[IKARUS Project--incidence of bone events in breast cancer: retrospective analysis of patients in oncological centres in the Czech Republic and Slovakia]. / Projekt IKARUS--zjistení incidence kostních príhod u karcinomu prsu: retrospektivní analýza nemocných dispenzarizovaných v onkologických centrech Ceské a Slovenské republiky.

BACKGROUND: Bone incidents today represent, in terms of frequency and the overall effect on the quality of life of patients with breast cancer, a serious health problem. In a number of clinical studies bisphosphonates have been shown to have a positive impact on reducing the risk of bone events and therefore to be effective in the prevention of bone events. The primary objective of this project was to identify the incidence of bone events in patients with metastatic breast cancer treated in the Czech and Slovak Republics. SUBJECTS: Retrospective, multi-centre, non-interventional, epidemiological and explorative studies to identify the incidence of bone events in the defined group of patients and a description of the practice of prevention and treatment of skeletal events in the years 2000-2005. Enrolled were patients with advanced metastatic breast cancer diagnosed in 2000. METHODS AND RESULTS: Analysis of overall survival and survival to disease progression, analysis of patterns of treatment of bone events and the practice of the use of bisphosphonates in the prevention of bone events in metastatic skeleton affection in the normal conditions of clinical practice, analysis of patient compliance in the treatment with bisphosphonates, analysis of the time interval between the occurrence of bone metastases and the occurrence of bone events and, last but not least, survival analysis of patients in relation to bone events. CONCLUSION: This work has shown that the practice of treatment with bisphosphonates since 2000 and assessed the survival of patients with metastatic breast cancer.

Biotransformation of styrene in mice. Stereochemical aspects.

Biotransformation of styrene and its toxic metabolite, phenyloxirane (1), in mice in vivo was studied. Mice were treated with single intraperitoneal doses of styrene (400 mg/kg of body weight), and with (R)-, (S)-, or racemic styrene oxide (150 mg/kg of body weight). Profiles of neutral and acidic metabolites were determined by GC/MS. Mandelic acid (3) and two mercapturic acids, N-acetyl-S-(2-hydroxy-2-phenylethyl)cysteine (5) and N-acetyl-S-(2-hydroxy-1-phenylethyl)cysteine (6), were found to be major urinary metabolites of both styrene and phenyloxirane. 1-Phenylethane-1,2-diol (2) was the main neutral metabolite. The rate of excretion of this metabolite, as determined by GC, was 5-10 times lower than that of mandelic acid. Several minor acidic metabolites were also identified. Among them, novel phenolic metabolites, namely, 2-(4-hydroxyphenyl)ethanol (7), (4-hydroxyphenyl)acetic acid (11), and two isomeric hydroxymandelic acids (12), are of toxicological significance. Main stereogenic metabolites were isolated as methyl esters from extracts of pooled acidified urine treated with diazomethane. The mandelic acid that was obtained was converted to diastereomeric Mosher's derivatives prior to analysis by NMR. Mercapturic acids were analyzed directly by (13)C NMR. Pure enantiomers of 1 were metabolized predominantly but not exclusively to corresponding enantiomers of 3. Styrene yielded predominantly (S)-mandelic acid. Fractions of mercapturic acids 5 and 6 isolated from urine amounted to 12-15% of the dose for all compounds that were administered. Conversion to mercapturic acids was highly regio- and stereoselective, yielding predominantly regioisomer 5. Styrene, as compared to racemic phenyloxirane, yielded slightly more diastereomers arising from (S)-1 than from (R)-1. These data can be explained by formation of a moderate excess of the less mutagenic (S)-1 in the metabolic activation of styrene in mice in vivo.

Is nitric oxide involved in 5-HT3 receptor-mediated neurogenic relaxation of guinea pig proximal colon?

The relaxations mediated by the activation of 5-HT receptors in the guinea pig proximal colon were investigated. Longitudinal strips were cut from the colon segment and placed into the bath. In the presence of atropine (0.2 microM), the relaxations were evoked by adding increasing concentrations of 5-HT (1-100 microM). Noncumulative concentration-response curves were established in the absence and presence of either 5-HT or nitric oxide synthase (NOS) antagonists. Selective 5-HT3 antagonists tropisetron (10 and 100 nM) and ondansetron (1 microM) inhibited the relaxations and shifted the concentration-response curves to the right. Similar effects were observed in the presence of the NOS inhibitor N(G)-nitro-L-arginine (3.2, 10, 32 microM) and partly reversed with L-arginine (100, 320 microM). N(G)-nitro-D-arginine, serving as a negative control, was ineffective. The relaxations were further inhibited in the presence of the soluble guanylate cyclase blocker methylene blue (10 microM) or NO scavenger hemoglobin (32 microM). These results suggest that the 5-HT3 receptor plays a role in neurogenic relaxations of guinea pig proximal colon, which are at least partly mediated via release of NO from nerve endings.

Stereochemical aspects of styrene biotransformation.

Urine of rats dosed with styrene (240 mg/kg), R-, S- and racemic styrene oxide (150 mg/kg) was analysed for mandelic acid enantiomers and for regioisomers and diastereomers of mercapturic acids by NMR spectrometry. Enantiomers of mandelic acid were converted to diastereomeric Mosher's derivatives prior to analysis. R- and S-styrene oxide yielded predominantly R- and S-mandelic acid, respectively, racemic styrene oxide gave predominantly the R-enantiomer whereas styrene yielded almost racemic mandelate. The regioselectivity of mercapturic acid formation was very similar for styrene, R- and S-styrene oxide. These three species yielded a 2:1 mixture of N-acetyl-S-(1-phenyl-2-hydroxyethyl)cysteine (MA1) and N-acetyl-S-(2-phenyl-2-hydroxyethyl)cysteine (MA2). R-Styrene oxide gave higher conversion to mercapturic acids (28%) than the S-isomer (19% of the dose). However, R-styrene oxide yielded stereospecifically S,R-MA1 and R,R-MA2 whereas S-styrene oxide gave R,R-MA1 and S,R-MA2. Styrene yielded a mixture of diastereomeric mercapturic acids. The ratios of R,R-/S,R-isomers were 80:20 and 15:85 for MA1 and MA2, respectively. These data suggest that styrene is metabolised stereoselectively to S-styrene oxide as a major enantiomer in rat in vivo. This enantiomer has been reported to be less mutagenic than R-styrene oxide in vitro.

The evidence for conjugated mandelic and phenylglyoxylic acids in the urine of rats dosed with styrene.

Male Wistar rats were dosed intraperitoneally with styrene (400 mg/kg). Urine samples were collected over phosphate buffer, pH 6.5 for 24 h. Excretion of mandelic (MA) and phenylglyoxylic acid (PGA) amounted to 1.66 +/- 0.62 and 5.21 +/- 2.44% of dose, respectively, as determined by ion-pair HPLC. After acidic hydrolysis, the amount of MA and PGA found in urine increased to 2.10 +/- 0.84 and 6.81 +/- 3.20% (mean +/- S.D.; n = 7), respectively. A similar increase was observed after alkaline hydrolysis of urine samples. Differences between hydrolysed and non-hydrolysed samples were significant in the paired t-test (P < 0.05). Further, urine samples were fractionated by HPLC. Fractions were subjected to acidic hydrolysis and analysed by HPLC and GC/MS. Both MA and PGA were detected in the fraction which did not contain any of these metabolites before hydrolytic treatment. Thus, MA and PGA, which are used as biomarkers of exposure to styrene, form hydrolysable conjugates in the rat. At least a minor part of the total urinary MA and PGA is bound in these conjugates.

Biotransformation of diethenylbenzenes, V. Identification of urinary metabolites of 1,2-diethenylbenzene in the rat.

1. Biotransformation of 1,2-diethenylbenzene (1) in rat was studied. Five urinary metabolites were isolated by extraction of acid hydrolysed urine and identified by nmr and mass spectroscopy, namely, 1-(2-ethenylphenyl)ethane-1,2-diol (2) 2-ethenylmandelic acid (3), 2-ethenylphenylglyoxylic acid (4), 2-ethenylphenylacetylglycine (5) N-acetyl-S-[1-(2-ethenylphenyl)-2-hydroxyethyl]cysteine (6) and N-acetyl-S-[2-(2-ethenylphenyl)-2-hydroxy-ethyl]cysteine (7). 2. In addition, minor metabolites, namely, 2-ethenylbenzoic acid (8) and 2-ethenylphenyl-acetic acid (9) were identified by glc-mass spectral analysis of the hydrolysed urine extract treated subsequently with diazomethane, hydroxylamine and a trimethyl-silylating reagent. Several compounds, which could arise from biotransformation of both ethenyl groups in the molecule of 1, were detected but not identified unequivocally. 3. A glucuronide was detected by tlc analysis of urine as a blue spot after spraying with naphthoresorcinol. Compounds showing molecular fragments indicating the glucuronide moiety were also detected by glc-mass spectroscopy in non-hydrolysed urine samples. 4. The total thioether excretion amounted to 5.3 +/- 2.4, 5.1 +/- 3.4 and 5.0 +/- 1.9% of the dose at 500, 300 and 100 mg/kg, respectively (mean +/- SD; n = 5). 5. Like styrene and other diethenylbenzene isomers, 1,2-diethenylbenzene is metabolically activated to a reactive epoxide intermediate, 2-ethenylphenyloxirane (10), which is further converted to the urinary metabolites mentioned above. The main detoxification pathways are hydrolysis to the glycol 2 followed by several oxidation steps, and conjugation with glutathione. The latter reaction is both regioselective and stereoselective. 6. The ratio of mercapturic acids 6:7 was 83:17. Each regioisomer consists of two diastereomers which show distinct resonance signals in the 13C-nmr. The diastereomer ratio was 82:28 and 79:21 for 6 and 7 respectively.

Biotransformation of acrolein in rat: excretion of mercapturic acids after inhalation and intraperitoneal injection.

Biotransformation of acrolein (ACR) was studied in vivo in the rat following inhalation and ip administration. The major and minor urinary metabolites were 3-hydroxypropylmercapturic acid (HPMA) and 2-carboxyethylmercapturic acid (CEMA), respectively. Male Wistar rats were exposed to ACR, 23, 42, 77 and 126 mg/m3, for 1 hr. The sum of mercapturic acids HPMA and CEMA excreted within 24 hr after the exposure amounted to 0.87 +/- 0.12, 1.34 +/- 0.5, 2.81 +/- 1.15, and 7.13 +/- 1.56 mumol/kg, i.e., 10.9 +/- 1.5, 13.3 +/- 5.0, 16.7 +/- 6.9, and 21.5 +/- 4.8% of the estimated absorbed dose, respectively. The dose estimate was based on reported values of minute respiratory volume and respiratory tract retention and was corrected for the ACR-induced changes in minute respiratory volume. In the relevant dose range (8.9 to 35.7 mumol/kg) the portion of mercapturic acids excreted was nearly constant for ip exposed rats. The sum of HPMA and CEMA amounted to 29.1 +/- 6.5% of the dose. These results indicate that the deficiency in rat lung metabolism of ACR to acrylic acid previously observed is not compensated by the other detoxication pathway in vivo, mercapturic acid formation. The health hazard arising from inhalation of ACR is likely to be higher than that from other routes of exposure.

Biotransformation of acrylates. Excretion of mercapturic acids and changes in urinary carboxylic acid profile in rat dosed with ethyl and 1-butyl acrylate.

1. The excretion of urinary metabolites was studied in rat dosed intraperitoneally with ethyl acrylate and 1-butyl acrylate. 2. Physiological carboxylic acids, namely, 3-hydroxypropanoic acid, lactic acid and acetic acid were determined by hplc and may be derived from the xenobiotic acrylates. 3. A significant increase in the amounts of 3-hydroxypropanoic acid and acetic acid excreted within 24 h after dosing was found in both the ethyl acrylate and 1-butyl acrylate-exposed rats. 4. A slight increase in the excretion of lactic acid (p < 0.10) was also found in animals exposed to ethyl and 1-butyl acrylates. 5. Two mercapturic acids, N-acetyl-S-(2-carboxyethyl)cysteine and the corresponding N-acetyl-S-[(2-alkoxycarbonyl)ethyl]cysteine were formed from both acrylate esters and were determined by glc. For ethyl acrylate the conversion to mercapturic acids amounted to 11% of the administered dose, whereas for 1-butyl acrylate the corresponding conjugates decreased from 3.6% to 0.5 mmol/kg to 1.6% at 3.0 mmol/kg. 6. Mercapturic acids appear to be potential biological markers of exposure to acrylate esters. However, more sensitive methods would be required for their determination than those available at present.

Metabolic pathways of 1-butyl [3-13C]acrylate. Identification of urinary metabolites in rat using nuclear magnetic resonance and mass spectroscopy.

1-Butylacrylate, an industrial monomer, is rapidly metabolized by carboxylesterase-catalyzed hydrolysis to acrylic acid and 1-butanol. Acrylic acid enters the intermediary metabolism and is efficiently degraded to carbon dioxide as the metabolic end product. To obtain a virtually complete metabolic pattern, rats were dosed by a single intraperitoneal dose of 1 mmol/kg 1-butyl [3-13C]acrylate. The urine was then analyzed by a one-dimensional 1H-detected and two-dimensional 1H-13C shift-correlated heteronuclear multiple-quantum NMR experiment. In this experiment, three urinary metabolites, namely, 3-hydroxypropanoic acid, N-acetyl-S-(2-carboxyethyl)cysteine, and N-acetyl-S-(2-carboxyethyl)cysteine sulfoxide, were identified comparing their 1H and 13C chemical shifts with those of authentic standards. In another experiment, to enhance minor metabolic pathways, rats were dosed with 0.25 mmol/kg of a carboxylesterase inhibitor, tri-o-tolyl phosphate, prior to 0.5 mmol/kg butyl [3-13C]acrylate. Under these conditions, N-acetyl-S-(2-carboxyethyl)cysteine, N-acetyl-S-[2-(butoxycarbonyl)-ethyl]cysteine, and N-acetyl-S-(2-carboxyethyl)cysteine sulfoxide were found in urine. No metabolites which would arise from a possible metabolic activation of 1-butyl acrylate to 1-butyl oxiranecarboxylate and its subsequent hydrolysis or glutathione conjugation were found. It is estimated that any metabolite amounting to more than 1% of the dose should be detected under these conditions. To study the routes by which BA enters the intermediary metabolism, incorporation of the label into urinary carboxylic acids was followed by GC/MS. Significant enrichment was found in 3-hydroxypropanoic acid and citric and isocitric acid but not in lactic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

Biotransformation of diethenylbenzenes. IV. A simple high-performance liquid chromatographic method for separation of urinary metabolites of 1,3-diethenylbenzene on analytical and semi-preparative scales.

A simple ion-suppression separation on reversed-phase columns, which is applicable for both analytical and semi-preparative work, is described. Six urinary metabolites of 1,3-diethenylbenzene (I), namely 1-(3-ethenylphenyl)-1,2-dihydroxyethane beta-D-glucosiduronates (two isomers, II and III), N-acetyl-S-[1-(3-ethenylphenyl)-2-hydroxyethyl]cysteine (IV), N-acetyl-S-[2-(3-ethenylphenyl)-2-hydroxyethyl]cysteine (V), 3-ethenylphenylmandelic acid (VI) and 3-ethenylphenylglyoxylic acid (VII), were isolated (Fig. 1). Four of them, IV-VII, have been identified in our previous work; the two glucosiduronates were identified for the first time by 1H NMR spectroscopy, fast atom bombardment mass spectrometry, and enzymic hydrolysis yielding 1-(3-ethenylphenyl)-1,2-dihydroxyethane as an aglycone. The method was reproducible the concentration range 0.05-5 mg/ml, the coefficient of variation being less than 7% (n = 5). Excretion of II-VI within 24 h in the urine of rats dosed with a single intraperitoneal injection of 100, 300 and 600 mg/kg I was determined quantitatively. The utility of the method is discussed in comparison with gas chromatographic-mass spectrometric techniques used previously.

Biotransformation of diethenylbenzenes. III: Identification of metabolites of 1,3-diethenylbenzene in rat.

1. Biotransformation of 1,3-diethenylbenzene (1) in rat gave four major metabolites, namely, 3-ethenylphenylglyoxylic acid (2), 3-ethenylmandelic acid (3), N-acetyl-S-[2-(3-ethenylphenyl)-2-hydroxyethyl]-L-cysteine (4) and N-acetyl-S-[1-(3-ethenylphenyl)-2-hydroxyethyl]-L-cysteine (5) were isolated from urine and identified by n.m.r. and mass spectrometry. 2. Four minor metabolites, 3-ethenylbenzoic acid (6), 3-ethenylphenylacetic acid (7), 3-ethenylbenzoylglycine (8) and 2-(3-ethenylphenyl)ethanol (9) were identified by g.l.c.-mass spectrometric analysis of urine extract derivatized in two different ways. 3. All identified metabolites are derived from 3-ethenylphenyloxirane (10), a reactive metabolic intermediate. No product of any metabolic transformation of second ethenyl group has been identified. However, several minor unidentified metabolites were detected by g.l.c.-mass spectrometry. 4. Total thioether excretion in 24 h urine after a single i.p. dose of 1 amounted to 28.3 +/- 3.5 dose (mean +/- SD). No significant differences in the thioether fraction were observed in the dose range 100-300 mg/kg. 5. Thioether metabolites consisted mainly of mercapturic acids 4 and 5. The ratio of metabolites 5 to 4 was 62:38. Each mercapturic acid consisted of two diastereomers. Their ratio, as determined by quantitative 13C-n.m.r. measurement was 95:5 and 79:21 for mercapturic acids 4 and 5, respectively.

Biotransformation of diethenylbenzenes. I. Identification of the main urinary metabolites of 1,4-diethenylbenzene in the rat.

1. Biotransformation of 1,4-diethenylbenzene (1) in rat was studied. Six urinary metabolites, namely, N-acetyl-S-[2-(4-ethenylphenyl)-2-hydroxyethyl]-L-cysteine (3), N-acetyl-S-[1-(4-ethenylphenyl)-2-hydroxyethyl]-L-cysteine (4), N-acetyl-S-[1-(4-formylphenyl)-2-hydroxyethyl]-L-cysteine (5), 1-(4-ethenylphenyl)ethane-1,2-diol (6), 4-ethenylbenzoic acid (9) and 4-ethenylbenzoyl-glycine (12) were isolated and identified by n.m.r. and mass spectrometry. 2. G.l.c.-mass spectral analysis of the methylated urine extract allowed the identification of four other metabolites, as 4-ethenylphenylacetic acid (11), 4-ethenylphenylacetylglycine (13), 4-ethenylmandelic acid (7), and 4-ethenylphenylglyoxylic acid (8). 3. The structures of the identified metabolites indicate that the main reactive intermediate in the metabolism of 1 is 4-ethenylphenyloxirane (2). The first step in the biotransformation of 1, formation of an oxirane, is very similar to the metabolic activation of styrene. However, subsequent steps lead not only to analogues of styrene metabolites but also to oxidation of the second ethenyl group leading to compound(s) which may contribute to the toxicity of 1, e.g. to the aldehyde 5. 4. Rats dosed with a single i.p. dose of 1 excreted nearly 5.6% of the dose as the glycine conjugate 12, irrespective of the dose. 5. In contrast, the total thioether fraction decreased significantly with increasing dose, being 23 +/- 3, 17 +/- 5 and 12 +/- 1% of dose at 100, 200 and 300 mg/kg, respectively (mean +/- SD).

N-acetyl-S-(1-cyano-2-hydroxyethyl)-L-cysteine, a new urinary metabolite of acrylonitrile and oxiranecarbonitrile.

Two mercapturic acids, i.e., N-acetyl-S-(1-cyano-2-hydroxyethyl)-L-cysteine (CHEMA) and N-acetyl-S-(2-hydroxyethyl)-L-cysteine (HEMA), were isolated from the urine of rats dosed with four successive doses of oxiranecarbonitrile (glycidonitrile, GN), 5 mg/kg, a reactive metabolic intermediate of acrylonitrile (AN). GC-MS analysis of methylated urine extracts from both AN- and GN-dosed rats showed another mercapturate which was identified as N-acetyl-S-(1-cyanoethenyl)-L-cysteine (1-CEMA) methyl ester using an authentic reference sample. The mass spectrum of this compound was very similar to that of a methylated metabolite of AN tentatively identified by Langvardt et al. (1980) as N-acetyl-3-carboxy-5-cyanothiazane (ACCT). In contrast, no ACCT was found in rats dosed with either GN or AN. Hence, there is no evidence for the formation of ACCT or its isomers in rats dosed with AN or GN. The methyl ester of 1-CEMA is formed artificially by dehydration of CHEMA methyl ester in the injector of the gas chromatograph.

Changes in the excretion of endogenous glycine conjugate as a possible artifact in toxicological experiments.

Changes in the urinary excretion of hippuric acid (HIA) and phenaceturic acid (PUA) as well as their metabolic precursors, i.e. benzoic (BA) and phenylacetic acid (PAA), in rats housed in glass metabolic cages for 4 days were monitored using gas-liquid chromatography. The amount of HIA excreted was 128 +/- 63 mumol/kg for female and 79 +/- 43 mumol/kg for male rats in the first 24 h and decreased to 11 +/- 7 mumol/kg (p less than 0.01) for female and 3.2 +/- 2.4 mumol/kg (p less than 0.001) for male rats on the 2nd day. These values remained nearly at the same level until the end of the experiment. The amount of PUA decreased from 48 +/- 12 mumol/kg on the 1st day to 22 +/- 9 mumol/kg (p less than 0.05) on the 2nd day by male rats, whereas by the females the decrease from 30 +/- 9 mumol/kg to 21 +/- 8 mumol/kg was not significant. The decrease in the excretion of glycine conjugates was compensated by a parallel increase in the level of unconjugated BA and PAA.

A multiple choice apparatus for electrophysiological investigations of spatial working memory in rats.

A multiple choice apparatus, minimizing the rat's movements and thus simplifying brain stimulation and/or recording in working memory experiments, consists of a dodecagonal enclosure (30 cm diameter, 100 cm high) with a horizontal platform assuming either an upper or a lower position, 43 or 65 cm below the top of the wall, respectively. The platform is moved between these two levels by a pneumatic system controlled by solid-state programming circuits. Each wall segment contains a choice window, 7 cm above the upper floor level, providing access to a recessed feeder. When the platform with a food-deprived rat moves into the upper position, the animal opens the hinged shutter of one window and gets the pellet. Five seconds later, a self-locking relay marks the visited window and the floor descends to the low position where it remains for a predetermined interval (e.g. 20 s), until it is raised again. The above cycle repeats as a long as different windows are chosen. When a choice is directed to an already visited window (error), the floor returns to the low position at once. During one trial, the animal is allowed 12 choices and the number of errors (i.e. choices directed to already entered windows) is recorded. In spite of the great reduction of kinaesthetic and vestibular signals and the almost complete elimination of visual extramaze cues, the working memory performance is similar to that in analogous radial maze.