human hepatocyte culture intoxicated with a-amanitin a-Amanitin (a-AMA) is the main toxin of Amanita phalloides and its subspecies (A. virosa and A. verna). The primary mechanism of a-AMA toxicity is associated with protein synthesis blocking in hepatocytes. Additionally, a-AMA exhibits prooxidant properties that may contribute to its severe hepatotoxicity. The aim of the present study was to assess the effect of a-AMA on lipid peroxidation and the activities of superoxide dismutase (SOD) and catalase (CAT) in human hepatocyte culture. The effects of benzylpenicillin (BPCN), N-acetyl-L-cysteine (ACC), and silibinin (SIL) on SOD and CAT activities and on lipid peroxidation in human hepatocyte culture intoxicated with a-AMA were also examined. In human hepatocyte culture, 48-hour expo- sure to a-AMA at a 2-mM concentration caused an increase in SOD activity, a reduction of CAT activity, and a significant increase in lipid peroxidation. Changes in SOD and CAT activity caused by a-AMA could probably enhance lipid peroxidation by increased generation of hydrogen peroxide combined with reduced detoxifica- tion of that oxygen radical. The addition of antidotes (ACC or SIL) to the culture medium provided more effective protection against lipid peroxidation in human hepatocytes intoxicated with a-AMA than the addition of BPCN, possessing no antioxidant properties.Death cap (Amanita phalloides) and its subspecies; death angel (Amanita virosa) and destroying angel (Amanita verna), are responsible for 95% of all mushroom-related deaths.1 The three species contain two main groups of toxins in their tissues, namely phallotoxins and amatoxins, which are both multicyc- lic peptides.Because phallotoxins are not absorbed from the gastrointestinal tract, they do not cause sys- temic manifestations of poisoning, although they may be responsible for gastrointestinal irritation. Amatox- ins are primary human hepatotoxins. Death cap poi- soning is characterized by liver necrosis, in many cases with acute hepatic insufficiency with subse- quent complications including hepatic coma, coagula- tion disorders, and renal failure.1-5 One medium-size specimen of death cap contains from 10 to 12 mg of amatoxins, whereas a dose as small as 0.1 mg/kg of body weight may be lethal for an adult human.6,7 a-Amanitin (a-AMA), the main amatoxin, is readilyabsorbed from the gastrointestinal tract and carried to the liver via the portal vein. Hepatocyte uptake of a-AMA is mediated by OATP1B3, a subtype of the organic anion transporting polypeptide (OATP) located in the plasma membrane.8 In hepatocytes, a-AMA inhi- bits protein synthesis by binding to RNA-polymerase II.1,9 Hepatocytes, which are dependent on a high rate of protein synthesis, are rapidly destroyed.1 According to Zheleva et al.,10 a-AMA also exhibits both antioxi- dant and prooxidant properties. In vitro and in vivo experiments on mice revealed that a-AMA may influ- ence the activities of superoxide dismutase (SOD) and catalase (CAT), enzymes crucial for the prevention of oxidative stress-related injury.10-12 These findings sup- port the hypothesis that a-AMA generates free radicals, which may contribute to its severe hepatotoxicity.10,12 However, it is uncertain what the effect of a-AMA is on the activities of enzymes protecting human hepato- cytes against oxidative stress. It is also unexplained whether changes in the redox system may play a signif- icant role in the pathogenesis of hepatic disorders in humans intoxicated with amanitin-containing mush- rooms. Benzylpenicillin (BPCN), N-acetyl-L-cysteine (ACC), and silibinin (SIL) are used as antidotes in a-AMA intoxication, but their efficacy and influence on the redox system during a-AMA intoxication is not fully established. The purpose of this study was to assess the effect of a-AMA on lipid peroxidation (LPO) and the activities of SOD and CAT in human hepatocyte culture. The effects of BPCN, ACC, and SIL on SOD and CAT activities and on LPO in human hepatocyte culture intoxicated with a-AMA were also examined. Materials and methods Chemicals and materials Media, supplements, and reagents used for hepatocyte culture, a-AMA, and all tested antidotes were obtained from Sigma Poland Chem (a-amanitin, cat. no A2263; Benzylpenicillin/Penicillin G potassium salt, cat. no P7794; N-acetyl-L-cysteine, cat. no A9165; Silibinin, cat. no. S0417). Fresh, single donor human hepatocytes plated in 6-well culture plates were obtained from Lonza, Belgium (batch no. HE0911101Hepatocyte culture All experiments were approved by the Local Ethics Commission at Wrocław Medical University. After 2 hours of initial incubation, the shipping medium was substituted with defined culture medium consist- ing of Earle's balanced salt solution (EBSS) and Waymouth's 752/1 supplemented with 10% foetal bovine serum (FBS). Following another 12 hours of incubation, the medium was exchanged and the pri- mary hepatocyte culture were maintained for 48 hours with a-AMA and/or the tested antidotes (ACC, BPCN, SIL) in the following final concentrations: control group - hepatocytes received medium without a-AMA or antidotes; group AMA: a-amanitin (2 mM); group BPCN: benzylpenicyllin (1 mM); group ACC: N-acetyl-L-cysteine (1 mM); group SIL: silibinin (100 mM); group AMA þ BPCN: a-amanitin (2 mM)
þ benzylpenicyllin (1 mM); group AMA þ ACC: a-amanitin (2 mM) þ N-acetyl-L-cysteine (1 mM); and group AMA þ SIL: a-amanitin (2 mM) þ silibinin
(100 mM). a-AMA was used at a concentration caus-
ing a reduction in cell viability in human hepatocyte cultures.13,14 The BPCN concentration corresponded to its plasma levels obtained after the dosage recom- mended in therapy of toadstool death cap poisoning, that is 300,000 - 1,000,000 U/kg/day intravenously (i.v.).1,15 There are no reports on a standard dosage regimen of ACC in mushroom poisoning. Therefore, we tested ACC in concentrations corresponding to its plasma levels obtained after the recommended dosage during the treatment of acetaminophen toxicity.16 SIL was used at concentrations corresponding to its
therapeutic plasma levels.17,18 In the AMA þ BPCN,
AMA þ ACC, and AMA þ SIL groups, hepatocytes
were simultaneously exposed to a-AMA and tested
antidotes.
SOD and CAT activity and the concentration of malonyldialdehyde (MDA) were determined in super- natants isolated from cultured hepatocyte homogenates after 48 hours of exposure to a-AMA and/or tested antidotes.
Analytical methods
SOD activity was determined using assay kits pro-
cured from Cayman Chemical Company (cat no. 706002). The assay was based on the generation of
O2- in a system containing xanthine oxidase. O2-
reduces tetrazolium salt to formazan dye, which is
measured colorimetrically. One unit of SOD activity is defined as the amount of enzyme needed to exhibit 50% dismutation of the superoxide radical.
CAT activity was determined using a Catalase Assay Kit (Cayman Chemical Company, cat. no
707002). This assay kit utilizes the peroxidatic function of CAT. The method is based on the reaction of the enzyme with methanol. Formaldehyde produced from methanol is measured colorimetrically with 4- amino-3-hydrazino-5-mercapto-1,2,4 triazole as a chromogen. One unit of CAT activity is defined as the amount of enzyme leading to the formation of 1.0 nmol of formaldehyde per minute.
Total amount of LPO products in the supernatants was determined as the concentration of malonyldial- dehyde (MDA) using an MDA Colorimetric Asssay Kit (Oxis International Inc., cat. no 21044). SOD and CAT activities and the concentration of MDA were determined using a plate reader (Microplate Reader, TECAN M200). CAT and SOD activities were expressed as enzyme units per mg of total protein and MDA concentration was expressed as nmol of MDA per mg of total protein. Total protein concentration in hepatocyte homogenates was determined by a Total Protein Assay Kit (Sigma Poland Chem. cat. no TP0200).
Statistical analysis
Differences between values were analyzed by
Kruskal-Wallis test using Statistica 7.1 software (Stat Soft, Poland) and p < 0.05 was considered statistically significant.
Results
SOD activity in the AMA group was significantly
higher than in the control group. In groups AMA þ
BPCN, AMA þ ACC, and AMA þ SIL, SOD activity
was significantly higher than in the control, but signif-
icantly lower than in the AMA group. No differences
in SOD activity were found between groups AMA þ
BPCN, AMAþACC, and AMAþSIL (Figure 1).
CAT activity in the AMA group was significantly
lower than in the control. In groups AMA þ BPCN,
AMA þ ACC, and AMA þ SIL, CAT activity was
significantly lower than in the control, but signifi-
cantly higher than in the AMA group. No differences
in CAT activity were found between groups AMA þ
BPCN, AMA þ ACC, and AMA þ SIL (Figure 2).
A significantly higher MDA concentration was
found in the AMA group than in the control, AMA
þ ACC, and AMA þ SIL groups. MDA concentration
in the AMA þ BPCN group was not significantly dif-
ferent from its concentration in the AMA group. In
groups AMA þ ACC and AMA þ SIL, MDA concen-
tration was not significantly different from that in the
control group and was significantly lower than in the
AMA þ BPCN group (Figure 3).
In groups BPCN, ACC, and SIL, values of the eval-
uated parameters of the redox system were not signif- icantly different from those in the control group (data not shown).
Discussion
a-AMA is a bicyclic octapeptide. The bicyclic struc-
ture and the presence of a tryptathionine moiety are critical for amanitin's toxicity.19 The primary mechanism of a-AMA toxicity is associated with pro- tein synthesis blocking in hepatocytes. Additionally, a-AMA toxicity may be associated with its potential direct prooxidative effect. Experimental studies by Zhelev, et al.20 suggest that a-AMA may be trans- formed to free radical intermediates (phenoxyl and/ or sulfinyl radicals) and
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