A Phase I clinical study of cisplatin-incorporated polymeric micelles (NC-6004) in patients with solid tumours.

BACKGROUND: On the basis of preclinical studies of NC-6004, a cisplatin-incorporated micellar formulation, we hypothesised that NC-6004 could show lower toxicity than cisplatin and show greater anti-tumour activity in phase I study. METHODS: A total of 17 patients were recruited in a range of advanced solid tumour types. NC-6004 was administered intravenously (i.v.) every 3 weeks. The dose escalation started at 10 mg m(-2) and was increased up to 120 mg m(-2) according to the accelerated titration method and modified Fibonacci method. RESULTS: One dose-limiting toxicity (DLT) occurred in a patient who was given 90 mg m(-2) of NC-6004, otherwise any significant cisplatin-related toxicity was not observed or generally mild toxicity was observed. Despite the implementation of post-hydration and pre-medication regimen, renal impairment and hypersensitivity reactions still developed at 120 mg m(-2), which led to the conclusion that the maximum tolerated dose was 120 mg m(-2), and the recommended dose was 90 mg m(-2), although DLT was not defined as per protocol. Stable disease was observed in seven patients. The maximum concentration and area under the concentration-time curve of ultrafilterable platinum at 120 mg m(-2) NC-6004 were 34-fold smaller and 8.5-fold larger, respectively, than those for cisplatin. CONCLUSION: The delayed and sustained release of cisplatin after i.v. administration contributes to the low toxicity of NC-6004.

Ticlopidine-induced hepatotoxicity is associated with specific human leukocyte antigen genomic subtypes in Japanese patients: a preliminary case-control study.

Genetic risk factors for ticlopidine-induced hepatotoxicity were determined in 22 Japanese patients with ticlopidine-induced hepatotoxicity and 85 Japanese patients who tolerated ticlopidine therapy without experiencing adverse reactions. There was a significant correlation between ticlopidine-induced hepatotoxicity and five human leukocyte antigen (HLA) alleles: HLA-A*3303, HLA-B*4403, HLA-Cw*1403, HLA-DRB1*1302 and HLA-DQB1*0604 (corrected probability (P)-value (Pc)<0.01). In particular HLA-A*3303 was present in 15 (68%) of the 22 patients with ticlopidine-induced hepatotoxicity and in 12 (14%) of the 85 ticlopidine-tolerant patients (odds ratio, 13.04; 95% confidence interval (CI), 4.40-38.59; the corrected P-value (Pc)=1.24 x 10(-5)). HLA-A*3303 was present in 12 (86%) of the 14 patients with ticlopidine-induced cholestatic hepatotoxicity (odds ratio, 36.50; 95% CI, 7.25-183.82, Pc=7.32 x 10(-7)). Ticlopidine-induced severe cholestatic hepatotoxicity occurred more frequently in subjects with HLA-A*3303 and its haplotype in Japanese patients. These findings may explain the high incidence of ticlopidine-induced hepatotoxicity in Japanese patients mediated via an immune-mediated mechanism.

Development of a novel optical bionanosensor.

We have developed a novel optical bionanosensor platform using a supported bilayer lipid membrane (SBLM), which has generic multi-analyte sensing capabilities. The SBLM is produced using a novel combination of ordered nanostructured thin film i.e. Langmuir-Blodgett (LB) and self-assembly deposition methodologies. A heptamer linear RGD (arginine-glycine-aspartate) containing peptide was covalently attached to a BODIPY (donor) lipid dye and utilised as an optical biosensor for integrin alpha(v)beta(3) loaded HUVEC's (sensitivity = 1000 cells ml(-1)). A second BODIPY (acceptor) lipid dye was integrated into the SBLM thus enabling signal amplification via a Forster resonance energy transfer (FRET) mechanism. The fluidity of the bilayer was confirmed via fluorescence recovery after photobleaching (FRAP) techniques and was performed without the need for fusogens.

Platelet interactions with liposomes carrying recombinant platelet membrane glycoproteins or fibrinogen: approach to platelet substitutes.

Liposomes carrying both recombinant platelet membrane glycoproteins GPIa/IIa (rGPIa/IIa) and GPIb alpha (rGPIb alpha) (rGPIa/IIa-Ib alpha-liposomes), or fibrinogen (Fbg-liposomes) were prepared. Their interactions with platelets on a collagen surface under flow conditions were evaluated using a recirculating flow chamber, mounted on an epifluorescence microscope, which allows for real-time visualization of fluorescence-labeled liposomes or platelets interacting with the surface. Adhesion of platelets to the collagen surface increased with increasing the shear rate from 600 to 2400 s(-1). Also, the percentages of surface coverage of rGPIa/IIa-Ib alpha-liposomes or Fbg-liposomes increased with increasing platelet adhesion. These phenomena were attenuated by a peptide containing arginine-glycine-aspartic acid (RGD-peptide), or prostaglandin E1 (PGE), but not by a peptide containing arginine-glycine-glutamic acid (RGE-peptide). In a homogeneous solution, rGPIa/IIa-Ib alpha-liposomes and Fbg-liposomes enhanced platelet aggregation in a dose-dependent manner, as evaluated using an aggregometer. These findings suggest that rGPIa/IIa-Ib alpha-liposomes and Fbg-liposomes form aggregates at the site of injury in blood vessels, resulting in stationary adhesion together with activated platelets.

Involvement of nuclear factor-kappaB (NF-kappaB) signaling in the expression of inducible nitric oxide synthase (iNOS) gene in rat C6 glioma cells.

It has been demonstrated from studies using NF-kappaB inhibitors that NF-kappaB may be involved in the iNOS induction stimulated by cytokines and/or lipopolysaccharide (LPS) in various cell types and tissues. However, the actions of the inhibitors are less selective and highly cytotoxic. We constructed stable clones of C6 cells transfected with two types of IkappaBalpha mutant genes (IkappaBalpha(SS --> AA); Ser-32/36 to Ala-32/36, IkappaBalpha(KK --> RR); Lys-21/22 to Arg-21/22). IkappaBalpha(SS --> AA) strongly inhibited (1) LPS-, IL-1beta-, and TNF-alpha-induced nuclear translocation and DNA binding of NF-kappaB to the kappaB site; and (2) iNOS induction stimulated by LPS or IL-1beta plus IFN-gamma. These results indicate that NF-kappaB plays a critical role in cytokines and/or LPS-induced iNOS induction. Surprisingly, similar to the endogenous IkappaBalpha, IkappaBalpha(KK --> RR) was degraded by various stimuli, and proteasome inhibitors blocked this event. These results suggest that another Lys residue(s), other than Lys-21/22, may be required for the ligand-induced IkappaBalpha degradation by the ubiquitin-proteasome pathway.

Targeting of liposomes carrying recombinant fragments of platelet membrane glycoprotein Ibalpha to immobilized von Willebrand factor under flow conditions.

Liposomes with covalently bound recombinant fragments of platelet membrane glycoprotein Ibalpha that retain the von Willebrand factor (vWf)-binding function (rGPIbalpha-liposomes) were prepared. Their interactions with an immobilized vWf surface under flow conditions were evaluated with a recirculating flow chamber, mounted on an epifluorescence microscope, which allows real-time visualization of fluorescence-labeled liposomes interacting with the surface. The interaction of rGPIbalpha-liposomes with the vWf surface was directly related to shear rate. At high densities of rGPIbalpha and vWf, rGPIbalpha-liposomes establishing contact with the vWf surface exhibited continuous displacement with decreased velocity relative to the hydrodynamic flow, depending on receptor density and matrix concentration. At lower densities of rGPIbalpha and vWf, rGPIbalpha-liposomes stopped only transiently, in the millisecond range, on the surface. This is the first study to demonstrate that the targeting of rGPIbalpha-liposomes is specific to the vWf surface under flow conditions.

Transient nuclear factor kappaB (NF-kappaB) activation stimulated by interleukin-1beta may be partly dependent on proteasome activity, but not phosphorylation and ubiquitination of the IkappaBalpha molecule, in C6 glioma cells. Regulation of NF-kappaB linked to chemokine production.

We previously reported that several stresses can induce cytokine-induced neutrophil chemoattractant expression in a nuclear factor kappaB (NF-kappaB)-dependent manner. In this study, we focused further on the regulation of NF-kappaB. The activation of NF-kappaB and the subsequent cytokine-induced neutrophil chemoattractant induction in response to interleukin-1beta (IL-1beta) were inhibited by proteasome inhibitors, MG132 and proteasome inhibitor I. Translocation of NF-kappaB into nuclei occurs by the phosphorylation, multi-ubiquitination, and degradation of IkappaBalpha, a regulatory protein of NF-kappaB. Nascent IkappaBalpha began to degrade 5 min after treatment with IL-1beta and disappeared completely after 15 min. However, IkappaBalpha returned to basal levels after 45-60 min. Interestingly, resynthesized IkappaBalpha was already phosphorylated at Ser-32. These results suggest that 1) the upstream signals are still activated, although the translocation of NF-kappaB peaks at 15 min; and 2) the regulated protein(s) acts downstream of IkappaBalpha phosphorylation. Western blotting showed that the resynthesized and phosphorylated IkappaB molecules were also upward-shifted by multi-ubiquitination in response to IL-1beta treatment. On the other hand, ATP-dependent Leu-Leu-Val-Tyr cleaving activity transiently increased, peaked at 15 min, and then decreased to basal levels at 60 min. Furthermore, the cytosolic fraction that was stimulated by IL-1beta for 15 min, but not for 0 and 60 min, could degrade phosphorylated and multi-ubiquitinated IkappaBalpha. These results indicate that the transient translocation of NF-kappaB in response to IL-1beta may be partly dependent on transient proteasome activation.

[The intracellular mechanism of NF-kappa B activation involved in iNOS and chemokine induction in C6 glioma cells].

To elucidate the intracellular mechanism of NF-kappa B activation, we performed the involvement of I kappa B alpha of NF-kappa B in the expression of inducible NO synthase (iNOS) and chemokine (CINC) following pretreatment with bacterial endotoxin (LPS) or IL-1 beta, respectively, using rat C6 glioma cells. We found that herbimycin A, a tyrosine protein kinase inhibitor, blocked: 1) LPS/IFN gamma-induced iNOS expression, 2) LPS-induced intranuclear translocation of activated NF-kappa B (p50. p65) and 3) IFN gamma-induced autophosphorylation and activation of Jak 2 and Stat 1 as well as intranuclear translocation of phosphorylated Stat 1. Furthermore, transfection of a dominant negative form of I kappa B alpha (SS-->AA) suppressed LPS/IFN gamma-induced iNOS expression, suggesting that NF-kappa B, in particular, I kappa B alpha molecules could play important roles in the iNOS expression. We also found in IL-1 beta-induced CINC expression using cultured C6 glioma cells, the transient translocation of NF-kappa B in response to IL-1 beta is partly dependent on transient proteasome activation. Thus we suggest that the formation of heterodimer p50.p65 from inactive trimer p50.p65.I kappa B alpha, particularly, proteolytic degradation and dissociation of I kappa B alpha from p50.p65 are a critical phase in NF-kappa B activation during LPS-induced iNOS and IL-1 beta-induced CINC expression in astroglial cells.

Effects of kyotorphin (L-tyrosyl-L-arginine) ON[3H]NG-nitro-L-arginine binding to neuronal nitric oxide synthase in rat brain.

L-Tyrosyl-L-arginine (kyotorphin) is known as an endogenous analgesic neuropeptide. We examined whether kyotorphin and other arginine-containing neuropeptides were endogenous substrates for neuronal nitric oxide synthase (NOS) in the rat brain. Cytosol fractions of the rat cerebellum contained higher concentrations of neuronal NOS (nNOS) than endothelial NOS. In rat cerebellar cytosol, the binding activity of [3H]NG-nitro-L-arginine (NNA) was inhibited equally by L-arginine (L-Arg), kyotorphin, and L-leucyl-L-Arg (a kyotorphin receptor antagonist). Binding activities were inhibited to lesser degrees by fibronectin active fragments, bradykinin, and dynorphin A, but were not inhibited by L-tyrosyl-D-Arg or substance P. Interestingly, the inhibition of [3H]NNA binding by kyotorphin was attenuated by inhibitors of kyotorphin-hydrolyzing peptidases (KTPases) such as bestatin and arphamenine B. These results suggest that kyotorphin is degraded to L-Arg by KTPases, which in turn may act as substrate for nNOS.

Activation of Stat1 and subsequent transcription of inducible nitric oxide synthase gene in C6 glioma cells is independent of interferon-gamma-induced MAPK activation that is mediated by p21ras.

Rat C6 glioma cells have been used to characterize molecular events involved in the regulation of inducible nitric oxide synthase (iNOS) gene expression stimulated by interferon-gamma (IFN-gamma) plus lipopolysaccharide (LPS). IFNs induce a signaling event which involves activation of Stat1 transcription factor. Previous studies have shown that IFNs also induce extracellular signal-regulated kinase/mitogen-activated protein kinase (ERK/MAPK) activation. However, the mechanisms by which IFNs stimulate MAPK activation remain elusive. Here we show that in C6 glioma cells, transiently expressing the dominant-negative form of c-Ha-Ras (Asn-17) abrogated IFN-gamma-induced ERK1 and ERK2 activation. Furthermore, PD98059, a specific MEK1 inhibitor, also blocked this activation. These results indicate that p21ras and MEK1 are required for IFN-gamma-induced ERK1 and ERK2 activation. Recent studies have reported that MAPK is responsible for serine phosphorylation of Stat1 which is required for Stat1's DNA binding and maximal transcriptional activity. Thus, we examined the role of the Ras-MAPK pathway in Stat1 activation and subsequent iNOS induction in C6 glioma cells. Further experiments showed that neither Asn-17 Ras expression nor concentrations of PD98059, which completely abrogated IFN-gamma-induced ERK1 and ERK2 activation, affected Stat1 DNA binding activity or iNOS induction, indicating that the Ras-MAPK pathway does not appear to be involved in the activation of Stat1 and subsequent iNOS induction in C6 glioma cells.

NG-nitro-L-[3H]arginine binding properties of neuronal nitric oxide synthase in rat brain.

NG-Nitro-L-arginine (L-NNA), a derivative of L-arginine (L-Arg), is known as a pseudosubstrate and inhibitor for nitric oxide synthase (NOS). To clarify the regulatory mechanism of substrate-binding domain in neuronal NOS (nNOS), we examined the characteristics of NG-nitro-L-[3H]Arg (L-[3H]NNA) binding using the cytosolic fraction and purified nNOS from the rat cerebellum, in comparison with L-[14C]citrulline formation from L-[14C]Arg. The L-[3H]NNA binding was inhibited by L-NNA > NG-methyl-L-Arg > diphenyleneiodonium > L-Arg, but was not inhibited by L-citrulline and D-Arg. Thus, L-NNA seems to bind the substrate-binding domain in the nNOS with high affinity rather than L-Arg. Even in the absence of NADPH, tetrahydrobiopterin (BH4) and Ca2+, the L-[3H]NNA binding activity was observed in the cerebellar cytosol, although L-[14C]citrulline could not be produced from L-[14C]Arg. L-[3H]NNA binding was increased by BH4 alone and was markedly enhanced by NADPH plus BH4 (NADPH/BH4), but not by Ca2+/CaM. In contrast, L-[14C]citrulline was formed only in the presence of NADPH/BH4 and Ca2+. Similar results were obtained in purified nNOS. These results suggest that L-[3H]NNA seems to bind the substrate-binding domain in the nNOS but the binding affinity of L-Arg was lower than the affinity of L-NNA. Although the substrate binding is necessary to BH4 and NADPH, Ca2+/CaM are further necessary for the formation of NO and L-citrulline.

Interaction of RGD liposomes with platelets.

The interactions of platelets and liposomes with the tripeptide arginine-glycine-aspartic acid (RGD) as a surface ligand (RGD liposomes) were studied. The results suggest that the presence of the RGD ligand on the liposomes results in receptor-mediated mixing of lipid and aqueous contents of the liposomes and platelets. Mixing of the lipid and aqueous contents of RGD liposomes with platelets is approximately 4-9 times and 3-4 times greater than that for unlabeled liposomes, respectively. Measurements of the cytoplasmic free Ca2+ concentration in platelets, [Ca2+]i, show that the RGD liposomes have little effect on [Ca2+]i.

Kyotorphin (L-tyrosyl-L-arginine) as a possible substrate for inducible nitric oxide synthase in rat glial cells.

L-Arginine (L-Arg) is an endogenous substrate for nitric oxide synthase (NOS). In the present study, we examined whether L-tyrosyl-L-Arg (kyotorphin), an endogenous analgesic neuropeptide, might be a substrate for inducible NOS (iNOS) in the brain. Both kyotorphin and L-Arg caused an accumulation of nitrites in lipopolysaccharide (LPS)-treated glial cells cultured from infant rat brains. However, such accumulation of nitrites was not induced by NG-nitro-L-Arg (a NOS inhibitor), L-tyrosyl-D-Arg (D-kyotorphin) or D-Arg. L-Leucyl-L-Arg (an antagonist for kyotorphin receptors) or bestatin (an inhibitor for kyotorphin-hydrolyzing peptidase) did not inhibit the kyotorphin-induced accumulation of nitrites in LPS-treated cells. On the contrary, L-Leucyl-L-Arg caused an accumulation of nitrites in a concentration-dependent manner. The results indicate that nitric oxide (NO) is produced in LPS-treated glial cells directly from kyotorphin through the catalytic action of iNOS.

Study on in vitro stability of polymerized liposomes.

We studied the stability of liposomes composed of polymerized phospholipid, 1,2-bis-(octadeca-2,4-dienoyl)-sn-glycero-3-phosphocholine (DENPC), to pH changes and the presence of bile salts, monitoring the leakage of 3H-sucrose entrapped in liposomes. The stability of polymerized DENPC-liposomes to acidic media (pH 3.3 and 2), and the presence of bile salts (20 mM), was much higher than that of nonpolymerized DENPC-liposomes and liposomes composed of conventional phospholipids. The stability of polymerized DENPC-liposomes was increased in the presence of carboxymethyl chitin (CM-chitin).

Herbimycin A suppresses NF-kappa B activation and tyrosine phosphorylation of JAK2 and the subsequent induction of nitric oxide synthase in C6 glioma cells.

Herbimycin A, a potent tyrosine kinase inhibitor, suppressed nitric oxide synthase (NOS) induced by lipopolysaccharide (LPS) and interferon-gamma (IFN-gamma) in C6 glial cells. LPS activated NF-kappa B, and this effect was inhibited by pretreatment with herbimycin A. In addition, IFN-gamma activated the tyrosine protein kinase, JAK2, and tyrosine-phosphorylation by itself was also inhibited by herbimycin A. These results suggest that herbimycin A suppresses iNOS induction by inhibition of both NF-kappa B activation caused by LPS, and tyrosine-phosphorylation of JAK2 caused by IFN-gamma in C6 glioma cells.

Mechanistic study on toxicity of positively charged liposomes containing stearylamine to blood.

We studied the interaction of stearylamine (SA) containing liposomes (SA-liposomes) with erythrocyte ghost (EG) or platelets, utilizing the Tb/dipicolinate (Tb/DPA) assay for the mixing of aqueous contents and a resonance energy transfer (RET) assay for the mixing of lipid. The results demonstrate that SA-liposomes and EG, after aggregation, have a great tendency to mix their lipid before the mixing of the internal contents. The mixing of their contents takes place inside the vesicles due to the fusion of SA-liposomes and EG, followed by the leakage of the contents from the vesicles. In the presence of carboxymethyl chitin (CM-chitin), SA-liposomes-EG interaction was inhibited, indicating that CM-chitin reduces the tendency of SA-liposomes to interact with EG. The lipid mixing between SA-liposomes and platelets was not affected by CM-chitin or phagocytosis inhibitors: EDTA, cytochalasin B, or 2,4-dinitrophenol and iodoacetate, indicating the importance of glycoproteins on the platelet membrane surface in the interaction of SA-liposomes with platelets.

Noninvasive estimation of left ventricular Max(dP/dt) from aortic flow acceleration and pulse wave velocity.

The Doppler method of obtaining left ventricular Max(dP/dt) proposed recently was based on the measurement of mitral regurgitation velocity. Since Max(dP/dt) is an isovolumic phase index, its use in cases of mitral regurgitation may be open to argument. However, we had proposed a noninvasive method of estimating left ventricular Max(dP/dt) based on different principles. In our method, Max(dP/dt) had been given by Max(dP/dt) = (rho)cMax (du/dt), where rho is the blood density, c is the pulse wave velocity, and u is the flow velocity in the aorta. We had derived the above equation theoretically, and confirmed its validity by animal experiments. In our previous study, we also applied our method in the clinical setting. The aortic flow velocity was measured by Doppler echocardiography, and the pulse wave velocity by mechanocardiography or Doppler echocardiography. (Rho)cMax(du/dt) obtained noninvasively was compared with Max(dP/dt) measured with a catheter-tip micromanometer. We found an excellent correlation between (rho)cMax(du/dt) and Max(dp/dt), and concluded that (rho)Max(du/dt) is useful in assessing noninvasively the contractile state of the left ventricle. Here, we summarize our method, review previous results, and report new results of the clinical application of our method.

Toxicity of liposomes containing low mol% of dienoyl phosphocholine to blood: use of carboxymethyl chitin to reduce toxicity.

Toxic effects of liposomes composed of the synthetic lipid, 1,2-bis(octadeca-2,4-dienoyl)-sn-glycero-3-phosphocholine (C18DENPC) and cholesterol (Cho) were studied. In the present work, we have explored, 1) fusion between C18DENPC/Cho-liposomes and erythrocyte ghost (EG) membranes with resonance energy transfer assay, 2) hemolysis induced by C18DENPC/Cho-liposomes and 3) turbidity changes in native plasma on contact with C18DENPC/Cho-liposomes, in the presence or absence of carboxymethyl chitin (CM-chitin). In the absence of CM-chitin, extents of fusion, hemolysis and turbidity changes in native plasma increased with the decrease in C18DENPC content. In the presence of CM-chitin at a concentration of 10(-3) or 10(-2)% (w/v), fusion of C18DENPC/Cho-liposome with EG was inhibited. Extents of hemolysis and turbidity changes in native plasma induced by C18DENPC/Cho-liposomes were reduced depending upon CM chitin concentration.

Purification and characterization of liposomes encapsulating hemoglobin as potential blood substitutes.

In view of the desirability to increase the survival time of the liposome-based artificial red blood cells in vivo, the variables influencing optimum hemoglobin capture and preservation for the bovine hemoglobin-loaded liposomes (LEHb) are investigated. In order to predict the in vivo response, the necessary experiments for the in vitro system characterization have been carried out. The liposomes are prepared by the Reverse Phase Evaporation technique and then purified using a Sepharose 4B column. The purified LEHbs display a unimodal size distribution in the submicron range with a volume average diameter of 0.115 microns and a particle count of 1.25* 10(15) per ml of suspension. Analysis of the lipi/Hb content of the liposomes reveals that the variations in the ratio of Hb encapsulated to lipid entrapped (Hb/L)f as a function of the initial Hb concentration ([Hb]o) is insignificant compared to the net augmentation of (Hb/L)f as a function of the increasing initial lipid to Hb loading ([L]o). Meanwhile high [Hb]o s are necessary for the preservation of oxyhemoglobin.