Drug usage evaluation: perspectives and reappraisal.
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Biomedical subjects
Publications and source records attributed to T J Van Mouwerik.
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In HCT 116 cells, a human colon cancer cell line, the levels of thymidine (0.6 microM) and hypoxanthine (9 microM) contributed to the tissue culture medium by the fetal bovine serum significantly reduced the growth inhibition and lethality produced by 0.1 microM methotrexate. Dipyridamole, an inhibitor of nucleoside transport, potentiated the growth inhibitory effects of methotrexate when the cells were grown in medium that was changed daily. However, when the medium was supplemented with dialyzed serum, methotrexate cytotoxicity was not increased by dipyridamole. Similarly, in cloning experiments, dipyridamole increased the cell killing produced by methotrexate. The potentiation of methotrexate toxicity produced by dipyridamole was mediated through inhibition of thymidine uptake. The uptake of 1 microM thymidine was inhibited 50% by 0.12 microM dipyridamole but neither hypoxanthine nor guanine uptake was decreased by dipyridamole (5 microM). As a result, the decrease in dTTP pools produced by methotrexate was augmented by dipyridamole. In contrast, dipyridamole did not influence the effect of methotrexate on ribonucleoside triphosphate pools. HCT 116 cells avidly salvaged low concentrations of thymidine, and methotrexate increased this capacity. Conversion of 0.11 microM thymidine to thymidine triphosphate was increased by 55%, from 16.6 to 25.7 pmoles/10(6) cells, following exposure to 1.0 microM methotrexate. Dipyridamole blocked this pool expansion. This study suggests that the salvage of physiological levels of thymidine may diminish the cytotoxic effects of methotrexate on human colon cancer cells. Inhibition of thymidine uptake by dipyridamole may be an effective strategy to increase the cytotoxicity of methotrexate.
Amsacrine, an antineoplastic agent currently undergoing clinical trials in the U.S., has been shown to be active against adult and pediatric leukemias, Hodgkin's disease, and non-Hodgkin's lymphomas. Amsacrine is highly bound to plasma proteins and is eliminated primarily via hepatic metabolism. Severe hepatic dysfunction will result in a decreased excretion rate of the drug. The primary side effect is a dose-related suppression of bone marrow function. Other reported toxic effects include mucositis, nausea, vomiting, cardiotoxicity, liver dysfunction, and alopecia. Despite these negative effects, amsacrine appears to have a role in the combination therapy of acute leukemias.