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Biomedical subjects

J Robert

Publications and source records attributed to J Robert.

At least 217 records · Page 12Linked to original sources

Reversed-phase high-performance liquid chromatographic method for the simultaneous quantitation of the carboxylate and lactone forms of the camptothecin derivative irinotecan, CPT-11, and its metabolite SN-38 in plasma.

Irinotecan, also known as CPT-11 (I), is a potent semi-synthetic derivative of 20(S)-camptothecin (CPT). Like all known active derivatives of CPT, the lactone forms of I and its active metabolite SN-38 (II) are reversibly hydrolysed to inactive carboxylate forms. We describe a sensitive and selective HPLC method using the ion-pairing reagent tetrabutylammonium phosphate (TBAP) which allows the simultaneous determination of the carboxylate and lactone forms of I and II in human plasma samples following the precipitation of plasma proteins with an ice-cold mixture of acetonitrile and methanol. The mobile phase was 0.075 M ammonium acetate buffer (pH 6.4)-acetonitrile (78:22, v/v) containing 5 mM TBAP. Separation of the compounds was performed on a radially-compressed C18 column. The limits of quantitation in human plasma were 2 and 10 ng/ml for the two forms of II and I, respectively. In addition, we propose the use of CPT lactone both as an internal standard and as a "watchdog" for sample status. Under unsuitable storage conditions, CPT elutes increasingly in its carboxylate form thereby alerting the operator of possibly erroneous determinations of the concentrations of both forms of I and II. The retention times of the peaks of interest are well separated from the solvent front. This enables the detection of early eluting metabolites. The method was successfully used for monitoring of the two forms of I and II in patients treated with I.

Antineoplastic Agents, Phytogenic↗

Left-sided colon and colorectal anastomoses: Doppler ultrasound as an aid to assess bowel vascularization. A prospective evaluation of 200 consecutive elective cases.

Two hundred non-randomized left-sided colon and colorectal anastomoses were performed on 199 consecutive patients admitted over a 4-year period (107 men and 92 woman with a median age of 66 years). There were 117 high anastomoses (above the peritoneal reflection), 86 (74%) of which were hand sewn, and 83 low anastomoses, 78 (94%) stapled with an EEA instrument. Adequate blood supply was assessed with a Doppler ultrasound in all but 5 cases. In ten patients bowel edges to be anastomosed were recut because of a negative Doppler ultrasound reading. One hundred and eighty-nine anastomoses were radiologically controlled. In-hospital post-operative mortality was 2.5% and morbidity 20%. There were two (1%) clinical anastomotic leaks and three (1.5%) radiological leaks. Use of Doppler ultrasound is simple and safe to assess vascularization of the intestinal edges. It may have contributed to the low anastomotic complication rate observed in this series.

Adult↗

Experimental saccular aneurysms. II. A new model in swine.

A new technique for surgical construction of experimental lateral saccular aneurysms on the common carotid artery of swine is described. It involves end-to-side suturing of an isolated segment of vein to an artery. During a short period of parent artery clamping, an elliptical arteriotomy is fashioned through the open-ended vein graft, the open end of which is subsequently tied and clamps are removed to form an aneurysmal vein pouch. The principal advantage of this technique is the short period of vascular clamping necessary to isolate a segment of the parent artery. This prevents severe endothelial injury and prolonged postoperative vasospasm, both of which may promote intra-aneurysmal thrombosis. Narrow- or wide-necked aneurysms can be created. Steps in the surgical construction of this model are detailed, and specific advantages of using swine are highlighted.

Animals↗

Modulation of anthracycline accumulation and metabolism in rat hepatocytes in culture by three revertants of multidrug resistance.

The aim of this study was to compare the action of three multidrug resistance (MDR) modulators, cyclosporine A, S 9788, and verapamil, on the efflux of two anthracyclines, doxorubicin and daunorubicin, and of daunorubicinol, the C-13 alcohol metabolite of daunorubicin. Rat-hepatocyte primary cultures have been used as a model of P-glycoprotein (Pgp) expression. This model allows the study of MDR at different levels of Pgp expression, which increases in parallel with the time in culture; furthermore, the hepatocytes are capable of metabolizing drugs, which enables the determination of the role of Pgp on metabolite efflux. All modulators tested were incubated for 6 h at concentrations of 1, 5, and 15 microM with doxorubicin (0.5 microM) and at 1 and 15 microM with daunorubicin (0.5 microM) on hepatocytes grown for 4 and 48 h in culture. Daunorubicinol (0.5 microM) was tested with modulators at 48 h of culture. In fresh hepatocytes, the three MDR modulators did not induce an increase in the intracellular retention of anthracycline as compared with controls (no MDR modulator). At 48 h of culture, the three test drugs increased doxorubicin intracellular accumulation. In contrast, daunorubicin retention was not modified, but that of its metabolites was increased. Within the concentration range tested, cyclosporine was the most potent modulator without dose-dependent activity. The activity rank order was cyclosporine > S 9788 > verapamil. Cyclosporine and S 9788 were as active in coincubation as in preincubation with anthracyclines. Verapamil had no action when incubated before the addition of anthracyclines. Cyclosporine and S 9788 had an effect on the intracellular retention of daunorubicinol used alone whereas verapamil did not. The action of cyclosporine and S 9788 on the retention of daunorubicinol proves that at least a part of the efflux of C-13 alcohol metabolites of anthracyclines is mediated by Pgp. This study shows that S 9788, cyclosporine, and verapamil are MDR modulators in hepatocytes with high-level Pgp expression. This study also demonstrates that hepatocytes are a potent tool for the study of the action of new MDR modulators on cytostatic drugs as well as on their metabolites.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Contribution of specific skeletal muscle metabolic abnormalities to limitation of exercise capacity in patients with chronic heart failure: a phosphorus 31 nuclear magnetic resonance study.

Several studies of phosphorus 31 (31P) magnetic resonance spectroscopy (MRS) have demonstrated the presence of skeletal muscle metabolic abnormalities during exercise in patients with chronic heart failure (CHF). We studied the contribution of these abnormalities to the limitation of exercise capacity in CHF. In 25 patients (age 57 +/- 2 years, left ventricular ejection fraction [LVEF] 28% +/- 1.6%, peak oxygen consumption (VO2) 16 +/- 1.2 ml/kg/mm) (mean +/- SEM), we studied the calf muscle at rest and during plantar flexion with 31P MRS. The phosphocreatine (PCr) depletion rate was significantly negatively correlated to peak VO2 (r = -0.62, p = 0.001) but not to LVEF. Muscle pH was correlated with the inorganic phosphorus (Pi)/PCr ratio (r = -0.69, p = 0.0001) and with the PCr/adenosine triphosphate beta (ATP beta) ratio (which negatively relates to adenosine diphosphate [ADP] concentration) (r = 0.65, p = 0.00001). Although muscle ATP (ATP/sum of phosphorus [sigma P] remained stable, in 8 patients ATP/sigma P decreased significantly (-15% +/- 4%, p = 0.0002). In this ATP-depleted group, peak VO2 was significantly lower than that of the nondepleted group and PCr depletion more rapid, whereas LVEF did not differ. Skeletal muscle metabolic abnormalities in CHF contribute markedly to the alteration of exercise capacity. Rapid PCr depletion and muscle acidosis are the most relevant abnormalities. ATP depletion and excessive increase in ADP during exercise may contribute further to exercise limitation specifically in patients with more marked CHF.

Adenosine Diphosphate↗

Individual dose adaptation of anticancer drugs.

The dose of anticancer drugs is currently adjusted to the patient body surface area, although patients have different abilities to clear anticancer drugs. The dose adjustment to physiological functions permits major toxic accidents to be avoided. The adjustment to tumour drug content is considered, but for ethical or technical reasons, it cannot be used routinely The best criterion for the dose adjustment seems to be drug plasma concentration. The relationship between plasma concentration and efficacy may not be excellent, since it depends on the presence of resistant cells and on the blood flow through the tumour. A relationship between plasma concentration and/or the area under the curve (AUC) with toxicity has been reported with all major anticancer drugs. Different methods of dose adjustment to the drug plasma concentration are reported. In conclusion, dose adjustment to the drug plasma concentration or to the AUC can improve the chemotherapy efficacy, while reducing toxicity.

Antineoplastic Agents↗

Enhanced cytotoxicity of doxorubicin encapsulated in polyisohexylcyanoacrylate nanospheres against multidrug-resistant tumour cells in culture.

We have studied the cytotoxicity and accumulation of doxorubicin encapsulated in polyisohexylcyanoacrylate nanospheres in a model of doxorubicin-resistant rat glioblastoma variants differing by their degree of resistance to this drug. We observed that the particulate form of doxorubicin was always more cytotoxic than free doxorubicin, whereas coadministration of drug-unloaded nanospheres with free doxorubicin did not modify significantly doxorubicin cytotoxicity. In C6 0.001 cells, which were 6-fold resistant and present a pure multidrug-resistant phenotype, the reversal of doxorubicin resistance was complete. In C6 0.1 cells, which were 60-fold resistant, as with C6 1V cells (selected with vincristine), the reversal of doxorubicin resistance was almost complete, with a residual resistance factor of 2-3. In C6 0.5 cells, which were 600-fold resistant to doxorubicin, the reversal of resistance was only partial and, in all cases, not above the expected participation of P-glycoprotein to the phenotype of resistance. Intracellular drug accumulation after 2-h exposure to 17.2 mumol/l doxorubicin was systematically reduced by a factor of 2-3 when doxorubicin was incubated under the form of nanospheres; doxorubicin accumulation after a 2-h exposure to IC50 was also highly reduced in all cell lines for doxorubicin-loaded nanospheres. This work shows that association of doxorubicin with nanoparticles could provide a useful tool for circumventing multidrug resistance, probably by a bypass of P-glycoprotein rather than by an inhibition of this pump.

Animals↗

Multidrug resistance circumvention by a new triazinoaminopiperidine derivative S9788 in vitro: definition of the optimal schedule and comparison with verapamil.

The current work was undertaken to investigate the importance of exposure sequence and duration in achieving the maximum reversal action of S9788 on doxorubicin (DOX) cytotoxicity against cells that exhibit the (MDR) multidrug resistance phenotype: the MCF7/DOX cell line. Accumulation and release of DOX were examined in this cell line. The reversal effect was compared with that obtained with verapamil. S9788 activity was schedule dependent: when comparing incubation with S9788 before or after treatment with DOX, the best reversal factor was obtained in the case of a post-treatment incubation (65.6 +/- 7.7 vs 20.8 +/- 7.0). S9788 was a more potent modulating agent than verapamil, whatever the schedule of exposure of the cells to the reversal agent. The reversal of resistance after short-term DOX exposures was caused not only by prolonged cellular accumulation of DOX, but also by its prolonged retention after transfer of cells to DOX-free medium. A relationship was noted between cellular exposure to DOX and the cytotoxic effect, and so the reversal of resistance induced by S9788 appears to be directly linked to the level of cell exposure to DOX. This work provided a rationale for improving the schedule of administration of S9788 in clinical trials.

Antineoplastic Agents↗

Skeletal muscle phosphate metabolism abnormalities in volume-overload experimental heart failure.

We studied skeletal muscle phosphate metabolism abnormalities to examine their contribution at an early stage of congestive heart failure (CHF) in rats with aortocaval fistula (ACF) 4 wk after the procedure. In a group of 26 rats (13 with ACF and 13 sham operated), we assessed the degree of CHF. The ACF produced a significant rise in heart weight and plasma atrial natriuretic peptide. In a second group of 26 rats (13 ACF and 13 sham operated), we performed 31P-magnetic resonance spectroscopy in the gastrocnemius muscle during motor activity produced by electrical stimulation. The rate of phosphocreatine depletion, expressed by its initial slope, was higher in the ACF rats compared with controls (0.078 +/- 0.01 vs. 0.041 +/- 0.007; P < 0.03). pH and ATP decreased and phosphodiesters increased in all rats during electrical stimulation, with no difference between ACF rats and controls. The kinetics of phosphocreatine recovery were not different between ACF rats and controls. Together with previous studies, our present results suggest that muscle metabolism abnormalities in CHF may vary according to the experimental model and may be observed early in the course of the disease.

Adenosine Triphosphate↗

Lymphoid tumors of Xenopus laevis with different capacities for growth in larvae and adults.

Three new lymphoid tumors offering an assortment of variants in terms of MHC class I expressions, MHC class II expression, and Ig gene transcription have been discovered in the amphibian Xenopus. One was developed in an individual of the isogenic LG15 clone (LG15/0), one in a frog of the LG15/40 clone (derived from a small egg recombinant of LG15), and one (ff-2) in a male ff sib of the individual in which MAR1, the first lymphoid tumor in Xenopus was found 2 years ago. These tumors developed primarily as thymus outgrowths and were transplantable in histocompatible tadpoles but not in nonhistocompatible hosts. Whereas LG15/0 and LG15/40 tumor cells also grow in adult LG15 frogs, the ff-2 tumor, like the MAR1 cell line, is rejected by adult ff animals. Using flow cytometry with fluorescence-labeled antibodies and immunoprecipitation analysis, we could demonstrate that, like MAR1, these three new tumors express on their cell surface lymphopoietic markers recognized by mAbs F1F6 and RC47, as well as T-cell lineage markers recognized by mAbs AM22 (CD8-like) and X21.2, but not by immunologobulin (Ig) nor MHC class II molecules. Another lymphocyte-specific marker AM15 is expressed by 15/0 and 15/40 but not ff-2 tumor cells. The ff-2 tumor cell expresses MHC class I molecule in association with beta 2-microglobulin on the surface, 15/40 cells contain cytoplasmic class I alpha chain that is barely detected at the cell surface by fluocytometry, and 15/0 cells do not synthesize class I alpha chain at all. The three new tumors all produce large amounts of IgM mRNA of two different sizes but no Ig protein on the membrane nor in the cytoplasm. All tumor cell types synthesize large amount of Myc mRNA and MHC class I-like transcripts considered to be non classical.

Animals↗

Phosphorus magnetic resonance spectroscopy: a noninvasive technique for the study of occlusive arterial leg disease and peripheral vasodilator therapy.

Using 31P nuclear magnetic resonance spectroscopy of the calf muscle, the authors studied patients with peripheral arterial occlusive disease. They studied PCr depletion and intracellular pH during aerobic exercise in patients and controls. The phosphocreatine (PCr) index ([PCr]/([PCr] + [Pi])) at rest was correlated with blood flow measured by plethysmography. During aerobic exercise a greater decrease in pH was obtained in patients (p < 0.03). They also studied the work necessary to reach a PCr index = 0.5 during ischemic exercise. This workload was lower in patients than in controls: 32.99 +/- 3.04 J vs 58.89 +/- 8.55 J, p < 0.05. After vasodilator therapy the workload was improved in patients: 32.99 +/- 3.04 J vs 38.85 +/- 3.54 J, p < 0.05. These results suggest that therapy resulted in improved tissue perfusion in patients.

Arterial Occlusive Diseases↗

Clinical pharmacokinetics of epirubicin.

Epirubicin (4'-epidoxorubicin) is a new anthracycline that has activity similar to doxorubicin (adriamycin) in a variety of solid neoplasms and haematologic malignancies. Importantly, epirubicin causes less cardiotoxicity than doxorubicin. There is extensive distribution of epirubicin into tissues and the elimination of the drug is predominantly biliary, with less than 15% of the drug excreted in the urine. The metabolism of epirubicin is characterised by complex biotransformation to relatively or totally inactive metabolites, including a 13-dihydro derivative, epirubicinol, 2 glucuronides and 4 aglycones. Quantitatively, the glucuronides of epirubicin and epirubicinol are very important, and this pathway, which is unique to epirubicin metabolism in humans, might explain the better tolerability of this drug compared with doxorubicin. Epirubicin pharmacokinetics may be described by a 3-compartment model, with median half-life values of 3.2 minutes, 1.2 and 32 hours for each phase. Total plasma clearance is 46 L/h/m2 and volume of distribution at steady-state is 1000 L/m2. The pharmacokinetics of epirubicin appears to be linear for doses up to the maximal tolerated dose of 150 to 180 mg/m2. Both intraperitoneal and intravesical administration of epirubicin are feasible, but remain of a rather restricted interest. The area under the plasma concentration-time curve of epirubicin is fairly well correlated with the relative kill of white blood cells. Therefore, epirubicin clearance can be used to predict haematological toxicity.

Aging↗

[Pharmacokinetic mechanisms of resistance to anticancer medications].

Besides the cellular mechanisms of resistance, which can be described in terms of molecular alterations, the lack of sensitivity of a tumour to a drug may result from an inadequacy between the pharmacokinetics of the drug and the kinetics of the tumour cells. Dose and duration of infusion of a drug may govern its activity; the drugs exhibiting a short half-life in plasma and a marked phase-dependence in their mechanism of action have to be administered as continuous infusions. The existence of sanctuary compartments within the body, which are protected by barriers such as the blood-brain barrier, may also contribute to the failure of the molecules unable to cross these barriers. Finally, the tumour cell kinetics may unfavour the general activity of drugs: this is the case of slowly growing tumours, which contain an important proportion of GO cells. The optimisation of the mode of administration of a drug is a requisite for the expression of its activity.

Antineoplastic Agents↗