Cell death induced by peroxidized low-density lipoprotein: endopepsis.

Peroxidized low-density lipoprotein (p-LDL) has been previously demonstrated to be preferentially cytotoxic to certain malignant cells compared to normal cells of the same type. We present evidence that p-LDL is at least partially taken up through the LDL receptor and that it becomes localized in lysosomes. The integrity of lysosomes of p-LDL-treated cells is compromised, and leakage of their contents into the cytosol occurs. This leakage occurs early and precedes mitochondrial dysfunction. Brefeldin A inhibits this leakage, perhaps by interfering with the traffic between endosomes and lysosomes. Electron micrographs taken at various times suggest a mechanism of cell death which resembles certain aspects of the broad definition of apoptosis. However, we suggest that the cell death observed following p-LDL-induced release of lysosomal contents is essentially unique, with released lysosomal enzymes degrading the cell from within. We suggest that this process should be described as endopepsis.

Effects of tumor necrosis factor-alpha on peroxidation of plasma lipoprotein lipids in experimental animals and patients.

Changes in the plasma lipid composition are observed in patients and animals with malignancy and certain other diseases that are consistent with peroxidation of plasma lipoprotein lipids. These changes can be observed with water-suppressed proton (H-1) and carbon-13 (C-13) nuclear magnetic resonance spectroscopy (NMR) and gas chromatography. Gas chromatography provides evidence of a decrease in polyunsaturated fatty acids relative to monounsaturated fatty acids. This evidence is consistent with that observed by C-13 NMR spectroscopy. Mediators for these effects were sought. Cytokines, known to be released in response to malignant tumor cells and to affect lipid metabolism, were injected into normal mice and their effects on the H-1 and C-13 NMR spectra of plasma lipids were observed. Mouse recombinant tumor necrosis factor-alpha (mr-TNF-alpha) significantly decreased the H-1 methyl and methylene lipid linewidths, and the C-13 spectra indicated a decrease in the relative concentration of polyunsaturated fatty acids. The same changes were directly confirmed by gas chromatographic analysis, showing decreases in the amount of linoleic and arachidonic acids and other polyunsaturated fatty acids relative to monounsaturated fatty acids and in the ratio of polyunsaturated to monounsaturated fatty acids. Serial plasma samples from volunteers receiving an infusion of endotoxin showed similar changes in their C-13 NMR spectroscopy at times when peak TNF-alpha values were measured. In addition, in these samples the C-13 NMR spectra showed direct evidence of lipid peroxidation products. These changes were similar to those observed commonly in the plasma of cancer patients. Other cytokines (human recombinant interleukin-1 alpha [hr-IL-1 alpha], hr-IL-2, mouse recombinant interferon-gamma) did not produce these effects. We conclude that TNF-alpha is a mediator (but not necessarily the only one) of changes in plasma lipoprotein lipid composition due to peroxidation and that this is a mechanism for the changes observed in the NMR spectra of plasma from cancer patients and from normal animals injected with TNF-alpha.

Selective cytotoxicity of low-density lipoprotein to helper T cells of cutaneous T-cell lymphoma after photoperoxidation with 8-methoxypsoralen.

Lymphocyte-containing plasma subjected to photolysis in the presence of 8-methoxypsoralen (methoxsalen, 8-MOP) has previously been shown to be effective against cutaneous T-cell lymphoma and the AIDS-related complex. The mechanism of this effect was thought to involve photoreaction of 8-MOP with DNA, based on certain in vitro experiments. The results of this study suggest a different mechanism. Low-density lipoprotein (LDL) from fresh human plasma was photosensitized by addition of 8-MOP and exposure to UV light (mp-LDL), and the reactions of the LDL lipids and the chemical actions induced by these reactions were monitored. In a separate procedure, LDL was peroxidized with hydrogen peroxide and peroxidase (p-LDL). mp-LDL and p-LDL were then tested in cytotoxicity assays on HuT-78 helper T cells of cutaneous T-cell lymphoma. These results indicate that (a) LDL in plasma in the presence of very low concentrations of 8-MOP (200 ng/mL) can be peroxidized by UV light; (b) this photoperoxidized LDL is cytotoxic to helper T cells of cutaneous T-cell lymphoma in a dose-dependent manner; but (c) it does not kill normal lymphocytes under similar conditions. The findings also suggest alternative therapeutic strategies for treatment of cutaneous T-cell lymphoma, such as direct utilization of peroxidized LDL.

The NMR blood test for cancer: current status.

Our laboratory has developed nuclear magnetic resonance (NMR) techniques for detecting cancer. Using water-suppressed proton (H-1) NMR spectroscopy, we observed that the linewidths of the resonances of methyl and methylene moieties in lipoprotein lipids were consistently narrower in plasma samples from cancer patients than in those from controls. These findings have been corroborated by a number of independent laboratories, but other investigators have been unable to reproduce our results. One reason for the variability of results obtained with H-1 NMR may be that hypertriglyceridemia also induces linewidth narrowing of lipoprotein lipid methyl and methylene resonances, and can cause false positive results. We show that this ambiguity can be circumvented by using a second test based on the carbon-13 (C-13) NMR spectrum of plasma. Here we postulate that the cancer-associated changes seen in H-1 and C-13 NMR spectra are caused by peroxidation of lipoprotein lipids, an effect that may be induced by tumor necrosis factor-alpha released during malignancy.

C-13 NMR spectroscopy of plasma reduces interference of hypertriglyceridemia in the H-1 NMR detection of malignancy. Application in patients with breast lesions.

We have previously described the application of water-suppressed proton nuclear magnetic resonance (H-1 NMR) spectroscopy of plasma for detection of malignancy. Subsequently, hypertriglyceridemia has been identified as a source of false positive results. We now describe a confirmatory, adjunctive technique--analysis of the carbon-13 (C-13) NMR spectrum of plasma--which also identifies the presence of malignancy but is not sensitive to the plasma triglyceride level. Blinded plasma samples from 480 normal donors and 208 patients scheduled for breast biopsy were analyzed by water-suppressed H-1 and C-13 NMR spectroscopy. Triglyceride levels were also measured. Among the normal donors, there were 38 individuals with hypertriglyceridemia of whom 18 had results consistent with malignancy by H-1 NMR spectroscopy. However, the C-13 technique reduced the apparent H-1 false positive rate from 7.0% to 0.6%. Similarly, in the breast biopsy cohort, C-13 reduced the false positive rate from 2.8% to 0.9%. Furthermore, the accuracy of the combined H-1/C-13 test in this blinded study was greater than 96% in 208 patients studied.

Cooperativity in the calcium ion-induced quenching of the intrinsic fluorescence of a series of normal and GLA-deficient bovine prothrombin fragment 1 molecules.

Ca2+ titrations of the intrinsic fluorescence of a series of gamma-carboxyglutamic acid (GLA)-deficient bovine prothrombin fragments 1 yield response Hill plot parameters useful for characterization of the metal ion-binding process. 11-, 10-, and 9-GLA fragments 1 exhibit Tm (the (Ca2+)total concentration at which ln (B/F) = 0 in the response Hill plot) values between 0.2 and 0.3 mM. A 22-fold increase in Tm to 5.4 mM is observed for 8-GLA fragment 1. Tm decreases to 3.8 mM for the 7- and 6-GLA proteins. The value of h, about 2.8 +/- 0.2 for 11-, 10-, and 9-GLA fragments 1, abruptly decreases to 1.2-1.3 for 8-, 7-, and 6-GLA fragments 1. The observed degree of quenching induced by saturating levels of calcium ions is affected by both changes in the intrinsic fluorescence of the metal ion-free proteins and in the maximum possible degree of quenching in the presence of calcium. The kinetic characteristics of the calcium ion-induced quenching of the intrinsic fluorescence of 6-GLA fragment 1 are identical to those observed in 10-GLA fragment 1, suggesting that the fluorescence quenching observed in the 6- and 10-GLA fragments 1, while different in magnitude, involves similar processes. Observation of an abrupt change in the relative electrophoretic mobilities of 11- to 9-GLA fragments 1 compared to 8- to 6-GLA fragments 1, in the absence or presence of Ca2+, suggests the existence of a major protein conformation change which occurs concomitantly with the noted changes in Tm and h response Hill plot parameters. Molecular mechanics calculations suggest a structural hypothesis unifying these observations. Central to this model is the presumption of the existence of hydrogen bond-mediated interactions between metal ion-binding sites.

Nuclear magnetic resonance studies of sodium/calcium exchange in frog perfused, beating hearts.

This study explores the effect of extracellular Ca2+ concentration ([Ca2+]o), on the intracellular Na+ concentration ([Na+]i), in frog intact hearts using nuclear magnetic resonance spectroscopy, which allows for the measurement of [Na+]i in perfused, beating hearts. Decreases in [Ca2+]o yielded marked increases in [Na+]i. A similar effect was seen during inhibition of the Na+/K+ pump and was fully reversible. This sensitivity of [Na+]i to [Ca2+]o, previously observed using microelectrodes, supports a crucial physiological role for Na+/Ca2+ exchange in frog intact, beating hearts.

Measurement of left ventricular mass in rats using electrocardiogram-gated magnetic resonance imaging.

To evaluate the ability of electrocardiogram (ECG)-gated magnetic resonance (MR) imaging to assess in vivo left ventricular (LV) mass in the rat, we studied 20 healthy adult Sprague-Dawley and Fischer 344 rats and 8 additional rats that underwent scanning after induction of volume overload by aortic leaflet disruption. ECG-gated spin-echo pulse sequences were used to acquire a series of 1-mm thick modified short-axis images of the left ventricle. The area enclosed by the endocardial and epicardial borders of the left ventricle was multiplied by the interslice distance and specific gravity of myocardium to obtain calculated slice mass. Total LV mass was obtained by summing the individual slices. The calculated value for LV mass was then compared with the LV mass as determined at postmortem examination. Linear regression analysis showed an excellent correlation of MR-estimated mass (x) with autopsy-measured LV mass (y) (y = 0.90x + 65, r = 0.98). For this method intraobserved and interobserver slice correlations were 0.97 and 0.96, respectively. There was no significant difference in LV mass as determined from a series of diastolic vs. systolic images in a subset of six animals. Over a mean of 6.5 wk of observation, LV mass increased by 40% in the animals subjected to aortic leaflet disruption. These results demonstrate that MR imaging is highly accurate for the non-invasive in vivo assessment of LV mass in the adult rat.

Alteration of aliphatic lipid proton NMR linewidths by malignant tumors in guinea pigs.

Water-suppressed proton nuclear magnetic resonance spectroscopy was used to observe plasma lipoprotein lipid methyl and methylene resonances from guinea pigs which had been injected with viable or heat-killed line 1 or line 10 tumor cells or sterile oil. It was shown that the widths of these resonances became significantly sharper as the number of tumor cells grew. Plasma from tumor-free control animals showed no change in the NMR linewidths. It is concluded that the changes observed reflect a specific host response to viable tumor cells, and in these models there is a reciprocal relationship between the number of viable tumor cells and the linewidths of plasma lipoprotein methyl and methylene resonances.

NMR characteristics of "visible" intracellular myocardial potassium in perfused rat hearts.

Nuclear magnetic resonance (NMR) spectroscopy provides a unique view of ions through its noninvasive character and relaxation time measurements. Several previous studies have demonstrated that only approximately 20% of cardiac intracellular potassium is visible with current NMR techniques. This study investigates the NMR visible intracellular potassium in a perfused rat heart preparation. When shift reagents were used to separate the intra- and extracellular signals, an intracellular T1 of 11.8 +/- 0.6 ms, and an intracellular T2 with two time constants of 1.3 +/- 0.6 ms (33 +/- 8%) and 10.1 +/- 1.9 ms (67 +/- 4%) were measured. Curve stripping techniques used to separate the intra- and extracellular components of a bulk relaxation decay yielded an intracellular T1 of 8.4 +/- 0.3 ms and an intracellular T2 with two time constants of 1.1 +/- 0.6 ms (38 +/- 10%) and 8.0 +/- 1.6 ms (62 +/- 12%). These results demonstrate that there are at least two distinct pools of potassium within the cardiac cell in slow exchange with each other on the NMR time scale. Studies with an enriched 41K perfusate demonstrated that the exchange rate for the visible intra- and extracellular potassium is on the order of 15 min.

Cytoplasmic Mg2+ concentration in platelets: implications for determination of Ca2+ with aequorin.

The concentration of cytoplasmic ionized Mg2+ ([Mg2+]i) varies considerably among different cell types. It has not been measured in platelets. Incorrect estimates of this value could markedly affect many intracellular investigations, including calibration of measurements of platelet cytoplasmic ionized Ca2+ concentration ([Ca2+]i) with the photoprotein aequorin and other Ca2+-sensitive probes. [Mg2+]i was measured in washed, gel-filtered human platelets suspended in modified Tyrode buffer by two methods: 31P-nuclear magnetic resonance (NMR) spectroscopy of intact platelets and null-point titration in platelets selectively permeabilized with digitonin. The 31P-NMR spectra demonstrated that the [Mg2+]i, as calculated from the chemical shift values of ATP resonances, was 0.23 +/- 0.02 (SD) mM in unstimulated platelets. The mean [Mg2+]i as determined by null-point titration was 0.3 +/- 0.1 mM (range: 0.1-0.6 mM). When this [Mg2+]i value was used to construct a Ca2+-calibration curve for aequorin, the indicated [Ca2+]i values in resting and stimulated platelets were lower than those obtained from curves based on previously assumed values for [Mg2+]i (1.0-1.25 mM). This finding largely resolves the discrepancy between resting [Ca2+]i as determined by aequorin or by quin2, fura-2, and indo-1.

A synthetic functional metabolic compartment. The role of propinquity in a linked pair of immobilized enzymes.

A system was created to model the influence of microcompartments on linked enzymatic reactions. Creatine kinase and hexokinase were covalently attached to Sepharose beads. The gel could be perfused in a specially constructed chamber inside a 360-MHz NMR spectrometer at different flow rates with solutions containing various concentrations of substrates. 31P NMR studies were carried out on the linked enzymatic reaction, creatine phosphate + glucose----creatine + glucose 6-phosphate in two enzyme gels differing in only one aspect, the average distance between hexokinase and creatine kinase. At a distance on the order of 0.1 mm between the enzymes, the average bulk concentrations of substrates and products in the perfusate determined the overall function of the linked system. At an average distance of the order of 10 nm, flux through the linked pair was much higher and much less dependent on the concentration of the intermediate substrate/product ADP/ATP. Even at adenine nucleotide concentrations far below the Km of hexokinase, substantial amounts of glucose 6-phosphate were produced when the enzymes were near but not when they were distant. From saturation transfer measurements and turnover calculations, the lifetime of ATP in the system is estimated to be 0.14-0.5 s when the enzymes are near. This compares to 6 s for distant enzymes. From this it appears that the pair of linked enzymes comprise a functional compartment supported by propinquity in which hexokinase has preferential access to ATP produced by creatine kinase, and creatine kinase to ADP from the hexokinase reaction.

Sodium transport and phosphorus metabolism in sodium-loaded yeast: simultaneous observation with sodium-23 and phosphorus-31 NMR spectroscopy in vivo.

Simultaneous 23Na and 31P NMR spectra were obtained from a number of yeast suspensions. Prior to NMR spectroscopy, the yeast cells were Na-loaded: this replaced some of the intracellular K+ with Na+. These cells were also somewhat P-deficient in that they had no polyphosphate species visible in the 31P NMR spectrum. In the NMR experiments, the Na-loaded cells were suspended in media which contained inorganic phosphate, very low Na+, and a shift reagent for the Na+ NMR signal. The media differed as to whether dioxygen, glucose, or K+ was present individually or in combinations and as to whether the medium was buffered or not. The NMR spectra revealed that the cells always lost Na+ and gained phosphorus. However, the nature of the Na+ efflux time course and the P metabolism differed depending on the medium. The Na+ efflux usually proceeded linearly until the amount of Na+ extruded roughly equalled the amount of NH4+ and orthophosphate initially present in the medium (external phosphate was added as NH4H2PO4). Thus, we presume this first phase reflects a Na+ for NH4+ exchange. The Na+ efflux then entered a transition phase, either slowing, ceasing, or transiently reversing, before resuming at about the same value as that of the first phase. We presume that this last phase involves the simultaneous extrusion of intracellular anions as reported in the literature. The phosphorus metabolism was much more varied. In the absence of exogenous glucose, the P taken up accumulated first as intracellular inorganic phosphate; otherwise, it accumulated first in the "sugar phosphate" pool. In most cases, at least some of the P left the sugar phosphate pool and entered the polyphosphate reservoir in the vacuole. However, this never happened until the phase probably representing Na+ for NH4+ exchange was completed, and the P in the polyphosphate pool never remained there permanently but always eventually reverted back to the sugar phosphate pool. These changes are interpreted in terms of hierarchical energy demands on the cells under the different conditions. In particular, the energy for the Na+ for NH4+ exchange takes precedence over that required to produce and store polyphosphate. This conclusion is supported by the fact that when the cells are "forced" to exchange K+, as well as NH4+, for Na+ (by the addition of 5 times as much K+ to the NH4+-containing medium), polyphosphates are never significantly formed, and the initial linear Na+ efflux phase persists possibly 6 times as long.(ABSTRACT TRUNCATED AT 400 WORDS)

Nuclear magnetic resonance studies of intracellular ions in perfused frog heart.

Intracellular sodium, potassium, and lithium were observed in a perfused frog heart by nuclear magnetic resonance (NMR) spectroscopy. A perfusate buffer containing the shift reagent, dysprosium tripolyphosphate, was used in combination with mathematical filtering or presaturation of the extracellular resonance to separate the intra- and extracellular sodium NMR signals. Addition of 10 microM ouabain to the perfusate, perfusion with a zero potassium, low-calcium buffer, and replacement of 66% of the perfusate sodium with lithium resulted in the following percent changes in the intracellular sodium levels (mean +/- SD): ouabain + 460 +/- 60% (n = 6), zero potassium + 300 +/- 30% (n = 3), and lithium - 51 +/- 6% (n = 3). An increase of 45% in the intracellular sodium was observed when changing the pacing rate from 0 to 60 beats/min (with proportional changes for intermediate pacing rates). The ratio of intracellular potassium to sodium concentration was determined to be 2.3 by NMR, indicating that a substantial amount of the intracellular potassium is undetectable with these NMR methods. In addition, intracellular lithium was observed during perfusion with a lithium-containing perfusate.

MR imaging of the aortic root and proximal coronary arteries.

Six patients who had recently undergone selective coronary and left ventricular angiography were prospectively examined with MR to show the aortic root and proximal coronary arteries. The examinations were performed with a superconductive 1.5-T instrument with spin-echo sequences and ECG-gated multiple slices of 5-mm thickness. The location and plane direction of the scan were guided by findings on initial coronary MR scout scans and by a review of the angiograms. In four of the six patients both coronary orifices and the proximal centimeters of both coronary arteries were identified. In the remaining two, only the left proximal coronary artery was seen. Although segments of more peripherally located portions of the main coronary arteries and branches were detectable, a prospective and conclusive identification without knowledge of the angiographic anatomy would have been extremely difficult. Differential diagnostic problems, such as erroneous interpretation of pericardial recesses and coronary veins, were observed. Unsuccessful demonstration of the right coronary artery orifice in two cases coincided with more peripherally located occlusion of the vessels on the angiogram. MR with spin-echo sequences appears to be unsatisfactory for diagnosis of coronary arteriosclerotic disease, but it may be useful in other conditions that result in significant coronary dilatation, such as fistulae and aneurysms.

Intracellular sodium and lithium NMR relaxation times in the perfused frog heart.

We have used a combination of a shift reagent and mathematical filtering or presaturation of the extracellular sodium resonance for the quantitative investigation of the intracellular sodium and lithium relaxation times in the perfused frog heart. While the T1 of the intracellular sodium was found to consist of a single-exponential time constant (approximately 23 ms), the T2 was better fit as a double-exponential decay with time constants of approximately 2 and 17 ms. However, the relative amplitudes of the two time constants in the T2 decay were found to be inconsistent with those which would be expected from a homogeneous pool of nuclei undergoing quadrupolar interactions. The relaxation times were not changed by a fivefold increase in the intracellular sodium level (due to perfusion with a ouabain-containing buffer). The T1 and T2 of the intracellular lithium (after perfusion with lithium-containing buffer) were both well fit by single exponentials (700- and 31-ms time constants, respectively).

Complete inhibition of creatine kinase in isolated perfused rat hearts.

Transient exposure of an isolated isovolumic perfused rat heart to low concentrations (0.5 mM) of perfusate-born iodoacetamide resulted in complete inhibition of creatine kinase and partial inhibition of glyceraldehyde-3-phosphate dehydrogenase in the heart. At low levels of developed pressure, hearts maintained mechanical function, ATP, and creatine phosphate levels at control values. However, iodoacetamide-inhibited hearts were unable to maintain control values of end diastolic pressure or peak systolic pressure as work load increased. Global ischemia resulted in loss of all ATP without loss of creatine phosphate, indicating lack of active creatine kinase. These results indicate that isovolumic perfused rat hearts are able to maintain normal function and normal levels of high-energy phosphates without active creatine kinase at low levels of developed pressure.