T-cell subsets in drug-induced toxic epidermal necrolysis.
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Biomedical subjects
Publications and source records attributed to H F Merk.
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HaCaT keratinocyte cultures were exposed to twelve hydrophilic anthralin derivatives 1 to 12 with substituents at C-1 and C-8 of the anthrone skeleton, of one H at C-10 and of both H's at C-10 by lacton rings. After 3 microM treatment growth was determined by cellular protein content, 3H-thymidine- and 14C-amino-acid-uptake and cytotoxicity by the release of cytoplasmic LDH into the culture medium. In comparison to acetone control (100%) anthralin suppressed mean protein content, as well as DNA- and protein-synthesis to 33, 28, and 21%, respectively, and the drug revealed an enzyme release of 660%. In relation to the parent drug we found similar cell growth inhibitory effects of compounds 4, 6, 8, 9, 10, and 12. Deriv. 4, 8, and 10 were, however, to some extent less cytotoxic than anthralin, whereas deriv. 6, 9, and 12 were in the same range. An extreme suppression of growth parameters which differed from the anthralin effect by a factor 0.5-0.8 was caused by deriv. 11, showing the same cytotoxicity. Deriv. 1, 2, 3, 5, and 7 did not demonstrate any cytotoxicity. Concerning growth parameters, deriv. 2 induced a slight stimulation, deriv. 3 and 7 were completely ineffective, deriv. 1 and 5 induced slightly to moderately inhibited proliferation but both being much less effective than anthralin. These data indicate that the "minimum structure" concept by Krebs and Schaltegger--claiming 1-hydroxy-9-anthrone as a precondition for clinical antipsoriatic potency--is not valid at least in cell-biological tests and point toward possible usefulness of some experimental model compounds as alternative antipsoriatics.
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The toxicity of quinones--including certain chemotherapeutic agents such as doxorubicin--have been related to the enzymatic or nonenzymatic formation of the corresponding semiquinones and their subsequent reaction with molecular oxygen yielding superoxide anion radicals by spontaneous regenerating of the quinones. This semiquinone redox cycling is prevented by the NAD(P)H:quinone reductase (NQR; EC 1.6.99.2) because it mediates a 2-electron reduction which results in the formation of hydroquinones instead of semiquinones. Interestingly, inducers of this enzyme such as butylated hydroxytoluene protect against the severe ulceration of accidental infiltration of doxorubicin into the area around the intravenous infusion. Recently, it has been shown that this highly protective enzyme has a very high basal activity in the epidermis which is in the same range as in the liver. The human gene of the NQR is localized on chromosome 16 and has been cloned recently as well as the gene of the murine liver NQR. We determined NQR in the cytoplasma of murine skin, liver, and human keratinocytes using 2,6-dichlorophenol-indophenol as substrate. In order to characterize this enzyme, induction by polycyclic hydrocarbones and inhibition with several known inhibitors of dihydrodiol dehydrogenase, aldo-keto and carbonyl reductase activities were determined. There was a similar pattern of inhibition of the basal and induced activity in all tissues so far investigated. Pyrazole, progesterone and phenobarbital did not inhibit; however, rutin and indomethacin inhibited dose-dependently. The most potent inhibitor was dicoumarol. These findings suggest that the same enzymatic form is present in liver and skin, and in murine skin and human keratinocytes.
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It has been estimated that of all new cancers diagnosed annually in the USA almost one third originate in the skin such as basal cell carcinoma, squamous cell carcinoma, and melanoma. Much progress has been achieved in our understanding of the pathogenesis and it became clear primarily by studies of chemical carcinogenesis in murine skin that this is a stepwise process comprising at least three distinct stages: initiation, promotion, and malignant conversion or progression. This knowledge of the pathogenesis prompted to the development of chemoprevention of cancer in humans. Large clinical chemoprevention intervention studies with vitamin A, -carotene, vitamin E, and selenium are on the way. The metabolism of chemical carcinogens by cytochrome P-450 isozymes and other xenobiotica metabolizing enzymes has been proven essential in chemocarcinogenesis but it plays also a crucial role in the biotransformation of cancer themotherapeutic agents and may be of importance in influencing the efficacy as well as the side effects of these drugs in the target organ. Although our current knowledge is limited, studies of the xenobiotic metabolizing enzymes in extrahepatic tissues such as the skin demonstrate that they are possible. They may be of special importance in the near future in order to design individual therapies that will avoid unwanted toxicities and enhance therapeutic effectiveness.
Skin aging is associated with alterations regarding its barrier function, the amount and composition of lipids, as well as the cutaneous blood flow. All these factors affect the absorptive capacity of the skin. As a major clinical problem after topical application in aged patients, we find increased toxicity of salicylates (strong absorption, permeation and resorption, elevated free serum fraction, increased renal toxicity) and coffein (decreased hepatic clearance). Sun-ray filter creams protecting against UVB only will decrease the synthesis of vitamin D, and a prolonged exposure to the sun will results in an increased metabolism by UVA of vitamin D leaving inactivated compounds. This again is of special importance since, in the elderly, we usually find the synthesis of vitamin D already decreased. Therefore, these patients should be treated with sun-ray filter creams providing protection against both UVA and UVB.
Clotrimazole, an N-substituted imidazole, is a widely used topical agent for the treatment of superficial fungal infections. In this study, the effect of application of clotrimazole to the skin of neonatal rats on the induction response of the cytochrome P-450-dependent monooxygenase system in epidermis and liver has been examined. A single topical application of clotrimazole (10 mg/100 g) to rats resulted in a 53% increase in hepatic cytochrome P-450 content. Clotrimazole treatment also resulted in significant induction of epidermal 7-ethoxycoumarin-O-deethylase activity. Hepatic p-nitrophenol hydroxylase, an enzyme, catalyzed principally by the ethanol inducible cytochrome P-450 isozyme, was also significantly induced (58%) by topically applied clotrimazole. This enzyme activity was undetectable in epidermal microsomes. Further characterization of the cytochrome P-450 isozymes induced in liver by clotrimazole treatment was based on monoclonal antibodies (MAbs) raised against purified rat liver cytochrome P-450 isozymes induced by phenobarbital (MAb 2-66-3) and ethanol (MAb 1-98-1). Hepatic microsomes prepared from clotrimazole-treated rats showed significant immunoreactivity on Western blot with both the MAbs whereas no reactivity occurred in epidermal microsomes. Our data indicate that topical application of clotrimazole to rats results in the induction of selected cytochrome P-450 isozyme(s) in liver and epidermis which may have implications for the therapeutic use of this compound.
Leukotriene B4 (LTB4,5-12-dihydroxy 6,8,10,14-eicosatetraenoic acid), an enzyme-catalyzed oxidation product of arachidonic acid, is a major inflammatory mediator. Human polymorphonuclear leukocytes and rodent hepatic microsomes catabolize LTB4 to 20-OH-LTB4 and 20-COOH-LTB4, which is mediated by a cytochrome P-450 catalyzed reaction termed the LTB4 omega-hydroxylase. In this study we investigated the catabolism of LTB4 in rat, guinea pig, and human epidermis. The incubation of 3H-LTB4 (9 microM) for 60 min in the presence of oxygen, NADPH, and epidermal microsomes prepared from neonatal fat (3.0 mg) or adult guinea pig (2.6 mg) resulted in the formation of 20-OH-LTB4 and 20-COOH-LTB4. Metabolite identification was based on co-chromatography on high pressure liquid chromatography with highly purified reference standards. The formation of 20-OH-LTB4 and 20-COOH-LTB4 was accompanied by the disappearance of LTB4. The rate of formation of 20-OH-LTB4 was 9-12-fold higher than that of 20-COOH-LTB4. Product formation was negligible with boiled microsomes, required NADPH and oxygen, was linear with respect to incubation time and protein, and was maximal at pH 7.4. LTB4-omega-hydroxylase activity was inhibited (greater than 90%) by carbon monoxide or 2-diethylaminoethyl-2,2-diphenylvalerate hydrochloride (SKF-525A) (1 mM), whereas alpha-naphthoflavone produced only moderate (13%) or no effects. Topical application of 3-methylcholanthrene and other conventional inducers of epidermal monooxygenase activities to neonatal rats (100 mg/kg, single treatment) did not result in an increase in epidermal LTB4-omega-hydroxylase activity. The addition of 3H-LTB4 (30 nmoles) to primary human keratinocytes followed by incubation at 37 degrees C resulted in time-dependent disappearance of LTB4 and appearance of 20-OH-LTB4 and 20-COOH-LTB4 in the medium. These results suggest that LTB4 is catabolized by the cytochrome P-450-dependent enzyme system in rodent and human skin and that this may participate in modulating the effects of this proinflammatory lipid in this tissue.
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Assay systems for the evaluation of carcinogen interaction with human tissues are essential for assessing cancer risk. Human hair roots (HHR) are a readily obtainable epithelial tissue source that have been employed for investigating inherited enzyme activities. In this study HHR were found to possess cytochrome P-450-dependent 7-ethoxyresorufin-O-deethylase (ERD) activity which measures cytochrome P-450 isoenzymes that are highly specific (in the order of greater than 95%) markers for the metabolic activation of many environmental carcinogenic substances such as the polycyclic aromatic hydrocarbons (PAHs). Topical application of PAHs (in liquor carbonis detergens) to the scalp of human volunteers was found to enhance the activity of this enzyme in freshly plucked hair roots. Oral and topical administration of ketoconazole to the same subjects resulted in an appreciable (up to 73%) inhibition of detectable enzyme activity. Our data suggest that measurement of ERD in HHR may be a useful marker for the study of toxifying species of cytochrome P-450 isozymes in human populations.
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Cytochrome P-450-dependent arylhydrocarbon-hydroxylase (AHH) activity and inducibility by benzanthracene (BA) was measured in cultured guinea pig and human epidermal cells. Basal AHH-activity (AHHb) in guinea pig epidermal cells was much higher than in human epidermal cells. AHHb in guinea pig epidermal cells was directly related to the labeling index and decreased to the original level between the 5th and 7th day of cell culturing. On the other hand, the induction-ratio of AHH reached its maximum level when the number of cells began to rise (proliferation phase) and remained high at day 7 of the cell culture. These results suggest a cell growth dependent activity and inducibility of carcinogen-metabolizing enzymes, such as AHH, in isolated epidermal cells.