DNA topoisomerase I content of a pair of human melanoma cell lines with very different radiosensitivities correlates with their in vitro sensitivities to camptothecin.

In this study, we set out to determine if the differential sensitivities to CPT between a radioresistant (Sk-Mel-3) and a radiosensitive (HT-144) human melanoma cell line, and also between cultures with a different growth phase in each cell line, were related to endogenous differences in cellular transport of CPT or to DNA topo I catalytic activities and content. Cultures of HT-144 and Sk-Mel-3 cells in both the exponential, or plateau (i.e. confluent), phase of growth were compared. Cellular response to CPT was determined by clonogenic survival assay. Drug accumulation and efflux were determined using [3H]CPT. Topo I catalytic activity was determined from the ability of nuclear extracts prepared from the cells to relax supercoiled DNA plasmid. Nuclear extracts of the cells were also used to determine topo I content by western blotting. The significantly enhanced sensitivity of exponential-phase, relative to plateau-phase, cultures of both cell lines was related to an enhanced accumulation of [3H]CPT in one (i.e. HT-144), but not the other, cell line. Thus the higher sensitivity of exponential-phase cultures of HT-144 relative to those of Sk-Mel-3 can at least be partially accounted for on the basis of a relatively higher accumulation. However, a higher accumulation was not the reason why plateau-phase cultures of HT-144 were relatively more sensitive than those of Sk-Mel-3. Although there were no significant differences (at the p < 0.05 level) between the endogenous catalytic activities of topo I extracted from exponential- and plateau phase-cultures of both these cell lines, there was a trend for HT-144 cells to show higher endogenous topo I catalytic activities compared to Sk-Mel-3 cells. In contrast, topo I content was higher in exponential- relative to plateau phase-cultures of both cell lines, and in HT-144 relative to Sk-Mel-3 when cultures in a similar growth phase were compared. The relative differences in sensitivity to CPT observed in vitro between these two cell lines, and also between exponential- and plateau phase-cultures of each cell line, correlates best with topo I content rather than topo I catalytic activity or [3H]CPT transport.

Sequence of treatment is important in the modification of camptothecin induced cell killing by hyperthermia.

We investigated the modification of camptothecin (CPT)-induced cell killing by hyperthermia in a radioresistant human melanoma (Sk-Mel-3) and a human normal (AG1522) cell line. CPT, a topoisomerase (topo) I inhibitor, was given as a 1 h exposure at variable doses up to 34 microM; hyperthermia was given either before or following CPT treatment. Hyperthermia was given either as a treatment of 41 degrees C for 8 h (termed lower temperature hyperthermia, LTH) or 45 degrees C for 15 min (termed higher temperature hyperthermia, HTH). LTH preceding CPT treatment had no effect on Sk-Mel-3 but potentiated killing of AG1522 cells. HTH preceding CPT treatment, however, almost completely abrogated the toxicity of CPT to both Sk-Mel-3 and AG1522 cells. These results therefore provided evidence for a lack of enhancement of CPT toxicity towards Sk-Mel-3 cells when hyperthermia preceded treatment with CPT. There was also no potentiation of killing of both cell lines when LTH followed treatment with CPT. In contrast, the killing of Sk-Mel-3 cells was slightly potentiated, whereas that of AG1522 cells was reduced, when HTH followed CPT. These results therefore suggested a potential for enhancement of killing of Sk-Mel-3 relative to AG1522 cells when HTH, but not LTH, followed CPT treatment. In addition, we found that a preceding exposure ot HTH did not affect either accumulation or efflux of[3H]CPT in both cell lines. Thus the significantly reduced cytotoxicity observed under those conditions was not related simply to a modification of accumulation or efflux of CPT. We found no significant differences in the atalytic activities of topo I extracted from the nuclei of Sk-Mel-3 and AG1522 cells that were either heated under HTH conditions or that were no subjected to such treatment. These results therefore suggested that the substantial reduction of cytotoxicity seen when HTH preceded CPT treatment was also not due to an effect on topo I catalytic activity. Our results therefore demonstrate that the sequence of application of hyperthermia and CPT is very important in determining the amount and, possibly, selective potentiation of tumour relative to normal cell cytotoxicity.

Reduction of etoposide induced cell killing by hyperthermia can occur without changes in etoposide transport or DNA topoisomerase II activity.

We investigated the modification of etoposide (i.e. VP-16)-induced cell killing by hyperthermia in a radioresistant human melanoma (Sk-Mel-3) and a human normal (AG1522) cell line. VP-16, a DNA topo II poison, was given as a 1 h exposure at variable doses up to 35 microM; hyperthermia was given either before or following VP-16 treatment. Hyperthermic treatment comprised one of the following: 41 degrees C for 8 h, 42 degrees C for 2 h or 45 degrees C for 15 min. Hyperthermia preceding VP-16 treatment reduced the cytotoxicity of the latter; the reduction of VP-16 cytotoxicity was directly proportional to the severity of the hyperthermic treatment. For a particular combination of hyperthermic dose and VP-16 concentration, generally similar responses were seen in both cell lines. There were no effects on VP-16 cytotoxicity when both Sk-Mel-3 and AG1522 cells were heated at 41 degrees C for 8 h following treatment with VP-16. However, heating both cell lines at 45 degrees C for 15 min following VP-16 treatment again reduced the amount of cytotoxicity associated with VP-16. In addition, we found that a preceding exposure to 45 degrees C, 15 min heating did not affect either cellular accumulation or efflux of [3H]VP-16 in both cell lines. This suggested that the reduction in VP-16 cytotoxicity observed under those conditions was not due to a modification of VP-16 transport. We found no differences between the catalytic activities of topo II extracted from nuclei of Sk-Mel-3 and AG1522 cells that were either heated at 45 degrees C for 15 min or that were not subjected to such treatment. These results therefore suggested that the substantial reduction of cytotoxicity seen when 45 degrees C, 15 min heating preceded VP-16 treatment was also not due to an effect on topo II catalytic activity. Our results therefore demonstrate that hyperthermia, given either before or after VP-16, can actually reduce the amount of VP-16 cytotoxicity and that this can occur without any overt changes in VP-16 accumulation and efflux or in topo II catalytic activity.

Collecting morbidity data in general practice: the Somerset morbidity project.

OBJECTIVE: To collect a valid, complete, continuous, and representative database of morbidity presenting to primary care and to use the data to help commission services on the basis of local need and effectiveness. SETTING: Computerised general practices in Somerset. METHODS: Participating general practices were selected to be representative of the district health authority population for general practice and population characteristics. All conditions presented at face to face consultations were assigned a Read code and episode type and the data were regularly validated. Data were sent by modem from the practices via a third party to the health authority each week. MAIN OUTCOME MEASURES: Proportion of consultations coded and accuracy of coding. RESULTS: 11 practices agreed to participate. Validations for completeness during April 1994 to March 1995 revealed that 96.4% of the records were coded; 94% of the 1090 records validated had appropriate episode types and 87% appropriate Read codes. The results have been used to help formulate the health authority's purchasing plans and have enabled a change in the local contracts for surgery for glue ear. CONCLUSIONS: The project has shown the feasibility of establishing a network of practices recording and reporting the morbidity seen in primary care. Early indications are that the data can be useful in evidence based purchasing.

Cell killing, DNA polymerase inactivation and radiosensitization to low dose rate irradiation by mild hyperthermia in four human cell lines.

Four human cell lines (one fibroblast, two melanoma and one glioma) were evaluated for their responses to hyperthermia and thermalradiosensitization. For mild hyperthermia (40-42 degrees C), there was little to no chronic thermotolerance development during protracted heating for up to 72 h. In addition, there was no significant thermotolerance for polymerase inactivation during mild hyperthermia. For high temperature hyperthermia, polymerase beta was more thermal sensitive than aphidicolin sensitive polymerase alpha + delta + epsilon, (termed polymerase alpha) but during mild hyperthermia ther relative sensitivities were reversed. Polymerase beta was resistant to mild hyperthermia and polymerase alpha was very sensitive. Within each cell line there was a correlation between polymerase alpha inactivation and the degree of radiosensitization (TER) and amongst the cell lines the most radiation resistant cell line had less polymerase alpha inactivation than the most sensitive cell line for similar values of TER's. These data indicate that, amongst the cell lines, radiosensitivity and polymerase alpha sensitivity may influence TER and that for a given cell line, or possibly tumour, polymerase alpha inactivation may have potential as an indicator to determine TER for mild hyperthermia treatments in radiosensitization to low dose rates.

Cross-sensitivity to x-radiation and type-I and type-ii DNA topoisomerase inhibitors in a range of human and rodent cell-lines.

We compared the relative X-radiation response of confluent (i.e. essentially non-proliferating) cultures of three human tumor (U-87MG, Mel-3, HT-144), one human normal (AG1522) and two rodent normal (AA8, V3) cell lines to their relative sensitivities to a DNA topoisomerase (topo) II poison (etoposide) and to a topo I poison (camptothecin). The relative sensitivity of these cell lines to etoposide (for 8 h exposure at 37 degrees C) is extremely similar to their relative X-radiation sensitivity, suggesting a direct correlation between X-radiation sensitivity and susceptibility to killing by topo II poison. The relative sensitivities of these cell lines to camptothecin (also 8 h, 37 degrees C exposure) also agree generally with their relative X-radiation sensitivities although the correlation is not as good as for etoposide. In addition, exponential phase (i.e, actively proliferating) cultures of the radiosensitive HT-144 cells are more susceptible to killing by both etoposide and camptothecin than the radioresistant Mel-3, confirming previously reported cross-sensitivities between X-radiation and topo poisons in actively proliferating cultures of other types of cell lines. Hence our results suggest that the previously reported cross-sensitivity between topo II poisons and X-radiation in actively proliferating rodent cell lines is also observed in 'non-proliferating' rodent and human cell lines. Additionally, there is cross-sensitivity between topo I poisons and X-radiation in both rodent and human cell lines as well.

Cultured chinese-hamster ovary cells lack a transferable x-radiation resistance factor.

We determined if we could transfer X-radiation resistance from CHO AA8 cells to their radiosensitive, mutant V3 cells by several methods. These methods include co-incubating the two cell lines for three days before irradiation, adding heavily-irradiated AA8 to V3 cells following irradiation of the latter and then co-incubating these cells for at least eight days during the colony-forming assay and lastly, adding conditioned medium from unirradiated, subconfluent AA8 cells to V3 cultures and incubating for two days before irradiation. None of these procedures enhanced the clonogenic survival of the V3 cells to a single dose of 4 Gy X-radiation. Adding heavily-irradiated V3, instead of AA8, cells did not increase the clonogenic survival of the 4 Gy-irradiated V3 cells either, indicating that there was no autocrine mode of action. Moreover, adding conditioned medium from a related CHO cell line, K1, to its own radiosensitive, mutant 5-11 and incubating for two days before irradiation did not enhance clonogenic survival of the latter to a single dose of 3 Gy X-radiation. We therefore conclude that it is unlikely that CHO cells have the X-radiation resistance factor that has been reported in some mouse melanoma cell lines by other investigators.

Evaluation of cisplatin response in three radiation resistant and three radiation sensitive cell lines.

The cisplatin response was studied in three radiation sensitive mutant cell lines each paired with normally responding or radiation resistant cell lines of parental or similar origin. The radiation sensitive cell lines V3 (CHO), AT5BI (human fibroblast) and HT144 (melanoma) also showed reduced or lack of ability to repair sublethal radiation damage. Also, V3 did not repair radiation induced DNA double strand breaks and AT5BI was excision repair deficient. None of these cell lines show any cross sensitivity to cisplatin treatment. Instead the response was more like the paired normally radiation responding cell lines, except for AT5BI which showed cisplatin resistance. Thus the mechanisms causing radiation sensitivity in the three cell lines are not involved in cisplatin sensitivity.

Inhibition of potentially lethal and sublethal damage repair by camptothecin and etoposide in human melanoma cell lines.

We investigated the ability of camptothecin (CPT), an inhibitor of topoisomerase (topo) I, and etoposide (VP-16), an inhibitor of topo II, to potentiate X-radiation response and to inhibit the repair of potentially lethal damage (PLDR) and sublethal damage (SLDR) in confluent cultures of a radioresistant (Sk-Mel-3) and a radiosensitive (HT-144) human melanoma cell line. CPT or VP-16 were present both during irradiation and during the subsequent delayed plating period allowed for repair of X-radiation damage. When the direct toxicities of CPT or VP-16 were corrected for, we found that a dose of either drug that killed approximately 15% of the clonogenic cells potentiated the effects of radiation differentially on the cell lines. CPT and VP-16 inhibited the increase in survival brought about by delayed plating of HT-144 but not Sk-Mel-3 cells. In both cell lines, CPT inhibited SLDR but not PLDR. VP-16 also inhibited SLDR in both cell lines, however, in contrast with CPT, it also inhibited PLDR in HT-144 cells. Our results therefore suggest that either topo I and II are both implicated in the repair of X-radiation damage, or that the lesions formed by CPT and VP-16 with DNA are able to impair the processing of X-radiation repair. In addition, we found that in the absence of the topo inhibitors, the two cell lines repaired similar amounts of PLD from an isosurvival level. Sk-Mel-3, however, repaired significantly increased SLD from an isosurvival level (about three-fold, p < 0.05) compared with HT-144.

Thermal radiosensitization by 41 degrees C hyperthermia during low dose-rate irradiation in human normal and tumour cell lines.

Three human cell lines (glioma, melanoma and fibroblast) were evaluated for responses to low dose-rate irradiation (LDRI) (0.88 and 0.41 cGy per min) alone or with concurrent heating (41 degrees C) during irradiation. In order to avoid cell cycle redistribution cells were held in plateau phase. The results show that the lowest LDRI gave maximum sparing in the glioma and the fibroblast cell lines while both dose rates achieved approximately the same effect in the melanoma line. The melanoma line was the most heat sensitive and showed the greatest thermal enhancement ratio (TER). For all cell lines TER was greatest at the lowest dose-rate, and in the melanoma the heat plus LDRI curve gave lower survival than the high dose-rate irradiation survival curves. These data show that concurrent mild hyperthermia combined with LDRI used in brachytherapy can enhance the effectiveness of clinical brachytherapy treatments. In addition, this effect was largest in the most resistant cell line indicating the potential for using this combination to overcome radioresistance in brachytherapy.

Comparison of thermoradiosensitization in two human melanoma cell lines and one fibroblast cell line by concurrent mild hyperthermia and low-dose-rate irradiation.

Two human melanoma cell lines, one radioresistant (SK-MEL-3) and one radiosensitive (HT-144), and a normal human fibroblast line (AG1522) were evaluated for thermoradiosensitization of low-dose-rate irradiation by concurrent mild hyperthermia (39-41 degrees C). None of the cell lines expressed chronic thermotolerance during heating at 39-41 degrees C. The SK-MEL-3 cells were the most heat sensitive, while AG1522 and HT-144 cells had the same sensitivity at 39 and 40 degrees C but HT-144 cells were more sensitive at 41 degrees C. All cell lines expressed thermal enhancement of radiosensitivity with heating during irradiation which increased with heating temperature. The SK-MEL-3 cells, which were the most resistant to radiation and demonstrated the greatest repair of sublethal damage (SLD) during low-dose-rate irradiation, had the greatest thermal enhancement of radiosensitivity, while the HT144 cells, which were the most sensitive and expressed little repair of SLD during low-dose-rate irradiation, had the smallest thermal enhancement of radiosensitivity. These data show that concurrent mild hyperthermia during low-dose-rate irradiation may be most efficacious in radiation-resistant tumor cells which express resistance through an enhanced capacity for repair of SLD.

Postirradiation exposure to hypotonic saline shows normal damage processing in radiation-sensitive cell lines.

Three pairs of cell lines (one human and two Chinese hamster ovary (CHO) cell lines) each comprising a cell line with a normal radiation response and a radiation-sensitive mutant, were evaluated for recovery of potentially lethal damage (PLDR) and recovery of sublethal damage (SLDR). In all cases, the normal cell lines (GM1522, human; AA8-4 and K1, CHO) exhibited capacity for PLDR and SLDR was also normal in the two CHO lines. For the mutants (GM3395, human AT; V3 and 5-11, CHO) there was no ability for PLDR and SLDR was also absent in the two CHO cell lines. Postirradiation exposure to hypotonic NaCl solutions resulted in fixation of radiation damage in all the cell lines. This form of damage is repaired if left unperturbed after irradiation. This shows that cells have a large capacity for repair of this form of damage which accounts for much greater changes in survival than those observed in conventional PLDR experiments. These data show that the mutant cell lines retained their capacity to repair the damage which was susceptible to postirradiation fixation by anisotonic salt solutions. In addition, initial (i.e. preirradiation) DNA polymerase activities were measured in the four CHO cell lines; they were not correlated to radiation sensitivity.

The direct measurement of protein kinase C (PKC) activity in isolated membranes using a selective peptide substrate.

A protein kinase C (PKC)-selective peptide substrate was used to develop a method for measuring PKC activity directly and quantitatively in isolated cell membranes without prior detergent extraction and reconstitution of the enzyme with phosphatidylserine and TPA in the presence of excess Ca2+. This simple and rapid method can reliably measure changes in membrane-associated PKC activity induced by various bioactive compounds such as hormones and growth factors. Also, this method, which measures PKC activity in its native membrane-associated state, has the advantage of being able to distinguish between active and inactive PKC associated with cell membranes.