstrate that modification of cellular fatty acid composition may dramatically affect the sensitivity of a tumor cell to Adriamycin.

Electron spin resonance studies on intact cells and isolated lipid droplets from fatty acid-modified L1210 murine leukemia.

It has been suggested that the formation of cytoplasmic lipid droplets may produce an artifact and be responsible for the differences in membrane physical properties detected in lipid-modified cells using fluorescence polarization or spin label probes. To investigate this, the electron spin resonance spectra of lipid droplets isolated from the cytoplasm of L1210 leukemia cells were compared with spectra obtained from the intact cell. Mice bearing the L1210 leukemia were fed diets containing either 16% sunflower oil or 16% coconut oil in order to modify the fatty acid composition of the tumor. A microsome-rich fraction prepared from L1210 cells grown in animals fed the sunflower oil-rich diet contained more polyenoic fatty acids (52 versus 29%), while microsomes from L1210 cells grown in animals fed the coconut oil-rich diets contained more monoenoic fatty acids (37 versus 12%). The order parameter calculated for lipid droplets labeled with the 5-nitroxystearic acid spin probe was only about one-half that of intact cells, whereas it was similar to that obtained for pure triolein droplets suspended in buffer. Order parameters of the inner hyperfine splittings calculated from the spectra of cells grown in the sunflower oil-fed animals [0.543 +/- 0.001 (S.E.)] were lower than those from the cells grown in animals fed the coconut oil diets (0.555 +/- 0.002) (p less than 0.005). In contrast, the order parameters of the lipid droplets isolated from the cells grown in animals fed sunflower oil (0.303 +/- 0.029) or coconut oil (0.295 +/- 0.021) were not significantly different, indicating that motion of a spin label probe in the highly fluid cytoplasmic lipid droplets is not affected by these types of modifications in cellular fatty acid composition. Therefore, the electron spin resonance changes that are observed in the intact cells cannot be due to localization of the probe in cytoplasmic lipid droplets. These results support the conclusion that the electron spin resonance changes observed with the 5-nitroxystearic acid spin probe are due to changes in membrane fluidity produced by the modification in cellular lipid composition.

Utilization of long-chain free fatty acids and glucose by human leukemic blast cells.

We have studied the utilization of free fatty acid and glucose by human leukemic blast cells. Palmitate was both incorporated into complex cellular lipids, primarily phospholipids and triglycerides, and oxidized to CO2. The predominant phospholipid synthesized was phosphatidylcholine. Only a small proportion of the incoming fatty acid was modified structurally before incorporation into lipid esters. After incubation with [1-14 C]palmitate, 91% of the radioactivity recovered in cell lipids remained in fatty acids containing 16 carbon atoms. Studies with labeled glucose revealed little de novo synthesis of fatty acid, and the majority of the radioactivity from glucose was located in the water-soluble fraction after saponification of the esters. We conclude that the free fatty acids contained in the extracellular fluid provide much of the fatty acid for required cellular lipid synthesis in human leukemic blast cells. Since there is little elongation of incoming palmitate before incorporation into cellular lipids, it may be possible to alter the fatty acid composition of membrane phospholipids by changing the proportion of the various free fatty acids available to the leukemic cells.

Influence of rate of heating on thermosensitivity of L1210 leukemia: membrane lipids and Mr 70,000 heat shock protein.

We examined the effect of rate of temperature rise on the thermosensitivity of a murine lymphoblastic leukemia. L1210 cells suspended in RPMI 1630 medium:5% fetal bovine serum at pH 7.4 were heated from 37 degrees C-42 degrees C, or 44 degrees C over variable times (immediately, 30, 60, 120, 180 min) in a circulating water bath controlled by an electronic temperature programmer. Survival of the cells using a soft agar clonogenic assay was plotted against the time at final temperature so that a Do (min of heat required to reduce survival by 63% on the exponential portion of the survival curve) could be calculated as an estimate of thermosensitivity. Cells heated from 37 degrees C-42 degrees C over a time period of 30 min (10 degrees C/h) were less thermosensitive (Do 62.7 +/- 12.5 min) as compared to those exposed immediately to 42 degrees C (Do 38.5 +/- 2.2 min). Cells heated over a period of 180 min (1.6 degrees C/h) showed almost no death even after 4 h at 42 degrees C. Thermosensitivity of cells heated to several other high temperatures was also a function of rate of heating. This relative thermal resistance induced by slow heating was not a result of a change in membrane cholesterol content or fatty acid composition. Similarly, there was no difference between cells heated at slow and fast rates in cell cycle distribution or in cellular protein concentration. The major heat shock protein of Mr 70,000, which was induced by immediate heating, was not synthesized at the same high rate 1-12 h after heat treatment by the cells made thermotolerant with slow heating. We conclude that the thermosensitivity of this neoplastic cell can be altered considerably by the rate of heating. This alteration is not due to a change in membrane lipids. Furthermore, the heat shock protein at Mr 70,000 which was synthesized after immediate heating could not be demonstrated in the gradually heated L1210 leukemia cells.

Effect of docosahexaenoic acid on rate of differentiation of HL-60 human leukemia.

We have utilized an experimental model of cell lipid modification that allows study of the effect of a polyunsaturated fatty acid on the linked processes of cellular differentiation and growth arrest. HL-60 human leukemia cells were grown in media supplemented with 10 microM concentrations of the fatty acid docosahexaenoic acid (22:6) or oleic acid (18:1) or in unsupplemented media. Gas chromatographic analysis of phospholipid extracts from HL-60 cells grown in unmodified or 18:1-supplemented media revealed 39% and 36% 18:1, 13 and 12% polyenoics, and 2 and 3% 22:6, respectively. In contrast, cells from 22:6-supplemented cultures had 22% 18:1, 18% total polyunsaturated fatty acids, and 10% 22:6. Retinoic acid was added to cells grown in the various media, and phorbol ester-induced superoxide generation, nitroblue tetrazolium reduction, and growth arrest were determined as measures of differentiation. Unmodified and 18:1-enriched cells showed inducible oxidative burst activity beginning at 48 h after the addition of retinoic acid and continuing to increase for 5 days. In marked contrast, the 22:6-enriched leukemia cells exhibited an increased oxidative activity as early as 24 h which is equivalent to about one division cycle time. G1/0-specific growth arrest was associated with the oxidative phenotypic differentiation in all three cell types. However, cells enriched with 22:6 demonstrated early growth arrest and differentiation considerably in advance of 18:1-modified or unmodified cells. An effect on the cellular differentiation process could be detected after even a brief 1-h exposure of the cells to 22:6. Therefore, a highly polyunsaturated fatty acid which is actively incorporated into membrane structures appreciably accelerates the differentiation process of this human neoplastic cell.

Membrane lipid modification and sensitivity of leukemic cells to the thioether lipid analogue BM 41.440.

Since the ether lipid anticancer drugs are membrane targeted, we examined the effect of membrane lipid structural alteration on their cytotoxicity. Enrichment with docosahexaenoic acid increased the sensitivity to the thioether lipid BM 41.440, compared to control cells enriched with oleic acid. The effect was dependent upon drug concentration, time, and the extent of cellular fatty acid enrichment. Other polyunsaturated fatty acids had a similar effect, which was proportional to the degree of unsaturation of the molecule inserted. Depletion of cellular glutathione with buthionine sulfoximine increased the sensitivity to ether lipid, but prooxidants such as Fe2+ and antioxidants such as vitamin E had little effect. The addition of serum to the incubation medium markedly diminished the cytotoxicity of ether lipids for cells modified with both docosahexaenoic acid and oleic acid, probably due to binding of the drug to serum components. The toxicity of another ether lipid, 1-O-octadecyl-2-O-methyl-rac-glycero-3-phosphocholine, was not affected appreciably by membrane alteration. Drug uptake studies with a radiolabeled BM 41.440 analogue, 1-[3H]hexadecylthio-2-ethyl-rac- glycero-3-phosphocholine, demonstrated no difference in transport at early time points and no difference in accumulation up to 60 min. We conclude that increases in cellular and/or membrane fatty acid polyunsaturation heighten the cytotoxic effect of a membrane-active ether lipid. The effect is not due to a change in drug transport or accumulation. It may be related to a change in oxidative events. These observations provide further confirmation of the membrane being the target of ether lipid action, using biochemical rather than morphological techniques. Most importantly, this observation offers a potential innovative approach to therapy.

Sensitivity of K562 and HL-60 cells to edelfosine, an ether lipid drug, correlates with production of reactive oxygen species.

Edelfosine (1-O-octadecyl-2-O-methyl-rac-glycero-3-phosphocholine; ET-18-OCH3), a membrane-targeting anticancer ether lipid drug has been shown previously in vitro to be capable of initiating oxidative processes in cells. Here we study two human leukemia cell lines (HL-60 and K562) that have different sensitivities to edelfosine; HL-60 cells are more sensitive than K562 cells. To determine whether edelfosine alters the sensitivity of these lines to an oxidative stress, cells were subjected to the oxidative stress of iron(II) plus ascorbate and then monitored for free radical formation, membrane integrity, and cytotoxicity. The HL-60 cell was sensitive to the ether lipid drug in clonogenic and dye exclusion assays; a lipid-derived free radical was generated by this sensitive cell in the presence of small amounts of Fe2+ and ascorbate as detected by electron paramagnetic resonance and the spin trap alpha-(4-pyridyl-1-oxide)-N-tert-butylnitrone. There was also simultaneous generation of an ascorbate-free radical, which has been shown to estimate cellular oxidative flux. In contrast, the K562 cell was resistant to edelfosine cytotoxicity in all assays and did not generate either lipid-derived or ascorbate-free radicals. Subcellular homogenates of the HL-60 cell generated both radicals when exposed to the drug, but homogenates of K562 did not generate either, suggesting that differential drug uptake or intracellular drug localization is not the cause of the difference in oxidation. Trypan blue uptake by the HL-60, but not the K562 cells, measured under the same conditions as the oxidation experiments, demonstrated a loss of membrane impermeability with similar time and concentration dependence, suggesting a causal relationship of membrane damage and radical generation. Complementary studies of HL-60 cell membrane integrity with propidium iodide impermeability and light scatter using the flow cytometer showed a concentration dependence that was similar to radical generation. Biochemical studies of the fatty acids of the HL-60 cell revealed more highly polyunsaturated lipids in the cells. Cellular antioxidant enzymes and vitamin E contents of the two cell lines were similar. We conclude that there is a time- and concentration-dependent generation of important oxidations by the sensitive HL-60 cells exposed to the membrane-targeted ether lipid, but the resistant K562 cells are oxidatively silent. This may be due in part to the differences in fatty acid polyunsaturation of the cellular membranes. The difference in oxidative susceptibility could be the basis for drug resistance to this membrane-specific anticancer agent.

Fatty acid utilization by L1210 murine leukemia cells.

L1210 murine leukemia cells grow in an ascites plasma that contains lipids, including 0.62 +/- 0.046 (S.E.) MICRONEq free fatty acid per ml. in vitro incubations demonstrated that isolated L1210 cells readily utilize free fatty acid that is added to the incubation medium. When the cells were incubated with albumin-bound [1-14C]palmitate, about 12 times more radioactivity was incorporated into cell lipids than was oxidized to CO2. Triacylglycerols contained 1.5 to 4 times more radioactivity than phospholipids, and from 48 to 69% of the phospholipid radioactivity was recovered in the choline phosphoglycerides. [1-14C]Palmitate utilization increased as the fatty acid concentration of the medium was raised, the largest increase occurring in the triacylglycerol fraction. Palmitate utilization also was increased by the presence of carbohydrates in the medium, their effectiveness (in descending order) being glucose, mannose, galactose, fructose, and glycerol. By contrast, ribose did not produce any stimulatory effect. During a 1-hr incubation, between 82 and 87% of the [1-14C]palmitate that was taken up remained as palmitic acid. From 8 to 15% was elongated to stearate, and only 2 to 3% was desaturated to palmitoleate and oleate. Based upon the lipid content, growth rate, and palmitate utilization rate of the cells, it appears that a major portion of the lipid requirements of the L1210 cell may be supplied by the fatty acid contained in the ascites plasma. In addition, our results suggest that most of the saturated fatty acid taken up is incorporated into cell lipids without structural modification.

Adriamycin transport and sensitivity in fatty acid-modified leukemia cells.

The membrane phospholipids of L1210 murine leukemia cells were modified by supplementing the growth medium with micromolar concentrations of polyunsaturated or monounsaturated fatty acids. This procedure results in enrichment of cellular phospholipids by the supplemented fatty acid. Enrichment with polyunsaturated fatty acids resulted in a marked increase in sensitivity to adriamycin as compared to enrichment with monounsaturated fatty acids. The increased cytotoxicity was directly proportional to the extent of unsaturation of the inserted fatty acid, but there was no difference in cells enriched with n-3 compared with n-6 family fatty acids. To explore the mechanism of this observation, we examined whether augmented uptake of the drug might explain the increased cytotoxicity. The uptake of [14C]adriamycin, which was approximately linear at later time points, was only partially temperature dependent and never reached a steady state. Initial uptake at time points prior to 60 s could not be measured due to high and variable rapid membrane adsorption. Cellular accumulation of drug was greater in the docosahexaenoate 22:6-enriched L1210 cells as compared to oleate 18:1-enriched cells and was about 32% greater after 20 min. When L1210 cells were enriched with six fatty acids of variable degrees of unsaturation, the accumulation of adriamycin was directly correlated with the average number of double bonds in the fatty acids contained in cellular phospholipids. There was no difference in efflux of drug from cells pre-loaded with adriamycin. We conclude that the greater accumulation of adriamycin by the polyunsaturated fatty acid-enriched L1210 cells likely explains the increased sensitivity of these cells to adriamycin compared to 18:1-enriched cells.

Evidence for rate-limiting steps in sterol synthesis beyond 3-hydroxy-3-methylglutaryl-coenzyme A reductase in human leukocytes.

When human blood leukocytes are incubated with [2-14C]acetate only about 32% of the nonsaponifiable lipid radioactivity is recovered in digitonin-precipitable material. Using thin-layer chromatography and gas-liquid radiochromatography, we have determined that most of the label from [2-14C]acetate in the nonsaponifiable fractions is in lanosterol, squalene and an unidentified sterol. Only 11% of the acetate radioactivity is contained in cholesterol. This distribution does not change when cholesterol synthesis is depressed by the addition of lipoproteins to the medium. These findings are in marked contrast to studies with liver, where most of the nonsaponifiable radioactivity derived from acetate is recovered in digitonin-precipitable sterols. Furthermore, they suggest that rate-limiting steps beyond the 3-hydroxy-3-methylglutaryl coenzyme A reductase reaction exist in the sterol synthesis pathway of human leukocytes.

Mechanism of defective sterol synthesis in human leukocytes.

When human lymphocytes, granulocytes and monocyte-enriched cell preparations were incubated with [2-14C]acetate, only 10-36% of the radioactivity incorporated into the nonsaponifiable lipid fraction was present as digitonin-precipitable sterols. This percentage is considerably less than that observed for rat hepatocytes (95%) or human liver slices (68%). Even though a marked increase in the incorporation of labeled acetate into both nonsaponifiable lipids and digitonin-precipitable sterols resulted from stimulation of lymphocytes with concananvalin A or granulocytes by phagocytosis, the proportion of nonsaponifiable lipid radioactivity that was digitonin-precipitable remained low. These findings suggest that rate-limiting steps beyond the 3-hydroxy-3-methylglutaryl coenzyme A reductase reaction exist in the sterol synthetic pathway of leukocytes. Pulse-chase experiments demonstrated a precursor product relationship in leukocytes between lanosterol and cholesterol, but some squalene appears to be in a pool that is not further metabolized. A subcellular fraction prepared from mixed leukocytes was incapable of converting appreciable amounts of [3H]squalene to lanosterol or cholesterol, suggesting an enzyme deficiency in this segment of the sterol synthetic pathway. With isolated liver microsomes, 50% of the nonsaponifiable lipid radioactivity synthesized from [3H]squalene was recovered in cholesterol when the system contained added liver cytosol. By contrast, if the liver cytosol was replaced by leukocyte cytosol, 14-fold less radioactivity was incorporated into nonsaponifiable lipids, and only 17% of the radioactivity was recovered in cholesterol. When sterol-carrier protein 1, partially purified from rat liver, was added to leukocyte cytosol, [3H]squalene incorporation into lanosterol increased more than 3-fold. With the addition of both sterol-carrier protein 1 and sterol-carrier protein 2, cholesterol synthesis increased 2-fold. These results suggest that the low cholesterol synthetic activity in human leukocytes is due to a defect in one or more of the microsomal enzymes that operate between squalene and cholesterol, as well as to a deficiency of sterol-carrier proteins in leukocyte cytosol.

Adult acute lymphoblastic leukemia: results of the Iowa HOP-L protocol.

Fifty-nine consecutive previously untreated adult patients with acute lymphoblastic leukemia (ALL) were entered onto a prospective single-arm trial of doxorubicin, vincristine, prednisone, and asparaginase (HOP-L) induction therapy followed by CNS prophylaxis and 3 years of maintenance therapy. Consolidation therapy was not administered. The study population included a large number of older (greater than 50 years) patients. Seventy-five percent of patients achieved complete remission. With a median follow-up of 6 years, the median duration of complete remission is greater than 4 years, with 53% of patients expected to remain in remission at both 3 and 5 years. Overall, median survival duration is 27.9 months, with 45% and 35% of all patients expected to survive 3 and 5 years, respectively. Multivariate analysis identified patients with T-cell disease and mediastinal masses (P less than .001) and those with low values of lactic dehydrogenase (LDH) (P = .057) as being at greatest risk of relapse. Therapy was well tolerated by patients under age 35, but older patients suffered appreciable mortality. We conclude that this treatment program is effective therapy for adult ALL, yielding a large proportion of durable remissions despite the exclusion of consolidation therapy.