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Evaluation of 1H-NMR and GC/MS-based metabonomics for the assessment of liver and kidney toxicity
(2009)
For the assessment of metabonomics techniques for the early, non-invasive detection of toxicity, the nephrotoxins gentamicin (s.c. administration of 0, 60 and 120 mg/kg bw 2x daily for 8 days), ochratoxin A (p.o. administration of 0, 21, 70 and 210 µg/kg bw 5 days/week for 90 days) and aristolochic acid (p.o. administration of 0, 0.1, 1.0 and 10 mg/kg bw for 12 days) were administered to rats and urine samples were analyzed with 1H-NMR and GC/MS. Urine samples from the InnoMed PredTox project were analyzed as well, thereby focusing on 1H-NMR analysis and bile duct necrosis as histopathological endpoint. 1H-NMR analysis used water supression with the following protocol: 1 M phosphate buffer, D2O as shift lock reagent, D4-trimethylsilylpropionic acid as chemical shift reference, noesygppr1d pulse sequence (Bruker). For multivariate data analysis, spectral intensity was binned into 0.04 ppm wide bins. GC/MS analysis of urine was carried out after protein precipitation with methanol, drying, derivatization with methoxyamine hydrochloride in pyridine and with methyl(trimethylsilyl)trifluoroacetamide on a DB5-MS column using EI ionization. The chromatograms were prepared for multivariate data analysis using the R-program based peak picking and alignment software XCMS version 2.4.0. Principal component analysis (PCA) to detect and visualize time-point and dose-dependent differences between treated animals and controls and orthogonal projection to latent structures discriminant analysis (OPLS-DA) for identification of potential molecular markers of toxicity was carried out using SIMCA P+ 11.5 1H-NMR-based markers were identified and quantified with the Chenomx NMR Suite, GC/MS based markers were identified using the NIST Mass Spectral Database and by co-elution with authentic reference standards. PCA of urinary metabolite profiles was able to differentiate treated animals from controls at the same time as histopathology. An advantage over classical clinical chemistry parameters regarding sensitivity could be observed in some cases. Metabonomic analysis with GC/MS and 1H-NMR revealed alterations in the urinary profile of treated animals 1 day after start of treatment with gentamicin, correlating with changes in clinical chemistry parameters and histopathology. Decreased urinary excretion of citrate, 2-oxoglutarate, hippurate, trigonelline and 3-indoxylsulfate increased excretion of 5-oxoproline, lactate, alanine and glucose were observed. Ochratoxin A treatment caused decreased excretion of citrate, 2-oxoglutarate and hippurate and and increased excretion of glucose, myo-inositol, N,N-dimethylglycine, glycine, alanine and lactate as early as 2 weeks after start of treatment with 210µg OTA/kg bw, correlating with changes in clinical chemistry parameters and histopathology. Integration of histopathology scores increased confidence in the molecular markers discovered. Aristolochic acid treatment resulted in decreased urinary excretion of citrate, 2-oxoglutarate, hippurate and creatinine as well as increased excretion of 5-oxoproline, N,N-dimethylglycine, pseudouridine and uric acid. No alterations in clinical chemistry parameters or histopathology were noted.Decreased excretion of hippurate indicates alterations in the gut microflora, an effect that is expected as pharmacological action of the aminoglycoside antibiotic gentamicin and that can also be explained by the p.o. administration of xenobiotica. Decreased Krebs cycle intermediates (citrate and 2-oxoglutarate) and increased lactate is associated with altered energy metabolism. Increased pseudouridine excretion is associated with cell proliferation and was observed with aristolochic acid and ochratoxin A, for which proliferative processes were observed with histopathology. 5-oxoproline and N,N-dimethylglycine can be associated with oxidative stress. Glucose, a marker of renal damage in clinical chemistry, was observed for all three nephrotoxins studied. Single study analysis with PCA of GC/MS chromatograms and 1H-NMR spectra of urine from 3 studies conducted within the InnoMed PredTox project showing bile duct necrosis revealed alterations in urinary profiles with the onset of changes in clinical chemistry and histopathology. Alterations were mainly decreased Krebs cycle intermediates and changes in the aromatic gut flora metabolites, an effect that may result as a secondary effect from altered bile flow. In conclusion, metabonomics techniques are able to detect toxic lesions at the same time as histopathology and clinical chemistry. The metabolites found to be altered are common to most toxicities and are not organ-specific. A mechanistic link to the observed toxicity has to be established in order to avoid confounders such as body weight loss, pharmacological effects etc. For pattern recognition purposes, large databases are necessary.
Azoles are important chemicals used as antifungal agents in agriculture and human medicine, but also as cytostatic drugs in tumour chemotherapy. Antifungal activities are based on inhibition of lanosterol-14α-demethylase (CYP51). CYP51 catalyses the oxidative removal of the methyl group # 32 of lanosterol to produce follicular fluid meiosis activating steroid (FF-MAS). For fungi the later resulting ergosterol is an essential compound of the cell membrane. Exposed fungi lack ergosterol, which leads to a collapse of the cell membrane. In mammals cholesterol, the downstream product of lanosterol-14α-demethylation necessary for the synthesis of bile acids, mineral corticoids, glucocorticoids and sex steroids, can be supplemented with food intake. However FF-MAS and the resulting T-MAS (testis meiosis activating steroids), the direct products of the CYP51 reaction, act as meiosis-activating steroids on ovaries and testes and are not supplemented with food intake. Inhibition of CYP51 in humans may therefore affect the endocrine system and is an unwanted side effect of azoles. Aromatase (CYP19) catalyses the demethylation of testosterone to estradiol and is inhibited by azoles. Reduction of estrogen levels by CYP19 inhibition is the working principle of cytostatic drugs used in breast cancer therapy but is considered an unwanted side effect for azoles used to treat fungal infections. A favourable fungicide or antifungal drug should be a strong inhibitor of fungal CYP51. In contrast human CYP51 and human CYP19 should not be inhibited by an azole fungicide or antifungal agent. The favourable cytostatic drug should show a high potency towards human CYP19. Neither human CYP51 nor fungal CYP51 should be inhibited by a cytostatic drug. The aim of this work was to assess: are fungicides and antifungal drugs strong inhibitors of fungal CYP51? In return do they not inhibit human CYP51 and human CYP19? Do cytostatic drugs strongly inhibit human CYP19? And in return do they not inhibit human CYP51 or fungal CYP51? Inhibitory potencies of 22 azole compounds used for the three purposes were tested in four inhibition assays: i) on commercially available human CYP19 utilising a fluorescent pseudo substrate dibenzylfluorescein (DBF) ii) on CYP19 utilising testosterone as substrate iii) on human CYP51 and iv) Candida albicans CYP51 utilising lanosterol as substrate. Product formation was measured by liquid chromatography – tandem mass spectrometry utilising photospray ionisation (APPI). A functional human CYP51 was available from BD Gentest Cooperation. A functional enzyme complex comprising of the Candida albicans lanosterol-14α-demethylase and the Candida tropicalis oxidoreductase was expressed in the baculovirus system. When comparing inhibitory potencies on CYP19, human CYP51 and Candida albicans CYP51 a number of agents show desirable patterns of inhibition e.g. the two cytostatic drugs, or two antifungal agents used in human medicine, fluconazole and itraconazole, and a wide variety of the fungicides, e.g. cyproconazole and hexaconazole. Undesirable patterns of inhibition were exhibited by a number of compounds, e.g. prochloraz, bifonazole, ketoconazole and miconazole. Seven compounds show a more complex picture of inhibitory potencies though. To get a picture of residue levels of azoles in food in a model case an LC-ESI-MS/MS method was developed for the determination of azole compounds in wine. All residues were below the maximum residue levels set by authorities. To classify the inhibitory potencies on the different enzyme systems IC50 values obtained were compared to exposure levels measured in farmers, maximum plasma concentrations in humans reported after exposure to antifungal drugs and to acceptable daily intake levels set by authorities. Based on the findings presented, the following conclusions can be drawn. The risk for agricultural workers set by exposure to azole fungicides with respect to human CYP51 and CYP19 can be regarded as negligible when safety measures are adhered to. As a matter of principle however, the usage of bifonazole, miconazole and ketoconazole has to be viewed with caution in respect to the high level of inhibition of human CYP51 and/or CYP19. Under the assumption that the acceptable daily intake amounts set by authorities for azole compounds are not exceeded the residues do not pose a threat to consumer safety judged by our findings. Inhibition of CYP19 with the consequence of a reduction of estradiol levels has to be regarded as a possible disrupting effect of the hormone balance. The relevance of FF-MAS and T-MAS in the endocrine system however still has to be evaluated completely bringing with it the question of how much importance has to be attached to the inhibition of human CYP51.