title: 123I-ITdU-mediated nanoirradiation of DNA efficiently induces cell kill in HL60 leukemia cells and in doxorubicin-, beta-, or gamma-radiation-resistant cell lines.
abstract: Resistance to radiotherapy or chemotherapy is a common cause of treatment failure in high-risk leukemias. We evaluated whether selective nanoirradiation of DNA with Auger electrons emitted by 5-(123)I-iodo-4'-thio-2'-deoxyuridine ((123)I-ITdU) can induce cell kill and break resistance to doxorubicin, beta-, and gamma-irradiation in leukemia cells.
  
  
  METHODS
  4'-thio-2'-deoxyuridine was radiolabeled with (123/131)I and purified by high-performance liquid chromatography. Cellular uptake, metabolic stability, DNA incorporation of (123)I-ITdU, and the effect of the thymidylate synthase (TS) inhibitor 5-fluoro-2'-deoxyuridine (FdUrd) were determined in HL60 leukemia cells. DNA damage was assessed with the comet assay and quantified by the olive tail moment. Apoptosis induction and irradiation-induced apoptosis inhibition by benzoylcarbonyl-Val-Ala-Asp-fluoromethyl ketone (z-VAD.fmk) were analyzed in leukemia cells using flow cytometry analysis.
  
  
  RESULTS
  The radiochemical purity of ITdU was 95%. Specific activities were 900 GBq/micromol for (123)I-ITdU and 200 GBq/micromol for (131)I-ITdU. An in vitro cell metabolism study of (123)I-ITdU with wild-type HL60 cells demonstrated an uptake of 1.5% of the initial activity/10(6) cells of (123)I-ITdU. Ninety percent of absorbed activity from (123)I-ITdU in HL60 cells was specifically incorporated into DNA. (123)I-ITdU caused extensive DNA damage (olive tail moment > 12) and induced more than 90% apoptosis in wild-type HL60 cells. The broad-spectrum inhibitor of caspases zVAD-fmk reduced (123)I-ITdU-induced apoptosis from more than 90% to less than 10%, demonstrating that caspases were central for (123)I-ITdU-induced cell death. Inhibition of TS with FdUrd increased DNA uptake of (123)I-ITdU 18-fold and the efficiency of cell kill about 20-fold. In addition, (123)I-ITdU induced comparable apoptotic cell death (>90%) in sensitive parental leukemia cells and in leukemia cells resistant to beta-irradiation, gamma-irradiation, or doxorubicin at activities of 1.2, 4.1, 12.4, and 41.3 MBq/mL after 72 h. This finding indicates that (123)I-ITdU breaks resistance to beta-irradiation, gamma-irradiation, and doxorubicin in leukemia cells.
  
  
  CONCLUSIONS
  (123)I-ITdU-mediated nanoirradiation of DNA efficiently induced apoptosis in sensitive and resistant leukemia cells against doxorubicin, beta-irradiation, and gamma-irradiation and may provide a novel treatment strategy for overcoming resistance to conventional radiotherapy or chemotherapy in leukemia. Cellular uptake and cell kill are highly amplified by inhibiting TS with FdUrd.
authors.affiliation: Nuclear Medicine Clinic, Universität Ulm, Ulm, Germany. sven.reske@uniklinik-ulm.de
authors.forename: Sven N
authors.initials: SN
authors.lastname: Reske
authors.forename: Sandra
authors.initials: S
authors.lastname: Deisenhofer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Glatting
authors.forename: Boris D
authors.initials: BD
authors.lastname: Zlatopolskiy
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Morgenroth
authors.forename: Andreas T J
authors.initials: AT
authors.lastname: Vogg
authors.forename: Andreas K
authors.initials: AK
authors.lastname: Buck
authors.forename: Claudia
authors.initials: C
authors.lastname: Friesen
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology*; D017209:Apoptosis; D001610:Beta Particles; D045744:Cell Line, Tumor; D004249:DNA Damage; D003857:Deoxyuridine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004317:Doxorubicin / Q000494:pharmacology*; D019008:Drug Resistance, Neoplasm; D005720:Gamma Rays; D018922:HL-60 Cells; D006801:Humans; D007457:Iodine Radioisotopes; D036103:Nanotechnology; D011836:Radiation Tolerance; D019275:Radiopharmaceuticals / Q000494:pharmacology*
chemical_list: C465667:5-iodo-4'-thio-2'-deoxyuridine; D000970:Antineoplastic Agents; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D004317:Doxorubicin; D003857:Deoxyuridine