A Cell Culture Assay for the Detection of Cardiotoxicity
LOW-FRIEDRICH, FERDINAND VON BREDOW, AND WILHELM SCHOEPPE
IRIS
An important
step in minimizing
research
is the study
protein”
formation,
assay to monitor
which digestion
systems
as well
proteins.” sible
as to known
Pharmaceuticals
cardiotoxic
subtherapeutic
cardiotoxins relevant
effects:
Cyclosporine
concentrations.
to induce
toxic
drugs.
system
The
“shock
data presented
for cardiotoxicity “Heat
Key Words:
ranges
protein”
the de nova medicine
A evokes
Azathioprine
same effect but at concentration ability
with
“shock
cells
in other
synthesis
of “shock
highly
demonstrate
seems
level.
The
to be restricted
that the proposed
at
exert the
above the therapeutic
obviously
for pos-
formation
and methyl-prednisolone
synthesis
re-
cellular
were tested protein”
as an
were pre-
fetal mice. These
protein ” formation
in transplant
stress
cardiac myocytes
l&day-old
“shock
in medical
the use of “shock
to cell-damaging
and cultured
from
inducing
We propose
response
Isolated method
to typical substances
of animal experiments
systems.
is a cellular
cardiotoxicity.
pared by a trypsin spond
the number
of in vitro model
in vitro
to
model
is animal saving and sensitive.
shock
proteins”;
Cardiac myocytes;
Cardiotoxins;
In Vitro
assay. INTRODUCTION Experiments
in pharmacology
is expensive,
accompanied
are usually dependent
by ethical
problems,
on the use of animals,
and of little public
which
acceptance.
In
addition, the results obtained in in vivo experiments are difficult to interpret due to the fact that they deal with a very complicated system consisting of different organs
and their
interaction.
A probable
solution
to these
problems
is offered
by
the model system cell culture, which allows the monitoring of pharmaceutical effects in an animal-saving and organ-specific manner. Another advantage of the in vitro
test is the ability
wider
to control
range than in the whole
An important letalis media”
and determine
the experimental
field of pharmacological
research
is the measurement
(LD5,,) of new drugs. The development
of experimental
improve the specificity of the assay and save animals can be achieved by determining toxicity in different suring the concentration
dependence
Address ternal
reprint
Medicine,
furt am Main Received
D-6000
Frankfurt
requests Hospital
70, Federal
January
am Main
to: Dr. med.
70, Federal
1, 1990;
revised
of the “dosis strategies
that
is a challenge. More specificity organs separately and by mea-
Medicine, Republic
Iris Low-Friedrich,
of the Johann Wolfgang Republic
in a
of the toxic effect.
From the Department of Nephrology, Center for Internal Goethe-University,
parameters
animal.
Hospital
of the Johann
Wolfgang
of Germany.
Department
Goethe-University,
of Nephrology,
Theodor-Stern-Kai
Center 7, D-6000
for InFrank-
of Germany. and accepted
September
1, 1990.
133 Journalof
Pharmacological Methods
0 1991 Else&r
Science Publishing
25, 133-145 (1991) Co., Inc.. 655 Avenue of the Americas, New York, NY 10010
0160.5402/91/$3.50
134
I. Liiw-Friedrich
et al.
We are engaged ments documented The test system
in the development above,
of a toxicity
assay that fulfills
that is, one that saves a considerable
is based on the phenomenon
of “shock
to stress with the de nova synthesis of certain proteins, The toxic
change
in the environmental
chemical
nature;
the cells respond
such as heavy thesis.
metals
The existence perature effects selective analoguous (Lemeaux
Cells respond
the so-called
shock proteins.
can be of a physical
chemicals,
with
as well
and to toxic
a change
as
agents,
in protein
syn-
of shock proteins was first described in 1962 in a study on temin Drosophila melanogaster (Ritossa, 1962). For almost 15 years the
induction
of proteins
response
to a “heat
was thought shock”
1978). Other
et al., 1978) and plants
to be unique
was detected
to the fly.
In 1978 an
in avian and mammalian
tis-
groups found the same activity in bacteria
(Fink and Zeuther,
1978).
Today,
it is generally
that indeed
shock proteins
all organisms-from bacteria to man-are able to produce (Schlesinger et al., 1982). The detection of a general reaction mech-
anism to toxic agents proves that it is obviously a conserved of the organism, which was very successful in evolution. The mechanism that the presence
of cell protection of these proteins
and after a vital “stress”
duties:
(Schlesinger,
The 90,000-Dalton
strategy for the survival
by shock proteins is still speculative. It seems increases the cellular ability to recreate during 1986). The most frequent
ilies are of 90,000, 70,000, and 30,000 called ubiquitin (8000 D) (Ciechanover ferent
of animals.
proteins.”
to a rise in temperature
or radical-forming
sues (Kelley and Schlesinger, accepted
condition
the require-
amount
shock protein
Dalton mol. wt., a fourth shock et al., 1984). The shock proteins
shock
protein
family
functions in cellular metabolism. It exists as a complex ceptors and as a complex with virus-coded polypeptides
has a variety
fam-
protein is fulfill dif-
of important
with steroid hormone re(Schuh et al., 19851, and
it binds calcium-dependently to actin (Nishida et al., 1986). This shock protein influences cell proliferation by regulating the entry into a new mitosis (lida and Yahara, 1984). The 70,000-Dalton cytoplasm
to nucleus
shock proteins and return
they concentrate “stress,” strengthen the cytoskeleton
move immediately
to cytoplasm
in the (Welch
nucleolus
upon
forming
and Suhan,
after a shock event from
cell regeneration.
1985);
insoluble these
During
aggregates
complexes
the and
are de-
stroyed by an ATP-dependent reaction (Lewis and Pelham, 1985). The low molecularweight shock proteins form large insoluble aggregates in the perinuclear region after a “stress” and dissociate during cell recovery. Ubiquitin, one of these shock proteins, reactions
is coupled to the l -lysine-group of, polypeptides by a cascade of enzymatic (Munro and Pelham, 1985). Polypeptides transformed in that way are pre-
ferred objects of protease digestion. It is assumed that the protease activity is a part of the cellular mechanism that tolerates stress (Schlesinger, 1986); in this way polypeptides are activited, which derepress the shock-protein-coding genes (Figure 1). The data accumulated in the literature clearly indicate that shock proteins are always synthetized when the cell is threatened by a toxic environment. Hence, the detection of shock proteins might be a useful tool in monitoring toxicity. assay based on this phenomenon should fulfill certain requirements:
A toxicity
Cardiotoxicity
1. The shock formation
protein
de nova synthesis
must be demonstrated
by classical
inductors
in the investigated
of shock
protein
cell culture.
2. Well-known toxic agents should be able to provoke the synthesis of shock proteins dependent on the organ source of the cell culture, for example, cardiotoxins should
affect the protein
formation
in myocardial
cell cultures.
3. If potentially toxic agents induce the formation of shock proteins concentrations, they can be regarded as toxins. 4. Non toxic substances reasonable
should
also be unable
to evoke
at reasonable
shock protein
synthesis
at
concentrations.
The data presented assay to detect
in this study might
establish
the test system as a screening
cardiotoxicity.
Stress (heat or toxin) I +
denaturation of cellular proteins
c
“ubiquitin” guided, ATP dependent proteolysis .............................. \ l. . . . . . . . . z : : de-repression of shock protein coding genes >
L- rv] FIGURE 1.
methionine Scheme of “shock protein” formation.
135
136
I. Liiw-Friedrich
et al.
METHODS Preparation of Fetal Mouse Cardiac Myocytes Fetal mouse examine
cardiac
the toxicity
nant mouse with 8-12 to remove
blood,
phate-buffered
myocytes
are prepared
of IO concentrations fetuses.
Briefly,
cut into smaller
to Low et al. (1989).
and placed
To
we need only kill 1 preg-
hearts from 18-day-old
pieces,
saline (PBS) (NaCI,
according
of 1 substance,
fetal mice are washed
in 6 ml of calcium-free
8 g/L; KCI, 0.2 g/L; Na*HPO,,
phos-
1.15 g/L; KH2P04,
0.2 g/L). All preparation steps are performed under sterile conditions with the addition of 25 U/mL of penicillin and 25 kg/mL of streptomycin to the buffers and media. 0.1%).
Next,
4 mL of 0.25%
The pieces
agitation,
which
pernatant
is discarded
in PBS. After
trypsin
are then
when
in PBS is added
digested
stopped
(final concentration
allows
the pieces
the supernatant
under
to settle to the bottom.
and the pieces are again resuspended
15 min of agitation,
of trypsin:
for 15 min at room temperature
in 10 ml of 0.1% trypsin
is again discarded.
The super-
natants of the following two digestion steps are collected. The digestion by dilution of the supernatant containing the cells into equal volumes alpha-medium
(Stanners
et al., 1971) supplemented
slight
The su-
is stopped of ice-cold
with 20% fetal calf serum
(FCS).
The yield of cells can be increased when the heart pieces are flushed cautiously with a stream of buffer. The cells are collected by centrifugation at 4°C in a Sorvall SS 34 rotor at 1000 rpm for 10 min. The cells are washed in 10 mL of alpha-medium supplemented with 20% FCS. They are centrifuged again as described above. Then the pellet
is resuspended
cell number
in 3 mL of alpha-medium
is determined
in a cell-counting
plus 20% FCS. Thereafter,
chamber.
The amount
the
of cells is ad-
justed to 5 x IO5 cells per dish. They are kept for 2 days in the incubator at 37°C in an atmosphere of 5% CO* saturated with water. There the cells attach themselves tightly to the dishes (Nunclon able culture
surface
dishes:
(Dulbecco’s minimum essential mented with 5% FCS, IO mmol/L and 25 kg/mL are exposed
material,
area, 8.8 cm2). After
streptomycin,
polystyrene;
incubation
diameter,
3.5 cm; avail-
they are transferred
to DMEM
medium) (Dulbecco and Freeman, 1959) suppleHepes, 2.5 mmol/L L-glutamine, 25 U/mL penicillin,
pH 7.4. The cells are kept
to the experimental
in this medium
until they
conditions.
Cells Labelling with L-(~ S)Methionine After
incubation
of the cells for a definite
min of heat shock (42°C) exposure, are incubated
for an additional
The labelling is stopped cold PBS, and dissolving Gold,
time
period
with the toxins
0.1 mCi of L-(35S)methionine
2 hr in a water-saturated
by removing the supernatant, the cells in 1 mL of O’Farrell’s
is added.
atmosphere
or after 5 The cells
with 5% CO,.
washing the cells with icesample buffer (O’Farrell and
1973).
SDS-gel Electrophoresis The proteins are precipitated minute (cpm) in each sample cpm in approximately
according to Wessel and Fltigge (1984). Counts per are determined by liquid scintillation, and 100,000
50 j.d O’Farrell’s
sample
buffer are applied
per slot. Gradients
Cardiotoxicity of 5%-15%
of acrylamide
or 10% acrylamide
are used for SDS-gel
electrophoresis
according to Laemmli (1970). The slab gels are run for 8 hr at 160 V. Phosphorylase b (mol. wt. 94,000 Dalton), albumin (mol. wt. 67,000 Dalton), ovalbumin (mol. wt. 43,000 Dalton),
carboanhydrase
wt. 20,100 Dalton) 0.99: The times.
gels shown
Staining
of Proteins
The
proteins
ethanol,
(mol. wt. 30,000 Dalton),
serve as molecular
weight
are representative;
are stained
with
0.1%
markers. each
experiment
Coomassie
80 mL acetic acid, 670 mL water,
and trypsin
inhibitor
(mol.
The value of r* is better was performed
brilliant
blue
than three
R 250 in 250 mL
and 1% glycerol.
Autoradiography The fixed
and stained
slabs are dried
gels are fixed to the film (B-max) in a commercial
on Whatman
for 72-144
3 MM
paper.
Then
hr. The films are developed
the slab and fixed
system.
Materials L-(35S)methionine was supplied by NEN, FCS by Gibco (Eggenstein, FRG), DMEM, alpha-medium, trypsin, and antibiotics by Biochrom KG (Berlin, FRG). Films for autoradiography
(B-max) were
purchased
from Kodak. Poly(oxyethylene)-40-ricin All drugs were taken from commercial highest
purity
available.
The pregnant
from Amersham,
and developer
and fixer
was provided by Sandoz (Nurnberg, packages; the other chemicals were NMRI
mice lived on standard
FRG). of the
diets.
RESULTS To fulfill
the requirements
the myocardial
cells with
of the toxicity
typical
assay formulated
agents well
thesis in other organisms and tissues. Indeed, served: 0.1 mmol/L CdClz induces the formation
known
above,
to induce
and one 30,000-Dalton protein; 0.001% H202 provokes 30,000 Dalton shock protein (Figure 2). The synthesis of the 30,000 Dalton shock protein is evoked 22.5
protein
syn-
the expected effects could be obof two proteins of the 70,000-Dalton
family
0.05 mg Hg/L) HgC12. At concentrations
we incubated
shock
kmol/L
(=
the synthesis
of a
by 0.25 Pmol/L
(=
0.5 mg Hg/L),
additionally
two de nova synthetized proteins of the 70,000-Dalton family can be detected (Figure 3). These findings are in good agreement with practical clinical experience where the first toxic effects of Hg are observed at concentrations of 0.04 mg/L (Beratungsstelle bei Vergiftungen und Giftinformation, Klinikum der Johannes Gutenberg-Universitat, D-6500 Mainz, FRG; personal communication). The same effect is observed with ZnClz: concentrations r5 kmol/L induce the 30,000 Dalton shock protein; ?I00 Fmol/L ZnClz the proteins of the 70,000-Dalton family are expressed, too (data not shown). At a short-term elevation of temperature to 42°C for 5 min, the de nova synthesis of proteins of the 70,000-Dalton family could be documented (data not shown). This pattern of shock protein formation after exposition to dif-
137
138
I. Low-Friedrich et al.
MW
70000
-
30000
-
A
D
FIGURE 2. Shock protein induction by CdCI,, H,Oz, and allylamine. Fetal mouse myocardial cells were incubated with 0.1 mmol/L CdClz (A), 1 x 10m3% HzOz (C), or 0.01 mmolll allylamine (D) for 2 hr (B, control). Afterward, 0.1 mCi of L-(35S)methionine was added; incubation was prolonged for another 2 hr at 37°C. Then the cells were dissolved in O’Farrell’s sample buffer. SDS-gel electrophoresis was run with 100,000 cpm/slot.
ferent culture
“stress”
conditions
leads one to the conclusion
that cardiac
myocytes
in
react exactly like other mammalian cells. The formation of a 71,000-Dalton of rats after an in vivo exercise test has already protein” in the myocardium
“shock been observed
(Hammond
et al., 1982).
The next step of our experimental work consisted of-according to our postulations-the investigation of a substance that has proven cardiotoxicity in clinical and/or morphological examinations. We choose allylamine, an unsaturated aliphatic amine used in the production of plastics and drugs as a stabilizer. Histologically, allylamine causes myocardial fibrosis. As observed electronmicroscopically, the single myocytes undergo necrosis with clumped myofibrils, electron-dense mitochondrial deposits, and cell lysis after application of two gavage doses of 150 mg/ kg allylamine, 24 hr apart (Boor, 1983). Of this substance 0.01 mmol/L (= 0.57 mg/
Cardiotoxicity
MW
70 000
30 000
F FIGURE 3. Shock protein expression induced by HgClz. The cardiac myocytes were treated as described in the legend to Figure 2. (A) 5 pmol/L; (B) 2.5 ~mol/L; (C) 1 pmol/L; (D) 0.5 pmol/L; (E) 0.25 pmol/L HgC&; and (F) control.
L) provokes the de nova synthesis of the 30,OOODalton polypeptide (Figure 2). This result suggests that proven cardiotoxic agents indeed formation
of shock proteins.
The effect to allylamine,
on protein synthesis seems to be restricted to toxins. In comparison we tested other stabilizers-benzoic and sorbic acid-which are defi-
nitely not dangerous to the myocardium. tein synthesis of the cultured myocytes formation
in our assay stimulate the
of “shock
proteins”
might
The chemicals did not influence (Figure 4). These results indicate
be a specific
indicator
the prothat the
of toxic environmental
conditions. As examples
for potentially
cardiotoxic
drugs,
we examined
the whole
group
of
immunosuppressive pharmaceuticals relevant in transplant medicine. The questionable cardiotoxicity of cyclosporine A is discussed but not proven. The drug inhibits the proliferation of immune-competent cells; nephrotoxicity has already been confirmed. Cyclosporine A stimulates the de nova synthesis of a 30,000-Dalton shock protein in cardiac myocytes. This effect can already be detected at concen-
139
140
I. Lbw-Friedrich et al.
MW
30000
-
C
B
F
E
D
FIGURE 4. Incubation of fetal mouse myocardial cells in benzoic acid does not evoke shock protein synthesis. The cells were treated as described in the legend to Figure 2. (A) 1%; (B) 0.1%; (C) 0.05%; (D) 0.01%; (E) 0.001% benzoic acid; and (F) control. trations
of the pharmaceutical
of the amount
of shock
210
protein
ng/mL.
formed
A quantitative
shows
porine A doses (Figure 5). The therapeutic concentration is between 100 and 150 ng/mL. Although a direct correlation doses and human
serum
to the concentrations
levels cannot
be established,
in the cell culture
exert toxic effects already We could demonstrate must be attributed to (poly(oxyethylene)-40-ricin)
densitometrical
an increase
elevated
a comparison
assay indicates
analysis cyclos-
range of cyclosporine A between the cell culture of these values
that cyclosporine
at subtherapeutic levels. that the cyclosporine A effect the
with
on
protein
A might synthesis
pharmaceutical itself as the cyclosporine solvent does not affect the protein synthesis of cultured heart
cells (data not shown). Another standard immunosuppressant, azathioprine, has an acute LDSO in mice in sensitive tissues occurs at much of 650 mg/kg (Elion et al., 1961). Cytotoxicity lower concentrations, that is, in the order of 5- (Boll et al., 1971) IO (Wilson, 1965) t.@mL for bone marrow and lymph node cells in vitro, respectively. Protein synthesis
Cardiotoxicity
20 -
15-
10
0
80
50
20
cyclosporine A
100
1ng 1 ml 1
FIGURE 5. Increasing relative amounts of the 30,000-Dalton shock protein induced by rising concentrations of cyclosporine A. The relative amounts of the 30,000-Dalton shock protein are given as a percentage of the total cellular protein content. Mean f SD obtained from the densitometrical analysis of five representative experiments is shown.
documented thioprine induces 250
by leucine
concentrations
incorporation 260
the de nova synthesis
t.@mL
(Figure
61, which
results of densitometric cyclosporine A.
lymphocytes
and Forbes,
of the 30,000-Dalton is distinctly
measurements
The same effect is obtained
in human
k.g/mL (Smith
above were
is inhibited
shock protein
at concentrations
the pharmacological comparable
with methyl-prednisolone,
at aza-
1967, 1970). Azathioprine
to those
dosages. achieved
a corticosteroid
The with
hormone,
inducing the de nova synthesis of the 30,000-Dalton shock protein at unphysiologically high concentrations (~0.5 mg/mL, Figure 7). The acute LDSO of methylprednisolone is 768 mg/kg in mice and 650 mg/kg both of which are also rather high dosages.
in rats (Hoechst
AC,
1975a,b),
In the treatment of acute rejection crises after organ transplantation, antibody preparations directed against certain immune-competent ceils are employed. These solutions do not influence the protein synthesis of cultured heart cells over a wide concentration
range (data not shown).
The results presented suggest that the study of shock protein synthesis in cultured cells provides a fast survey on the potential toxicity of a complete group of substances.
141
142
I. Liiw-Friedrich
et al.
MW
30000
-
A
FIGURE 6. Shock protein formation induced by azathioprine. scribed in the legend to Figure 2. (A) 100 &ml; (B) 75 &ml; (E) 1 @ml azathioprine; and (F) control.
F
E
B
The cells were treated as de(C) 50 p.g/mL; (D) 25 kg/ml;
DISCUSSION Our
studies
present
a test system for the assessment
of cardiotoxicity
based on
the detection of shock protein synthesis in a myocardial cell culture. Shock protein formation in heart cells is induced by cardiotoxic agents; substances
(sorbic
acid, benzoic
acid, poly(oxyethylene)-40-ricin,
several
two different
an-
tibody solutions) that are suggested to be nontoxic do not evoke shock protein synthesis. Chemicals that exert toxic effects can be divided into damaging and harmless agents by their ability to evoke shock protein formation. Shock protein synthesis is concentration-dependent so that the degree of toxicity can be estimated by the toxin concentration needed for the induction of shock protein formation. It seems that low concentrations of “severe” toxins or high concentrations of “moderate” toxins induce the 30,000-Dalton shock protein, whereas the proteins of the 70,000-Dalton family are expressed at high concentrations of “severe” toxins. This observation needs further investigation and might provide
Cardiotoxicity
MW
30000
-
A
C
D
FIGURE 7. Shock protein induction by methyl-prednisolone. The cultured myocytes were treated as described in the legend to Figure 2. (A) control; (B) 0.25 mg/mL; (C) 0.5 mg/mL; and (D) 0.75 mg/mL methyl-prednisolone.
insight in the different functions of “shock proteins ” in cellular protection. The de nova expression of these proteins is detectable when the cells are morphologically still intact, when they still have vital functions, such as contractility in myocytes, and when metabolism is not roughly disturbed, for example, the cells are still capable of protein synthesis. These results document that the test system reacts even
143
144
I. Liiw-Friedrich
et al.
more
than
sensibly
sensitivity
does
the measurement
of cell death.
of the assay has been demonstrated
In comparison advantages:
to whole-animal
Toxicity
ner. The number
of animals
and the organs
experiments,
is determined
removed
the cell culture
organ-specifically
needed
We
conclude
that the
test provides
several
by these data. in the described
is very low, only one pregnant
is sufficient
to investigate
10 different
sensitive mouse
man-
is killed,
concentrations
of
one substance. We focused more effective were
on the problem of cardiotoxicity. Theoretically, and animal saving when all important organs-liver,
removed
toxicity
to the special hepatocytes period before
and prepared
test to other
simultaneously
organ cell cultures
abilities
for cell culture.
might provide
of the cells investigated.
may change
in production
the assay could be kidneys, heartThe transfer
a different
Cytochrome
levels after
primary
may not be detected
nonsubstrate specific
specificity.
toxins
must
applied to other Whole-animal
to either
culture,
even
lack of correct
investigations
be performed
before
the shock
organ cell cultures. studies are performed
to determine
Several concentration
series requiring many laboratory cannot be avoided completely and their
model can enlighten
the
careful
new pharmaceuticals.
metabolites
due
Therefore,
possible
animals. because
due
P450 isoenzymes
of 24 hr. Some compounds have to be metabolized by cytochrome they become toxic. If the level of isoenzymes is changed, potentially
compounds
of the
performance
protein
letalis
or
of organ-
test system
the “dosis
a
P450 toxic
enzymes
on the effects
of
over
can be
media”
ranges have to be examined,
of
each test
Presumably, the whole-animal experiment it is able to monitor the interactions of
accumulations
the critical concentrations
in different
organs.
The cell culture
and by that way avoid a large number
of in vivo tests performed in search of the toxic dosages. Increasing scientific interests concentrate on the practical
use of shock proteins
in clinical routine: Hyperthermia is discussed as an additional therapeutic strategy for the treatment of cancer, preferably in addition to radiation. After the first heat treatment,
the level of shock proteins
in the tumor
cells increases
and they develop
a temporary resistance to the effects of heat. By measuring the production of shock proteins, clinicians may be able to identify exactly the period of most vulnerability to determine the onset shock proteins in tumor and to determine would
of the next treatment. The development cells has started; test systems to identify
the extent of ischemic
like to add an additional
formation
by proposing
on shock protein This work
are investigated
for the diagnostic
an assay for the detection
(Ember,
1989). We
use of shock
of organ-specific
toxicity
protein based
synthesis.
was supported
to Ms. Ch. Heinecker
damage
indication
of an assay for metabolic insults
by the Scheidel-Stiftung,
for her expert
preparation
Frankfurt
am Main,
FRG. The authors
are indebted
of the manuscript.
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