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1.
J Trace Elem Med Biol ; 63: 126665, 2021 Jan.
Article En | MEDLINE | ID: mdl-33152670

BACKGROUND: Recently, gadolinium from linear GBCAs has been reported to deposit in various regions of the body. Besides gadolinium, other lanthanides are used in medical care. In the current study, we investigated deposition of lanthanum in two patients who received lanthanum carbonate as a phosphate binder due to chronic kidney injury and compared it to additionally found Gd deposition. METHODS: Tissue specimens of two patients with long-term application of lanthanum carbonate as well as possible GBCA application were investigated. Spatial distribution of gadolinium and lanthanum was determined by quantitative laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) imaging of tissue sections. The deposition of gadolinium and lanthanum in different organs was compared, and the ratio of Gd concentration to La concentration (Gd-to-La-ratio) was investigated on an individual pixel base within the images. RESULTS: Deposition of Gd and La was found in all investigated tissues of both patients. Gd and La exhibited high spatial correlation for all samples, with the main deposition being located in the middle coat (tunica media) of blood vessels. The Gd-to-La-ratio was similar in the tissues investigated (between 8 ±â€¯4 (mean ±â€¯standard deviation) and 10 ±â€¯2), except for the thyroid vasculature and surrounding tissue (90 ±â€¯17) as well as the cerebellum (270 ±â€¯18). Here, the ratio was significantly increased towards higher Gd concentration. CONCLUSION: The results of this study demonstrate long-term deposition of La and comparable localization of additionally found Gd in various tissues of the body. La deposition was relatively low, considering the total administered amount of lanthanum carbonate of up to 11.5 kg, indicating a low absorption and/or high excretion of lanthanum. However, the total amount of deposited La is significant and raises questions about possible adverse side effects. The ratio-approach allows for the usage of the additionally generated Gd data, without detailed knowledge about possible GBCA applications. The significantly decreased Gd-to-La-ratio in the brain might be explained by the lanthanum being released and taken up as free La3+ ion in the stomach that impedes a crossing of the blood-brain-barrier while the intravenously injected GBCAs might dechelate first when they have already crossed the blood-brain-barrier.


Contrast Media/analysis , Gadolinium/analysis , Lanthanum/analysis , Contrast Media/administration & dosage , Gadolinium/administration & dosage , Humans , Lanthanum/administration & dosage , Lasers , Male , Mass Spectrometry , Middle Aged , Tissue Distribution
2.
Sci Rep ; 10(1): 18156, 2020 10 23.
Article En | MEDLINE | ID: mdl-33097778

Glioblastoma (GBM) is a malignant brain tumour with a dismal prognosis, despite best treatment by surgical resection, radiation therapy (RT) and chemotherapy with temozolomide (TMZ). Nanoparticle (NP) therapy is an emerging consideration due to the ability of NPs to be formulated and cross the blood brain barrier. Lanthanum oxide (La2O3) NPs are therapeutically advantageous due to the unique chemical properties of lanthanum making it cytotoxic to cancers, and able to enhance existing anti-cancer treatments. However, La2O3 NPs have yet to be thoroughly investigated in brain tumors. We show that these NPs can reach the brain after venous injection, penetrate into GBM cells via endocytosis, dissociate to be cytotoxic, and enhance the therapeutic effects of RT and TMZ. The mechanisms of cell death by La2O3 NPs were found to be multifaceted. Increasing NP concentration was correlated to increased intrinsic and extrinsic apoptosis pathway markers in a radical oxygen species (ROS)-dependent manner, as well as involving direct DNA damage and autophagic pathways within GBM patient-derived cell lines. NP interactions to sensitize GBM to RT and TMZ were shown to involve these pathways by enhancing ROS and apoptotic mechanisms. We therefore demonstrate the therapeutic potential of La2O3 NPs to treat GBM cells in vitro, and encourage translational exploration in the future.


Brain Neoplasms/therapy , Glioblastoma/therapy , Lanthanum/administration & dosage , Metal Nanoparticles/administration & dosage , Oxides/administration & dosage , Temozolomide/pharmacology , Animals , Apoptosis/drug effects , Apoptosis/radiation effects , Brain/pathology , Brain Neoplasms/pathology , Cell Line, Tumor , Cell Survival/drug effects , Cell Survival/radiation effects , Chemoradiotherapy/methods , Drug Resistance, Neoplasm/drug effects , Drug Synergism , Glioblastoma/pathology , Humans , Injections, Intravenous , Lanthanum/pharmacokinetics , Mice , Oxides/pharmacokinetics , Radiation Tolerance/drug effects , Reactive Oxygen Species/metabolism , Signal Transduction/drug effects , Temozolomide/therapeutic use , Tissue Distribution , Xenograft Model Antitumor Assays
3.
J Toxicol Sci ; 45(8): 411-422, 2020.
Article En | MEDLINE | ID: mdl-32741894

Lanthanum oxide (La2O3) nanoparticles (NPs) have been widely used in photoelectric and catalytic applications. However, their exposure and reproductive toxicity is unknown. In this study, the effect of the intragastric administration of two different-sized La2O3 particles in the testes of mice for 60 days was investigated. Although the body weight of mice treated or not treated with La2O3 NPs was not different and La2O3 NPs were distributed in the organs including the testis, liver, kidney, spleen, heart and brain. La2O3 NPs accumulate more than micro-sized La2O3 (MPs) in mice testes. The histopathological evaluation showed that moderate reproductive toxicity induced by La2O3 NPs in the testicle tissues. Furthermore, increased MDA, 8-OHdG levels and decreased SOD activities were detected in the La2O3 NP-treated groups. Moreover, qRT-PCR and western blotting data indicated that La2O3 NPs affecting the blood-testis barrier (BTB)-related genes in mice testes. Taken together, these findings suggested that La2O3 NPs activated inflammation responses and cross the BTB in the murine testes. This study provided useful information for risk analysis and regulation of La2O3 NPs by administrative agencies.


Lanthanum/administration & dosage , Lanthanum/toxicity , Metal Nanoparticles/toxicity , Oxides/administration & dosage , Oxides/toxicity , Particle Size , Reproduction/drug effects , Testis/drug effects , Administration, Oral , Animals , Blood-Testis Barrier/metabolism , Deoxyadenosines/metabolism , Gene Expression/drug effects , Inflammation , Lanthanum/metabolism , Male , Malondialdehyde/metabolism , Metal Nanoparticles/administration & dosage , Mice , Oxides/metabolism , Superoxide Dismutase/metabolism , Testis/metabolism , Tissue Distribution
4.
Am J Nephrol ; 51(3): 201-215, 2020.
Article En | MEDLINE | ID: mdl-32023606

Chronic kidney disease (CKD) is associated with excess cardiovascular morbidity and mortality compared to the general population. Hyperphosphataemia, associated with vascular calcification and arterial stiffness, may play a key role in the pathogenesis of cardiovascular disease (CVD) associated with CKD, although phosphate reduction strategies have not consistently proven to beneficially affect clinically relevant outcomes. The IMpact of Phosphate Reduction On Vascular End-points in CKD (IMPROVE-CKD) study is an international, multi-centre, randomized, placebo-controlled trial investigating the effect of the phosphate binder lanthanum carbonate on intermediate cardiovascular markers in patients with stage 3b-4 CKD. The primary end-point is change in carotid-femoral pulse wave velocity (PWV, SphygmoCor) after 96 weeks. Secondary outcomes include change in abdominal aortic calcification (AAC, computed tomography), serum phosphate and fibroblast growth factor 23 (FGF-23). In total, 278 participants were recruited and randomized, mean age 63 ± 13 years, 69% male, 45% diabetes, 32% CVD, 33% stage 3b CKD and 67% stage 4 CKD. Mean estimated glomerular filtration rate and serum phosphate were 26.6 ± 8.3 mL/min/1.72 m2 and 1.25 ± 0.20 mmol/L, respectively. Median (interquartile range) intact and c-terminal FGF-23 levels were 133.0 (89.1-202) pg/mL and 221.1 (154.3-334.1) RU/mL, respectively. Mean PWV was 10.8 ± 3.6 m/s and 81% had AAC (median Agatston score 1,535 [63-5,744] Hounsfield units). PWV ≥10 m/s was associated with older age, diabetes, CVD, presence of AAC, higher systolic blood pressure (BP), larger waist circumference and higher alkaline phosphatase. AAC was associated with older age, male sex, diabetes, CVD, higher diastolic BP, dyslipidaemia (and use of statins), smoking, larger waist circumference and increased PWV. In conclusion, IMPROVE-CKD participants had high baseline risk for cardiovascular events, as suggested by high baseline PWV and AAC values.


Aorta/pathology , Kidney Failure, Chronic/drug therapy , Lanthanum/administration & dosage , Vascular Calcification/epidemiology , Vascular Stiffness/drug effects , Age Factors , Aged , Aorta/diagnostic imaging , Disease Progression , Female , Fibroblast Growth Factor-23 , Glomerular Filtration Rate , Heart Disease Risk Factors , Humans , Kidney Failure, Chronic/blood , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/diagnosis , Male , Middle Aged , Phosphates/blood , Pulse Wave Analysis , Sex Factors , Treatment Outcome , Vascular Calcification/blood , Vascular Calcification/diagnosis , Vascular Calcification/etiology
5.
Biol Trace Elem Res ; 196(1): 153-167, 2020 Jul.
Article En | MEDLINE | ID: mdl-31656980

Accumulation of lanthanum oxide nanoparticles (La2O3NPs) in the femur bone of rats after 30 days of oral administration was explored. Also, the influence of La2O3NPs on macro and trace elements in the rats' femur bone was assessed. Inductively coupled plasma mass spectrometry (ICP-MS) and inductively coupled plasma optical spectrometry (ICP OES) were used for total element determination in the bone after decomposition while laser ablation-ICP-MS (LA-ICP-MS) was used to investigate element distribution (bio-imaging) in the bone. Some differences in element concentrations in the bone between the rats treated with La2O3NPs at 1.0 mg kg-1 (T1), 10.0 mg kg-1 (T2), and 100 mg kg-1 (T3) body weight (bw) and the control rats (CTR) were observed. More differences were observed in the bone of rat treated with 10.0 mg kg-1 La2O3NPs bw. However, the highest change observed was for Mg, which concentration ranged from 5230 ± 12 µg kg-1 for the CTR group to 4130 ± 138 µg kg-1 for the T3 group. Minor changes were observed for Ba, Ca, Cr, Cu, Fe, Mg, Na, Pb, Sr, and Zn between CTR and animals treated with La2O3NPs at the different levels of concentration. It was possible to observe from LA-ICP-MS analysis that La2O3NPs were accumulated only on the surface of the bone, not deeper than about 5 µm. LA-ICP-MS allowed also to investigate the distribution of La and the other elements in a cross section of the femur bone head, where higher amounts of the elements are present at the external part of the bone. Therefore, it was demonstrated that La2O3NPs are incorporated on the surface of the bone and it has a small influence on some of the other elements evaluated.


Bone and Bones/chemistry , Lanthanum/analysis , Nanoparticles/analysis , Oxides/analysis , Administration, Oral , Animals , Bone and Bones/metabolism , Lanthanum/administration & dosage , Lanthanum/metabolism , Male , Nanoparticles/administration & dosage , Nanoparticles/metabolism , Oxides/administration & dosage , Oxides/metabolism , Rats , Rats, Wistar
6.
Cereb Cortex ; 30(3): 1244-1259, 2020 03 14.
Article En | MEDLINE | ID: mdl-31408166

Electrical activity is important for brain development. In brain slices, human subplate neurons exhibit spontaneous electrical activity that is highly sensitive to lanthanum. Based on the results of pharmacological experiments in human fetal tissue, we hypothesized that hemichannel-forming connexin (Cx) isoforms 26, 36, and 45 would be expressed on neurons in the subplate (SP) zone. RNA sequencing of dissected human cortical mantles at ages of 17-23 gestational weeks revealed that Cx45 has the highest expression, followed by Cx36 and Cx26. The levels of Cx and pannexin expression between male and female fetal cortices were not significantly different. Immunohistochemical analysis detected Cx45- and Cx26-expressing neurons in the upper segment of the SP zone. Cx45 was present on the cell bodies of human SP neurons, while Cx26 was found on both cell bodies and dendrites. Cx45, Cx36, and Cx26 were strongly expressed in the cortical plate, where newborn migrating neurons line up to form cortical layers. New information about the expression of 3 "neuronal" Cx isoforms in each cortical layer/zone (e.g., SP, cortical plate) and pharmacological data with cadmium and lanthanum may improve our understanding of the cellular mechanisms underlying neuronal development in human fetuses and potential vulnerabilities.


Cadmium/administration & dosage , Cerebral Cortex/drug effects , Cerebral Cortex/physiology , Connexins/metabolism , Lanthanum/administration & dosage , Neurons/drug effects , Neurons/physiology , Connexin 26/metabolism , Female , Fetus , Humans , Male , Membrane Potentials , Protein Isoforms/metabolism , RNA, Messenger/metabolism , Gap Junction delta-2 Protein
7.
Yakugaku Zasshi ; 139(11): 1435-1448, 2019.
Article Ja | MEDLINE | ID: mdl-31685740

Animal models of chronic kidney failure (CKF) have been developed for the pharmacodynamic evaluation of various phosphate binders that are used clinically to treat hyperphosphatemia in patients with chronic kidney disease. However, these models represent different disease states and severities, depending on the experimental conditions and are not clearly defined for pharmacological evaluation. In addition, experimental models have not yet been established for artificial dialysis. The purpose of this study was to confirm the utility of the various rat models of CKF and the mini-pig model of hemodialysis as models of hyperphosphatemia for pharmacodynamic evaluation. Various rat models of pre-dialysis CKF (oral adenine dosing, 5/6 resection, and ligation nephrectomy model) were evaluated through determinations of serum and urinary parameters (osmolality, creatinine, and phosphorus), pathological observations of kidney, and the phosphorus-absorbing properties of lanthanum carbonate (La) formulations. The rat and mini-pig models were compared based on each evaluation index. In the oral adenine dosing model, serum phosphorus increased markedly and the area under the serum phosphorus concentration-time curve (phosphorus AUC) decreased in a dose-dependent manner with the administration of La formulations. In contrast, a significant decrease in serum phosphorus AUC, a prolongation of the dialysis interval, and an improvement in dialysis efficiency were observed after administration of La formulations to the mini-pig hemodialysis model. Furthermore, the results of bioequivalence studies between two La formulations (Fosrenol and SW670, a generic formulation) suggested that the rat and mini-pig models are useful and precise as pre-dialysis and dialysis models, respectively.


Hyperphosphatemia/drug therapy , Hyperphosphatemia/etiology , Kidney Failure, Chronic/complications , Lanthanum/therapeutic use , Animals , Disease Models, Animal , Dose-Response Relationship, Drug , Lanthanum/administration & dosage , Lanthanum/pharmacokinetics , Lanthanum/pharmacology , Male , Rats, Wistar , Renal Dialysis , Swine , Swine, Miniature , Therapeutic Equivalency
8.
J Am Soc Nephrol ; 30(6): 1096-1108, 2019 06.
Article En | MEDLINE | ID: mdl-31085679

BACKGROUND: Higher serum phosphate and fibroblast growth factor-23 (FGF23) levels may be modifiable to prevent cardiovascular disease in CKD. Short-term studies have reported modest efficacy in phosphate and FGF23 reduction with intestinal phosphate binders in CKD. METHODS: To investigate effects of lanthanum carbonate (LC; a phosphate binder) and/or nicotinamide (NAM; an inhibitor of active intestinal phosphate transport) on serum phosphate and FGF23 in stage 3b/4 CKD, we conducted a randomized trial among individuals with eGFR 20-45 ml/min per 1.73 m2 to NAM (750 mg twice daily) plus LC (1000 mg thrice daily), NAM plus LC placebo, LC plus NAM placebo, or double placebo for 12 months. Dual primary end points were change from baseline in serum phosphate and intact FGF23 concentrations. RESULTS: Mean eGFR for the 205 participants was 32ml/min per 1.73 m2. At baseline, serum phosphate was 3.7 mg/dl and median FGF23 was 99 pg/ml (10th, 90th percentiles: 59, 205). Mean rates of change in phosphate increased slightly over 12 months in all groups and did not differ significantly across arms. Similarly, percent changes in FGF23 per 12 months increased for all arms except LC plus placebo, and did not differ significantly across arms. Gastrointestinal symptoms limited adherence. Adverse events rates were similar across arms. CONCLUSIONS: LC and/or NAM treatment did not significantly lower serum phosphate or FGF23 in stage 3b/4 CKD over 12 months. Although these agents appeared safe, intestinal symptoms limited adherence. Reducing phosphate and FGF23 in nondialysis CKD will require new approaches.


Fibroblast Growth Factors/blood , Lanthanum/administration & dosage , Niacinamide/administration & dosage , Phosphates/blood , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/drug therapy , Adult , Double-Blind Method , Female , Fibroblast Growth Factor-23 , Fibroblast Growth Factors/drug effects , Glomerular Filtration Rate/drug effects , Humans , Male , Middle Aged , Monte Carlo Method , Renal Insufficiency, Chronic/blood , Risk Assessment , Severity of Illness Index , Treatment Outcome
11.
Expert Rev Pharmacoecon Outcomes Res ; 19(3): 287-298, 2019 06.
Article En | MEDLINE | ID: mdl-30664365

INTRODUCTION: End-stage renal disease is associated with significant comorbidity and mortality. Among its implications, hyperphosphatemia constitutes a consistent and independent risk factor. The use of benchmark treatment, low-cost calcium-based binders declined due to a potential calcification effect on coronary arteries. AREAS COVERED: Given the increasing prevalence of end-stage renal disease and the high cost of hyperphosphatemia's new primary modality, the non-calcium based phosphate binders, we set-off to systematically assess the economic evaluations of non-calcium containing phosphate binders, sevelamer and lanthanum. The study was performed based on a systematic review of the economic evaluations of sevelamer and lanthanum. The cost-effectiveness profile of the two non-calcium-containing Phosphate Binders compared to calcium-based phosphate binders depends on several factors such as future dialysis costs, utility values, age, survival, and phosphorus levels. EXPERT OPINION: The comparison between the two agents is rather inconclusive; nevertheless, current review suggests that non-calcium-based phosphate binders may yield a positive cost-effectiveness ratio in patients with inadequate phosphorus management and patient with longer life-expectancy. It is crucial that the literature is endowed with more data, specifically on survival, future dialysis costs, and calcification.


Hyperphosphatemia/drug therapy , Lanthanum/administration & dosage , Sevelamer/administration & dosage , Chelating Agents/administration & dosage , Chelating Agents/economics , Cost-Benefit Analysis , Humans , Hyperphosphatemia/economics , Kidney Failure, Chronic/economics , Kidney Failure, Chronic/therapy , Lanthanum/economics , Life Expectancy , Renal Dialysis/economics , Sevelamer/economics
12.
Biol Trace Elem Res ; 187(2): 482-491, 2019 Feb.
Article En | MEDLINE | ID: mdl-29876795

Lanthanum could cause cognitive impairment in children and rodent animals. The normal blood-brain barrier (BBB) integrity is essential for protecting the brain from systemic toxins and maintaining the homeostasis for proper neuronal function. BBB dysfunction has been implicated as a potential mechanism of heavy metal-induced neurotoxicity. The present study was aimed to investigate effects of lanthanum on BBB integrity and endothelial junctional complexes in the cerebral cortex of young rats. Animals were exposed to lanthanum chloride (LaCl3) through drinking water under 0, 0.25, 0.5, and 1.0% concentrations from postnatal day 0 until 30 days after weaning. LaCl3-exposure increased BBB permeability, caused ultrastructure changes in cerebral capillaries, and reduced protein expression of claudin-5, occludin, and VE-cadherin. Due to the critical role of matrix metalloproteinases (MMPs) in BBB integrity, we further examined alterations in MMPs activity and expression. Enhanced gelatinase activity and upregulated MMP-9 expression were observed after LaCl3-exposure, concurrently with decreased expression of endogenous inhibitor tissue inhibitors of metalloproteinase (TIMP)-1. Taken together, this study demonstrated that postnatal lanthanum exposure caused leakage of BBB in young rats, partially attributed to upregulation of MMP-9 and reduction of junctional proteins expression.


Blood-Brain Barrier/drug effects , Cadherins/deficiency , Claudin-5/deficiency , Lanthanum/pharmacology , Matrix Metalloproteinase 9/metabolism , Occludin/deficiency , Up-Regulation/drug effects , Administration, Oral , Animals , Antigens, CD/metabolism , Blood-Brain Barrier/metabolism , Blood-Brain Barrier/pathology , Cadherins/metabolism , Claudin-5/metabolism , Dose-Response Relationship, Drug , Female , Intercellular Junctions/drug effects , Intercellular Junctions/metabolism , Intercellular Junctions/pathology , Lanthanum/administration & dosage , Male , Occludin/metabolism , Oxidation-Reduction , Rats , Rats, Wistar
13.
J Nephrol ; 32(2): 265-272, 2019 Apr.
Article En | MEDLINE | ID: mdl-30588573

BACKGROUND: The relationship between oral activated charcoal (OAC) and hyperphosphatemia and vascular calcification is not completely clear. We observed and recorded the effects of OAC on hyperphosphatemia and vascular calcification in stage 3-4 chronic kidney disease (CKD). METHODS: In a randomized controlled study, we included 97 patients with stage 3-4 CKD. In the first phase of the experiment, the patients were randomly divided into the OAC group and placebo group. The endpoint of this phase was the development of hyperphosphatemia. The patients with hyperphosphatemia were selected into the second phase of the study. These patients underwent coronary artery multidetector computed tomography (MDCT) and were randomly divided into three groups: the OAC group, the calcium carbonate (CC) group and the lanthanum carbonate (LC) group. RESULTS: The first and second phases of the experiment were followed for 12 months. In the first phase of the experiment, there was a statistically significant difference in the proportion of patients with hyperphosphatemia between the OAC and placebo groups (28.57% vs. 79.17%, X2 = 24.958, P = 0.000). In the second phase, the differences in coronary calcification score (CACS) between the OAC group, the CC group and the LC group were statistically significant (525.5 ± 104.2 vs 688.1 ± 183.7 vs 431.4 ± 122.5, P < 0.01). CONCLUSION: Oral activated charcoal effectively delays the onset of hyperphosphatemia in patients with chronic kidney disease. OAC appears to delay the development of vascular calcifications in stage 3-4 CKD patients.


Calcium Carbonate/administration & dosage , Charcoal/administration & dosage , Chelating Agents/administration & dosage , Hyperphosphatemia/prevention & control , Lanthanum/administration & dosage , Phosphates/blood , Renal Insufficiency, Chronic/drug therapy , Vascular Calcification/prevention & control , Administration, Oral , Adult , Aged , Biomarkers/blood , Calcium Carbonate/adverse effects , Charcoal/adverse effects , Chelating Agents/adverse effects , Female , Humans , Hyperphosphatemia/blood , Hyperphosphatemia/diagnosis , Hyperphosphatemia/etiology , Lanthanum/adverse effects , Male , Middle Aged , Renal Insufficiency, Chronic/blood , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/diagnosis , Time Factors , Treatment Outcome , Vascular Calcification/blood , Vascular Calcification/diagnostic imaging , Vascular Calcification/etiology
14.
Biomed Environ Sci ; 31(5): 363-375, 2018 May.
Article En | MEDLINE | ID: mdl-29866218

OBJECTIVE: The present study was undertaken to evaluate the subchronic toxicity of lanthanum and to determine the no observed adverse effect level (NOAEL), which is a critical factor in the establishment of an acceptable dietary intake (ADI). METHODS: In accordance with the Organization for Economic Co-operation and Development (OECD) testing guidelines, lanthanum nitrate was administered once daily by gavage to Sprague-Dawley (SD) rats at dose levels of 0, 1.5, 6.0, 24.0, and 144.0 mg/kg body weight (BW) per day for 90 days, followed by a recovery period of 4 weeks in the 144.0 mg/kg BW per day and normal control groups. Outcome parameters were mortality, clinical symptoms, body and organ weights, serum chemistry, and food consumption, as well as ophthalmic, urinary, hematologic, and histopathologic indicators. The benchmark dose (BMD) approach was applied to estimate a point of departure for the hazard risk assessment of lanthanum. RESULTS: Significant decreases were found in the 144.0 mg/kg BW group in the growth index, including body weight, organ weights, and food consumption. This study suggests that the NOAEL of lanthanum nitrate is 24.0 mg/kg BW per day. Importantly, the 95% lower confidence value of the benchmark dose (BMDL) was estimated as 9.4 mg/kg BW per day in females and 19.3 mg/kg BW per day in males. CONCLUSION: The present subchronic oral exposure toxicity study may provide scientific data for the risk assessment of lanthanum and other rare earth elements (REEs).


Lanthanum/administration & dosage , Lanthanum/toxicity , Animals , Blood Chemical Analysis , Body Weight , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Male , No-Observed-Adverse-Effect Level , Rats , Rats, Sprague-Dawley , Specific Pathogen-Free Organisms , Toxicity Tests, Subchronic , Urinalysis
15.
Value Health ; 21(3): 318-325, 2018 03.
Article En | MEDLINE | ID: mdl-29566839

BACKGROUND: Phosphate binders are used to treat hyperphosphatemia among patients with chronic kidney disease (CKD). OBJECTIVES: To conduct an economic evaluation comparing calcium-free binders sevelamer and lanthanum with calcium-based binders for patients with CKD. METHODS: Effectiveness data were obtained from a recent meta-analysis of randomized trials. Effectiveness was measured as life-years gained and translated to quality-adjusted life-years (QALYs) using utility weights from the literature. A Markov model consisting of non-dialysis-dependent (NDD)-CKD, dialysis-dependent (DD)-CKD, and death was developed to estimate the incremental costs and effects of sevelamer and lanthanum versus those of calcium-based binders. A lifetime horizon was used and both costs and effects were discounted at 1.5%. All costs are presented in 2015 Canadian dollars from the Canadian public payer perspective. Results of probabilistic sensitivity analysis were presented using cost-effectiveness acceptability curves. Sensitivity analyses were conducted for risk pooling methods, omission of dialysis costs, and persistence of drug effects on mortality. RESULTS: Sevelamer resulted in an incremental cost-effectiveness ratio of $106,522/QALY for NDD-CKD and $133,847/QALY for DD-CKD cohorts. Excluding dialysis costs, sevelamer was cost-effective in the NDD-CKD cohort ($5,847/QALY) and the DD-CKD cohort ($11,178/QALY). Lanthanum was dominated regardless of whether dialysis costs were included. CONCLUSIONS: Existing evidence does not clearly support the cost-effectiveness of non-calcium-containing phosphate binders (sevelamer and lanthanum) relative to calcium-containing phosphate binders in DD-CKD patients. Our study suggests that sevelamer may be cost-effective before dialysis onset. Because of the remaining uncertainty in several clinically relevant outcomes over time in DD-CKD and NDD-CKD patients, further research is encouraged.


Calcium Carbonate/economics , Cost-Benefit Analysis/methods , Hyperphosphatemia/economics , Lanthanum/economics , Renal Insufficiency, Chronic/economics , Sevelamer/economics , Adult , Aged , Calcium Carbonate/administration & dosage , Chelating Agents/administration & dosage , Chelating Agents/economics , Female , Humans , Hyperphosphatemia/drug therapy , Hyperphosphatemia/epidemiology , Lanthanum/administration & dosage , Male , Middle Aged , Randomized Controlled Trials as Topic/economics , Randomized Controlled Trials as Topic/methods , Renal Insufficiency, Chronic/drug therapy , Renal Insufficiency, Chronic/epidemiology , Sevelamer/administration & dosage
16.
Photodiagnosis Photodyn Ther ; 21: 306-311, 2018 Mar.
Article En | MEDLINE | ID: mdl-29331661

LaF3: Ag nanoparticles (NPs) were synthesized by the co-precipitation method. The produced NPs were characterized by X-ray diffraction (XRD) pattern, scanning electron microscope (SEM), dynamic light scattering (DLS) and Fourier transform infrared spectroscopy (FTIR). The emission spectrum of LaF3:Ag NPs is mostly overlapped with the absorption band of protoporphyrin IX (PpIX) and their conjugation was confirmed by studying fluorescence resonance energy transfer (FRET) from LaF3:Ag donor to protoporphyrin IX acceptor. The energy transfers from LaF3:Ag NPs to photosensitizer molecules is very efficient. So, the produced LaF3:Ag NPs can be recommended as light source for photodynamic therapy (PDT). The thiol group of cysteine was bound to LaF3:Ag NPs in order to conjugate LaF3:Ag NPs and protoporphyrin IX. UVC light source was used to excite fluorescent LaF3:Ag NPs. The reactive oxygen species (ROS) produced by photosensitizer was identified using special fluorescent probes (anthracene, methylene blue and methyl orange) as detectors.


Fluorides/pharmacokinetics , Lanthanum/pharmacokinetics , Metal Nanoparticles/chemistry , Photochemotherapy/methods , Photosensitizing Agents/pharmacokinetics , Protoporphyrins/radiation effects , Drug Carriers/chemistry , Dynamic Light Scattering , Fluorides/administration & dosage , Lanthanum/administration & dosage , Microscopy, Electron, Scanning , Reactive Oxygen Species/metabolism , Silver/chemistry , Spectroscopy, Fourier Transform Infrared , X-Ray Diffraction
17.
Curr Med Chem ; 25(1): 113-117, 2018.
Article En | MEDLINE | ID: mdl-28486924

BACKGROUND: Lanthanum (La) is considered to be a non-essential element. La has been used for several decades in China to improve yield in plant production and has also been shown to have significant performance enhancing effects in feeding trials on animal husbandry. The estimated dietary intake of La in humans is below 150 µg, which is lower than 10% of the estimated limit of safe and acceptable daily intake. METHODS: The present review is based on literature search in available databases. RESULTS: Upon ingestion of La as carbonate, the lanthanum ion (La3+) is released in the stomach and traps dietary phosphate as insoluble lanthanum phosphate complexes in the gut, thereby inhibiting phosphate absorption. Lanthanum carbonate as a drug to lower serum phosphate in endstage kidney failure was approved for human use by the US FDA in 2004 and by the EU in 2006. When used to treat patients with advanced renal insufficiency, lanthanum carbonate is administered orally at a dose of maximally 3000 mg per day. The uptake of lanthanum ions from the gut to the circulation is negligible. And few systemic side effects have been recorded upon the use of lanthanum carbonate as a phosphate binding drug, although gastrointestinal discomfort with pain, vomiting and diarrhea may occur. Lanthanum carbonate has the potential to chelate to drugs with anionic groups and therapeutic co-administration with lanthanum carbonate may reduce the bioavailibility of drugs like tetracyclines, quinolones and levothyroxine. CONCLUSION: The findings in this review confirm that lanthanum carbonate is a clinically useful phosphate binding drug with few side effects in advanced renal failure.


Carbonates/therapeutic use , Lanthanum/therapeutic use , Organometallic Compounds/therapeutic use , Phosphates/therapeutic use , Renal Insufficiency/drug therapy , Binding Sites , Carbonates/administration & dosage , Carbonates/chemistry , Humans , Lanthanum/administration & dosage , Lanthanum/chemistry , Organometallic Compounds/administration & dosage , Organometallic Compounds/chemistry , Phosphates/administration & dosage , Phosphates/chemistry
18.
Invest Radiol ; 53(3): 167-172, 2018 03.
Article En | MEDLINE | ID: mdl-28990973

OBJECTIVES: The aim of the study was to explore the role of the stability of metal complexes in the processes that lead to the metal retention in the brain and other tissues of mice administered with lanthanides-based contrast agents. This issue was tackled by the simultaneous injection of gadolinium (Gd)-diethylentriamminopentaacetate (DTPA) and lanthanum-DTPA, which have the same charge and structure but differ in their thermodynamic stability by 3 orders of magnitude. MATERIALS AND METHODS: A total of 20 healthy BALB/c mice were administered by a single intravenous injection with a dose consisting of 0.6 mmol La-DTPA/kg and 0.6 mmol Gd-DTPA/kg. Then the animals were killed at different time points: 4, 24, 48, and 96 hours (5 mice each group).In an additional protocol, 5 mice were administered with 9 doses of 0.3 mmol La-DTPA/kg and 0.3 mmol of Gd-DTPA/kg every 2 days over a period of 3 weeks. The sacrifice time was set to 3 weeks after the last administration. After sacrifice, the Gd and La content in liver, spleen, kidney, muscle, cerebrum, cerebellum, bone, eye, skin, blood, and urine was determined by inductively coupled plasma-mass spectrometry. RESULTS: A general decrease in the content of both the lanthanides was observed upon delaying the sacrifice time. At relatively short times after the injection (up to 96 hours), in the spleen, kidney, muscle, skin, and eye, almost the same content of La and Gd was detected, whereas in the cerebrum, cerebellum, bones, and liver, the amount of retained La decreased much slower than that of Gd, yielding a progressive increase in La/Gd ratio. The amount of retained La in the various tissues 21 days after the last of 9 administrations of La-DTPA and Gd-DTPA was always significantly higher than that of Gd. The concentration of both La and Gd decreased rapidly both in blood and in urine samples. DISCUSSION: The departure from the 1:1 ratio in the amounts of La and Gd determined in the investigated tissues has been used to gain information on the role of the complex stability and "wash-out" kinetics. The behavior of the less s` La-DTPA highlights processes occurring for Gd-DTPA at a slower rate.The herein obtained results support the view that most of the La/Gd retained in the brain arises from the intact chelate that has extravasated immediately after the intravenous administration. Long-term deposition of metal ions from internal reservoirs seems particularly relevant for liver and spleen.


Contrast Media/pharmacokinetics , Gadolinium DTPA/pharmacokinetics , Gadolinium/pharmacokinetics , Lanthanum/pharmacokinetics , Animals , Bone and Bones/metabolism , Brain/metabolism , Contrast Media/administration & dosage , Eye/metabolism , Gadolinium/administration & dosage , Gadolinium DTPA/administration & dosage , Injections, Intravenous , Kidney/metabolism , Lanthanum/administration & dosage , Liver/metabolism , Mice , Mice, Inbred BALB C , Models, Animal , Muscle, Skeletal/metabolism , Skin/metabolism , Spectrophotometry, Atomic , Spleen/metabolism , Time Factors
19.
Arch Toxicol ; 92(4): 1407-1419, 2018 Apr.
Article En | MEDLINE | ID: mdl-29264619

Lanthanum (La) can impair learning memory and induce behavioral abnormalities in animals. However, the mechanism underlying these adverse effects of La is still elusive. It has been demonstrated that lactate derived from astrocytes is the major energy source for neurons during long-term memory (LTM) formation and the deficiency of lactate supply can result in LTM damage. However, little work has been done with respect to the impact of La on the lactate production in astrocytes and astrocyte-neuron lactate transport (ANLT). Herein, experiments were undertaken to explore if there was such an adverse effect of La. Primary culture rat cortical astrocytes and primary co-culture rat cortical astrocyte-neuron were treated with (0.125, 0.25 and 0.5 mM) lanthanum chloride (LaCl3) for 24 h. The results showed that LaCl3 treatment significantly downregulated the mRNA and protein expression of glucose transporter 1 (GLUT1), glycogen synthase (GS), glycogen phosphorylase (GP), lactate dehydrogenase A (LDHA), and monocarboxylate transporter 1, 2 and 4 (MCT 1 2 and 4); upregulated the mRNA and protein expression of lactate dehydrogenase B (LDHB); and decreased the glycogen level, total LDH and GP activity, GS/p-GS ratio and lactate contents. Moreover, rolipram (20, 40 µM) or forskolin (20, 40 µM) could increase the lactate content by upregulating GP expression and the GS/p-GS ratio, as well as antagonize the effects of La. These results suggested that La-induced learning-memory damage was probably related to its suppression of lactate production in astrocytes and ANLT. This study provides some novel clues for clarifying the mechanism underlying the neurotoxicity of La.


Astrocytes/metabolism , Glycogen/metabolism , Lactic Acid/metabolism , Lanthanum/toxicity , Animals , Biological Transport/drug effects , Cells, Cultured , Cerebral Cortex/cytology , Cerebral Cortex/drug effects , Coculture Techniques , Lanthanum/administration & dosage , Memory, Long-Term/drug effects , Primary Cell Culture , Rats
20.
Microscopy (Oxf) ; 66(5): 366-370, 2017 Oct 01.
Article En | MEDLINE | ID: mdl-29016922

Triolein emulsion has been known to increase vascular permeability in the brain when it is infused into the carotid artery. The purpose of this study was to identify the morphologic mechanism of increased vascular permeability in brain induced by infusion of emulsified triolein into the carotid artery by transmission electron microscopy (TEM). Triolein emulsion was infused into the carotid artery of rats. TEM using lanthanum tracer was used to evaluate morphologic changes in endothelium with a focus on transcytotic vesicles and tight junction opening. The treat group showed multiple transcytotic vesicles containing lanthanum tracer within endothelium on TEM. TEM also revealed that lanthanum tracer entered neural interstitium through tight junctions between capillary endothelial cells infrequently in the treat group. No evidence of transcytotic vesicles containing lanthanum tracer or lanthanum leakage through tight junctions was observed in the control group. Transcytosis and the opening of tight junctions appears the pathway for vascular permeability enhancement by triolein. This result could be utilized in studies on the blood-brain barrier and by those searching for chemotherapeutic methods that deliver anti-tumor agents to normally drug inaccessible organs.


Blood-Brain Barrier/drug effects , Capillary Permeability/drug effects , Triolein/administration & dosage , Animals , Blood-Brain Barrier/cytology , Blood-Brain Barrier/ultrastructure , Carotid Arteries/drug effects , Carotid Arteries/ultrastructure , Drug Delivery Systems/methods , Emulsions/administration & dosage , Endothelium/drug effects , Infusions, Intra-Arterial , Lanthanum/administration & dosage , Lanthanum/blood , Microscopy, Electron, Transmission/methods , Rats , Transcytosis/drug effects
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