Shalit I, Kletter Y, Weiss K, Gruss T, Fabian I
Infectious Disease Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Eur J Haematol. 1997 Feb;58(2):92-8. doi: 10.1111/j.1600-0609.1997.tb00930.x.
We compared the effect of 6 quinolones on growth of murine bone marrow (BM) progenitor cells in vitro, and their in vivo effect on repopulation of BM and on survival of sublethally irradiated mice. The addition of clinically attainable concentrations of ciprofloxacin, sparfloxacin or clinafloxacin, in concert with pokeweed mitogen (PWM) to murine spleen cells, resulted in a significant enhancement in colony stimulating activity. A 1.5-1.8 fold increase in the number of myeloid progenitors (CFU-C) was observed in the presence of quinolone-PWM spleen conditioned medium (SCM) (prepared with the above-mentioned quinolones) compared with control cultures exposed to PWM-SCM only. Three other quinolones showed either no stimulatory-effect (fleroxacin, norfloxacin) or had an inhibitory effect (ofloxacin) on CFU-C growth. The stimulatory quinolones share in common a cyclopropyl moiety at position N1 of the quinolone ring. This moiety is lacking in the other 3 quinolones. The secretion of interleukin-3 (IL-3) and granulocyte-macrophage colony-stimulating factor (GM-CSF) by murine spleen cells exposed to quinolone-PWM-SCM was significantly enhanced with all 6 quinolones. However, this effect was associated with a parallel increase in CFU-C only with ciprofloxacin (10 micrograms/mL), sparfloxacin (1 microgram/mL) and clinafloxacin (0.05 microgram/mL). The in vivo activity was assessed in sublethally irradiated mice (650 rad) treated with quinolones for 5 d. The number of CFU-C in BM and the number of peripheral white blood cells (WBC) 8 d post-irradiation was significantly enhanced in mice treated with ciprofloxacin (45 mg/kg/d), sparfloxacin (22.5 mg/kg/d) and clinafloxacin (11.25 mg/kg/d) compared to saline treated animals (p < or = 0.05). Clinafloxacin at higher dosage (45 mg/kg/d) resulted in a decrease in myeloid progenitors in BM. A similar increase in progenitors and WBC was observed in animals treated with high doses, above clinical relevance, of ofloxacin, and norfloxacin (90 mg/kg/d), and with fleroxacin (45 and 90 mg/kg/d). Quinolone-treated animals, at the above-cited doses, showed enhanced survival on d18 compared to saline treated animals. The only exception was the higher mortality of clinafloxacin-treated mice. The above observations imply that certain quinolones, sharing specific molecular structure, are potential immunomodulators at clinically relevant concentrations. These compounds should be further studied in neutropenic patients and BM or peripheral blood progenitor cell recipients.
我们比较了6种喹诺酮类药物对小鼠骨髓(BM)祖细胞体外生长的影响,以及它们对BM再增殖和亚致死剂量照射小鼠存活的体内影响。将临床可达到浓度的环丙沙星、司帕沙星或克林沙星与商陆有丝分裂原(PWM)一起添加到小鼠脾细胞中,可显著增强集落刺激活性。与仅暴露于PWM-SCM的对照培养物相比,在喹诺酮-PWM脾条件培养基(SCM)(用上述喹诺酮制备)存在下,髓系祖细胞(CFU-C)数量增加了1.5 - 1.8倍。其他3种喹诺酮对CFU-C生长要么无刺激作用(氟罗沙星、诺氟沙星),要么有抑制作用(氧氟沙星)。具有刺激作用的喹诺酮在喹诺酮环的N1位都有一个环丙基部分。其他3种喹诺酮没有这个部分。用喹诺酮-PWM-SCM处理的小鼠脾细胞分泌白细胞介素-3(IL-3)和粒细胞-巨噬细胞集落刺激因子(GM-CSF),这6种喹诺酮都能显著增强。然而,只有环丙沙星(10微克/毫升)、司帕沙星(1微克/毫升)和克林沙星(0.05微克/毫升)能使这种作用与CFU-C平行增加。在亚致死剂量照射(650拉德)的小鼠中,用喹诺酮处理5天来评估体内活性。与生理盐水处理的动物相比,用环丙沙星(45毫克/千克/天)、司帕沙星(22.5毫克/千克/天)和克林沙星(11.25毫克/千克/天)处理的小鼠在照射后8天,BM中的CFU-C数量和外周白细胞(WBC)数量显著增加(p≤0.05)。高剂量('45毫克/千克/天)的克林沙星导致BM中髓系祖细胞减少。在用高于临床相关剂量(90毫克/千克/天)的氧氟沙星、诺氟沙星以及氟罗沙星(45和90毫克/千克/天)处理的动物中,观察到祖细胞和WBC有类似增加。与生理盐水处理的动物相比,上述剂量的喹诺酮处理动物在第18天显示出存活率提高。唯一的例外是克林沙星处理的小鼠死亡率较高。上述观察结果表明,某些具有特定分子结构的喹诺酮在临床相关浓度下是潜在的免疫调节剂。这些化合物应在中性粒细胞减少患者以及BM或外周血祖细胞接受者中进一步研究。