Chapter One provides a general introduction into the biology and chemistry of nitric oxide, with particular focus on the role of nitric oxide in cardiovascular disease, cancer and hypoxia. It also details the types of organic functional groups used as nitric oxide donors, with detailed discussion of nitrate esters, furoxans and sydnonimines. Chapter Two discusses prostate cancer. It provides an overview into the development of prostate cancer, prostate cancer staging, and treatment. The key molecular aspects of prostate cancer are detailed, and the types of treatment available outlined. Chapter Three details the synthesis and activity of NCX-1102, a nitric oxide-donating analogue of the non-steroidal anti-inflammatory drug sulindac, and the synthetic work in the preparation of analogues of NCX-1102, using nitrate esters, furoxans and sydnonimines as nitric oxide-donating functional groups. The compounds prepared were tested against a prostate cancer cell line (PC3) and the cytotoxicity results are presented. Chapter Four describes the synthesis of nitric-oxide donating analogues of abiraterone, a CYP17 inhibitor for the treatment of prostate cancer. The results of cytotoxicity assays against PC3 cells are detailed. Chapter Five discusses the application of nitric oxide-donating functional groups in tandem with biologically active motifs. The synthesis of nitric oxide-donating amino acids, and their application to the preparation of nitric oxide-donating RGD peptides and prostate-specific membrane antigen inhibitors is presented, along with representative biological evaluation. Chapter Six introduces possible future work for the continuation of the project, suggesting the synthesis of fluorinated sydnonimines, prostate-specific membrane antigen inhibitors combined with for prostate cancer imaging and a “tool-box” of nitric oxide-donating bioconjugation reagents.

published_or_final_version / abstract / Medicine / Master / Master of Philosophy

published_or_final_version / abstract / Anatomy / Doctoral / Doctor of Philosophy

published_or_final_version / Pharmacology and Pharmacy / Master / Master of Philosophy

Barrett's esophagus (BE) is a premalignant disease associated with esophageal adenocarcinoma (EAC). This condition is highly associated with gastroesophageal reflux disease (GERD) which is characterized as chronic exposure of the esophagus to acid and bile acids. An understanding of the cytotoxic and tumorigenic capacity of bile acids and acid during a reflux episode will lead to the identification of markers for therapeutic intervention. The major goal of the following studies was to determine the mechanisms responsible for bile acid-induced alteration in intracellular pH (pHi) the effect on DNA damage, apoptosis and the adaptive resistance to reflux episodes in cells derived from normal esophagus (HET1A) or BE (CP-A) and EAC (JH-EsoAd1). In addition, I explored the therapeutic potential of UDCA oral therapy in BE cells.Here we show a novel mechanism of bile acid-induced, nitric oxide-mediated inhibition of the sodium-hydrogen exchanger (NHE) is a pathway bile acids utilize to induce acid-mediated DNA damage. This same mechanism can elicit apoptosis-resistance which we demonstrate by the complete inhibition of NHE with pharmacological inhibitor of NHE, EIPA. In addition, chronic exposure of bile acids and acid, in-vitro, confers resistance to cytotoxicity and makes cells derived from the squamous epithelium of the esophagus resemble BE and EAC. Finally, modifying the bile acid composition with glycol-Ursodeoxycholic acid (GUDCA) prevents many of the malignant effects of bile acids and acid and suggests a possible therapeutic strategy for those that suffer from GERD. The conclusion from this study suggest that bile acid reflux should be controlled in patients who suffer from GERD

Sex dimorphism in the prevalence, onset, development and progression of cardiovascular disease (CVD) is well recognized. Sex-specific differences in adaptation to cardiac pathological progressions such as cardiac hypertrophy (CH), and the extent to which they are attributable to sex hormones requires further delineation. The objective of this dissertation was to determine which cardiac vasoactive systems are responsible for sex-specific differences in CH modulation using the atrial natriuretic peptide gene-disrupted (ANP-/-) mouse model. First, sex-specific differences in the expression of the cardiac natriuretic peptide (NP) and nitric oxide synthase (NOS) systems were evaluated. Next, the influence of 17β-Estradiol (E2) on the expression and signaling of the cardiac NP and NOS systems was determined in ovariectomized (OVX) female ANP+/+ and ANP-/- mice. Finally, sex-specific differences in cardiac adaptation to Angiotensin II (ANGII) pressure overload were elucidated in male and intact female ANP+/+ and ANP-/- mice. These studies revealed that males predominantly use the NP system and females predominantly use the NOS system. Sex-specific differences in the cardiac NOS system were further enhanced by E2 in OVX female ANP+/+ and ANP-/- mice. In the female ANP-/- mouse, E2 was found to signal through the NOS system to significantly increase plasma cGMP. Finally, male and female differences were demonstrated in the sex-specific patterns of cardiac vasoactive gene system expression and development of cardiac dysfunction in response to ANGII treatment. Sex dimorphism was observed in the expression of BNP and NPR-A in male and female ANP-/- mice treated with ANGII. Female ANP+/+ and ANP-/- ANGII-treated mice exhibited elevated E/E’ ratios that were not found to the same extent in genotype matched ANGII-treated male mice, demonstrating that female mice developed ANGII-mediated mild left ventricle diastolic dysfunction. Based on the results of this dissertation, we conclude that sex-specific differences do indeed exist in the cardiac adaptation to pathological stresses. These data support the understanding that a progression towards sex-specific CVD treatments is warranted, with a particular emphasis on the potential benefits of female-specific targeting of the cardiac NOS system. / Thesis (Ph.D, Anatomy & Cell Biology) -- Queen's University, 2013-08-23 14:21:45.324

Hypertensive patients exhibit impaired exercise capacity, a strong independent risk factor for cardiovascular disease, and the mechanisms responsible for this are not fully determined. Potential candidates may include endothelial vasomotor dysfunction and arterial stiffness, both of which are associated with hypertension. Impairment of the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway plays a major role in the development of these abnormalities, suggesting that enhancement of NO-cGMP signalling through phosphodiesterase type 5 (PDE5) inhibition may offer therapeutic potential in arterial hypertension. This thesis investigated the effects of the PDE5 inhibitor sildenafil citrate on exercise-induced vasodilatation, maximal exercise capacity and arterial stiffness in hypertensive patients, using different studies involving local limb and whole body exercise. Preliminary dose-ranging studies were initially performed to investigate the intraarterial (brachial) effects of sildenafil on forearm blood flow (FBF), and to select an appropriate, cGMP-independent, vasodilator to use as a control. On the basis on these studies, it was established that sildenafil, infused at 50μg/min, and verapamil, infused at 5μg/min, had similar vasodilator effect on FBF. Ten untreated hypertensive patients and ten matched normotensive subjects were then studied in a three-way, randomised, single-blind and placebo-controlled FBF study. The aim was to investigate the effects of sildenafil on handgrip exercise-induced vasodilatation, and to compare this response with verapamil and saline (placebo). Preinfusion exercise-induced vasodilatation was significantly reduced in hypertensive compared with normotensive subjects (P<0.001). However, after the infusions, while verapamil did not affect the vasodilator response to exercise in either group, sildenafil substantially enhanced this response in hypertensive patients, but not in normotensive subjects (P<0.05). These results suggested that sildenafil, through an increase in cGMP levels in the vasculature, substantially and selectively improves the vasodilator response to handgrip exercise in hypertensive patients.

Cardiovascular disease (CVD) such as hypertension and stroke are serious illnesses that impact on the lives of millions all over the world, with 972 million (26% of the world’s population) suffering from hypertension in year 2000, and an estimated 1.56 billion to be affected by 2025. Hypertension, being one of the most common CVD is associated with the development of stroke, peripheral vascular diseases, myocardial infarction, renal failure as well as cardiac failure. Several studies have shown a seasonal correlation for both the systolic and diastolic blood pressure in mankind. A hypertension trial done by the Medical Research Council in the 1980s showed the average blood pressure being lower in summer than winter, and this difference was more significant in the elderly than the younger population. Other than seasonal variation, blood pressure (including hypertension prevalence) is also noted to correlate with latitude, being higher at places further away from the equator. Other cardiovascular related diseases such as stroke and acute coronary syndrome are also shown occur more frequently in winter. The morbidity and mortality of CVD could be due to various factors including diet, culture, race and social status, but within the United Kingdom, all cause mortality (with cerebral-vascular disease being the major one) correlates with latitude even after accounting for all known risk factors, with CVD risks highest in the north. We propose that this difference in cardiovascular mortality is caused by variations in ultraviolet exposure other than temperature. Known mechanisms of sunlight exposure that affect cardiovascular health include temperature and the ultraviolet B (UVB) mediated photolysis of 7-dehydrocholesterol in the skin to produce 1,25 dihydroxycholecalciferol (Vitamin D). UVB is however a potent skin carcinogen, and calculating risk-benefit ratios for exposure will be important. We believe that independently of vitamin D, nitric oxide plays an important role in blood pressure regulation and cardiovascular health, accounting for seasonal and latitude variation. In 1961, Furchgott demonstrated relaxation of rabbit aorta by irradiating them with ultraviolet light, and in later research he noted this effect is most significant in the ultraviolet A (UVA) spectrum. Recently, Mowbray showed a rich store of various nitro-species within human skin and Oplander showed a reduction of blood pressure in human after giving whole body UVA irradiation. We therefore hypothesize that independently of vitamin D, NO mediates the UVA induced beneficial effects on cardiovascular health. To support our hypothesis, in vivo as well as in vitro studies were conducted. We recruited a total of 63 healthy volunteers and monitored blood pressure, forearm blood flow as well as other cardiovascular parameters before and after UVA irradiation. Blood samples were also taken for the measurement of circulatory nitro-species. We have noted a significant reduction of blood pressure (from 84.5±1.76 to 81.33±1.37 mmHg) and increased forearm blood flow (1.95±0.28 to 2.94±0.47 mL/100mL of tissue/min) after UVA irradiation of human skin; simultaneously, we also noted a rise in circulatory nitrite (0.5±0.04 μM before irradiation to 0.72±0.04 μM) and a drop in circulatory nitrate (11.79±0.64 μM before irradiation and 8.99±0.4 μM). For us to further clarify the role of nitric oxide in different latitude, a monochromator machine that generates specific wavelength of light was been used to irradiate aqueous nitrite solution, and the total amount of nitric oxide release at different latitude was then calculated according to the irradiance of various wavelength across the globe. The results of our studies provide evidence suggesting that nitric oxide release induced by UVA irradiation of the skin can account for the difference in cardiovascular mortality and morbidity by latitude. The current public health advice of avoiding sun exposure to reduce the risk of developing skin cancer may need to be modified.

Tumour hypoxia has been demonstrated to cause development of an aggressive tumour phenotype and is associated with increased patient mortality and poorer response to treatments such as chemotherapy and radiotherapy. Previous studies have established that hypoxia exists within a nidus of prostate cancer. Based on the importance of the tumour microenvironment, especially hypoxia, in prostate cancer, the major aims of this thesis were to establish: (a) the role of a novel putative survival factor, dermcidin, in prostate cancer survival under hypoxia/oxidative stress; and (b) the effect of nitric oxide-donating non-steroidal anti-inflammatory drugs (NO-NSAIDS), a new class of drugs, on the killing of prostate cancer cells subjected to hypoxia. A wide-range of confirmatory, cellular and molecular biology techniques were employed in this thesis. The PC-3 hormone-insensitive prostate cancer cell line was used for the majority of studies as this cell line represents hormone-independent prostate cancer, treatment of which is currently palliative. Cell incubation at 0.2% oxygen for 48 hours was established as suitable conditions to stimulate the development of the hypoxia response. Upregulation of nuclear hypoxia-inducible factor-1α protein was the main marker used to assess the hypoxia response. Dermcidin messenger RNA production was found to occur in a range of prostate cancer cell lines; was upregulated in cell lines by both hypoxic and oxidative stress; and found to act as a proliferation, survival and pro-invasion factor under hypoxia and oxidative stress in immortalised prostate cancer cell lines. Furthermore, the portion of the dermcidin molecule responsible for the survival advantage was localised to the proteolysis-inducing factor core peptide subunit. However, subsequent analysis of primary cancer samples from prostate cancer patients revealed that dermcidin was not expressed in these tumours, although dermcidin mRNA was identified in analysis of other primary tumours. As such, the role of dermcidin in prostate cancer was not evaluated further in this thesis. Investigation of NO-sulindac (a NO-NSAID drug) in hypoxic PC-3 cells showed that these agents were significantly more pro-necrotic, pro-apoptotic and anti-invasive than traditional, unnitrated sulindac. NO-sulindac was found to downregulate the hypoxia response mounted by PC-3 cells under hypoxia via the Akt signalling pathway. Finally, analysis of the role of NO-sulindac in radiosensitising hypoxic PC-3 cells showed that NO-sulindac caused significant radiosensitisation under normoxia, but particularly in hypoxic conditions. As such, NO-NSAIDs show great promise as neoadjuvant, concurrent and adjuvant treatments for patients with hypoxic prostate cancer. The findings of this thesis illustrate several potential novel strategies for treatment of hormone-independent prostate cancer.

Approved for public release; distribution is unlimited / The production of nitric oxide by soft solar X-rays in the E-region of the ionosphere is investigated. An empirical expression for the variation in X-ray flux as a function of F10.7 is determined. This expression is incorporated into a one-dimensional diffusive photochemical model to compute nitric oxide densities. No results of these calculation are compared with NO observation from the Solar Mesosphere Explorer satellite. Variations of X-ray flux by a factor of 30 over the solar cycle can explain the observed variation in nitric oxide densities. / http://archive.org/details/investigationofp00duma / Lieutenant, United States Navy