Seither R L, Rape T J, Goldman I D
Department of Medicine, Medical College of Virginia, Richmond 23298.
Biochem Pharmacol. 1989 Mar 1;38(5):815-22. doi: 10.1016/0006-2952(89)90236-0.
This paper describes studies that further explore the pharmacologic activity of the 7-hydroxy catabolite of methotrexate (7-OH-MTX). A 3-hr exposure of L1210 leukemia cells to 100 microM 7-OH-MTX produced negligible suppression of cell growth despite the build-up of intracellular polyglutamyl congeners to levels 2.7 times greater than the dihydrofolate reductase (DHFR) binding capacity. There was no evidence for direct inhibition of DHFR under these conditions based upon measurements of cellular tetrahydrofolate cofactor and dihydrofolate levels, nor was there suppression of [3H]deoxyuridine incorporation into DNA or [14C]formate incorporation into purines. When the interval of exposure to 100 microM 7-OH-MTX was increased to 6 hr, cell growth was inhibited by 60% and there was mild (approximately 50%) inhibition of purine and thymidylate biosynthesis associated with a small increase in cellular dihydrofolate and a small decline in cellular tetrahydrofolates. Consistent with weak inhibition of DHFR was the absence of significant binding of 7-OH-MTX polyglutamates to DHFR as assessed by gel filtration of cell extracts. Mild direct inhibition of purine biosynthetics by 7-OH-MTX- or MTX-polyglutamyl congeners was demonstrated based upon inhibition of [14C]formate incorporation into purines in cells pretreated with fluorodeoxyuridine so as to prevent tetrahydrofolate cofactor depletion or dihydrofolate polyglutamate build-up. Effects of a 6-hr exposure of cells to 100 microM 7-OH MTX on cell growth were reversed completely by 10 microM leucovorin; effects on cells containing comparable levels of MTX polyglutamyl congeners were unaffected by leucovorin. These studies demonstrate very weak inhibition of L1210 leukemia cell growth and purine, pyrimidine and tetrahydrofolate synthesis by the polyglutamyl congeners of 7-OH-MTX. The data suggest that effects of 7-OH-MTX polyglutamates on folate-requiring enzymes are not likely to play an important role in moderate-dose MTX regimens. However, pharmacologic activity may be expressed in high-dose MTX protocols when high blood levels of 7-OH-MTX are sustained over long intervals to the extent to which polyglutamate congeners accumulate in tumor cells and add to the much more potent inhibitory effects of MTX polyglutamates already present. Pharmacologic activity, however, would be diminished, if not completely reversed, by the concurrent administration of leucovorin.
本文描述了进一步探究甲氨蝶呤的7-羟基代谢物(7-OH-MTX)药理活性的研究。将L1210白血病细胞暴露于100微摩尔/升的7-OH-MTX中3小时,尽管细胞内多聚谷氨酰同类物的积累量达到二氢叶酸还原酶(DHFR)结合能力的2.7倍,但对细胞生长的抑制作用微乎其微。基于对细胞内四氢叶酸辅因子和二氢叶酸水平的测量,没有证据表明在这些条件下DHFR受到直接抑制,也没有抑制[3H]脱氧尿苷掺入DNA或[14C]甲酸掺入嘌呤。当将暴露于100微摩尔/升7-OH-MTX的时间间隔增加到6小时时,细胞生长受到60%的抑制,嘌呤和胸苷酸生物合成受到轻度(约50%)抑制,同时细胞内二氢叶酸略有增加,细胞内四氢叶酸略有下降。通过对细胞提取物进行凝胶过滤评估,7-OH-MTX多聚谷氨酸与DHFR没有明显结合,这与对DHFR的弱抑制作用一致。基于对用氟脱氧尿苷预处理的细胞中[14C]甲酸掺入嘌呤的抑制作用,证明了7-OH-MTX或MTX多聚谷氨酰同类物对嘌呤生物合成有轻度直接抑制作用,从而防止四氢叶酸辅因子耗竭或二氢叶酸多聚谷氨酸积累。细胞暴露于100微摩尔/升7-OH MTX 6小时对细胞生长的影响可被10微摩尔亚叶酸完全逆转;对含有相当水平MTX多聚谷氨酰同类物的细胞的影响不受亚叶酸影响。这些研究表明,7-OH-MTX的多聚谷氨酰同类物对L1210白血病细胞生长以及嘌呤、嘧啶和四氢叶酸合成的抑制作用非常弱。数据表明,7-OH-MTX多聚谷氨酸对需要叶酸的酶的影响在中等剂量甲氨蝶呤治疗方案中不太可能起重要作用。然而,在高剂量甲氨蝶呤方案中,当长时间维持高血药浓度的7-OH-MTX,使多聚谷氨酸同类物在肿瘤细胞中积累,并增强已存在的MTX多聚谷氨酸的更强抑制作用时,可能会表现出药理活性。然而,如果同时给予亚叶酸,药理活性将会减弱,甚至完全消失。