title: Vitamin E reduces accumulation of amiodarone and desethylamiodarone and inhibits phospholipidosis in cultured human cells.
abstract: Chronic administration of amiodarone (AMIO), widely used by clinicians for the treatment of therapy-resistant cardiac arrhythmias, is frequently associated with serious side-effects. AMIO and its main metabolite desethylamiodarone (DEA) are known to induce phospholipidosis in vivo and in cultured cells presumably by inhibition of lysosomal phospholipid degradation. D-alpha-Tocopherol = vitamin E (alpha-TOC) was able to reduce AMIO and DEA toxicity in cell cultures. Results from the present study showed that alpha-TOC reduced phospholipidosis in cultured human skin fibroblasts chronically exposed to micromolar concentrations of AMIO and DEA and inhibited cumulative uptake of the drugs in a dose-dependent manner. A linear correlation was observed between cellular AMIO levels and phospholipid accumulation suggesting a stoichiometric relationship. alpha-TOC was also effective in clearing previously accumulated phospholipids after discontinuation of the drug treatment. The results can best be explained by an interference of alpha-TOC (a) with drug-phospholipid complex formation responsible for both phospholipid storage and drug accumulation, and (b) with pre-existing drug-phospholipid complexes, accelerating their dissociation and rendering phospholipids to substrates for lysosomal phospholipases. The finding raises hope that side-effects of AMIO and DEA can be prevented or made reversible by the administration of alpha-TOC. It must, however, be proven that the antiarrhythmic drug will still be effective.
authors.affiliation: Department of Pharmacology, University of Bern, Switzerland.
authors.forename: U E
authors.initials: UE
authors.lastname: Honegger
authors.forename: I
authors.initials: I
authors.lastname: Scuntaro
authors.forename: U N
authors.initials: UN
authors.lastname: Wiesmann
mesh_terms: D000638:Amiodarone / Q000031:analogs & derivatives* / Q000378:metabolism; D002478:Cells, Cultured; D006801:Humans; D006868:Hydrolysis; D010743:Phospholipids / Q000378:metabolism*; D014810:Vitamin E / Q000494:pharmacology*
chemical_list: D010743:Phospholipids; D014810:Vitamin E; C036116:desethylamiodarone; D000638:Amiodarone