title: Interactions between the new cytotoxic drug CHS 828 and amiloride and mitomycin C in a human tumour cell line and in tumour cells from patients.
abstract: BACKGROUND
  CHS 828 is a novel cyanoguanidine with cytotoxic properties which was recently shown to induce an early increase in extracellular acidification. This could hypothetically be exploited for combination with drugs interfering with, or being dependent on, pH for their effect.
  
  
  METHODS
  The isobole method and the additive model were used to evaluate the combinations CHS 828-amiloride and CHS 828-mitomycin C (MMC) in the lymphoma cell line U-937 GTB and in primary cultures of tumour cells from patients.
  
  
  RESULTS
  Amiloride, which blocks the Na(+)/H(+) antiport, shifted the CHS 828 dose-response curve to the left in a synergistic manner according to the additive interaction model. MMC is a bioreductive drug with enhanced cytotoxicity at acidic pH. A lowering of pH induced by CHS 828 would theoretically create a favourable environment for bioreduction of MMC. The interaction between these drugs was mainly classified as additive by both methods, but was synergistic at the highest effect level tested. In addition, there were sub-additive to synergistic interactions between CHS 838 and MMC in 76% of the haematological samples tested.
  
  
  CONCLUSIONS
  Circumstantial evidence indicated that the mechanisms for the interactions could be pH independent. Thus, the interaction between CHS 828 and amiloride was synergistic while the interaction between CHS 828 and MMC in tumour cells was at least additive.
authors.affiliation: Department of Medical Sciences, Division of Clinical Pharmacology, University Hospital, Uppsala, Sweden. Sara.Ekelund@medsci.uu.se
authors.forename: Sara
authors.initials: S
authors.lastname: Ekelund
authors.forename: Ingrid
authors.initials: I
authors.lastname: Persson
authors.forename: Rolf
authors.initials: R
authors.lastname: Larsson
authors.forename: Peter
authors.initials: P
authors.lastname: Nygren
mesh_terms: D000584:Amiloride / Q000494:pharmacology*; D000903:Antibiotics, Antineoplastic / Q000494:pharmacology*; D003486:Cyanides / Q000494:pharmacology*; D004232:Diuretics / Q000494:pharmacology*; D004347:Drug Interactions; D006146:Guanidines / Q000494:pharmacology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008223:Lymphoma / Q000473:pathology*; D016685:Mitomycin / Q000494:pharmacology*; D014407:Tumor Cells, Cultured
chemical_list: D000903:Antibiotics, Antineoplastic; D003486:Cyanides; D004232:Diuretics; D006146:Guanidines; C401312:N-(6-chlorophenoxyhexyl)-N''-cyano-N''-4-pyridylguanidine; D016685:Mitomycin; D000584:Amiloride