Clinical implication of multiple risk factor control in the management of diabetic macrovasucular complications.

Using cross-sectional and prospective analyses, the risk factors for macroangiopathy (MA) in nonobese Type 2 diabetic patients were evaluated. In the cross-sectional study, we determined a cutoff point for each variable at which changes in the prevalence of total MA reached statistically significant levels. In the prospective study, those who met more than four out of seven control criteria as set forth in the Multiclinical Study for Diabetic Macroangiopathy (MSDM) had less risk of MA in Type 2 diabetes initially diagnosed without MA compared with those who fulfilled less than three factors. These results suggest that multiple risk factor control is the most effective and reasonable way to lower the incidence of MA in Type 2 diabetes.

A functional assay for quantitation of the apparent affinities of ligands of P-glycoprotein in Caco-2 cells.

PURPOSE: To develop a facile functional assay for quantitative determination of the apparent affinities of compounds that interact with the taxol binding site of P-glcoprotein (P-gp) in Caco-2 cell monolayers. METHODS: A transport inhibition approach was taken to determine the inhibitory effects of compounds on the active transport of [3H]-taxol, a known substrate of P-gp. The apparent affinities (K(I) values) of the compounds were quantitatively determined based on the inhibitory effects of the compounds on the active transport of [3H]-taxol. Intact Caco-2 cell monolayers were utilized for transport inhibition studies. Samples were analyzed by liquid scintillation counting. RESULTS: [3H]-Taxol (0.04 microM) showed polarized transport with the basolateral (BL) to apical (AP) flux rate being about 10-20 times faster than the flux rate in the AP-to-BL direction. This difference in [3H]-taxol flux could be totally abolished by inclusion of (+/-)-verapamil (0.2 mM), a known inhibitor of P-gp, in the incubation medium. However, inclusion of probenecid (1.0 mM), a known inhibitor for the multidrug resistance associated protein (MRP), did not significantly affect the transport of [3H]-taxol under the same conditions. These results suggest that P-gp, not MRP, was involved in taxol transport. Quinidine, daunorubicin, verapamil, taxol, doxorubicin, vinblastine, etoposide, and celiprolol were examined as inhibitors of the BL-to-AP transport of [3H]-taxol with resulting K(I) values of 1.5+/-0.8, 2.5+/-1.0, 3.0+/-0.3, 7.3+/-0.7, 8.5+/-2.8, 36.5+/-1.5, 276+/-69, and 313+/-112 microM, respectively. With the exception of that of quinidine, these K(I) values were comparable with literature values. CONCLUSIONS: This assay allows a facile quantitation of the apparent affinities of compounds to the taxol-binding site in P-gp, however, this assay does not permit the differentiation of substrates and inhibitors. The potential of drug-drug interactions involving the taxol binding site of P-gp can be conveniently estimated using the protocol described in this paper.

Optical characterization of liposomes by right angle light scattering and turbidity measurement.

Liposomes have frequently been used as models of biomembranes or vehicles for drug delivery. However, the systematic characterization of lipid vesicles by right angle light scattering and turbidity has not been carried out despite the usefulness of such studies for size estimation. In this study, liposomes of various sizes were prepared by sonication and extrusion. The mean cumulant radii of the vesicles were determined by dynamic light scattering. The lamellarities were estimated based on fluorescence quenching of N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)dipalmitoyl-L-alpha-phosph ati dylethanolamine by sodium dithionite. Right angle light scattering intensity and optical density at 436 nm per unit lipid concentration were measured as a function of vesicle radius. With a vesicle radius < or =100 nm, the optical parameters could be well explained by the Rayleigh-Gans-Debye theory in which the liposomes were modeled as homogeneous spheres with mean refractive indices determined by the volume fractions of lipids in vesicles.

Mechanism of synergism between antimicrobial peptides magainin 2 and PGLa.

The antimicrobial peptides magainin 2 and PGLa, discovered in the skin of the African clawed frog, Xenopus laevis, exhibit marked synergism [Westerhoff, H. V., Zasloff, M., Rosner, J. L., Hendler, R. W., de Waal, A., Vaz Gomes, A., Jongsma, A. P. M., Riethorst, A., and Juretic, D., Eur. J. Biochem. 228, 257-264 (1995)], although the mechanism is not yet clear. They are believed to kill bacteria by permeabilizing membranes. In this study, we examined the interactions of these peptides in lipid bilayers. PGLa, like magainin 2, preferentially interacts with acidic lipids, forming an amphipathic helix. The peptide induces the release of a water-soluble dye, calcein, entrapped within liposomes. The coexistence of magainin 2 enhances membrane permeabilization, which is maximal at a 1:1 molar ratio. Fluorescence experiments using L18W-PGLa revealed that both peptides form a stoichiometric 1:1 complex in the membrane phase with an association free energy of -15 kJ/mol. Single amino acid mutations in magainin 2 significantly altered the synergistic activity, suggesting that precise molecular recognition is involved in complex formation. The complex as well as each component peptide form peptide-lipid supramolecular complex pores, which mediate the mutually coupled transbilayer transport of dye, lipid, and the peptide per se. The rate of pore formation rate is in the order complex >/= PGLa > magainin 2, whereas the pore lifetime is in the order magainin 2 > complex > PGLa. Therefore, the synergism is a consequence of the formation of a potent heterosupramolecular complex, which is characterized by fast pore formation and moderate pore stability.

Modulation of magainin 2-lipid bilayer interactions by peptide charge.

Magainin 2, an antimicrobial peptide from Xenopus skin, assumes an amphiphilic helix when bound to acidic phospholipids, forming a pore composed of a dynamic, peptide-lipid supramolecular complex [Matsuzaki et al. (1996) Biochemistry 35, 11361-11368]. Upon the disintegration of the pore, a fraction of the peptide molecules stochastically translocates across the bilayer (Matsuzaki, et al., 1995). In order to investigate the effects of peptide charge on the magainin 2-lipid bilayer interactions, we synthesized four magainin 2 analogs with different charges (0-6+). MG0: K10E, K11E, F12W-magainin 2. MG2+: K10E, F12W-magainin 2. MG4+: F12W-magainin 2. MG6+: F12W, E19Q-magainin 2 amide. An increase in charge resulted in a stronger binding of the peptide to the negatively charged membranes, suggesting that electrostatic attractions play a crucial role in the binding process. The helical stability in a trifluoroethanol/buffer mixture was decreased with increasing positive charge because of electrostatic repulsions between the closely spaced positive side chains, whereas the helicity in the lipid bilayer was much higher and appeared to be independent of the peptide charge. However, enhanced repulsions between the highly positively charged helices destabilized the pore. Therefore, the efficiency of the most basic peptide (MG6+) to translocate across the bilayer was the greatest by virtue of the short life span of its pore and the very tight membrane binding. The charge distribution of wild-type magainin 2 was found to be so designed as to exhibit the maximal lytic activity by simultaneously achieving a strong binding and a moderate pore stability.

Peptide helicity and membrane surface charge modulate the balance of electrostatic and hydrophobic interactions with lipid bilayers and biological membranes.

An amphipathic model peptide, KLALKLALKALKAAKLA-NH2, and its complete double D-amino acid replacement set was used to analyze the process of peptide binding at lipid vesicles of different surface charge and to determine the structure of the lipid-bound peptides using CD spectroscopy. The relationship between peptide helicity, model membrane permeability, and biological activity has been studied by dye release from liposomes and investigation of antibacterial and hemolytic activity. The accumulation of cationic KLAL peptides at and the membrane-disturbing effect on bilayers of high negative surface charge were found to be dominated by charge interactions. Independent of any structural propensity, the cationic peptide side chains bind to the anionic phosphatidylglycerol moieties. The charge interactions hold the peptides at the bilayer surface, where they may disturb preferentially lipid headgroup organization by formation of peptide-lipid clusters. In contrast, KLAL peptide interaction with bilayers of low negative surface charge is highly dependent on peptide helicity. With decreasing amounts of anionic phosphatidylglycerol in the bilayer the membrane-disturbing effect of KLAL and other helical analogs substantially increases despite drastically reduced binding affinity. Less helical peptides exhibit reduced bilayer-disturbing activity, showing that the hydrophobic helix domain is decisive for binding at and inducing permeability in membranes of low negative surface charge. It is suggested that hydrophobic interactions drive the penetration of the amphipathic peptide structure into the inner membrane region, thus disturbing the arrangement of the lipid acyl chains and causing local disruption. On the basis of the proposed model for membrane disturbance, interactions modulating antibacterial and hemolytic activity are discussed.

An antimicrobial peptide, magainin 2, induced rapid flip-flop of phospholipids coupled with pore formation and peptide translocation.

The effect of an antimicrobial peptide, magainin 2, on the flip-flop rates of phospholipids was investigated by use of fluorescent lipids, i.e., anionic N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)dipalmitoyl-L-alpha- phosphatidylethanolamine (NBD-PE), 1-oleoyl-2-[12-((7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino)- dodecanoyl]-L-alpha-phosphatidic acid (C12-NBD-PA), 1-oleoyl-2-[12- ((7-nitrobenz-2-oxa-1,3-diazol-4-yl)- amino)dodecanoyl]-L-alpha-phosphatidyl-L-serine (C12-NBD-PS), and zwitterionic 1-palmitoyl-2-[6-((7- nitrobenz-2-oxa-1,3-diazol-4-yl)amino)caproyl]-L-alpha-phosphatidy lcholine (C6-NBD-PC). Their intrinsic flip-flop half-lives at 30 degrees C in the absence of the peptide were 1.1 h, ca. 7 h, ca. 8 days, and > 2 days, respectively. The peptide accelerated the flip-flop half-lives of the fluorescent lipids to an order of minutes. Furthermore, the flip-flop was coupled with the membrane permeabilization and the peptide translocation [Matsuzaki, K., Murase, O., Fujii, N., & Miyajima, K. (1995) Biochemistry 34, 6521-6526], suggesting pore-mediated flip-flop. The flip-flop rate was independent of the initial labeling conditions (outer leaflet label or inner leaflet label). From these results, a model was proposed, in which the lipids translocate across the membrane by lateral diffusion along the wall of the pores composed of the peptides and the lipids. A simple theoretical calculation could explain the coupling of the flip-flop with the permeabilization.

Transbilayer transport of ions and lipids coupled with mastoparan X translocation.

The transbilayer movement of ions and lipids induced by mastoparan X, a peptidic toxin from Vespa xanthoptera, was investigated by use of lipid vesicles as a model membrane system. Negatively charged phosphatidylglycerol remarkably enhanced the peptide-lipid interactions. Mastoparan X induced the ion flow by forming a short-lived, multimeric pore in the lipid bilayer, as determined from the leakage of an anionic dye, calcein, from the liposomes. The pore formation was coupled with the translocation of the peptide into the inner leaflet. The latter was detected by three experiments using fluorescence techniques [Matsuzaki, K., Murase, O., Fujii, N., & Miyajima, K. (1995) Biochemistry 34, 6521-6526; Matsuzaki, K., Murase, O., & Miyajima, K. (1995) Biochemistry 34, 12553-12559]. The lipid flip flop was monitored on the basis of the chemical quenching of 7-nitrobenz-2-oxa-1,3-diazol-4-yl (NBD)-labeled lipids by sodium dithionite. Mastoparan X triggered the rapid flip-flop of both negatively charged and zwitterionic lipids in coupling with the pore formation and the peptide translocation. A novel model of the mastoparan-lipid interactions was proposed to explain these observations.

Kinetics of pore formation by an antimicrobial peptide, magainin 2, in phospholipid bilayers.

The kinetics of the pore formation by magainin 2, an antimicrobial peptide from Xenopus laevis, in lipid vesicles was investigated. The pore formation was estimated by the efflux of a fluorescent dye, calcein, from large unilamellar vesicles composed of egg yolk phosphatidylglycerol. The time courses of the dye release were well-described by a novel model in which the peptide molecules translocate from the outer to the inner monolayer by forming a pore. The concentration dependence of the leakage rate suggested that the pore consists of pentameric magainin. The obtained kinetic parameters estimate that, at a lipid-to-peptide molar ratio of 117, 9 pores with a lifetime of 40 microseconds open per second per vesicle in the initial phase. The apparent deactivation of the pore with increasing time can be ascribed to the reduced peptide density in the outer leaflet due to the translocation. Incorporation of phosphatidylcholine destabilized the pore, indicating the importance of anionic lipids in the stable pore formation.

Translocation of a channel-forming antimicrobial peptide, magainin 2, across lipid bilayers by forming a pore.

A channel-forming antimicrobial peptide, magainin 2, has been shown to translocate across phospholipid bilayers by forming a pore comprising multimeric peptides. The translocation was demonstrated by four sets of experiments by use of resonance energy transfer from tryptophan introduced into the peptide to a dansyl chromophore incorporated into the lipid membrane. The translocation was coupled to pore formation, as detected by the dye efflux from the lipid vesicles; about 30% of the total peptide molecules translocated into the inner leaflets over 10 min, while 80% of the dye molecules leaked out at a lipid to peptide ratio of 57. This novel model can explain the problems debated so far, i.e., the peptide forms an ion channel whereas the magainin helix essentially lies parallel to the membrane surface. Channel (pore) formation in the vesicles is a transient process observable mainly during the early stage of the peptide membrane interactions.

Orientational and aggregational states of magainin 2 in phospholipid bilayers.

Magainins from Xenopus skin are antimicrobial peptides with broad spectra, and their action mechanisms are considered to be the permeabilization of bacterial membranes. To elucidate their molecular mechanisms, three analog peptides of magainin 2, each having a Trp residue substituted for Phe at the 5th, 12th, or 16th position, were synthesized, and their interactions with acidic phospholipid membranes were investigated by fluorescence. The Trp substitution did not significantly affect the properties of the parent peptide. The binding isotherms of these peptides to the membranes, which were obtained on the basis of fluorescence changes upon membrane binding of the peptides, were sigmoidal, suggesting the association of the bound peptide molecules. A quantitative analysis indicated that the formed aggregate is a dimer. The observation that the initial rate constant of magainin 2 induced leakage of calcein from liposomes was dependent on the fourth power of the peptide concentration demonstrates the formation of a tetrameric pore. A blue shift and intensity enhancement of Trp fluorescence in the presence of the membranes indicate that those Trp residues are buried in the hydrophobic region of the bilayers. Furthermore, the depths of the Trp residues, which were determined using the n-doxylphosphatidylcholine quenching technique, were about 10 A from the bilayer center irrespective of the peptide aggregational state. Thus, it was concluded that the orientation of the magainin 2 alpha-helix is parallel to the membrane surface. A model of the pore formation will be proposed on the basis of these observations.