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Inhibitory effects of mixed disulfides from disulfiram on the metabolism and genotoxicity of N-nitrosodiethylamine.

Disulfiram (CAS 97-77-8, DSF), a potent anticarcinogenic compound, is known to form mixed disulfides with sulfhydryl group containing amino acids or proteins in vivo. In the present study the stabilities of two mixed disulfides which may arise in the metabolism of disulfiram, i.e. S-(N,N-diethyldithiocarbamoyl)-N-acetyl-L-cysteine (AC-DDTC) and S-(N,N-diethyldithiocarbamoyl)-L-glutathione (GS-DDTC) in phosphate buffer (pH 7.2) and in rat liver subcellular fractions were investigated as well as their influences on the glutathione (GSH)-related detoxifying system, on the metabolism of [14C] N-nitrosodiethylamine (NDEA) and on the genotoxic activity of NDEA in rats. Both substances were stable in buffer and in microsomes but were degraded in cytosol showing a half life of 4.7 h (AC-DDTC) and 3.2 h (GS-DDTC). Addition of GSH to the incubation media accelerated the degradation of mixed disulfides in cytosol. In vivo administration of AC-DDTC and GS-DDTC (1.7 mmol/kg i.p.) led to an increase in hepatic GSH content and to an inhibition of the activity of NDEA deethylase. Both mixed disulfides inhibited the metabolism of NDEA. After a 28 mg/kg i.p. dose of [14C] NDEA only 0.4% was excreted unchanged in the urine. Pretreatment with AC-DDTC and GS-DDTC caused a 10 to 20 fold increase in the amount of NDEA excreted in the urine. The occurrence of DNA single strand breaks in rat liver cells induced by NDEA was completely neutralized by the pretreatment with AC-DDTC.

Animals↗

Treatment of scabies with disulfiram and benzyl benzoate emulsion: a controlled study.

In a double-blind study, 38 adults with scabies were treated with the scabicide Tenutex (a proprietary aqueous emulsion containing 0.5% DDT, 2% disulfiram and 22.5% benzyl benzoate) and 42 patients were treated with a similar emulsion lacking DDT. The treatment consisted of a single whole-body (except for the head) application which was washed off after 24 hours. When examined 3 weeks later, both groups were completely cured. Thereafter, a further 35 patients took part in an open trial with the DDT-free Tenutex emulsion and all patients were cured, irrespective of whether the treatments were administered by skilled personnel or by themselves at home. It is concluded that for the treatment of scabies in Sweden, the most commonly used preparation, Tenutex, can be replaced, without risk of loss of efficacy, by an emulsion containing 2% disulfiram and 22.5% benzyl benzoate, i.e. Tenutex without DDT.

Administration, Topical↗

[Acute and reversible myoclonic encephalopathy, extrapyramidal syndrome, polyneuropathy caused by chronic disulfiram poisoning].

This 44-year woman was admitted for weight loss and global intellectual slowing. She had mild chronic alcoholic neuropathy. She was discontinued alcoholic consumption for 6 months and was given disulfiram (1.5 g/day) since then. She developed over a 5-day period acute neuropathy, confusion and extrapyramidal symptoms with oculo-cephalogyric and dystonic movements and myoclonus. Electromyography revealed a severe polyneuropathy. After disulfiram withdrawal, confusion and extrapyramidal symptoms disappeared within a few days, but sensitivo-motor deficit improved more slowly. Nerve biopsy was suggestive of a pure axonal neuropathy.

Acute Disease↗

Absence of disulfiram-type reactions to single and multiple doses of cefonicid: a placebo-controlled study.

Disulfiram-type reactions after ingestion of alcohol have been reported in patients treated with a number of cephalosporin antibiotics; predominantly with agents containing the methylthiotetrazole side chain, although other similar configurations have also been implicated. Since cefonicid has a sulphonic acid thiotetrazole substitution, we investigated the possibility of a cefonicid-ethanol interaction in 15 healthy volunteers. During the first two crossover phases of the study, single 1 g doses of cefonicid followed by ethanol challenges were compared to placebo followed by ethanol challenges. In the third phase, all volunteers received three consecutive 1 g doses of cefonicid given at 24 h intervals followed by an ethanol challenge. At no time did any of the subjects experience a disulfiram-type reaction, and their blood aldehyde concentrations did not increase throughout the study.

Acetaldehyde↗

Disulfiram metabolism in isolated mesophyll cells and inhibition of photosynthesis and cyanide-resistant respiration.

Tetraethylthiuram disulfide (disulfiram) stimulated medium acidification when added at a concentration of 0.4 millimolar to illuminated or nonilluminated suspensions of Asparagus sprengeri Regel mesophyll cells. Similar concentrations inhibited photosynthesis and cyanide-resistant respiration. The reduction product of disulfiram, diethyldithiocarbamic acid, accumulated in concentrations sufficient to account for the observed acidification.

Journal Article↗

[Disulfiram-induced hepatitis]

Overt disulfiram-induced hepatitis is rare; it has a high mortality rate, especially when the etiology is non suspected and when the treatment is not promptly discontinued. The Authors describe a case of disulfiram-induced acute hepatitis and emphasize close clinical and biochemical monitoring.

Journal Article↗

Disulfiram-mediated inhibition of NF-kappaB activity enhances cytotoxicity of 5-fluorouracil in human colorectal cancer cell lines.

5-Fluorouracil (5-FU) is the major chemotherapeutic component for colorectal cancer (CRC) and other types of solid tumours. Resistance of cancer cells to 5-FU is considered the major obstacle for successful chemotherapy. NF-kappaB is a transcription factor. Cancer cells with high NF-kappaB nuclear activity demonstrate robust chemo- and radio-resistance. We demonstrated that nuclear NF-kappaB activity in CRC cell lines, DLD-1 and RKO(WT), was significantly induced by 5-FU in a concentration- and time-dependent manner. 5-FU induced IkappaBalpha degradation and promoted both NF-kappaB nuclear translocation and its DNA binding activity. 5-FU treatment did not influence the activities of AP-1, AP-2, Oct-1, SP-1, CRE-B and TFIID. Disulfiram (DS), a clinically used anti-alcoholism drug, strongly inhibited constitutive and 5-FU-induced NF-kappaB activity in a dose-dependent manner. DS inhibited both NF-kappaB nuclear translocation and DNA binding activity but had no effect on 5-FU-induced IkappaBalpha degradation. Used in combination, DS significantly enhanced the apoptotic effect of 5-FU on DLD-1 and RKO(WT) cell lines and synergistically potentiated the cytotoxicity of 5-FU to both cell lines. DS also effectively abolished 5-FU chemoresistance in a 5-FU resistant cell line H630(5-FU) in vitro. As DS has extensive preclinical and clinical experience, translating its anticancer usage from in vitro study to clinical trials is relatively straightforward.

Active Transport, Cell Nucleus↗

Effect of disulfiram on the genotoxic potential of acetaldehyde in mouse spermatogonial cells.

The initial purpose of the study was to determine the potential of acetaldehyde (Ace) to increase the rate of sister-chromatid exchanges (SCEs) in mouse spermatogonia. We tested four doses of Ace (from 0.4 to 400.0 mg/kg), including a negative and a positive control group (distilled water and cyclophosphamide, respectively). The results showed that all tested doses were SCE inducers. The highest tested dose increased the control level more than three times. Also, the cumulative frequencies of SCEs per cell were higher in the Ace-treated animals than in the control cells. Ace is transformed into acetate through the enzyme aldehyde dehydrogenase, a process that may be blocked by disulfiram (Dis) generating the accumulation of Ace. The second purpose of the study was to determine if the administration of Dis (150 mg/kg) could increase the SCE rate produced by non-genotoxic doses of Ace. (0.004 and 0.04 mg/kg). The animals treated with the two doses of Ace alone showed no increase in the frequency of SCEs; also, Dis by itself was not an SCE inducer. However, the groups of animals previously treated with Dis showed an increase of 31 and 60% with respect to the values obtained with the two doses of Ace alone. Furthermore, the cumulative frequencies of SCEs per cell were higher in the animals administered with both compounds together than in those treated with them separately. These results suggest the need to extend this type of study to other models.

Acetaldehyde↗

The effect of disulfiram on cyclophosphamide-mediated myeloid toxicity.

We have previously shown that disulfiram (DSF) blocks the urotoxicity of cyclophosphamide (CYT) in mice and increases the oncolytic effect of CYT in the L1210 murine leukemia. However, mice treated with CYT and DSF appeared to have longer-lasting neutropenia than animals treated with CYT alone. To determine whether DSF uroprotection of CYT-treated mice was associated with increased myeloid toxicity, we examined the effects of DSF plus CYT treatment on the bone marrow granulocyte/macrophage progenitor cell (GM-CFC). Marrow cellularity and GM-CFC numbers were analyzed at 1, 2 and 3 days after injection of CYT (62.5 or 125 mg/kg) or CYT plus DSF (200 mg/kg). CYT alone caused a decrease in total marrow cellularity varying from 20% to 50% of control. Animals given CYT plus DSF had a somewhat greater decrease in total marrow cellularity than those treated with CYT alone. However, in mice treated with CYT plus DSF, the GM-CFC were relatively well preserved and the recovery of the GM-CFC was not prolonged by DSF. It appears from these studies that the acute toxic effect of CYT on the granulocyte/macrophage progenitor cells is not enhanced by DSF.

Animals↗

Influence of disulfiram on the organotropy of the carcinogenic effect of dimethylnitrosamine and diethylnitrosamine in rats.

In former studies in rats and mice it was shown that the acute toxicity of dimethylnitrosamine (DMNA) and diethylnitrosamine (DENA) is reduced by additional treatment with tetraethylthiuramdisulfide [(Disulfiram, Antabus (DSF)]. In long-term experiments in 40 rats given 500 mg/kg DSF/week the substance did not show carcinogenic effects, however, influenced the action of the nitrosamines. DENA, which was administered to 38 rats in a dosage of 20 mg/kg/week, induced liver tumors in 90% of the animals; in 29% besides some precancerous stages predominantly malignant carcinomas of the oesophagus were seen. DMNA when given to 31 rats in a dosage of 4 mg/kg/week induced liver tumours in 55% of the animals. 26 rats were treated with a combination of 500 mg/kg DSF/week and 20 mg/kg DENA/week. In only 31% of the animals of this group liver tumors were found, however, 81% of them besides some precancerous stages showed predominantly carcinomas of the oesophagus. The combination of 500 mg/kg DSF/week and 4 mg/kg DMNA/week induced only 1 liver tumor (=3%) out of a group of 29 animals, whereas 59% of them showed squamous cell carcinomas of the paranasal sinus that were not seen when DMNA was given alone.

Animals↗

Inhibition of diethylnitrosamine-induced strand breaks in liver DNA by disulfiram.

Disulfiram (DSF) delayed the appearance of diethylnitrosamine (DEN)-induced strand breaks in liver DNA of rats. The fragmentation of liver DNA produced by DEN was studied 4 and 24 h after administration of the carcinogen on alkaline sucrose gradients. A single dose of 500 mg/kg DSF given 1 h prior to carcinogen treatment delayed for at least 4 h the DEN--induced strand breaks in liver DNA. A single DSF pretreatment, however, did not protect against carcinogen-induced strand breaks when observed 24 h after DEN injection. It is possible that continuous administration of DSF might inhibit the DEN-produced damage of the genetic material.

Animals↗

Disulfiram neuropathy.

A case of sensorimotor polyneuropathy during disulfiram administration is described. This complication partially resolved after the medication was stopped. Pathological observations revealed axonal changes and neurofilament accumulation was found in a few myelinated and unmyelinated axons.

Alcoholism↗

Effects of disulfiram on the metabolism of nitrosodiethylamine during liver carcinogenesis.

We have studied the effects of disulfiram (DSF) administration on the metabolism of nitrosodiethylamine (NDEA) in rats during acute and chronic administration. DSF was found to have the following effects during the course of carcinogenesis: (a) marked decrease in the exhalation of 14CO2 derived from 14C-NDEA; (b) reduction of the total levels of DNA and RNA ethylation in the liver. In acute experiments DSF caused an increase in the amount of NDEA in organs and in the urine. We suggest that inhibition of NDEA biotransformation and the subsequent decrease in the total level of DNA ethylation may prevent specific chemical interactions relevant to carcinogenesis.

Alkylation↗

Modifying effects of disulfiram on DNA adduct formation and persistence of benzaldehyde in N-nitroso-N-methyl-benzylamine-induced carcinogenesis in rats.

Whereas disulfiram (DSF) is known to inhibit tumor formation resulting from a number of chemical carcinogens, such inhibition does not apply to nitrosamines. In the present study, biochemical and morphological findings were examined to elucidate the effect of DSF on long-term application of N-nitroso-N-methylbenzylamine (NMBA). HPLC and fluorescence detection were used to determine O6-methylguanine (O6-MG) in DNA obtained from the respiratory tract of rats subjected to long-term simultaneous application of DSF and NMBA. After 2 days of treatment, more O6-MG was detected in the proximal portion of the respiratory tract, including the trachea and main bronchi, than in the distal portion. The findings were reversed after 10 and 30 days, at which time formation of the DNA adduct was substantially higher in the distal portion of the respiratory tract, despite increases in both portions. The biochemical results corresponded to morphological findings. Initially, increased numbers of metabolizing goblet cells appeared in mucous cell hyperplasia in the proximal respiratory tract. Subsequently, the hyperplasia migrated to distal regions of the respiratory tract; at this stage, the goblet cells disappeared from the proximal portion, which now revealed toxic degeneration, atrophy and subsequent squamous metaplasia of the mucous lining and squamous papillomas. At various times during a 40-day period, 2 to 7 times more O6-MG in pulmonary DNA was detected in rats treated with DSF and NMBA, than with NMBA alone, whereby distinct amounts of O6-MG were found in the latter animals. In contrast to the above-mentioned morphological findings, no morphological alterations occurred in the respiratory tract of the animals treated with NMBA alone. It is therefore conceivable that the above pathological lesions resulted not merely from the presence of DNA adducts, but also from an additional, previously unspecified effect. As benzaldehyde (BA) is formed in equimolar amounts in NMBA metabolism and DSF has been demonstrated to inhibit aldehyde metabolism, this aldehyde is a possible candidate for such an effect. In the present study, rats were therefore treated with BA, DSF, or NMBA, or combinations thereof. Histomorphological evaluation of these experiments revealed that long-term application of BA alone led to the following alterations in the respiratory tract: goblet cell hyperplasia, hyperplasia of the peribronchial lymphatic system, mucous epithelial atrophy and accompanying perivasculitis--the same alterations seen under long-term application of NMBA and DSF.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

The influence of disulfiram on the half life and metabolic clearance rate of diphenylhydantoin and tolbtamide in man.

Diphenylhydantoin (DPH) and tolbutamide serum levels were studied in ten volunteers before and after 4 days of disulfiram treatment. The mean DPH half life increased significantly from 11.0 +/- a.2 h to 19.0 +/- 3.3 h, and the mean DPH metabolic clearance rate decreased significantly from 51.2 +/- 17.2 ml/min to 33.9 +/- 12.0 ml/min during medication. No significant changes in the half life or metabolic clearance rate of tolbutamide was observed.

Adult↗

Disulfiram lowers Ca2+, Mg(2+)-ATPase activity of rat brain synaptosomes.

The chronic administration of disulfiram (DS) to rats resulted in significant decrease of synaptosomal Ca2+, Mg(2+)-ATPase activity. In vitro studies indicated that DS (ID50 = 20 microM) produced a dose-dependent inhibition of Ca2+, Mg(2+)-ATPase. However, diethyldithio-carbamate, a metabolite of DS, failed to modify Ca2+, Mg(2+)-ATPase activity, implying that the decrease in ATPase activity in DS administered rats was due to the effect of parent compound. The DS-mediated inhibition (48%) of ATPase activity was comparable with a similar degree of inhibition (49%) achieved by treating the synaptosomal membranes with N-ethylmaleimide (ID50 = 20 microM) in vitro. Furthermore, the inhibition by DS was neither altered by washing the membranes with EGTA nor reversed by treatment with sulfhydryl reagents such as GSH or dithiothreitol. About 74% and 68% decrease of synaptosomal Ca2+, Mg(2+)-ATPase specific activity was observed when treated with DS (30 microM) and EGTA (100 microM) respectively. The remaining 25-30% of total activity is suggested to be of Mg(2+)-dependent ATPase activity. This indicates that both these drugs may act on a common target, calmodulin component that represents 70-75% of total Ca2+, Mg(2+)-ATPase activity. Therefore, DS-mediated modulation of synaptosomal Ca2+, Mg(2+)-ATPase activity could affect its function of maintaining intracellular Ca2+ concentration. This could contribute to the deleterious effects on CNS.

Animals↗