Recent advances in biomedical applications of accelerator mass spectrometry

The use of radioisotopes has a long history in biomedical science, and the technique of accelerator mass spectrometry (AMS), an extremely sensitive nuclear physics technique for detection of very low-abundant, stable and long-lived isotopes, has now revolutionized high-sensitivity isotope detection in biomedical research, because it allows the direct determination of the amount of isotope in a sample rather than measuring its decay, and thus the quantitative analysis of the fate of the radiolabeled probes under the given conditions. Since AMS was first used in the early 90's for the analysis of biological samples containing enriched ¹⁴C for toxicology and cancer research, the biomedical applications of AMS to date range from in vitro to in vivo studies, including the studies of 1) toxicant and drug metabolism, 2) neuroscience, 3) pharmacokinetics, and 4) nutrition and metabolism of endogenous molecules such as vitamins. In addition, a new drug development concept that relies on the ultrasensitivity of AMS, known as human microdosing, is being used to obtain early human metabolism information of candidate drugs. These various aspects of AMS are reviewed and a perspective on future applications of AMS to biomedical research is provided.     

Acetazolamide and Dexamethasone in the Prevention of Acute Mountain Sickness

We randomly assigned 32 healthy backpackers to receive placebo, acetazolamide (250 mg twice a day), dexamethasone acetate (4 mg four times a day), or both drugs in combination to determine the drug efficacy in preventing acute mountain sickness (AMS) at altitudes of 3,650 to 4,050m (12,000 to 13,300 ft). The incidence of AMS was high but symptoms were generally mild. Combined drug therapy was superior to both placebo and single drug therapy in risk reduction. Using acetazolamide alone was moderately beneficial in preventing the occurrence of AMS, although minor side effects were frequent. The use of dexamethasone alone did not significantly reduce the AMS incidence, and discontinuing its use resulted in symptoms suggestive of adrenal insufficiency. For recreational backpackers, routine drug prophylaxis is not recommended, in view of the mild nature of this illness and the adverse effects of medications. The efficacy of combined acetazolamide-dexamethasone therapy warrants further investigation at higher altitudes, where AMS is more severe, and the dexamethasone should be withdrawn gradually to avoid a possible adrenal crisis.     

Network Neighbors of Drug Targets Contribute to Drug Side-Effect Similarity

In pharmacology, it is essential to identify the molecular mechanisms of drug action in order to understand adverse side effects. These adverse side effects have been used to infer whether two drugs share a target protein. However, side-effect similarity of drugs could also be caused by their target proteins being close in a molecular network, which as such could cause similar downstream effects. In this study, we investigated the proportion of side-effect similarities that is due to targets that are close in the network compared to shared drug targets. We found that only a minor fraction of side-effect similarities (5.8 %) are caused by drugs targeting proteins close in the network, compared to side-effect similarities caused by overlapping drug targets (64%). Moreover, these targets that cause similar side effects are more often in a linear part of the network, having two or less interactions, than drug targets in general. Based on the examples, we gained novel insight into the molecular mechanisms of side effects associated with several drug targets. Looking forward, such analyses will be extremely useful in the process of drug development to better understand adverse side effects.     

膜片钳技术的新进展及其在药物高通量筛选中的应用

作为先进的细胞电生理技术,膜片钳一直被奉为研究离子通道的“金标准”。应用膜片钳技术可以证实细胞膜上离子通道的存在并能对其电生理特性、分子结构、药物作用机制等进行深入的研究。基因组学、蛋白质组学研究表明,以离子通道为靶标的药物研究在未来具有很大的发展空间。为了突破由于筛选技术所造成的针对离子通道为靶标的药物研发的瓶颈,近年来,对膜片钳技术进行了改进以适合药物高通量筛选的需求,由此产生了一些新的技术。本文就最近几年膜片钳技术的新进展及其在药物高通量筛选中的应用进行了综述。     

Prodrug Approaches for Enhancing the Bioavailability of Drugs with Low Solubility

Low water solubility and low bioavailability are frequent problems in drug development, particularly in the area of central nervous system (CNS) drugs. This short review describes selected prodrug approaches which have been developed to enhance the bioavailability of drugs, especially that of poorly soluble drugs. Some of the most successful drugs on the market are prodrugs. With a better understanding of active‐transport processes at cell membranes in the gut as well as at the blood–brain barrier, the importance of prodrug approaches will further increase in the future. Prodrug approaches will already be considered in the early phase of drug discovery.     

Toxicogenomics in drug discovery: from preclinical studies to clinical trials

Gene expression analysis applied to toxicology studies, also referred to as toxicogenomics, is rapidly being embraced by the pharmaceutical industry as a useful tool to identify safer drugs in a quicker, more cost-effective manner. Studies have already demonstrated the benefits of applying gene expression profiling towards drug safety evaluation, both for identifying mechanisms underlying toxicity, as well as for providing a means to identify safety liabilities early in the drug discovery process. Furthermore, toxicogenomics has the potential to better identify and assess adverse drug reactions of new drug candidates or marketed products in humans. While much still remains to be learned about the relevance and the application of gene expression changes in human toxicology, the next few years should see gene expression technologies applied to more stages and more programs of the drug discovery and development process. This review will focus on how toxicogenomics can or has been applied in drug discovery and development, and will discuss some of the challenges that still remain.     

Variability in Response to Drugs

Variability in the response to drugs is due to three principal components—the disease, the responsiveness of tissues, and the concentration of the drug at its site of action (as reflected by its plasma concentration). The relative contributions of these components will differ not only for different drugs but also for different effects of the same drug. Rational drug therapy depends on knowledge of all three factors.     

Effervescence Assisted Fusion Technique to Enhance the Solubility of Drugs

The solubility of five poorly soluble drugs was enhanced by using an effervescence assisted solid dispersion (EASD) technique. EASDs were prepared by using modified fusion method. Drug and hydrophilic carrier were melted, and in this molten mixture, effervescence was generated by adding effervescence couple comprising organic acid (citric acid) and carbonic base (sodium bicarbonate). Solubility of drug powders, solid dispersions, and EASDs was determined at 25°C using shake flask method. Atorvastatin calcium, cefuroxime axetil, clotrimazole, ketoconazole, and metronidazole benzoate were estimated using a spectrophotometer at 246, 280, 260, 230, and 232 nm (λ_max), respectively. Solubility of atorvastatin calcium (from 100 to 345 μg/ml), cefuroxime axetil (from 441 to 1948 μg/ml), clotrimazole (from 63 to 677 μg/ml), ketoconazole (from 16 to 500 μg/ml), and metronidazole benzoate (from 112 to 208 μg/ml) in EASDs was enhanced by 3.45-, 4.4-, 10.7-, 31.2-, and 1.8-fold, respectively. Scanning electron micrographs of drug powder, solid dispersion, and EASDs were compared. Scanning electron micrographs of EASDs showed a uniform distribution of drug particles in the carrier matrix. Morphology (size and shape) of cefuroxime axetil particles was altered in solid dispersion as well as in EASD. EASDs showed better solubility enhancement than conventional solid dispersions. The present technique is better suitable for drugs having a low melting point or melt without charring. Effervescence assisted fusion technique of preparing solid dispersions can be employed for enhancing solubility, dissolution, and bioavailability of poorly soluble drugs.KEY WORDS: dissolution, effervescence, fusion, solid dispersion, solubility     

Crystallo-co-agglomeration: A novel technique to obtain ibuprofen-paracetamol agglomerates

The purpose of this research was to obtain directly compressible agglomerates of ibuprofen-paracetamol containing a desired ratio of drugs using a crystallo-co-agglomeration technique. Crystallo-co-agglomeration is an extension of the spherical crystallization technique, which enables simultaneous crystallization and agglomeration of 2 or more drugs or crystallization of a drug and its simultaneous agglomeration with another drug or excipient. Dichloromethane (DCM)-water system containing polyethylene glycol (PEG) 6000, polyvinyl pyrollidone, and ethylcellulose was used as the crystallization system. DCM acted as a good solvent for ibuprofen and bridging liquid for agglomeration. The process was performed at pH 5, considering the low solubility of ibuprofen and the stability of paracetamol. Loss of paracetamol was reduced by maintaining a low process temperature and by the addition of dextrose as a solubility suppressant. The agglomerates were characterized by differential scanning calorimetry, powder x-ray diffraction (PXRD), and scanning electron microscopy and were evaluated for tableting properties. The spherical agglomerates contained an ibuprofen-paracetamol ratio in the range of 1.23 to 1.36. Micromeritic, mechanical, and compressional properties of the agglomerates were affected by incorporated polymer. The PXRD data showed reduction in intensities owing to dilution and reduced crystallinity. Thermal data showed interaction between components at higher temperature. Ethylcellulose imparted mechanical strength to the agglomerates as well as compacts. The agglomerates containing PEG have better comparessibility but drug release in the initial stages was affected owing to asperity melting, yielding harder compacts. The agglomeration and properties of agglomerates were influenced by the nature of polymer.     

Amelioration of acute mountain sickness: Comparative study of acetazolamide and spironolactone

Acetazolamide and spironolactone were evaluated for their ameliorating effects on acute mountain sickness (AMS). Studies were conducted in 29 healthy male subjects in lowland and at a height of 3,500 m after their airlift. A modified General High Altitude Questionnaire (GHAQ) was used to evaluate the effectiveness of these drugs for reducing the intensity of AMS symptoms. Both the drugs were found to be helpful in minimising the occurrence as well as severity of most of the symptoms. Spironolactone seems to be a superior prophylactic agent than acetazolamide.     

Atomic Force Microscopy and pharmacology: From microbiology to cancerology

Background

Atomic Force Microscopy (AFM) has been extensively used to study biological samples. Researchers take advantage of its ability to image living samples to increase our fundamental knowledge (biophysical properties/biochemical behavior) on living cell surface properties, at the nano-scale.

Scope of review

AFM, in the imaging modes, can probe cells morphological modifications induced by drugs. In the force spectroscopy mode, it is possible to follow the nanomechanical properties of a cell and to probe the mechanical modifications induced by drugs. AFM can be used to map single molecule distribution at the cell surface. We will focus on a collection of results aiming at evaluating the nano-scale effects of drugs, by AFM. Studies on yeast, bacteria and mammal cells will illustrate our discussion. Especially, we will show how AFM can help in getting a better understanding of drug mechanism of action.

Major conclusions

This review demonstrates that AFM is a versatile tool, useful in pharmacology. In microbiology, it has been used to study the drugs fighting Candida albicans or Pseudomonas aeruginosa. The major conclusions are a better understanding of the microbes' cell wall and of the drugs mechanism of action. In cancerology, AFM has been used to explore the effects of cytotoxic drugs or as an innovative diagnostic technology. AFM has provided original results on cultured cells, cells extracted from patient and directly on patient biopsies.

General significance

This review enhances the interest of AFM technologies for pharmacology. The applications reviewed range from microbiology to cancerology.     

Identification of susceptibility to acute mountain sickness by detecting vascular tone using a photoplethysmographic sensor

Objective: Vascular tone had shown the potential susceptibility to acute mountain sickness(AMS), however the detailed tendency has not been studied. Methods: Vascular tone, SpO_2 and Rate pressure product(RPP) were studied in seventeen healthy subjects before and after rapid ascent from sea level to 3658 m. Human acute mountain sickness was evaluated by the Lake Louise Score(LLS). Results: Nine of the seventeen participants were diagnosed with AMS. On initial exposure, there was a significant decrease in vascular tone between subjects with and without AMS. Significance was also found in the decrease of SpO_2 before and after rapid ascent but the differences between subjects with and without AMS did not reach significance during the initial phase. Conclusions: Vascular tone on initial exposure in response to rapid ascent is a possible sign of susceptibility to AMS. Conclusion: measurement of vascular tone using a wearable sensor throughout the acute phase response will provide numerical values of pathophysiology throughout the development of AMS.     

Approaches to antiviral drug development

At present, only a few drugs have been approved by the FDA for therapy of viral infections in humans. There is a great need for antiviral drugs with increased potency and decreased toxicity, as well as drugs to treat viral diseases for which no drug or vaccine is currently available. Two approaches for development of antiviral drugs are described--an empirical strategy and a rational strategy--with several examples of each. Although many compounds have potent antiviral activity in cell culture, only a small fraction of these will go on to become antiviral drugs for use in humans. At this time, only seven synthetic compounds and alpha interferon have been approved by the FDA for therapy of viral infections in humans. None of these approved drugs are without toxicities, however, and hence there is a great need for antiviral drugs with increased potency and decreased toxicity, as well as for drugs to treat viral diseases for which no drug or vaccine is currently available. Two approaches for the development of antiviral drugs--the empirical and the rational strategies--and their applications and future directions are discussed.     

The clinical application of chronobiology to oncology

The introduction to medical practice of chemical agents for fighting human cancer some 30 years ago brought hope to a field of medicine previously shrouded in despair and impeded by superstition. Gradually more and better agents have become available to the physician and to the patient suffering from cancer. The physician-scientist has, in turn, learned a great deal about normal and abnormal cellular biology by using these drugs as probes. The observations that certain tissues and certain tumors share patterns of drug toxicity have led to a broadening of biologic understanding and to the use of combinations of drugs with shared antitumor activity and unshared toxicities. This empiric art of cancer chemotherapy has resulted in great progress in the treatment of a large number of advanced cancers. As important, however, is that this experience has resulted in knowledge which is leading to the development of rationally designed therapeutic regimens; to drug analogues seeking greater therapeutic-toxic ratios; to the development of methods for chemically interfering with toxic drug effects while allowing or enhancing antitumor effect; and to work defining effects of drug timing. Drug timing research considers drug dosage in respect to the timing of a drug relative to the timing of other drugs (drug-time-drug interactions) or to other doses of that same drug (drug-drug interval); the order of drugs (drug-drug sequence); and the timing of drugs relative to an internal organismic time structure (time-drug interactions). Data in this brief review clearly show that drug timing needs to be considered when designing rational chemotherapy for a living organism suffering from a cancer. The beautiful spatiotemporal complexity of life is not to be ignored or avoided, but should be considered as a golden opportunity to use what few imprecise chemical weapons we have a little more effectively.     

抗结核药物及其耐药相关突变位点的研究进展

结核病是结核分枝杆菌复合物引起的传染性疾病,致死率、致残率高,在全球传染病中居第2位。近年来耐药结核病所占比例逐年升高,成为消灭结核病面临的巨大挑战之一。传统的耐药诊断方法基于培养,费时费力,所需技术要求高;而现有分子检测方法仅能检测少量抗结核药物的少数耐药基因。因此,更好地理解抗结核药物的耐药机制有助于全面耐药诊断。本文对临床中使用频率较高的11类一线和二线抗结核药物及其相应耐药相关基因、突变位点的研究进展进行总结,尤其是对环丝氨酸、利奈唑胺、氯法齐明等二线药物的近期研究做了系统描述,为全面耐药诊断、精准治疗指导、新药研发及耐药机制深入研究提供了前期工作基础。     

Towards biomarker-dependent individualized chemotherapy: Exploring cell-specific differences in oxaliplatin–DNA adduct distribution using accelerator mass spectrometry

Oxaliplatin is a third-generation platinum-based anticancer drug that is currently used in the treatment of metastatic colorectal cancer. Oxaliplatin, like other platinum-based anticancer drugs such as cisplatin and carboplatin, is known to induce apoptosis in tumor cells by binding to nuclear DNA, forming monoadducts, and intra- and interstrand diadducts. Previously, we reported an accelerator mass spectrometry (AMS) assay to measure the kinetics of oxaliplatin-induced DNA damage and repair [Hah, S. S.; Sumbad, R. A.; de Vere White, R. W.; Turteltaub, K. W.; Henderson, P. T. Chem. Res. Toxicol. 2007, 20, 1745]. Here, we describe another application of AMS to the measurement of oxaliplatin–DNA adduct distribution in cultured platinum-sensitive testicular (833 K) and platinum-resistant breast (MDA-MB-231) cancer cells, which resulted in elucidation of cell-dependent differentiation of oxaliplatin–DNA adduct formation, implying that differential adduction and/or accumulation of the drug in cellular DNA may be responsible for the sensitivity of cancer cells to platinum treatment. Ultimately, we hope to use this method to measure the intrinsic platinated DNA adduct repair capacity in cancer patients for use as a biomarker for diagnostics or a predictor of patient outcome.     

Detection of Adriamycin-DNA adducts by accelerator mass spectrometry at clinically relevant Adriamycin concentrations

Limited sensitivity of existing assays has prevented investigation of whether Adriamycin-DNA adducts are involved in the anti-tumour potential of Adriamycin. Previous detection has achieved a sensitivity of a few Adriamycin-DNA adducts/10(4) bp DNA, but has required the use of supra-clinical drug concentrations. This work sought to measure Adriamycin-DNA adducts at sub-micromolar doses using accelerator mass spectrometry (AMS), a technique with origins in geochemistry for radiocarbon dating. We have used conditions previously validated (by less sensitive decay counting) to extract [(14)C]Adriamycin-DNA adducts from cells and adapted the methodology to AMS detection. Here we show the first direct evidence of Adriamycin-DNA adducts at clinically-relevant Adriamycin concentrations. [(14)C]Adriamycin treatment (25 nM) resulted in 4.4 +/- 1.0 adducts/10(7) bp ( approximately 1300 adducts/cell) in MCF-7 breast cancer cells, representing the best sensitivity and precision reported to date for the covalent binding of Adriamycin to DNA. The exceedingly sensitive nature of AMS has enabled over three orders of magnitude increased sensitivity of Adriamycin-DNA adduct detection and revealed adduct formation within an hour of drug treatment. This method has been shown to be highly reproducible for the measurement of Adriamycin-DNA adducts in tumour cells in culture and can now be applied to the detection of these adducts in human tissues.