Heather M. Wallace

Inhibitors of polyamine metabolism: Review article

Summary.The identification of increased polyamine concentrations in a variety of diseases from cancer and psoriasis to parasitic infections has led to the hypothesis that manipulation of polyamine metabolism is a realistic target for therapeutic or preventative intervention in the treatment of certain diseases.The early development of polyamine biosynthetic single enzyme inhibitors such as α-difluoromethylornithine (DFMO) and methylglyoxal bis(guanylhydrazone) showed some interesting early promise as anticancer drugs, but ultimately failed in vivo. Despite this, DFMO is currently in use as an effective anti-parasitic agent and has recently also been shown to have further potential as a chemopreventative agent in colorectal cancer.The initial promise in vitro led to the development and testing of other potential inhibitors of the pathway namely the polyamine analogues. The analogues have met with greater success than the single enzyme inhibitors possibly due to their multiple targets. These include down regulation of polyamine biosynthesis through inhibition of ornithine decarboxylase and S-adenosylmethionine decarboxylase and decreased polyamine uptake. This coupled with increased activity of the catabolic enzymes, polyamine oxidase and spermidine/spermine N1-acetyltransferase, and increased polyamine export has made the analogues more effective in depleting polyamine pools. Recently, the identification of a new oxidase (PAO-h1/SMO) in polyamine catabolism and evidence of induction of both PAO and PAO-h1/SMO in response to polyamine analogue treatment, suggests the analogues may become an important part of future chemotherapeutic and/or chemopreventative regimens.

Polyamine analogues as anticancer drugs.

Just over 30 years ago, the late Diane Russell published the first in a series of papers linking polyamines and cancer. These early studies led to a flurry of research activity in the polyamine field that continues to this day attempting to identify a role for the polyamines in cancer development, treatment and/or prevention. The recognition that polyamines are critical for the growth of cancer cells, and consequently the identification of their metabolic pathways as a target for therapeutic intervention, led to the development of a number of useful inhibitors of polyamine biosynthesis. Arguably the most significant addition to the polyamine field in the last 30 years was the synthesis of alpha-difluoromethylornithine (DFMO), which is being tested currently as a cancer chemopreventative agent in man and is used also as a highly effective trypanocidal agent. Although an extremely useful tool experimentally, DFMO has been disappointing in clinical trials with little therapeutic efficacy. Despite this setback, the polyamine pathway is still considered a viable target for chemotherapeutic intervention. This has led to the development of the polyamine analogues as multifunctional inhibitors that will produce inhibition of tumour cell growth, polyamine depletion and optimum therapeutic efficacy.

The polyamine transport system as a target for anticancer drug development

The vast majority of anticancer drugs in clinical use are limited by systemic host toxicity due to their non-specific side effects. These shortcomings have led to the development of tumour specific drugs which target a single-deregulated pathway or over expressed receptor in cancer cells. Whilst this approach has achieved clinical success, we have also learnt that targeting a single entity in cancer is rarely curative due to the large number of deregulated pathways, receptors and kinases which are also present, in addition to the target. An attractive alternative to improve targeting would be to harness the already established activity of known anticancer drugs by attaching them to a molecule that is transported into cancer cells via a selective transport system. One possibility for this approach is the polyamine pathway. This review provides a brief overview of the polyamine pathway and how, over the years, it has proved an exciting target for the development of novel anticancer agents. However, the focus of this article will be on the properties of the polyamine transport system and how these features could potentially be exploited to develop a novel and selective anticancer drug delivery system.

Polyamine analogues - an update.

Summary.The polyamines are growth factors in both normal and cancer cells. As the intracellular polyamine content correlates positively with the growth potential of that cell, the idea that depletion of polyamine content will result in inhibition of cell growth and, particularly tumour cell growth, has been developed over the last 15 years. The polyamine pathway is therefore a target for development of rationally designed, antiproliferative agents. Following the lessons from the single enzyme inhibitors (α-difluoromethylornithine DFMO), three generations of polyamine analogues have been synthesised and tested in vitro and in vivo. The analogues are multi-site inhibitors affecting multiple reactions in the pathway and thus prevent the up-regulation of compensatory reactions that have been the downfall of DFMO in anticancer chemotherapy. Although the initial concept was that the analogues may provide novel anticancer drugs, it now seems likely that the analogues will have wider applications in diseases involving hyperplasia.

Induction of spermidine/spermine n1-acetyltransferase in human cancer cells in response to increased production of reactive oxygen species

Reactive oxygen species (ROS) are involved in a number of disease states where they are believed to be responsible for cellular damage. In this study we examined the effect of ROS generation on polyamine catabolism. Treatment of human breast cancer cells with either H2O2 or hyperoxia increased the activity of spermidine/spermine N1-acetyltransferase (SSAT). These increases occurred before any significant signs of cellular injury. Agents known to decrease the production of reactive oxygen species such as dimethylthiourea and o-phenanthroline prevented the increase in SSAT activity indicating ROS involvement in the induction process. These results suggest that induction of SSAT may be a protective response to oxidative stress in mammalian cells facilitating removal of polyamines from the cell to prevent their toxic accumulation.

Elevation of monoacetylated polyamines in human breast cancers

Normal tissues contain only trace amounts of monoacetylated polyamines. N1-Acetylspermidine is present in high concentrations in mouse liver cells damaged by hepatotoxins and is also found in specialised cells of the hamster epididymis. In the present study human breast cancers were analysed for the presence of monoacetylated polyamines because N1-acetylspermidine is selectively elevated in human colorectal cancers. Free and monoacetylated polyamines (N1-acetylspermidine, N8-acetylspermidine and N1-acetylspermine), measured by high-performance liquid chromatography, were expressed as nmol/g wet wt of breast cancers (n = 54) or normal breast tissue (n = 15). Putrescine and monoacetylated polyamines were absent from normal breast tissue. Mean total content of monoacetylated polyamines in breast cancers 14.9 +/- 5.3 (S.E.) exceeded the mean total content of free polyamines (8.3 +/- 1.0) in normal breast tissue. Detectable levels of at least two of the monoacetylated polyamines were found in all breast cancers: N1-acetylspermidine was present in 51 (13.1 +/- 6.3), N8-acetylspermidine in 32 (0.6 +/- 0.1) and N1-acetylspermine in 28 tumours (1.2 +/- 0.3). There was no correlation between monoacetylated polyamine content of breast cancers and factors known to affect survival, i.e. tumour size, histological grade, oestrogen receptor status and node status. Monoacetylated polyamines are present in human breast cancers but not in normal breast tissue, implying that polyamine catabolism in breast cancers differs from that in normal breast tissue.

Polyamines and membrane transporters

In recent years, our understanding of the importance of membrane transporters (MTs) in the disposition of and response to drugs has increased significantly. MTs are proteins that regulate the transport of endogenous molecules and xenobiotics across the cell membrane. In mammals, two super-families have been identified: ATP-binding cassette (ABC) and solute carrier (SLC) transporters. There is evidence that MTs might mediate polyamines (PA) transport. PA are ubiquitous polycations which are found in all living cells. In mammalian cells, three major PA are synthesised: putrescine, spermidine and spermine; whilst the decarboxylated arginine (agmatine) is not produced by mammals but is synthesised by plants and bacteria. In addition, research in the PA field suggests that PA are transported into cells via a specific transporter, the polyamine transport system(s) (PTS). Although the PTS has not been fully defined, there is evidence that some of the known MTs might be involved in PA transport. In this mini review, eight SLC transporters will be reviewed and their potential to mediate PA transport in human cells discussed. These transporters are SLC22A1, SLC22A2, SLC22A3, SLC47A1, SLC7A1, SLC3A2, SLC12A8A, and SLC22A16. Preliminary data from our laboratory have revealed that SLC22A1 might be involved in the PA uptake; in addition to one member of ABC superfamily (MDR1 protein) might also mediate the efflux of polyamine like molecules.

Uptake and excretion of polyamines from baby hamster kidney cells (BHK-21/C13) the effect of serum on confluent cell cultures

In confluent cultures of BHK-21/C13 cells there was little uptake of exogenous polyamines and only a low level of polyamine biosynthesis. These cultures continuously excreted polyamines into the extracellular medium. Spermidine, in both the free and bound form, was the predominant excretion product, whereas the major intracellular polyamine was spermine implying that excretion of polyamines was specific. Reinitiation of growth by the addition of fresh serum immediately increased the uptake of exogenous putrescine, increased the biosynthesis of polyamines and decreased the excretion of polyamines. Thus, polyamine transport into and out of the cell appears to be regulated by the growth status of that cell.

On the natural chemoprevention of cancer.

Cancer is a complex disease to treat and the treatments have not progressed significantly in the last few years. Alternative strategies such as chemoprevention are being investigated. Proof of concept of chemoprevention has been shown with the non-steroidal anti-inflammatory drugs (NSAIDs); however there is significantly more interest in plant and naturally available compounds for chemoprevention. A number of different naturally occurring chemical compounds are reviewed here for their potential benefits and the pathways which they may target, in particular the polyamine pathway.

Polyamines reverse non-steroidal anti-inflammatory drug-induced toxicity in human colorectal cancer cells

Naproxen, sulindac and salicylate, three NSAIDs (non-steroidal anti-inflammatory drugs), were cytotoxic to human colorectal cancer cells in culture. Toxicity was accompanied by significant depletion of intracellular polyamine content. Inhibition of ornithine decarboxylase (the first enzyme of the polyamine biosynthetic pathway), induction of polyamine oxidase and spermidine/spermine N(1)-acetyltransferase (the enzymes responsible for polyamine catabolism) and induction of polyamine export all contributed to the decreased intracellular polyamine content. Morphological examination of the cells showed typical signs of apoptosis, and this was confirmed by DNA fragmentation and measurement of caspase-3-like activity. Re-addition of spermidine to the cells partially prevented apoptosis and recovered the cell number. Thus polyamines appear to be an integral part of the signalling pathway mediating NSAID toxicity in human colorectal cancer cells, and may therefore also be important in cancer chemoprevention in humans.