Cytotoxicity and P-glycoprotein inhibition by cardiotonic steroids

Herzwirksame Glykoside sind in der Natur sowohl im Tier- als auch im Pflanzenreich zu finden und werden regelmäßig zur Therpaie von Herzinsuffizienz eingesetzt. In letzter Zeit belegten viele Studien, dass herzwirksame Glykoside vielversprechende Substanzen für die Behandlung von Krebs darstellen. Ihr Wirkmechanismus basiert auf der Hemmung der Na+/K+-ATPase. Die Na+/K+-ATPase spielt neuerdings eine wichtige Rolle in der Krebsbiologie, da sie viele relevante Signalwege beeinflusst. Multiresistenzen gegen Arzneimittel sind oftmals verantwortlich für das Scheitern einer Chemotherapie. Bei multi-drug-resistenten Tumoren erfolgt ein Transport der Chemotherapeutika aus der Krebszelle hinaus durch das Membranprotein P-Glykoprotein. In der vorliegenden Arbeit wurde die Zytotoxizität von 66 herzwirksamen Glykosiden und ihren Derivaten in sensitiven und resistenten Leukämie-Zellen getestet. Die Ergebnisse zeigen, dass diese Naturstoffe die Zell-Linien in verschiedenen molaren Bereichen abtöten. Allerdings waren die Resistenz-Indizes niedrig (d. h. die IC50 Werte waren in beiden Zell-Linien ähnlich). Die untersuchten 66 Substanzen besitzen eine große Vielfalt an chemischen Substituenten. Die Wirkung dieser Substituenten auf die Zytotoxizität wurde daher durch Struktur-Aktivitäts-Beziehung (SAR) erforscht. Des Weiteren wiesen quantitative Struktur-Aktivitäts-Beziehung (QSAR) und molekulares Docking darauf hin, dass die Na+/K+-ATPase in sensitiven und resistenten Zellen unterschiedlich stark exprimiert wird. Eine Herunterregulation der Na+/K+-ATPase in multi-drug-resistenten Zellen wurde durch Western Blot bestätigt und die Wirkung dieser auf relevante Signalwege durch Next-Generation-Sequenzierung weiter verfolgt. Dadurch konnte eine Verbindung zwischen der Überexpression von P-Glykoprotein und der Herunterregulation der Na+/K+-ATPase hergestellt werden. Der zweite Aspekt der Arbeit war die Hemmung von P-Glykoprotein durch herzwirksame Glykoside, welche durch Hochdurchsatz-Durchflusszytometrie getestet wurde. Sechs wirksame Glykoside konnten den P-Glykoprotein-vermittelten Transport von Doxorubicin inhibieren. Zudem konnte die Zytotoxität von Doxorubicin in multi-drug-resistenten Zellen teilweise wieder zurück erlangt werden. Unabhängig von herzwirksamen Glykosiden war die Bewertung der Anwendung von molekularem Docking in der P-Glykoprotein Forschung ein weiterer Aspekt der Arbeit. Es ließ sich schlussfolgern, dass molekulares Docking fähig ist, zwischen den verschiedenen Molekülen zu unterscheiden, die mit P-Glykoprotein interagieren. Die Anwendbarkeit von molekularem Docking in Bezug auf die Bestimmung der Bindestelle einer Substanz wurde ebenfalls untersucht.

Impact of daclizumab, low-dose cyclosporine, mycophenolate mofetil and steroids on renal function after kidney transplantation

Early and long-term use of cyclosporine A (CsA) leads to increased risks of renal toxicity. We hypothesized that administration of daclizumab in combination with mycophenolate mofetil (MMF) allows a relevant reduction in the dose of CsA.

Rotator cuff muscles lose responsiveness to anabolic steroids after tendon tear and musculotendinous retraction: an experimental study in sheep

Long-standing rotator cuff tendon tearing is associated with retraction, loss of work capacity, irreversible fatty infiltration, and atrophy of the rotator cuff muscles. Although continuous musculotendinous relengthening can experimentally restore muscular architecture, restoration of atrophy and fatty infiltration is hitherto impossible.

Impact of estrogen replacement throughout childhood on growth, pituitary-gonadal axis and bone in a 46,XX patient with CYP19A1 deficiency

The adequate replacement dose of estrogens during infancy and childhood is still not known in girls. Aromatase deficiency offers an excellent model to study how much estrogens are needed during infancy, childhood and adulthood.

Gonadal function and fertility in survivors after Hodgkin lymphoma treatment within the German Hodgkin Study Group HD13 to HD15 trials

To optimize fertility advice in patients with Hodgkin lymphoma (HL) before therapy and during survivorship, information on the impact of chemotherapy is needed. Therefore, we analyzed gonadal functions in survivors of HL.

Fertility and gonadal function in female survivors after treatment of early unfavorable Hodgkin lymphoma (HL) within the German Hodgkin Study Group HD14 trial

In the HD14 trial, 2×BEACOPPescalated+2×ABVD (2+2) has improved the primary outcome. Compared with 4×ABVD, this benefit might be compromised by more infertility in women. Therefore, we analyzed gonadal function and fertility.

Regular treatment with salmeterol and inhaled steroids for chronic asthma: serious adverse events

Epidemiological evidence has suggested a link between beta2-agonists and increased asthma mortality. There has been much debate about possible causal links for this association, and whether regular (daily) long-acting beta2-agonists are safe. This is an updated systematic review.

Screening and testing for endocrine disruption in fish-biomarkers as "signposts," not "traffic lights," in risk assessment

Biomarkers are currently best used as mechanistic "signposts" rather than as "traffic lights" in the environmental risk assessment of endocrine-disrupting chemicals (EDCs). In field studies, biomarkers of exposure [e.g., vitellogenin (VTG) induction in male fish] are powerful tools for tracking single substances and mixtures of concern. Biomarkers also provide linkage between field and laboratory data, thereby playing an important role in directing the need for and design of fish chronic tests for EDCs. It is the adverse effect end points (e.g., altered development, growth, and/or reproduction) from such tests that are most valuable for calculating adverseNOEC (no observed effect concentration) or adverseEC10 (effective concentration for a 10% response) and subsequently deriving predicted no effect concentrations (PNECs). With current uncertainties, biomarkerNOEC or biomarkerEC10 data should not be used in isolation to derive PNECs. In the future, however, there may be scope to increasingly use biomarker data in environmental decision making, if plausible linkages can be made across levels of organization such that adverse outcomes might be envisaged relative to biomarker responses. For biomarkers to fulfil their potential, they should be mechanistically relevant and reproducible (as measured by interlaboratory comparisons of the same protocol). VTG is a good example of such a biomarker in that it provides an insight to the mode of action (estrogenicity) that is vital to fish reproductive health. Interlaboratory reproducibility data for VTG are also encouraging; recent comparisons (using the same immunoassay protocol) have provided coefficients of variation (CVs) of 38-55% (comparable to published CVs of 19-58% for fish survival and growth end points used in regulatory test guidelines). While concern over environmental xenoestrogens has led to the evaluation of reproductive biomarkers in fish, it must be remembered that many substances act via diverse mechanisms of action such that the environmental risk assessment for EDCs is a broad and complex issue. Also, biomarkers such as secondary sexual characteristics, gonadosomatic indices, plasma steroids, and gonadal histology have significant potential for guiding interspecies assessments of EDCs and designing fish chronic tests. To strengthen the utility of EDC biomarkers in fish, we need to establish a historical control database (also considering natural variability) to help differentiate between statistically detectable versus biologically significant responses. In conclusion, as research continues to develop a range of useful EDC biomarkers, environmental decision-making needs to move forward, and it is proposed that the "biomarkers as signposts" approach is a pragmatic way forward in the current risk assessment of EDCs.

F90927: a new member in the class of cardioactive steroids

F90927 is a newly developed cardioactive drug with a steroid-like structure. It acts directly and agonistically on the cardiac L-type Ca2+ channel by shifting its voltage-dependent activation toward more negative potentials. This leads to an increased influx of Ca2+ and, therefore, to a stronger contraction; however, no arrhythmias occur. Calcium current stimulation can already be observed at nanomolar concentrations, but higher concentrations of F90927 elevate intracellular Ca2+ concentration, causing a reduction of the myocardial compliance and an increased diastolic blood pressure. Vessels also react to F90927 and contract in its presence. Binding of F90927 with the L-type Ca2+ channel presumably occurs in the vicinity of the transmembrane domains III and IV of the alpha1 subunit. F90927 exhibits no use dependence and interacts with Ca2+ channel inhibitors of all three known classes of channel modulators (dihydropyridines, phenylalkylamines, and benzothiazepines), suggesting that it is a member of a new class of Ca2+ channel modulators. Due to its adverse effects on blood pressure and vessel contraction, F90927 is not an ideal drug candidate. It has, however, some unique properties, which makes it a promising tool to study the function of the L-type Ca2+ channel.

Precise estimation of postoperative cup alignment from single standard X-ray radiograph with gonadal shielding

This paper addresses the problem of estimating postoperative cup alignment from single standard X-ray radiograph with gonadal shielding. The widely used procedure of evaluation of cup orientation following total hip arthroplasty using single standard anteroposterior radiograph is known inaccurate, largely due to the wide variability in individual pelvic position relative to X-ray plate. 2D-3D image registration methods have been introduced to estimate the rigid transformation between a preoperative CT volume and postoperative radiograph(s) for an accurate estimation of the postoperative cup alignment relative to an anatomical reference extracted from the CT data. However, these methods require either multiple radiographs or a radiograph-specific calibration, both of which are not avaiable for most retrospective studies. Furthermore, these methods were only evaluated on X-ray radiograph(s) without gonadal shielding. In this paper, we propose to use a hybrid 2D-3D registration scheme combining an iterative landmark-to-ray registration with a 2D-3D intensity-based registration to estimate the rigid transfromation for a precise estimation of cup alignment. Quantitative and qualitative results evaluated on clinical and cadaveric datasets are given which indicate the validity of our approach.

Non-invasive measurement of steroids in fish-holding water: important considerations when applying the procedure to behaviour studies

Fish behaviourists are increasingly turning to non-invasive measurement of steroid hormones in holding water, as opposed to blood plasma. When some of us met at a workshop in Faro, Portugal, in September, 2007, we realised that there were still many issues concerning the application of this procedure that needed resolution, including: Why do we measure release rates rather than just concentrations of steroids in the water? How does one interpret steroid release rates when dealing with fish of different sizes? What are the merits of measuring conjugated as well as free steroids in water? In the ‘static’ sampling procedure, where fish are placed in a separate container for a short period of time, does this affect steroid release—and, if so, how can it be minimised? After exposing a fish to a behavioural stimulus, when is the optimal time to sample? What is the minimum amount of validation when applying the procedure to a new species? The purpose of this review is to attempt to answer these questions and, in doing so, to emphasize that application of the non-invasive procedure requires more planning and validation than conventional plasma sampling. However, we consider that the rewards justify the extra effort.