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Antimicrobial Agents and Chemotherapy, June 2002, p. 1728-1733, Vol. 46, No. 6
0066-4804/02/$04.00+0 DOI: 10.1128/AAC.46.6.1728-1733.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
Department of Pharmacology, University of Alabama at Birmingham, Birmingham, Alabama,1 Novirio Pharmaceuticals, Inc., Cambridge, Massachusetts,3 Novirio Pharmaceuticals, SARL,4 Laboratorie de Chimie Organique Biomoleculaire de Synthese, UMR CNRS-UM II 5625, Université Montpellier II, Montpellier, France,5 Department of Chemistry, University of Puerto Rico, Río Piedras Campus, San Juan, Puerto Rico2
Received 17 August 2001/ Returned for modification 19 November 2001/ Accepted 11 March 2002
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Recently, ß-L-thymidine (L-dT) and ß-L-2'-deoxycytidine (L-dC) were shown to be potent and specific inhibitors of HBV replication both in vivo and in vitro (50% effective concentrations [EC50s], 0.19 to 0.24 µM in human hepatoma 2.2.15 cells) (2). In a phase I-II clinical trial, treatment with L-dT has also been demonstrated to cause marked reductions in HBV DNA levels in chronically infected patients (C. L. Lai, S. G. Lim, M. F. Yuen, D. M. Pow, and M. W. Myers, Abstr. Eur. Assoc. Study Liver, abstr. 500, 2001; S. G. Lim, C. L. Lai, Y. M. Lee, D. M. Pow, and M. W. Myers, Abstr. Dig. Dis. Week, abstr. 2908, 2001). In vitro studies indicated that at concentrations as high as 100 µM L-dT and L-dC did not exhibit cellular or mitochondrial toxicities and did not inhibit human cellular DNA polymerases
, ß, and
(J. P. Sommadossi, M. L. Bryant, G. Gosselin, R. F. Schinazi, and J. L. Imbach, Program Abstr. 3rd Int. Conf. Ther. Viral Hepatitis, abstr. 19, Antivir. Ther. 4(Suppl. 4):8, 1999). Preliminary studies demonstrated the intracellular presence of phosphorylate derivatives of L-dT and L-dC [L. Placidi et al., abstract from the 3rd International Conference on Therapy for Viral Hepatitis, Antivir. Ther. 4(Suppl. 4):48, abstr. A122, 1999]. The present study examines the intracellular metabolism and extent of phosphorylation of L-dT and L-dC in HepG2 cells and primary cultured hepatocytes isolated from human liver.
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Cell culture conditions and determination of intracellular metabolites. HepG2 cells were obtained from the American Type Culture Collection (Manassas, Va.) and were grown in 225-cm2 tissue culture flasks in minimal essential medium supplemented with nonessential amino acids, 1% sodium pyruvate, 10% dialyzed fetal bovine serum, and 1% penicillin-streptomycin. The medium was renewed every 3 days, and the cells were subcultured once a week. For intracellular metabolism studies, confluent HepG2 cells were detached from the adherent monolayer by a 10-min exposure to 30 ml of trypsin-EDTA, followed by three consecutive washes with medium, and at confluency were seeded (2.5 x 106 cells per well) in a six-well plate. HepG2 cells were exposed to 1 or 10 µM [3H]L-dT or [3H]L-dC (1,000 and 500 dpm/pmol, respectively) for the specified time periods. The cells were maintained at 37°C under a 5% CO2 atmosphere. At selected times, the extracellular medium was removed and the cell layer was washed with ice-cold phosphate-buffered saline (PBS). Cells were removed from the wells by scraping in the presence of 60% methanol, and the cell-methanol mixture was incubated overnight at -20°C. L-dT or L-dC and their respective metabolites were extracted from the cells by incubation in 200 µl of cold methanol for 1 h on ice. The extracts were dried under a gentle filtered airflow and stored at -20°C until high-pressure liquid chromatography (HPLC) analysis. The method for calculating the concentration of phosphorylated metabolites (1 pmol/106 cells = 1 µM) was based on previous studies with H9 cells (5).
Isolation and culture of human hepatocytes. Human livers were obtained through the University of Alabama at Birmingham Liver Center. All livers had normal histologies and tested negative for human immunodeficiency virus and HBV. The isolation and culture of human hepatocytes were performed as described previously (12). Briefly, the livers were washed in situ at 4°C with Eurocollins buffer (12) supplemented with heparin to remove blood from the vessels. Liver samples were then perfused with previously oxygenated calcium-free HEPES buffer (pH 7.4) and then with 0.05% (wt/vol) collagenase solution containing calcium under recirculation and continuous oxygenation conditions. After 15 to 20 min of perfusion, necessary for disruption of Glisson's capsule, hepatocytes were suspended in L15 medium (Gibco BRL, Life Technologies) containing 5% fetal calf serum. The freshly isolated cells were then washed three times and centrifuged at 40 x g at 4°C for 10 min in L15 medium supplemented with 10% fetal calf serum to remove debris and damaged cells. After the final wash, the cell number was determined by an erythrosin B exclusion test. Viable hepatocytes (>90%) were resuspended in William's medium (Gibco BRL, Life Technologies) containing 2 mM glutamine and antibiotics. The hepatocytes were seeded at a density of 0.75 x 106 cells/ml in six-well plates previously coated with rat tail collagen, and the plates were incubated in a 5% CO2 atmosphere at 37°C. The cells were allowed to attach overnight, and then the medium was replaced by the same medium (without fetal bovine serum) containing 10 µM hydrocortisone hemisuccinate, 10 mM sodium pyruvate, 10 ng of selenium per ml, 4 µg of glucagon per ml, 6.8 µM ethanolamine, and 10 µg of human transferrin per ml. After 24 h, this medium was renewed and drug metabolic assays were initiated. The hepatocytes were incubated with 10 µM [3H]L-dT (1,000 dpm/pmol) or [3H]L-dC (1,000 dpm/pmol). At selected times, the extracellular medium was removed and the cell layer was washed with cold PBS, followed by cell scraping in 60% methanol as described above. L-dT or L-dC and their respective metabolites were extracted from the cells by incubation overnight at -20°C in 60% methanol, followed by an additional extraction with 500 µl of cold methanol for 1 h on ice. Combined extracts were dried under a gentle filtered airflow and stored at -20°C until analysis by HPLC. Extract residues were resuspended in 250 µl of distilled water, and 200 µl was injected onto the HPLC system described below.
Determination of intracellular L-dTTP, L-dCTP, and L-dUTP half-lives.
HepG2 cells (2.5 x 106 cells per well) were incubated with either 10 µM [3H]L-dT or [3H]L-dC (500 dpm/pmol) for 24 h at 37°C in a 5% CO2 atmosphere. The cells were then washed three times with drug-free medium to remove extracellular drug and incubated for specific time intervals. At selected times, the cells were washed three times with ice-cold PBS and intracellular L-dT, L-dC, and their metabolites were extracted with methanol as described above. The samples were then stored at -20°C until HPLC analysis. The half-life was calculated from 0.693/
, where
is the terminal-phase slope of a plot of the intracellular triphosphate concentration versus time.
Effect of addition of 10 µM L-dT or L-dC on phosphorylation of [3H]L-dT or [3H]L-dC. HepG2 cells (2.5 x 106 cells per well) were incubated in six-well plates at 37°C for 24 h with either [3H]L-dT and L-dC or [3H]L-dC and L-dT at a final concentration of 10 µM for each agent. After incubation, intracellular L-dT or L-dC and their respective metabolites were extracted and analyzed as described above.
HPLC analysis. Cell extracts were reconstituted in 250 µl of distilled water prior to HPLC analysis. L-dT, L-dC, and their respective metabolites were separated by reverse-phase HPLC with a Phenomenex 5-µm C18 column (model 1050; Hewlett-Packard Co., Palo Alto, Calif.) by manual injection of 200 µl. The mobile phase consisted of 25 mM ammonium acetate with 5 mM tetrabutylammonium phosphate (pH 7.0) (buffer A) and methanol (buffer B). Elution was performed with a multistage linear gradient (0 to 5%) of buffer B for the first 5 min that was then leveled off at 5% until 10 min, with a constant flow of 0.8 ml/min. The elution flow was then increased to 1 ml/min; and the gradient of buffer B was increased from 5 to 15% at 20 min, reaching 20% at 35 min, and was kept stable from 35 to 45 min, raised to 30% at 50 min, and finally increased by 5% every 5 min until 60 min. Radioactivity was measured by use of a radiochromatography analyzer (500TR Radiometric Flo-One; Packard Instrument Company, Inc., Meriden, Conn.). L-dT, L-dC, and their respective metabolites were identified by use of a combination of authentic cold standards and enzyme digestion of whole-cell extracts with phosphodiesterase and alkaline phosphatase.
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FIG. 1. HPLC radiochromatogram of intracellular extracts from primary human hepatocyte cultures exposed to 10 µM [3H]L-dT for 24 h.
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FIG. 2. HPLC radiochromatogram of intracellular extracts from primary human hepatocyte cultures exposed to 10 µM [3H]L-dC for 24 h.
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TABLE 1. Intracellular concentrations of L-dT 5'-phosphorylated metabolites in HepG2 cells after incubation with 10 µM [3H]L-dT
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TABLE 2. Intracellular concentrations of L-dT metabolites in primary cultured human hepatocytes cells after incubation with 10 µM [3H]L-dT
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TABLE 3. Intracellular concentrations of L-dC metabolites in HepG2 cells after incubation with 10 µM [3H]L-dC
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TABLE 4. Intracellular concentrations of L-dC metabolites in primary cultured human hepatocytes cells after incubation with 10 µM [3H]L-dC
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FIG. 3. Rate of decay of 5'-phosphorylated metabolites of L-dC, L-dT, and L-dU in HepG2 cells after exposure to 10 µM radiolabeled drug for 24 h.
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TABLE 5. Effect of 10 µM L-dT on phosphorylation of 10 µM [3H]L-dC in HepG2 cells
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TABLE 6. Effect of 10 µM L-dC on phosphorylation of 10 µM [3H]L-dT in HepG2 cells
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, ß, or
(2). In addition, L-dT has demonstrated marked reductions in HBV DNA levels in a phase I-II clinical trial (Lai et al., Abstr. Eur. Assoc. Study Liver, abstr. 500, 2001; Lim et al., Abstr. Dig. Dis. Week, abstr. 2908, 2001). In the HepG2 human hepatoma cell line and primary human hepatocytes, the 5'-triphosphate derivatives of L-dT and L-dC were the predominant metabolites detected in cell extracts. Interestingly, after exposure of HepG2 cells and primary human hepatocytes to L-dC, its 5'-phosphorylated deaminated metabolites were also observed. Similarly to what was shown with other ß-L-nucleoside analogues (4, 13, 14), L-dC was not a substrate for the degradative enzyme deoxycytidine deaminase (EC 3.5.4.14), as demonstrated by the lack of inhibition of 3',4',5',6'-tetrahydrouridine on the formation of 5'-phosphorylated L-dU derivatives (B. Hernandez-Santiago and J. P. Sommadossi, unpublished data). The lack of enzymatic deamination of ß-L-cytidine nucleoside analogues suggests that deoxycytidine deaminase may be enantioselective, as previous studies have reported that lamivudine and ß-L-2',3'-dideoxy-5-fluoro-3'-thiacytidine (FTC) were not deaminated by partially purified deoxycytidine deaminase. Under the same conditions, their respective ß-D enantiomers were rapidly deaminated to ß-D-2',3'-dideoxy-3'-thiauridine and ß-D-2',3'-dideoxy-5-fluoro-3'-thiauridine, respectively (3, 13, 14). When HepG2 cells were incubated with L-dC in the presence of deoxytetrahydrouridine, significant reductions in the concentrations of L-dUMP, L-dUDP, and L-dUTP were detected, demonstrating the involvement of deoxycytidylate deaminase (EC 3.5.4.12) in the formation of these 5'-phosphorylated metabolites from the deamination of L-dCMP (Hernandez-Santiago and Sommadossi, unpublished). In addition, L-dUTP is active against woodchuck hepatitis virus DNA polymerase (2). This metabolic pattern is of particular significance since the administration of one nucleoside yields two distinct pharmacologically active 5'-phosphorylated derivatives.
Moreover, results summarized in Tables 5 and 6 indicate that exposure of HepG2 cells to L-dT in combination with L-dC led to concentrations of their activated metabolites similar to those achieved with either agent alone, further warranting their use in combination chemotherapy. Indeed, in vitro and in vivo studies of the combination of L-dT and L-dC in the woodchuck model of chronic HBV infection indicate that the two drugs have a potent antiviral synergy when used in combination (E. G. Bridges, A. Juodawlkis, A. Faraj, B. Tennant, B. Korba, R. F. Schinazi, T. Barnett, G. Gosselin, J.-L. Imbach, C. Pierra, D. Dukhan, J.-P. Sommadossi, and M. Bryant, 13th Annu. Conf. Antivir. Res., Antivir. Res. 46:A62, 2000). The metabolic studies reported herein indicate that administration of L-dC to both cultured primary human hepatocytes and HepG2 cells led to the additional formation of the L-dCDP-choline metabolite. The formation of such a liponucleotide has previously been described with other cytidine analogues with the unnatural ß-L configuration, such as L-ddC and its 5-fluorinated derivative L-FddC (10). This liponucleotide may act as an intracellular precursor for the active nucleoside 5'-triphosphate.
Pharmacokinetic studies with HepG2 cells demonstrated that L-dTTP, L-dCTP, and L-dUTP exhibited extended half-lives of 15 h. Importantly, the concentrations of these triphosphates remained greater than the in vitro 50% inhibitory concentration of the triphosphates for the woodchuck hepatitis virus DNA polymerase (2). These long intracellular half-lives probably reflect a low affinity of the 5'-phosphorylated metabolite of L-dT and L-dC for degradative enzymes. This characteristic may also contribute to the potent antiviral activities of these unnaturally configured ß-L-nucleosides, as observed for lamivudine triphosphate and FTC triphosphate (3, 6).
In summary, the present study demonstrates that L-dT and L-dC are rapidly and extensively phosphorylated in HepG2 cells and primary human hepatocytes. The 5'-triphosphate derivatives of these two novel ß-L-nucleoside enantiomers achieved high intracellular concentrations. Incubation of cells with L-dC led to the formation of L-dUTP through the deamination of L-dCMP to L-dUMP by deoxycytidylate deaminase, as the parent compound, L-dC, was not a substrate for deoxycytidine deaminase. Furthermore, L-dTTP, L-dCTP, and L-dUTP exhibited long intracellular half-lives, with their concentrations remaining above their EC50s for HBV in 2.2.15 cells. Lastly, neither L-dT nor L-dC interfered with the level of phosphorylation of the other compound, suggesting that combination antiviral therapy could be possible.
Dedicated to the memory of Martin L. Bryant. ![]()
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