Machácková J, Gersl V, Adamcová M, Mazurová Y, Hrdina R, Mĕlka M, Nobilis M
Ustav farmakologie, Univerzita Karlova v Praze, Lékarská fakulta v Hradci Králové.
Acta Medica (Hradec Kralove) Suppl. 2000;43(2):119-38.
Anthracycline derivatives belong among the most effective antineoplastic drugs but their therapeutic use is limited by their side effects--a dose-related cardiotoxicity. The influence of repeated i.v. administration (once weekly, max. 10 weeks) of new antineoplastic agents--dimethoxybenfluron (DMB) (3,9-dimethoxybenfluron hydrochloride, C23H24O4NCl, M.w. 413.9, Institute of Experimental Biopharmaceutics, Czech Academy of Sciences, Hradec Králové, Czech Republic; 12 or 24 mg base/kg) and Oracin (6-[2-(2-hydroxyethyl)aminoethyl]-5,11-dioxo-5,6-dihydro-11H- indeno[1,2c]isoquinoline hydrochloride), C20H19N2O3Cl, M.w. 370.84, Research Institute for Pharmacy and Biochemistry, Prague, Czech Republic; 5 or 10 mg/kg) on cardiovascular, biochemical, haematological and histological parameters were studied in rabbits in vivo. Data obtained in these groups were compared with the group with experimentally induced cardiomyopathy (daunorubicin 50 mg/m2 i.v.) and with the control group (saline 1 ml/kg). Only mild and mostly no significant changes of the cardiovascular parameters (DMB 12 group: PEP:LVET ratio--0.408-0.502, LV dP/dtmax.--1337.0 kPa/s; DMB 24 group: PEP:LVET ratio--0.407-0.433, LV dP/dtmax.--1438.2 kPa/s), biochemical parameters (decrease in natrium, ALP and increase in glucose, GPX and GSH levels) and haematological parameters (increase in erythrocytes and decrease in leukocytes after the larger dose of the drug) were found in the dimethoxybenfluron groups. Repeated administration of the lower dose of Oracin induced only mild and mostly no significant changes of parameters (PEP:LVET ratio--0.393-0.475, LV dP/dtmax.--1092.4 kPa/s) in comparison with the control group. Though significant in some intervals, only a mild oscillation of the PEP:LVET ratio (0.368-0.446), decrease in LV dP/dtmax. (991.2 kPa/s) and--in comparison with control group--significantly higher blood pressure and lower heart rate were found after the higher dose of Oracin. In the most of haematological and biochemical parameters (with the exception of chlorides, protein and albumin levels) no significant changes were present. Histological examination of the heart revealed normal structure of the myocardium including minute changes of myocardium following administration of antineoplastic agents in all groups. Administration of new antineoplastic agents induced mostly mild changes of the followed-up parameters (PEP:LVET ratio, LV dP/dtmax., heart rate, levels of cardiac troponin T, survival of animals, haematological and biochemical parameters); the values of parameters were mostly significantly different from those in rabbits with daunorubicin-induced cardiomyopathy. On the basis of our results it is possible to conclude that the administration of dimethoxybenflurone and Oracin did not induce signs of cardiotoxicity in rabbits in vivo. This observation is considered to be important from the viewpoint of possible further clinical use of these new antineoplastic agents.
蒽环类衍生物属于最有效的抗肿瘤药物,但它们的治疗用途因其副作用——剂量相关的心脏毒性而受到限制。研究了新型抗肿瘤药物——二甲氧基苯氟隆(DMB)(3,9 - 二甲氧基苯氟隆盐酸盐,C23H24O4NCl,分子量413.9,捷克科学院实验生物制药研究所,捷克赫拉德茨克拉洛韦;12或24毫克碱/千克)和奥拉辛(6 - [2 - (2 - 羟乙基)氨基乙基]-5,11 - 二氧代-5,6 - 二氢-11H - 茚并[1,2 - c]异喹啉盐酸盐),C20H19N2O3Cl,分子量370.84,捷克布拉格药学与生物化学研究所;5或10毫克/千克)经静脉重复给药(每周一次,最多10周)对兔体内心血管、生化、血液学和组织学参数的影响。将这些组获得的数据与实验性诱导心肌病组(柔红霉素50毫克/平方米静脉注射)和对照组(生理盐水1毫升/千克)进行比较。在二甲氧基苯氟隆组中,仅发现心血管参数(DMB 12组:PEP:LVET比值——0.408 - 0.502,左心室dP/dtmax.——1337.0千帕/秒;DMB 24组:PEP:LVET比值——0.407 - 0.433,左心室dP/dtmax.——1438.2千帕/秒)、生化参数(钠、碱性磷酸酶降低,葡萄糖、谷胱甘肽过氧化物酶和谷胱甘肽水平升高)和血液学参数(较大剂量药物后红细胞增加,白细胞减少)有轻微且大多无显著变化。与对照组相比,重复给予较低剂量的奥拉辛仅引起参数的轻微且大多无显著变化(PEP:LVET比值——0.393 - 0.475,左心室dP/dtmax.——1092.4千帕/秒)。虽然在某些时间段有显著变化,但在给予较高剂量的奥拉辛后,仅发现PEP:LVET比值有轻微波动(0.368 - 0.446),左心室dP/dtmax.降低(991.2千帕/秒),并且与对照组相比,血压显著升高,心率降低。在大多数血液学和生化参数(除氯化物、蛋白质和白蛋白水平外)方面未发现显著变化。心脏组织学检查显示所有组心肌结构正常,包括给予抗肿瘤药物后心肌的微小变化。给予新型抗肿瘤药物大多引起后续参数(PEP:LVET比值、左心室dP/dtmax.、心率、心肌肌钙蛋白T水平、动物存活率、血液学和生化参数)的轻微变化;这些参数的值大多与柔红霉素诱导的心肌病兔的参数有显著差异。根据我们的结果可以得出结论,二甲氧基苯氟隆和奥拉辛的给药在兔体内未诱导心脏毒性迹象。从这些新型抗肿瘤药物可能进一步临床应用的角度来看,这一观察结果被认为是重要的。