title: Inhibition of carboxyethylphosphoramide mustard formation from 4-hydroxycyclophosphamide by carmustine.
abstract: It has been reported that the toxicity of carmustine (BCNU)/cyclophosphamide (CY)/etoposide regimen (when BCNU is split into 4 doses) is less than that of BCNU/CY/cisplatin regimen (when the same amount of BCNU is administered as a single dose). We hypothesized that this might in part be due to the inhibition of aldehyde dehydrogenase 1 (ALDH1) by BCNU or its degradation product, 2-chloroethyl isocyanate, which is likely to be more pronounced at the higher BCNU dose. The effects of BCNU and 2-chloroethyl isocyanate on the formation of carboxyethylphosphoramide mustard (CEPM) from 4-hydroxycyclophosphamide (HCY) was evaluated in human liver cytosol incubations. We found that CEPM formation from HCY was inhibited strongly by BCNU and weakly by 2-chloroethyl isocyanate. The mechanism of inhibition of ALDH1 activity by BCNU was elucidated using indole-3-acetaldehyde (IAL) as the probe substrate in ALDH1 prepared from human erythrocytes. BCNU was a competitive inhibitor of ALDH1 activity with a K(i) of 1.95 microM. The inhibition was independent of preincubation time and reversible by dialysis. The calculated %inhibition of ALDH1 activity by acrolein and BCNU in patients receiving BCNU in 4 split doses with CY was 81%, and it increased to 92% in single dose BCNU regimen. Thus, the calculation indicates that residual operating ALDH1 activity is halved in the presence of single-dose BCNU compared to split-dose BCNU. The inhibition of ALDH1 may contribute to the observed lower incidence of toxicity when BCNU was split into 4 doses compared with single dose and coadministered with CY although dose-dependent effects of BCNU on glutathione and glutathione reductase are also likely to contribute.
authors.affiliation: Department of Pharmaceutics, University of Washington, Seattle, Washington 981951, USA.
authors.forename: S
authors.initials: S
authors.lastname: Ren
authors.forename: J T
authors.initials: JT
authors.lastname: Slatterly
mesh_terms: D000171:Acrolein / Q000494:pharmacology; D000444:Aldehyde Dehydrogenase / Q000037:antagonists & inhibitors; D000080924:Aldehyde Dehydrogenase 1 Family; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000494:pharmacology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002330:Carmustine / Q000008:administration & dosage / Q000494:pharmacology*; D003520:Cyclophosphamide / Q000031:analogs & derivatives* / Q000378:metabolism*; D004791:Enzyme Inhibitors / Q000494:pharmacology; D006801:Humans; D066298:In Vitro Techniques; D017953:Isocyanates / Q000008:administration & dosage / Q000494:pharmacology*; D007527:Isoenzymes / Q000037:antagonists & inhibitors; D008099:Liver / Q000378:metabolism / Q000648:ultrastructure; D010752:Phosphoramide Mustards / Q000378:metabolism*; D050697:Retinal Dehydrogenase
chemical_list: D018906:Antineoplastic Agents, Alkylating; D004791:Enzyme Inhibitors; D017953:Isocyanates; D007527:Isoenzymes; D010752:Phosphoramide Mustards; C445000:carboxyethylphosphoramide mustard; C006995:2-chloroethyl isocyanate; C012358:4-hydroxycyclophosphamide; D000171:Acrolein; D003520:Cyclophosphamide; D000080924:Aldehyde Dehydrogenase 1 Family; D000444:Aldehyde Dehydrogenase; C510223:ALDH1A1 protein, human; D050697:Retinal Dehydrogenase; D002330:Carmustine