Kiyoshi Akagi

Correlation between cell killing effect and cell membrane potential after heat treatment: analysis using fluorescent dye and flow cytometry.

Exposure of mammalian cells to a temperature between 42 and 44 degrees C produces multiple effects on cellular metabolism. However, none of these effects have been demonstrated to be casually related to cell death. The plasma membrane has also been suggested to be one of the targets for hyperthermia. Hyperthermia influences the membrane fluidity and membrane fluidity affects both passive diffusion and active transport process. Here, we examined the effect of hyperthermia on the transmembrane potential V-79 cells using a lopophilic probe and flow cytometry. The underlying principle on which this method is based is that a freely diffusible cation distributes itself across the membrane according with the transmembrane potential and with the concentration gradient. By these methods, we tried to find the relation between the change of surviving fraction and membrane potential. We revealed that the membrane potential becomes to be depolarized by heat treatment between 41 and 44 degrees C immediately after heat treatment. In the relationship between the change in membrane potential and cell surviving fraction, the difference between 43 and 44 degrees C was not statistically significant but between 42 and 43 degrees C was statistically significant. These results imply that the cell membrane (potassium ion channel) is one of the targets of heat treatment and that duration of depolarized condition leads to cell death.

Measurement of intratumor pH by pH indicator used in 19F-magnetic resonance spectroscopy. Measurement of extracellular pH decrease caused by hyperthermia combined with hydralazine.

RATIONALE AND OBJECTIVES Without affect of metabolic changes, the authors measured intratumor pH by using 19F-magnetic resonance spectroscopy (MRS) with a fluorine compound (ZK-150471) on the basis of a calibration curve by pH electrode. METHODS Using the 4.7-tesla magnetic resonance apparatus, a fluorine compound that had acid-base equilibrial change and was impermeable within cell membranes was used. The fluorine compound was injected intravenously. The signal was obtained from mouse mammary cancer by creating an experimental tumor on the leg of mice. And the tumors, which were heated with and without hydralazine. The pH evaluated from chemical shift of the fluorine compound. The pH data was obtained from an electrode for reference. RESULTS The pH of nontreated tumors (n = 25) were 6.94 + 0.091. The pH decreased to 6.772 + 0.169 at 20 minutes even after 20 minutes of heating, and decreased to < 6.71 at 40 minutes after every heating time. The pH decreased to 6.456 at 20 minutes after 15 minutes of heating combined with hydralazine, and to 6.416 at 40 minutes after same treatment. CONCLUSIONS It is possible to measure the extracellular pH by 19F-MRS with the fluorine compound noninvasively in vivo, even after heating.

Enhancement of radiation effects by acyclovir

Acyclovir (ACV), a new antiviral drug, was used to investigate its effect of radiosensitivity in tumors in vivo. In in vivo experiments with Sarcoma-180 transplanted into the ICR mouse and FM3A transplanted into the C3H mouse, ACV enhanced the radiosensitivity of both tumors. In S-180, radiation effects were enhanced by treatment with 100 mg/kg of ACV from 30 min before to 60 min after irradiation. In S-180 treated by 400 mg/kg of ACV, the enhancement ratio was approximately 2.0, as evaluated by the growth delay method. In the FM3A tumor treated by 20 mg/kg of ACV, the enhancement ratio was approximately 1.3, as evaluated by tumor cure (TCD50 assay). ACV is already clinically used as an antiviral drug. Its ability to radiosensitize tumors could therefore have clinical potential when combined with radiotherapy.

Hydralazine at thermoradiotherapy: tumor size and blood flow effects.

PURPOSE This study was aimed to assess the dependence on tumor size and blood flow of the efficacy of a vasoactive drug hydralazine with thermoradiotherapy. METHODS AND MATERIALS Experiments were performed on mice bearing SCC-VII tumors with volumes of about 85 and 340 mm3 (7-8 or 11-12 days after transplantation, respectively). Local hyperthermia (water bath, 43 degrees C, 0.5 h) was started 3 h after irradiation of tumors. Hydralazine (2.5 mg/kg, IP) was given 0.5 h before heating. Tumor blood flow was evaluated by laser Doppler flowmetry before, during and up to 2 days after the treatments. RESULTS It was shown that hydralazine and hyperthermia, even in combination with each other, had very weak anti-tumor effect, especially for 85 mm tumors. The agents also insignificantly enhanced the efficacy of radiotherapy excluding the case of polyradiomodification for 340 mm3 tumors when a dose modifying factor of about 2.0 was achieved. Thermometry showed only a small improvement by HDZ in heating patterns of tumors of both sizes. Meanwhile, the therapeutic efficacy of hydralazine and heat was correlated with the changes in tumor blood flow, first of all with the delayed effects. The radiomodifiers induced only minor and transient suppression of perfusion in the smaller tumors, and more markedly and for longer time decreased blood flow in the larger tumors. In the latter case, the inhibiting effect of the drug plus hyperthermia remained for at least 48 h after the treatment. CONCLUSION (a) The combined use of hydralazine and heat seems to be advisable only at radiotherapy of rather large advanced tumors; (b) the efficacy of such radiomodification is correlated with prolonged inhibition of tumor blood flow by these agents; and (c) hydralazine and hyperthermia are likely to kill selectively both acutely and chronically hypoxic radioresistant cancer cells.

The influence of DNA ploidy of a human tumor cell line on the frequencies of micronuclei or chromosome aberrations after irradiation.

To develop methods for assessing the intrinsic cellular radiosensitivity, it is important to evaluate the relationship between DNA ploidy of cells and frequencies of micronuclei (MN) or chromosome aberrations after irradiation. From the original human fibrosarcoma cell line HT-1080, we isolated two clones which have different chromosome ploidy: clone 5 is pseudodiploid and clone 1 is heteroploid. We examined the radiosensitivity of the two clones using a clonogenic cell survival assay and a cytokinesis-block MN assay, and by scoring chromosome aberrations using the premature chromosome condensation (PCC) method combined with a fluorescence in situ hybridization (FISH) procedure immediately and at 24 h after irradiation. The MN frequency increased according to the irradiation dose in both clones. The MN frequency of clone 1 was significantly higher than that of clone 5 regardless of whether the assay was performed immediately or 24 h after irradiation. However, when the numbers of MN were normalized by the DNA index of each clone, a significant difference in the frequency of MN was not observed. In the PCC and FISH studies, there was a linear relationship between the radiation dose and the initial breaks of chromosome 4, but the breaks of clone 1 were much more frequent than those of clone 5. Twenty-four h after irradiation, the chromosome 4 breaks of clone 1 were observed much more frequently than those of clone 5 at the same radiation dose. When the numbers of chromosome 4 breaks were normalized by the number of chromosome 4 in each clone without radiation, no such difference in the number of breaks was observed. These findings demonstrated that the DNA content or chromosome ploidy influenced the induction of the MN or chromosome aberrations in HT-1080 cells after irradiation.

The use of a hypoxic cell radiosensitizer AK-2123 gave no improvement in thermoradiotherapy combined with hydralazine

An electron-affinic compound, AK-2123, and the anti-hypertensive agent, hydralazine, were combined with radiation and hyperthermia for treatment of murine SCC-VII tumours. Hydralazine markedly decreased tumour perfusion while AK-2123 had no influence on it. Hydralazine enhanced the tumouricidal effects of hyperthermia alone and in combination with radiation. AK-2123 provided a radiosensitization which was significant only in tumours irradiated without supplementary hyperthermia. The greatest tumour response was achieved when thermoradiotherapy was combined with hydralazine alone; the additional use of AK-2123 with this treatment combination did not further increase the effect. It is concluded that hydralazine plus heat virtually eliminated a hypoxia-related radioresistance in tumours, thus removing the requirement for AK-2123 administration.

New Technique for Mediastinal Temperature Measurement in Hyperthermic Cancer Treatment: Balloon Catheter in the Azygos Vein

The temperature in the mediastinum during hyperthermia is difficult to determine accurately. We measured the temperature in the azygos vein, using a new technique, and compared the measurements with temperatures in the oesophagus. Eight patients with mediastinal tumours resulting from lung cancer or oesophageal cancer were given hyperthermo-radiotherapy. The temperatures in the azygos vein and in the oesophagus were measured before and during blockage of the blood flow of the azygos vein using an angiographic balloon catheter. None of the patients had complications as a result of these procedures, and hyperthermia by capacitative heating was safely performed. The temperature in the azygos vein increased by a mean of 1.7°C (0.2–2.8°C) after blockage of the blood flow. The temperature in the oesophagus was 0.83 ± 1.09°C (mean ± SD) higher than that in the azygos vein. Measurement of the temperature in the azygos vein gives a more accurate estimate of mediastinal temperature than does oesophageal temperature but it is an invasive procedure.

Relevance of a New Impedance Matching, or Subtrap, Method for the Reduction of Pain During Hyperthermia

Capacitive heating is widely used in hyperthermic treatment of human malignancies. However, the pain on the body surface or thermoesthesia in the subcutaneous fatty layer may prevent an elevation of temperature in the tumors. Impedance matching is improved by a subtrap method entailing the application of two copper plates (10 x 850 x 0.06 mm) as a subtrap circuit to each of two capacitive electrodes. In a clinical trial the Tmax, Tave, Tmin for the subtrap method were all higher in comparison with those for the conventional technique (42.5 +/- 0.7 degrees C, 41.9 +/- 1.0 degrees C, 41.3 +/- 1.1 degrees C vs. 41.1 +/- 1.5 degrees C, 40.6 +/- 1.3 degrees C, 40.0 +/- 1.3 degrees C). Although the maximal radiofrequency (RF) power applied to patients was higher with the subtrap method (875 +/- 189 W vs. 763 +/- 200 W), the incidence of surface pain was reduced dramatically. It is concluded that the subtrap method substantially improves the RF capacitive heating of deep-seated tumors.

Multiple Pinhole Coded Apertureを用いたRl断層像

High energy collimators in use today are limited with respect to resolution and efficiency. The multiple pinhole coded aperture (hereafter abbreviated as MPCA) is a method being considered to improve the above. In our study we conducted basic experiments with an MPCA using an Anger-type gamma-camera. Using this method, we were able to perform radioisotope imaging and radioisotope tomographic effect. We have studied the resolution, detection efficiency, and tomographic effects of the MPCA. We found that, in the MPCA, detection efficiency is proportional to the number of pinholes and resolution is dependent upon the pinhole diameter. This tomographic effect is of the same principle as the stretching-type tomography, images on both side of the desired image appearing as noise images, affecting the depth resolution. Using an MPCA with a pinhole diameter of 3 mm and 3 pinholes positioned in an equilateral triangular pattern measuring 7.8 cm on each side, we attained a depth resolution of 3 cm. Because the MPCA method involves complicated image processing, the resulting image contains a factor of 2n-2 (where n is the number of pinhole) of noise, affecting the depth resolution.

Long-term results of thermoradiotherapy for superficial, subsurface tumors using a 430 MHz microwave heating system.

Superficial, subsurface tumors of 93 patients were treated with thermoradiotherapy using a 430 MHz microwave heating system (HTS-100). All patients had malignant tumors, and all were treated with a combination of hyperthermia and radiation. Satisfactory temperature data for each thermal parameter were achieved within a 5 cm depth for each tumor. The overall complete response (CR) rate was 39.8%; in the less than or equal to 3 cm (depth of tumor), the CR rate was 66.7%, in the 3-5 cm group, the CR rate was 42.9%. In the multivariate analysis, duration of local control correlated with tumor responses (CR). There were no instances of prominent late complications that were observed for greater than or equal to 6 months. This study suggests that the HTS-100 may improve tumor response and the duration of local control of superficial and subsurface tumors.