An experimental study of acute and chronic effects of phenacetin on the rat kidney, using clinical-chemical and biochemical methods.

In rats, changes in urinary enzymatic activities (AP, SP, LAP, beta-GLU, MUR) were recorded following the administration of phenacetin in acute doses (4.75 and 7.15 mmol/kg). Urinary AP and LAP activities were measured over 77 days in which 3.35 mmol phenacetin/kg were given daily. The results revealed immediate and delayed effects of phenacetin, depending upon the quality of the drug used. In the chronic series, changes in urinary enzymatic activities were less pronounced. Concomitant biochemical investigations of kidney cell fractions revealed the occurrence of mitochondrial damage under the influence of chronic phenacetin administration. Following acute doses of phenacetin, destructive alterations in the plasma membrane of kidney cells were encountered. Investigations of serum enzymatic activities 24 h after phenacetin administration did not reveal any significant changes.     

Micronucleus induction in mouse bone marrow by phenacetin administered intraperitoneally or orally

The extent and time course of induction of micronucleated polychromatic erythrocytes (MNPCEs) in mouse bone marrow were examined after administration of phenacetin as an insoluble suspension in olive oil by intraperitoneal injection (i.p.) or gastric intubation (p.o.) to 2 strains of mice, MS/Ae and CD-1, at doses up to 1200 mg/kg. The toxicity of phenacetin and the sensitivity of micronucleus induction differed in the 2 strains, but there was little difference in the extent of MNPCEs induced by the 2 administration routes.     

Species difference in the metabolic activation of phenacetin by rat and hamster liver microsomes

Phenacetin is mutagenic in Salmonella typhimurium TA 100 when liver 9,000 X g supernatant fractions from PCB-treated hamsters instead of rats are used. A mechanism of the species difference in phenacetin mutagenicity was investigated. By high-performance liquid chromatography analysis, it was found that phenacetin is activated to direct-acting mutagens through N-hydroxylation and deacetylation by hamster liver microsomes. Although no significant species difference was observed in N-hydroxylation, rates of deacetylation were 9 to 150 times higher in hamsters than in rats. The results indicate that the marked species difference in phenacetin mutagenicity is due to the difference in deacetylation activity between rat and hamster liver microsomes.     

Comparative Nephrotoxicity of Aspirin and Phenacetin Derivatives

Both aspirin and phenacetin derivatives were shown to be nephrotoxic when administered to rats as a single intravenous injection. Phenacetin derivatives tended to produce more severe renal damage and to be nephrotoxic in smaller doses than aspirin derivatives. With the exception of a single derivative, the renal lesions were confined to the proximal convoluted tubule, even after administration of compounds which under other conditions have induced renal papillary necrosis.     

The binding of radioactive label from labelled phenacetin and related compounds to rat tissues in vivo and to nucleic acids and bovine plasma albumin in vitro

1. acetyl-(3)H- and ethyl-(14)C-labelled derivatives of phenacetin and related compounds are described. 2. Radioactive label from the ethyl-(14)C-labelled derivatives of 4-nitrophenetole, 4-phenetidine and phenacetin binds in vitro to various extents to bovine plasma albumin, salmon sperm DNA and yeast RNA; the extent of binding is increased in the presence of a rat liver microsomal hydroxylating system and further increased when the microsomal enymes are induced by prior treatment of rats with 3-methylcholanthrene. 3. The ratios of the bound radioactive labels in vitro from [ethyl-(14)C]phenacetin, N-acetoxy[ethyl-(14)C]phenacetin, [acetyl-(3)H]phenacetin and [diacetyl-(3)H]N-acetoxyphenacetin per g-atom of DNA P, RNA P and per mol of protein in the absence of the microsomal system are approximately 1:60:11:863, 1:68:41:1835 and 1:88:713:2399 respectively. 4. Radioactive label from labelled phenacetin binds in vitro to all tissues examined, including the spleen, intestines, kidney and bladder; about 80% of the radioactivity bound to the liver is concentrated in the RNA and proteins. 5. Comparison of the relative extents of binding of radioactive label derived from equimolar amounts of labelled phenacetin, ethanol or acetate shows that the incorporation of labelled C(2) units into tissues and biological macromolecules in vivo and in vitro may account for only a part of the total bound radioactive label derived from phenacetin and not at all from the incorporation of radioactive acetate into nucleic acids. 6. Some implications of these findings are discussed.     

A rapid method for evaluation of analgesic and anti-inflammatory activity in rats

Carrageenin (2%) was used to produce edema and hyperalgesia; indomethacin, phenylbutazone, aspirin, ibuprofen, analgin, paracetamol and phenacetin were tested at different doses for anti-inflammatory and analgesic activity in the same rats as the peak for the edema reached at the end of 3rd hr and for the hyperalgesia at the end of 4th hr. Indomethacin, phenylbutazone and ibuprofen reduced edema and increased the pain threshold. Analgin and aspirin increased the pain threshold relatively at a low dose. Paracetamol and phenacetin were inactive in the doses tested. Carrageenin (2%) was observed to possess both phlogistic and allogenic properties.     

Retained folates in the rat.

The retention of radioactivity after doses of 14C- and 3H-labelled folic acid is described. Radioactivity was retained in liver, kidney and gut of rats for some time after administration of the dose. The retained radioactivity could not be displaced by large doses of unlabelled folic acid or unlabelled 5-methyltetrahydrofolate. 14C- and 3H-labbelled folates showed similar chromatographic behaviour onion-exchange chromatography to 5-methyltetrahydrofolate, and on ion-exchange and gel-permeation chromatography to synthetic pteroylhepta-gamma-glutamate.     

Phenacetin N-deacetylase and its non-identity with the serotonin sensitive aryl acylamidase of brain

Phenacetin N-deacetylase was characterized in monkey brain. The enzyme needed Triton X-100 for maximal extraction and it had a high specific activity in cerebellum and in the nuclear fraction of whole monkey brain. It differed from the brain aryl acylamidase in both the regional and subcellular distributions. Brain aryl acylamidase purified by affinity chromatography was ineffective in deacetylating phenacetin. All the potent inhibitors of brain aryl acylamidase such as serotonin, tryptamine, acetylcholine and its analogues and neostigmine had no effect on phenacetin deacetylase. However, brain pehnacetin deacetylase was moderately inhibited by indole-3-acetic acid and 5-hydroxy indole-3-acetic acid properties similar to those of liver aryl acylamidase. Acetaminophen was not deacetylated by the brain phenacetin deacetylase.     

In vivo effect of diallyl sulfide and cimetidine on phenacetin metabolism and bioavailability in rat

Numerous cytochrome P450 inhibitors have been described as effective modulators of cytochrome P450 isoforms activity in vitro. Their inhibitory efficiency may be considerably modified after in vivo application. The aim of this study was to examine the effect of oral administration of diallyl sulfide--a cytochrome P450 2E1 inhibitor and cimetidine--a cytochrome P450 2C6 and 2C11 inhibitor on rat serum concentration of phenacetin and its metabolite acetaminophen. Both inhibitors increased area under the curve (AUC(0-4 h)) for phenacetin by 50%. Only cimetidine reduced AUC(0-4 h) for acetaminophen indicating inhibition of O-deethylation activity. Quinidine--a cytochrome P450 2D subfamily and P-glycoprotein inhibitor did not change significantly phenacetin bioavailability. These results suggest that diallyl sulfide inhibits the deacetylation pathway catalysed by arylamine N-acetyl transferase. Beside cytochrome P450 1A2 other cytochrome P450 isoforms (2A6 and/or 2C11) are involved in phenacetin O-deethylation in rat.     

Experimentally induced toxic-haemolytic anaemia in laboratory rats following phenacetin administration

In an attempt to give assistance in the search for a simple haematological system for the detection of toxic-haemolytic effects of chemical substances, we used a battery of simple tests and phenacetin as a reference substance. The drug was administered in a single dose or repeatedly for two or four weeks. Higher plasma haemoglobin levels and symptoms of anaemia (decreased blood haemoglobin levels, erythrocytic counts, haematocrit) and activated erythropoiesis (increased reticulocyte counts, MCV, marrow and splenic E:M ratios) were found to be best marked following administration of phenacetin in the very high dose of 1.0 g/kg per orally for two weeks. Our results suggest that plasma haemoglobin levels could provide information on the haemolytic potential of phenacetin if the experimental schedule included the optimal combination of suitable phenacetin dosage and duration of loading.     

Some new aspects of the metabolism of phenacetin in the rat

1. Four new metabolites of phenacetin in the urine of the rat are described; these are (i) N-acetyl-S-ethylcysteine, (ii) quinol, (iii) acetamide and (iv) probably N-acetyl-S-2-(4-ethoxyacetanilido)cysteine S-oxide. 2. Metabolites (i), (iii) and (iv) were characterized and estimated by g.l.c., by t.l.c., by paper chromatography, by chemical reactions or by radioactive techniques after administration to rats of [ethyl-¹⁴C]phenacetin and [acetyl-³H]phenacetin; metabolite (ii), which was excreted mainly as conjugates of sulphuric acid and glucosiduronic acid, was measured by paper chromatography and characteristic colour reactions after enzymic and chemical hydrolysis of the conjugates. 3. Small amounts of azoxy-4-[ethyl-¹⁴C]ethoxybenzene and an unknown metabolite were also found in the urine of rats after administration of [ethyl-¹⁴C]phenacetin. 4. The likely mechanisms and some biological implications of these metabolic reactions are discussed.     

Estrogen receptors and androgen receptors in the mammalian liver

An estrogen receptor and an androgen receptor are present in the mammalian liver. In the liver of the rat, the estrogen receptor concentration increases markedly at puberty and this change correlates with enhanced estrogen stimulation of plasma renin substrate synthesis. High doses of estrogen are required for nuclear binding in liver when compared to doses for the uterus. The high dose requirement appears to be predominantly due to extensive metabolism in the hepatocyte of the estrogen to inactive derivatives. Furthermore, estradiol is much weaker than ethinyl estradiol for promoting nuclear binding in the liver. This is due to extremely rapid and extensive metabolism of estradiol. In human liver the concentration of estrogen receptor is low. An androgen receptor is present in high concentration in rabbit liver and is located predominantly in the nucleus after androgen administration. High concentrations of a putative androgen receptor are also present in human liver cytosol. Preliminary studies indicate that synthetic progestins can attach to the human liver androgen receptor. To date, a progesterone receptor has not been found in the mammalian liver. Thus, it appears that extensive steroid metabolism in liver preferentially diminishes sex steroid interaction with liver receptors and that androgen receptors may mediate progestin effects in liver. These observations provide a scientific basis for improved safety of oral contraceptives. Lowering the estrogen and progestin doses in oral contraceptives will decrease the major side-effects, which are liver mediated, and still maintain the desired effects at the hypothalamic-pituitary axis and uterus. Furthermore, it is likely that by selecting which estrogen, progestin or androgen is administered as well as by utilizing a parenteral route of administration that sex steroid effects on the liver could be minimized.     

No correlation between binding of glucocorticosteroids to specific cytoplasmic proteins in vivo and enzyme induction in the rat liver.

Time- and dose-dependence of the formation of the different cytoplasmic hormone-protein complexes were studied in the rat liver after administration in vivo of [3H]cortisol or [3H]dexamethasone and compared with the stimulation of RNA polymerase B and induction of tyrosine aminotransferase and tryptophan oxygenase. No correlation could be found between formation in vivo of any of the five cytoplasmic hormone-protein complexes found and stimulation of RNA polymerase B activity or enzyme induction. After administration of [3H]cortisol, different metabolites of cortisol could be demonstrated in the isolated hormone-protein complexes. No time- or dose-dependence of the metabolite patterns could be observed after application of hormone doses that were in the range of the biologically active doses. After administration of [3H]dexamethasone, the same hormone-protein complexes were observed, which contained, however, the injected steroid instead of metabolites. These results seem to indicate that the cytoplasmic binding components present in the rat liver are enzymes involved in the metabolism of the glucocorticosteroids and that dexamethasone binds to these enzymes as a substrate analogue.     

The micronucleus test with peripheral reticulocytes from phenacetin-treated mice.

The in vivo micronucleus test is conventionally performed using mouse bone marrow cells (BM assay). Using phenacetin as a test chemical, an alternative method using reticulocytes (RET assay) was examined to determine if this could be substituted for the BM assay. Single doses of 400, 600, and 800 mg/kg gave negative results 24 h after i.p. administration, but positive results were obtained with 600 and 800 mg/kg after 48 h. Responses were weak at 72 h. Double treatment enhanced the responses; 400 mg/kg gave a positive result. Maximum responses were generally reached 24 h after the second treatment, 48 h if doses were highly toxic. When the BM and RET assays were compared, the BM assay seemed to be slightly more sensitive than the RET assay; double treatment was superior to a single treatment in both BM and RET assays. Both assays can be used routinely but in the RET assay, sequential samples can be obtained from the same individuals without killing them, providing a firm basis to substitute it for the BM assay. Taking advantage of this characteristic of the RET assay, a regimen of double treatments and double sampling at 24 and 48 h is recommended for a wide range of doses. These data were obtained with CD-1 mice; MS/Ae mice gave a higher incidence of micronuclei than did the CD-1 strain.     

Chronic morphine treatment induces oxidant and apoptotic damage in the mice liver

Recently many researchers have proposed a protective role for morphine against tumor growth and metastasis, especially through induction of apoptosis in tumoral cells. These findings may lead to underestimation of cytotoxic effects of opioid drugs which are usually expected only at high doses. The present study was conducted to clarify whether repeated morphine administration, which is commonly used for relief from chronic pain, would interfere with liver antioxidant defence and hepatocytes vitality. Morphine was injected repeatedly at doses that have been reported to relieve cancer pain and reduce tumor spread in mice (5 and 10 mg/kg/day for nine consecutive days). The changes in hepatic glutathione concentration, its synthesis pathway and enzymatic antioxidant defense revealed the pro-oxidant effects of chronic morphine treatment on the liver. None of these changes were observed in those mice that were co-treated with naltrexone (opioid antagonist) and same doses of morphine. However induction of liver conjugating enzymes following morphine treatment was not receptor mediated. Moreover, chronic morphine treatment induced hepatocytes apoptosis. Interestingly, the apoptotic changes were antagonized by co-administration of either naltrexone or thiol antioxidant. In conclusion, although hepatotoxic effects of morphine at high doses have been reported previously, our findings propose that repeated morphine administration even at lower doses would induce oxidative stress in the liver, which may contribute to induction of apoptosis in hepatocytes. Since many of the observed adverse effects were mediated by opioid receptors, our results suggest that other opioid analgesics should also be used more cautiously.     

Xenobiotic metabolism in the human lung

The metabolism of xenobiotics by human lung has been investigated in tissue obtained from 10 patients undergoing pneumonectomy and compared with human liver activities in 6 different subjects. Lung microsomal fractions contain no detectable cytochrome P-450 while cytochrome b₅ values were 25% of those for human liver. NADH and NADPH-cytochrome c reductase activity are in the range of those reported for other species. Human lung microsomes possess < 3% of the metabolic activity of liver for the oxidation of benzpyrene, phenacetin and 7-ethoxycoumarin.     

Liver and kidney glucose-6-phosphatase levels in carbon tetrachloride- and DDT-administered mice.

Mouse liver and kidney glucose-6-phosphatase levels were found to be decreased 24 h after administration of various doses of carbon tetrachloride (CCl4) when compared to controls. Liver glucose-6-phosphatase levels were always decreased to a greater extent than the kidney enzyme in mice given the same amount of CCl4. Administration of p,p'-1,1,1,-trichloro-2,2-bis (p-chlorophenyl) ethane (p,p'-DDT) to mice did not significantly alter the glucose-6-phosphatase levels of liver or kidney.     

III. Evidence for the nephrotoxicity of analgesics

Analgesic nephropathy in man is a definite but complex and probably multifactorial disorder, which largely follows long-term abuse of mixed analgesics. In North America the disorder has been almost entirely associated with heavy ingestion of the combination acetylsalicylic acid (ASA), phenacetin and caffeine. There is less clinical and experimental evidence for the nephrotoxicity of single analgesics; however, evidence for the nephrotoxicity of ASA alone is greater than that for phenacetin. In view of the evidence for nephrotoxicity of most mild analgesics, removal of phenacetin from the market would be unlikely to eliminate the problem of analgesic nephropathy.     

On the location of cellular functions in perfused organs

Rappaport's picture of liver cells performing specialized functions in spatially distinct zones arranged in relation to hepatic blood flow, is arrived at from a new direction. Previously published data from perfused rat livers eliminating labelled acetaminophen, both pre-formed and formed in the liver from phenacetin, are interpreted to imply that the formation takes place wholly upstream of the elimination. This analysis exemplifies a general method of mapping such functional zones in perfused organs.     

Accumulation of activated lymphocytes in liver of endotoxin treated rabbits.

Intravenous administration of endotoxin in doses, 1.0 mg/kg, 0.1 mg/kg or 0.01 mg/kg caused activation (in the sense of nucleolar RNA synthesis) of the lymphocytes in peripheral blood, kidney and liver in rabbits. The evaluation of the ratio of lymphocyte count to the number of organ tissue cells leads to the conclusion that the accumulation of endotoxin activated lymphocytes occurs in liver.