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序贯甲氨蝶呤/5-氟尿嘧啶:可移植性啮齿动物结肠腺癌中FdUMP的形成及胸苷酸合成酶抑制作用

Sequential methotrexate/5-FU: FdUMP formation and TS inhibition in a transplantable rodent colon adenocarcinoma.

作者信息

Berne M H, Gustavsson B G, Almersjö O, Spears P C, Frösing R

出版信息

Cancer Chemother Pharmacol. 1986;16(3):237-42. doi: 10.1007/BF00293984.

DOI:10.1007/BF00293984
PMID:3698165
Abstract

Parameters for inhibition of thymidylate synthetase were studied after sequential methotrexate/5-fluorouracil (5-FU) administration in a dimethylhydrazine (DMH)-induced transplantable rat colon carcinoma. Tumor-bearing rats were treated with methotrexate (MTX) 40 mg/kg IP Bolus 5-FU, 100 mg/kg IP, was injected after 24 h. Micromethods for assay of 5-fluoro-2'-deoxyuridylate (FdUMP) and thymidylate synthetase (TS) were used to study the in vivo intracellular pharmacokinetics of 5-FU. Formation of FdUMP was equally rapid in tumors regardless of MTX pretreatment, with peak values found at 30 min. Although MTX pretreatment did not increase peak FdUMP levels, it appeared to result in increased persistence of FdUMP, well in excess of available TS-binding sites, at 24 and 48 h. The combination therapy was less effective in terms of TS inhibition over the first 8 h after 5-FU administration, but may have been associated with improved TS inhibition at later time points. Total levels of TS (TStot) steadily increased from a pre-5-FU treatment level of 18.8 pmol to more than 40 pmol/g at 24 h. MTX per se had no apparent effect on baseline TStot levels or on the 5-FU-mediated increases in TStot. We conclude that MTX and 5-FU were antagonistic in terms of TS inhibition over the first 8 h after 5-FU in this DMH-induced rat colon carcinoma, but were possibly synergistic in increasing persistent levels of FdUMP and TS inhibition at later time points. The observation that 5-FU treatment can result in progressive increases in TS levels in some tumors suggests that this may be an important mechanism of 5-FU resistance.

摘要

在二甲基肼(DMH)诱导的可移植大鼠结肠癌中,研究了序贯给予甲氨蝶呤/5-氟尿嘧啶(5-FU)后胸苷酸合成酶的抑制参数。荷瘤大鼠腹腔注射甲氨蝶呤(MTX)40mg/kg推注剂量,24小时后腹腔注射5-FU 100mg/kg。采用微量法测定5-氟-2'-脱氧尿苷酸(FdUMP)和胸苷酸合成酶(TS),以研究5-FU在体内细胞内的药代动力学。无论是否进行MTX预处理,肿瘤中FdUMP的形成速度相同,在30分钟时达到峰值。虽然MTX预处理并未增加FdUMP的峰值水平,但在24小时和48小时时,似乎导致FdUMP持续时间延长,远远超过可用的TS结合位点。联合治疗在5-FU给药后的前8小时内对TS抑制效果较差,但在后期可能与TS抑制改善有关。TS的总水平(TStot)从5-FU治疗前的18.8pmol稳步增加至24小时时的超过40pmol/g。MTX本身对基线TStot水平或5-FU介导的TStot增加没有明显影响。我们得出结论,在这种DMH诱导的大鼠结肠癌中,MTX和5-FU在5-FU给药后的前8小时内对TS抑制具有拮抗作用,但在后期可能在增加FdUMP持续水平和TS抑制方面具有协同作用。5-FU治疗可导致某些肿瘤中TS水平逐渐升高的观察结果表明,这可能是5-FU耐药的重要机制。

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本文引用的文献

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5-Fluorouracil in combination with hypoxathine and allopurinol: toxicity and metabolism in xenografts of human colonic carcinomas in mice.
Biochem Pharmacol. 1980 Jul 15;29(14):2077-80. doi: 10.1016/0006-2952(80)90495-5.
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5-Fluorouracil incorporation into human breast carcinoma RNA correlates with cytotoxicity.5-氟尿嘧啶掺入人乳腺癌RNA与细胞毒性相关。
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Thymidylate synthetase - substrate complex formation.胸苷酸合成酶 - 底物复合物的形成。
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Concurrent allopurinol and 5-fluorouracil: 5-fluoro-2'-deoxyuridylate formation and thymidylate synthase inhibition in rat colon carcinoma and in regenerating rat liver.
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Sequential methotrexate and 5-fluorouracil: mechanisms of synergy.甲氨蝶呤与5-氟尿嘧啶序贯治疗:协同作用机制
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Thymidylate synthetase inhibition in malignant tumors and normal liver of patients given intravenous 5-fluorouracil.接受静脉注射5-氟尿嘧啶的患者恶性肿瘤和正常肝脏中胸苷酸合成酶的抑制作用
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Prospective randomized trial of one-hour sequential versus simultaneous methotrexate plus 5-fluorouracil in advanced and recurrent squamous cell head and neck cancer.甲氨蝶呤联合5-氟尿嘧啶序贯一小时给药与同步给药用于晚期和复发性头颈部鳞状细胞癌的前瞻性随机试验。
J Clin Oncol. 1983 Dec;1(12):787-92. doi: 10.1200/JCO.1983.1.12.787.