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| Author(s): |
Samara Leite
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | Ribeirão Preto. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Ciências Farmacêuticas de Ribeirão Preto (PCARP/BC) |
| Defense date: | 2006-05-26 |
| Examining board members: |
Antonio Cardozo dos Santos;
Iguatemy Lourenco Brunetti;
Carlos Curti;
Orlando de Castro e Silva Júnior;
Sergio Akira Uyemura
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| Advisor: | Antonio Cardozo dos Santos |
| Abstract | |
Sulindac is a nonsteroidal anti-inflammatory drug (NSAID) known to inhibit non-selectively ciclooxygenases (COX) 1 and 2. Sulindac is therapeutically used as anti-inflammatory and analgesic in the symptomatic treatment of acute and chronic rheumatoid arthritis, osteoarthritis, and ankylosing spondylits. In addition to this property, a role in the prevention/regression of colonic carcinogenesis, has been described for both sulindac and metabolites. Nevertheless, its therapeutic use has been limited because of its toxicity to the gastrointestinal tract and liver, reported in the literature. Sulindac is a prodrug that is ?in vivo? metabolized to its pharmacological active metabolite, sulindac sulfide and its pharmacological inactive one, sulindac sulfone. In order to assess the effects of sulindac and its metabolites, we used ?in vitro? studies with isolated rat liver mitochondria, to evaluate the aspects of its toxicity in mitochondria; and studies with human hepatoma cell line (HepG2), to evaluate its affects after biotransformation. The present study shows that sulindac sulfide, but not sulindac sulfone or sulindac itself, cause mitochondrial uncoupling, releasing pre-accumulated Ca2+ from the organelle, and decrease Hep-G2 cell viability in an apparent association with cellular ATP depletion resulted from mitochondrial uncoupling-associated membrane potential dissipation. We therefore propose mitochondrial uncoupling by sulindac sulfide as a potential mechanism for the well established toxicity of sulindac, at least to the liver in humans. It was also observed a mitochondrial swelling in energized media that can occur without dependence on the calcium present in the media. This event was partial inhibited by CsA and Mg2+, and completely inhibited with the addition of BHT. It did not show any inhibition with the addition of ADP, ATP, DTT or NEM. These results can not be associated to the classical mitochondrial permeability transition that is dependent to calcium, and the mechanism of inhibition observed with BHT is not known, since it was not observed any production of free radicals in our models, but the swelling observed can also contribute to the toxic effects observed. The sulindac itself and the sulfone metabolite did not show any toxic effect observed for the sulfide form, indicating that just the pharmacological active metabolite is responsible for the toxic effects. The biotransformation (phase I and II reactions) can contribute to sulindac toxicity, because they generate the reduced form. Sulindac is also used in long term treatment, so it is necessary the monitoring of the hepatic function is necessary before and during the treatment, in order to prevent any further complication. (AU) | |