Organic nitrates such as glyceryl trinitrate (GTN) are commonly used to treat cardiovascular disease. They are prodrugs that require bioactivation for pharmacological activity. Currently, there are two proposed pathways of organic nitrate activation: a high-affinity pathway for high-potency nitrates (GTN and pentaerythrityl tetranitate) and a low-affinity pathway for low-potency nitrates (isosorbide dinitrate (ISDN) and isosorbide mononitrate). A major limitation in the utility of organic nitrates is the rapid onset of tolerance during chronic treatment. Inhibition of the enzymes responsible for bioactivation has been put forward as the major cause of tolerance, and aldehyde dehydrogenase 2 (ALDH2) has been proposed as the primary enzyme responsible for bioactivation in the high-affinity pathway. ALDH2 activity is decreased in GTN-tolerant tissues and it has been suggested that ALDH2 inactivation is the underlying cause of GTN tolerance. However, several aspects of this hypothesis are problematic. My objective was to develop an in vivo model of ISDN tolerance and to use this model to examine the effects of chronic ISDN treatment on ALDH2 activity and on organic nitrate-induced vasodilation. The hypothesis of my research is that the reduced potency of GTN caused by ISDN tolerance is mediated by a mechanism independent of ALDH2 inactivation. ISDN tolerance was induced in rats using an in vivo model in which animals were exposed to 0.8 mg/hr ISDN for 24-96 hr. ALDH2 activity was measured in liver mitochondrial fractions and tolerance was assessed in isolated aortic preparations. There was no inhibition of mitochondrial ALDH2 activity in ISDN-treated animals. However, chronic treatment with ISDN resulted in parallel rightward shifts of both the ISDN and GTN concentration-response curves, which increased with increased duration of exposure iii to ISDN. Concentration-response curves for acetylcholine (ACh), sodium nitroprusside (SNP), and diethylamine NONOate were unchanged in ISDN-treated animals. The model of chronic ISDN treatment results in cross tolerance to GTN but does not affect ALDH activity. The data presented in this study indicate no role for ALDH2 in the development of nitrate tolerance. / Thesis (Master, Pharmacology & Toxicology) -- Queen's University, 2011-05-30 12:06:05.785

A enzima aldeído desidrogenase 2 (ALDH2), localizada na matriz mitocondrial, é crucial na manutenção do balanço intracelular de aldeídos. Atualmente, estima-se que 8% da população mundial apresentam uma mutação pontual no gene da ALDH2 (E487K, ALDH2*2) que confere perda de até 95% na atividade enzimática. No presente projeto utilizamos camundongos knock-in ALDH2*2 para avaliar o impacto da mutação ALDH2 (E487K) na disfunção cardíaca induzida pelo infarto do miocárdio. Observamos que os animais mutantes possuem a atividade da ALDH2 reduzida e desenvolvem disfunção cardíaca e remodelamento ventricular semelhante aos animais selvagens após infarto do miocárdio. Porém, os animais com a mutação E487K possuem uma significante redução no consumo de oxigênio basal (respirometria), máximo (teste físico até a exaustão) e em mitocôndria cardíaca isolada, quando comparados aos animais selvagens. Por fim, o tratamento sustentado com Alda-1 (ativador da ALDH2) foi efetivo em restaurar a função cardíaca dos animais infartados, independente do genótipo. / Aldehyde dehydrogenase 2 (ALDH2), located in the mitochondrial matrix, is critical for the maintenance of cellular redox balance by removing reactive aldehydes produced during oxidative stress. It is estimated that 8% of the world population have a point mutation in the ALDH2 gene (E487K), which reduces its enzymatic activity by 95%. Here, we study the impact of the E487K variant of ALDH2 on myocardial infarction-induced heart failure, using ALDH2 E487K knock-in mice. We observed that mice carrying the ALDH2 variant have reduced ALDH2 activity and protein levels compared to WT mice. Despite of reduced oxidative metabolism, animals with ALDH2 mutation develop cardiac dysfunction and ventricular remodeling equivalent to WT animals after myocardial infarction. Finally, sustained Alda-1 treatment (ALDH2 activator) during 6 weeks improved cardiac function of infarcted animals, regardless of genotype.

Part I: Target identification studies are one of the most difficult but rewarding challenges in chemical biology. Part I of this thesis describes target identification studies for 5-nitrofuran containing hits. The 5-nitrofurans used in this study were identified in a phenotypic screen for compounds that induced melanocyte cells death in zebrafish. Chapter 1 provides brief overviews on three related areas of the project: 1) the use of zebrafish as a model organism in drug discovery; 2) phenotypic screening using zebrafish and 3) the strategies used in target identification studies. Chapter 2 describes the synthesis of and SAR studies on two series of 5-nitrofuran containing analogues. The design and preparation of biotinylated chemical probes based on the SAR data is also described. These chemical tools are then used in affinity chromatography studies and genetic validation of a potential target (zebrafish Aldh2) of the 5-nitrofuran compounds is reported. Chapter 3 provides a review of the biological and chemical processes that human ALDHs are known to mediate. In addition, small molecules that modulate ALDH2 activity are reviewed. A detailed study of the interaction between 5-nitrofurans and human ALDH2 including in vitro enzymatic assays is described leading to the conclusion that the 5- nitrofurans under study are substrates of human ALDH2. Further mechanism of action investigations using model reactions are also presented. Chapter 4 introduces the use of 5-nitrofuran containing drugs in the clinic and highlights the reported side-effects. Further investigation of the interaction between ALDH2 and 5- nitrofurans in zebrafish and yeast using ALDH2 inhibitors is described. Based on these results, a combination therapy strategy is proposed. Finally, the trypanocidal activity of the newly synthesised 5-nitrofurans is discussed. Experimental details and future work for Part I are presented in Chapters 5 and 6 respectively. Part II: Human sirtuins are associated with various biological functions and diseases, including cancer and neurodegeneration. Previous work from the Westwood Lab has led to the discovery of the tenovins that act as inhibitors of SIRT1 and SIRT2. Part II of the thesis reports the development of potent fixed ring tenovin analogues with high SIRT2 selectivity. Chapter 7 provides a brief review of the biology of human SIRT2 and the reported SIRT2 inhibitors available to date. This is followed by a short summary of the previous work on the tenovins in the Westwood Lab and the design of the fixed ring tenovin analogues. Chapter 8 describes the synthesis of three series of fixed ring tenovin analogues. SAR data is generated based on in vitro enzymatic assays against both SIRT1 and SIRT2 and the prepared analogues showed relatively high potency and selectivity against SIRT2. Further cell-based deacetylation assay are also discussed. All the experimental details are reported in Chapter 9 and Chapter 10 provides with conclusions and proposed future work.

Neurotrauma is a general term describing injury to the central nervous system (CNS); which comprises of the brain and spinal cord. The damage resulting from neurotrauma includes primary injury, which occurs from different sources such as compressed air hitting the brain (bTBI) or an object/bone contusing the spinal cord, resulting in a spinal cord injury (SCI). These various means of primary brain and spinal cord injury are further complicated by the many possible combinations of severity levels and frequencies. However, primary injuries are regarded in many cases as unavoidable with the immediate nerve damage being largely irreversible. Despite all this, primary injuries of the CNS are related by common biochemical pathways in secondary injury. Secondary injury is the cause of declining outcomes after neurotrauma and poor recovery. Secondary injury begins immediately after primary injury and can continue to trigger death of neurons for years later. Given this contribution to poor recovery and its slow progression, secondary injury provides an excellent window of opportunity for therapeutic intervention. A major factor and key link in secondary injury and its perpetuation is reactive aldehyde formation, such as acrolein, from lipid peroxidation. The common formation of acrolein in neurotrauma is attributed to the unique structure of the CNS: with neurons containing a high lipid content from myelin and heavy metabolic activity they are vulnerable to acrolein formation. Thus, acrolein in secondary injury is a point of pathogenic convergence between the various forms of neurotrauma, and may play a role as well in the development of neurotrauma linked disorders and related neurodegeneration. The overall goal of this thesis is to therefore develop better strategies for acrolein removal. We explore here endogenous clearance strategies and targeted drug delivery in SCI, investigate detailed cellular structure changes in bTBI, and acrolein formation and removal in Parkinson’s disease. These findings of pathology, and effectiveness of new or existing acrolein removal strategies, will allow us to better employ treatments in future studies.

A formação de aldeídos decorrente do estresse oxidativo é cardiotóxica e contribui para o aparecimento das doenças cardiovasculares. O aldeído 4-hidroxi-2-nonenal (4HNE) apresenta grande poder nocivo cardíaco. A enzima mitocondrial aldeído desidrogenase 2 (ALDH2) é a principal responsável pela remoção do 4HNE, sendo que a ativação farmacológica da ALDH2 previne danos cardíacos oriundos do processo de isquemia/reperfusão. Com o intuito de compreender o papel desta enzima na insuficiência cardíaca (IC) tivemos como objetivos: caracterizar o curso temporal de ativação da ALDH2 pós-infarto do miocárdio em ratos e estudar o efeito da ativação farmacológica sustentada da ALDH2 na IC. Nossos resultados apontam que na 1ª, 2ª e 4ª semanas pós-infarto a atividade da ALDH2 apresenta-se reduzida. Essa redução está associada à disfunção mitocondrial e cardíaca. Contudo, o tratamento com Alda-1 proporciona uma melhora dessas funções. Assim, concluímos que a ativação seletiva da ALDH2 reduz danos cardíacos, podendo ser considerada um novo alvo terapêutico no tratamento da IC. / Here we determined the benefits of chronic activation of ALDH2 on the progression of heart failure after the onset of symptoms using a post-myocardial infarction model. We showed that a six-week treatment of myocardial infarction-induced heart failure rats with Alda-1, a selective ALDH2 activator, enhanced contractile function, improved left ventricular compliance and increased diastolic dysfunction under basal conditions and after sudden pressure-overload stress. Moreover, sustained Alda-1 treatment showed no toxicity and promoted a cardiac anti-remodeling effect by suppressing myocardial hypertrophy and fibrosis. Moreover, ALDH2 activation-mediated cardioprotection was associated with improved mitochondrial function. Further Alda-1 treatment preserved mitochondrial function in vitro upon 4-HNE addition. Therefore, selective activation of mitochondrial ALDH2 reduces aldehydic load, preserves mitochondrial function and improves heart failure outcome, suggesting that ALDH2 activators have a potential therapeutic value for treating heart failure patients.

A formação de aldeídos decorrente do estresse oxidativo é cardiotóxica e contribui para o aparecimento das doenças cardiovasculares. O aldeído 4-hidroxi-2-nonenal (4HNE) apresenta grande poder nocivo cardíaco. A enzima mitocondrial aldeído desidrogenase 2 (ALDH2) é a principal responsável pela remoção do 4HNE, sendo que a ativação farmacológica da ALDH2 previne danos cardíacos oriundos do processo de isquemia/reperfusão. Com o intuito de compreender o papel desta enzima na insuficiência cardíaca (IC) tivemos como objetivos: caracterizar o curso temporal de ativação da ALDH2 pós-infarto do miocárdio em ratos e estudar o efeito da ativação farmacológica sustentada da ALDH2 na IC. Nossos resultados apontam que na 1ª, 2ª e 4ª semanas pós-infarto a atividade da ALDH2 apresenta-se reduzida. Essa redução está associada à disfunção mitocondrial e cardíaca. Contudo, o tratamento com Alda-1 proporciona uma melhora dessas funções. Assim, concluímos que a ativação seletiva da ALDH2 reduz danos cardíacos, podendo ser considerada um novo alvo terapêutico no tratamento da IC. / Here we determined the benefits of chronic activation of ALDH2 on the progression of heart failure after the onset of symptoms using a post-myocardial infarction model. We showed that a six-week treatment of myocardial infarction-induced heart failure rats with Alda-1, a selective ALDH2 activator, enhanced contractile function, improved left ventricular compliance and increased diastolic dysfunction under basal conditions and after sudden pressure-overload stress. Moreover, sustained Alda-1 treatment showed no toxicity and promoted a cardiac anti-remodeling effect by suppressing myocardial hypertrophy and fibrosis. Moreover, ALDH2 activation-mediated cardioprotection was associated with improved mitochondrial function. Further Alda-1 treatment preserved mitochondrial function in vitro upon 4-HNE addition. Therefore, selective activation of mitochondrial ALDH2 reduces aldehydic load, preserves mitochondrial function and improves heart failure outcome, suggesting that ALDH2 activators have a potential therapeutic value for treating heart failure patients.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19564号 / 医博第4071号 / 新制||医||1013(附属図書館) / 32600 / 京都大学大学院医学研究科医学専攻 / (主査)教授 高田 穣, 教授 武田 俊一, 教授 松本 智裕 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

I hypothesise that cancer cells with high aldehyde dehydrogenase (ALDHhigh) activity present a new therapeutic target and will be selectively sensitive to 5-nitrofuran pro-drugs. Cancers are heterogeneous and contain subpopulations of ALDHhigh cells with tumour initiating potential. ALDH enzymes metabolize toxic aldehydes, and are highly expressed in somatic and cancer stem cells (CSCs), although their function in CSCs is not fully understood. In a small molecule screen coupled with target ID, Zhou et al. (2012) recently discovered that clinically active 5-nitrofurans (5-NFNs) are substrates of ALDH2. 5-NFNs are a class of pro-drug widely used to treat bacterial and parasitic infections, where their relative specificity is driven by nitroreductases, but little is known about the enzymes that bio-activate 5-NFNs in humans. Recent clinical cancer research has found that the 5-NFN, nifurtimox, has anti-cancer properties and it is currently in Phase 2 clinical trials for neuroblastoma and medulloblastoma (ClinicalTrials.gov Identifier: NCT00601003), however the mechanism underlying this anti-cancer activity is unknown. In melanoma and other cancers, ALDH1A1 and ALDH1A3 are highly expressed in CSCs. I demonstrate the anti-cancer activity of 5-NFNs in cancer cell lines, where they express high sensitivity to 5-NFNs in cell viability assays (A375 melanoma cells EC50 = 867nM). To test if ALDH1 enzymes are substrates of 5-NFNs, I performed in vitro activity assays by monitoring NADH production (λ = 340nm). I found that the clinically available 5-NFNs, nifuroxazide and nifurtimox, in addition to our own newly synthesised 5-NFNs, are competitive substrates for human ALDH1A3 activity in vitro (P < 0.05). Notably, nifuroxazide is not a substrate for ALDH2, suggesting that nifuroxazide may show selectivity toward ALDH1. Enzymatic assays with purified human ALDH2, demonstrate that ALDH2 requires NAD+ for bio-activation of 5-NFNs. Consistent with these assays, I found that 5-NFNs are competitive substrates for ALDH activity in melanoma cells by Aldefluor™, with 5-NFNs displaying a prolonged competitive inhibition of ALDH activity compared with the known inhibitor, DEAB. Importantly, no-nitro control compounds show no activity toward ALDH enzymes in vitro or in culture. Kinetic living-cell imaging (IncuCyte ZOOM®) reveals that a subpopulation of ALDH1A3 siRNA transfected A375 cells are protected from 5-NFN toxicity (P > 0.05) and cell death (DRAQ7™: P < 0.0001), demonstrating a functional role for ALDH1A3 in mediating 5-NFN activity in cancer cells. In contrast, A375 cells overexpressing ALDH1A3 by cDNA transient transfection were hypersensitive to 5-NFNs (P < 0.001), determined by Muse™ cell viability. Computational docking studies reveal that 5-NFNs have the potential to fit within the interior of the ALDH enzymatic cavity and interact with the catalytic cysteine, thereby offering a potential mechanism for 5-NFN bio-activation. Finally, in collaboration, we show a unique interaction between 5-NFNs and ALDH using mass spectrometry and have initiated protein crystallography trials. My work demonstrates a novel and biologically relevant 5-NFN-ALDH interaction in cancer cells. I propose 5-NFNs have the potential to target ALDHhigh CSCs within a tumour and advance the repurposing of clinical 5-NFN pro-drug antibiotics as anti-cancer therapeutics.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22373号 / 医博第4614号 / 新制||医||1043(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 武田 俊一, 教授 小川 誠司, 教授 坂井 義治 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM