title: Cerebral formation in situ of S-carboxymethylcysteine after ifosfamide administration to mice: a further clue to the mechanism of ifosfamide encephalopathy.
abstract: The clinical use of the alkylating oxazaphosphorine ifosfamide is hampered by a potentially severe encephalopathy. S-carboxymethylcysteine (SCMC), a metabolite of ifosfamide (IF), activates the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)/kainate receptor, causes neuronal acidification, and could thus be responsible for the encephalopathy. Since the presence of SCMC in brain has not been documented following administration of IF, SCMC was measured in the brain of mice following both the individual i.p. administration of IF and SCMC. SCMC was found in a concentration of 108.2 +/- 29.7 nmol/g following IF, but was detectable at much lower levels following the administration of SCMC (21.1 +/- 21.2 nmol/g). Together with the observation that the concentration of SCMC was 10-fold higher in liver than in brain 1h after administration of SCMC, these findings suggest that the SCMC found after IF was formed in the brain in situ. The concentration of glutamic acid was similar in IF and SCMC treated animals. Methylene blue, which is used clinically to treat and to prevent IF encephalopathy, did not decrease the formation of SCMC in brain. By inhibiting monoamine oxidase activity it did, however, markedly increase the concentration of serotonin in brain which could modulate the effects of SCMC on AMPA/kainate receptors. Thus, SCMC is present in brain following the administration of IF and could contribute to the IF-associated encephalopathy by activation of AMPA/kainate receptors.
authors.affiliation: Department of Clinical Pharmacology, University of Bern, Murtenstrasse 35, CH-3010 Bern, Switzerland.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Lerch
authors.forename: Adrian
authors.initials: A
authors.lastname: Küpfer
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Idle
authors.forename: Bernhard H
authors.initials: BH
authors.lastname: Lauterburg
mesh_terms: D000818:Animals; D018906:Antineoplastic Agents, Alkylating / Q000493:pharmacokinetics* / Q000633:toxicity; D001921:Brain / Q000187:drug effects / Q000378:metabolism*; D001927:Brain Diseases / Q000139:chemically induced / Q000378:metabolism*; D002233:Carbocysteine / Q000493:pharmacokinetics* / Q000633:toxicity; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D018698:Glutamic Acid / Q000378:metabolism; D007069:Ifosfamide / Q000493:pharmacokinetics* / Q000633:toxicity; D008751:Methylene Blue / Q000494:pharmacology; D051379:Mice; D008996:Monoamine Oxidase Inhibitors / Q000494:pharmacology; D012701:Serotonin / Q000378:metabolism
chemical_list: D018906:Antineoplastic Agents, Alkylating; D008996:Monoamine Oxidase Inhibitors; D012701:Serotonin; D018698:Glutamic Acid; D002233:Carbocysteine; D008751:Methylene Blue; D007069:Ifosfamide