Thesis (Ph. D.)--University of Florida, 2005. / Typescript. Title from title page of source document. Document formatted into pages; contains 98 pages. Includes Vita. Includes bibliographical references.

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BACKGROUND:The glycolytic nature of malignant tumors contributes to high levels of extracellular acidity in the tumor microenvironment. Tumor acidity is a driving force in invasion and metastases. Recently, it has been shown that buffering of extracellular acidity through systemic administration of oral bicarbonate can inhibit the spread of metastases in a mouse model for metastatic breast cancer. While these findings are compelling, recent assessments into the use of oral bicarbonate as a cancer intervention reveal limitations.METHODS:We posited that safety and efficacy of bicarbonate could be enhanced by dichloroacetate (DCA), a drug that selectively targets tumor cells and reduces extracellular acidity through inhibition of glycolysis. Using our mouse model for metastatic breast cancer (MDA-MB-231), we designed an interventional survival study where tumor bearing mice received bicarbonate, DCA, or DCA-bicarbonate (DB) therapies chronically.RESULTS:Dichloroacetate alone or in combination with bicarbonate did not increase systemic alkalosis in mice. Survival was longest in mice administered bicarbonate-based therapies. Primary tumor re-occurrence after surgeries is associated with survival rates. Although DB therapy did not significantly enhance oral bicarbonate, we did observe reduced pulmonary lesion diameters in this cohort. The DCA monotherapy was not effective in reducing tumor size or metastases or improving survival time. We provide in vitro evidence to suggest this outcome may be a function of hypoxia in the tumor microenvironment.CONCLUSIONS:DB combination therapy did not appear to enhance the effect of chronic oral bicarbonate. The anti-tumor effect of DCA may be dependent on the cancer model. Our studies suggest DCA efficacy is unpredictable as a cancer therapy and further studies are necessary to determine the role of this agent in the tumor microenvironment.

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Dichloroacetate (DCA) is an investigational drug for the treatment of genetic mitochondrial diseases. Its primary site of action is the pyruvate dehydrogenase (PDH) complex, which it stimulates by altering its phosphorylation state and stability. DCA is metabolized by and inhibits the bifunctional zeta-1 family isoform of glutathione transferase/maleylacetoacetate isomerase. Polymorphic variants of this enzyme differ in their kinetic properties toward DCA, thereby influencing its biotransformation and toxicity, both of which are also influenced by subject age. Results from open label studies and controlled clinical trials suggest chronic oral DCA is generally well-tolerated by young children and may be particularly effective in patients with PDH deficiency. Recent in vitro data indicate that a combined DCA and gene therapy approach may also hold promise for the treatment of this devastating condition.

Os mastocitomas caninos são neoplasias originárias de mastócitos, sendo bastante prevalente entre os cães, por isso a importância de averiguar novas terapias para esta doença. O objetivo geral deste projeto foi investigar o efeito do DCA em mastocitomas caninos, por meio da realização de ensaios in vitro. Também foram investigados os efeitos do tratamento com DCA associado ao omeprazol ou merformina em linhagens de mastocitoma canino. As linhagens de mastocitoma canino utilizadas, grau 2 e 3, foram estabelecidas no Laboratório de Oncologia Experimental e Comparadas da FMVZ/USP e foram cultivadas em meio AIM-V. As células foram tratadas com diversas concentrações de DCA (de 0,31 a 100mM). O DCA 0,1; 0,5; 1,0; 5; 10 e 20mM foi também testado em associação com metformina (0,02; 0,2 e 2mM) ou com omeprazol (0,02; 0,1 e 0,2mM). Após os tratamentos, foi realizado ensaio para analisar a viabilidade celular utilizando o método do cristal violeta, com leituras em 3 e 5 dias. Ao contrário do que era esperado, o tratamento com dicloroacetato isolado ou com associações aumentou a população de células neoplásicas principalmente nas concentrações de 10 e 20mM. Num experimento realizado com três linhagens diferentes de mastocitomas caninos foram utilizadas concentrações de 10 a 100mM de DCA, e mostrou que a partir de 60mM há diminuição da viabilidade celular, sendo que o efeito se intensifica com o aumento das concentrações de DCA. Concluímos que o tratamento com DCA isoladamente, em concentrações de até 60mM, ou as associações com metformina e omeprazol não foram eficazes em diminuir a população de células de mastocitomas canino de graus 2 e 3 in vitro. Consideramos que a realização deste estudo foi importante para obter informações sobre os efeitos do DCA e associações em mastocitomas caninos. Os resultados deverão ser divulgados e evitarão o uso indiscriminado deste fármaco, cujas consequências poderiam ser adversas para os cães portadores de mastocitomas. / The Warburg effect or aerobic glycolysis is a phenomenon in which tumor cells convert glucose to lactic acid in the presence of oxygen, unlike normal cells in the body that perform the Krebs cycle and oxidative phosphorylation. Sodium dichloroacetate (DCA) activates pyruvate dehydrogenase (PDH), resulting in increased pyruvate within the mitochondria and in the reestablishment of normal metabolism of cellular respiration. Studies indicate that the association of DCA with metformin or omeprazole potentiate this effect. Canine mastocytomas are neoplasms originating from mast cells, being quite prevalent among dogs, so the importance of investigating new therapies for this disease. The general objective of this project was to investigate the effect of DCA on canine mast cell tumors, by performing in vitro tests. The treatment with dca DCA was then associated with omeprazole or merformin in canine mastocytoma cell lines. The canine mast cell tumor lines used, grade 2 and 3, were established in the Laboratory of Experimental and Comparative Oncology of FMVZ / USP and were cultured in AIM-V medium.. Treatment with DCA alone was performed with varying concentrations (0,31 mM to 100 mM). The associations were performed with 0,1; 0,5; 1,0; 5, 10 and 20 mM of DCA with 0,02; 0,2 and 2mM of metformin or with 0,02; 0,1 and 0,2 mM of omeprazole. After the treatments, an assay was performed to analyze cell viability using the crystal violet method, with readings at 3 and 5 days. Contrary to our expectations, treatment with dichloroacetate alone or with combinations increased the population of neoplastic cells mainly in the concentrations of 10 and 20mM. In an experiment with three different canine mastocytomas cell lines treated with DCA (10 to 100mM of DCA.), it was found that from 60mM the cell viability was decreased. This effect was intensified with increasing DCA concentrations. We conclude that treatment with DCA alone, at concentrations up to 60mM, or associated with metformin and omeprazole were not effective to decrease the population of canine mast cell tumors of grades 2 and 3 in vitro. The results should be disclosed and will avoid the indiscriminate use of this drug, the consequences of which could be adverse for dogs with mastocytomas.

Whilst progress has been made in reducing mortality in some cancers, mortality rates remain high in many cancers and there is a need to develop novel therapeutic strategies. In this thesis, various pharmacological strategies designed to enhance the activity of existing therapeutic drugs were evaluated. Cancer cells are dependent upon aerobic glycolysis (the Warburg effect) and glutamine uptake. Using clinically approved tyrosine kinase inhibitors and Bortezomib, significant enhancement of chemosensitivity was observed when used in combination with inhibitors of lactate dehydrogenase (Gossypol) and pyruvate kinase dehydrogenase (Dichloroacetate). In contrast, depletion of glutamine from media had to be extensive in order to induce cell death and cell death only occurred after prolonged exposure to glutamine-deprived conditions. This suggests that glutamine depletion strategies alone are unlikely to be successful but may be useful in combination with other agents targeting glutamine addiction in cancer cells. Finally, Temozolomide (TMZ) is an important drug in the treatment of glioblastomas but its activity is reduced by resistance mechanisms including O6 methyl guanine methyltransferase (MGMT) and mismatch repair (MMR). This thesis has identified analogues of TMZ (EA02-45, EA02-59, EA02-64 and EA02-65) that are MGMT and MMR independent in terms of inducing cell kill in vitro. These compounds are promising leads for future development. In conclusion, this thesis has demonstrated that interfering with the metabolic phenotype of cancer can enhance the activity of existing drugs and identified novel analogues of TMZ that circumvent drug resistance mechanisms that hamper the efficacy of TMZ.

Os mastocitomas caninos são neoplasias originárias de mastócitos, sendo bastante prevalente entre os cães, por isso a importância de averiguar novas terapias para esta doença. O objetivo geral deste projeto foi investigar o efeito do DCA em mastocitomas caninos, por meio da realização de ensaios in vitro. Também foram investigados os efeitos do tratamento com DCA associado ao omeprazol ou merformina em linhagens de mastocitoma canino. As linhagens de mastocitoma canino utilizadas, grau 2 e 3, foram estabelecidas no Laboratório de Oncologia Experimental e Comparadas da FMVZ/USP e foram cultivadas em meio AIM-V. As células foram tratadas com diversas concentrações de DCA (de 0,31 a 100mM). O DCA 0,1; 0,5; 1,0; 5; 10 e 20mM foi também testado em associação com metformina (0,02; 0,2 e 2mM) ou com omeprazol (0,02; 0,1 e 0,2mM). Após os tratamentos, foi realizado ensaio para analisar a viabilidade celular utilizando o método do cristal violeta, com leituras em 3 e 5 dias. Ao contrário do que era esperado, o tratamento com dicloroacetato isolado ou com associações aumentou a população de células neoplásicas principalmente nas concentrações de 10 e 20mM. Num experimento realizado com três linhagens diferentes de mastocitomas caninos foram utilizadas concentrações de 10 a 100mM de DCA, e mostrou que a partir de 60mM há diminuição da viabilidade celular, sendo que o efeito se intensifica com o aumento das concentrações de DCA. Concluímos que o tratamento com DCA isoladamente, em concentrações de até 60mM, ou as associações com metformina e omeprazol não foram eficazes em diminuir a população de células de mastocitomas canino de graus 2 e 3 in vitro. Consideramos que a realização deste estudo foi importante para obter informações sobre os efeitos do DCA e associações em mastocitomas caninos. Os resultados deverão ser divulgados e evitarão o uso indiscriminado deste fármaco, cujas consequências poderiam ser adversas para os cães portadores de mastocitomas. / The Warburg effect or aerobic glycolysis is a phenomenon in which tumor cells convert glucose to lactic acid in the presence of oxygen, unlike normal cells in the body that perform the Krebs cycle and oxidative phosphorylation. Sodium dichloroacetate (DCA) activates pyruvate dehydrogenase (PDH), resulting in increased pyruvate within the mitochondria and in the reestablishment of normal metabolism of cellular respiration. Studies indicate that the association of DCA with metformin or omeprazole potentiate this effect. Canine mastocytomas are neoplasms originating from mast cells, being quite prevalent among dogs, so the importance of investigating new therapies for this disease. The general objective of this project was to investigate the effect of DCA on canine mast cell tumors, by performing in vitro tests. The treatment with dca DCA was then associated with omeprazole or merformin in canine mastocytoma cell lines. The canine mast cell tumor lines used, grade 2 and 3, were established in the Laboratory of Experimental and Comparative Oncology of FMVZ / USP and were cultured in AIM-V medium.. Treatment with DCA alone was performed with varying concentrations (0,31 mM to 100 mM). The associations were performed with 0,1; 0,5; 1,0; 5, 10 and 20 mM of DCA with 0,02; 0,2 and 2mM of metformin or with 0,02; 0,1 and 0,2 mM of omeprazole. After the treatments, an assay was performed to analyze cell viability using the crystal violet method, with readings at 3 and 5 days. Contrary to our expectations, treatment with dichloroacetate alone or with combinations increased the population of neoplastic cells mainly in the concentrations of 10 and 20mM. In an experiment with three different canine mastocytomas cell lines treated with DCA (10 to 100mM of DCA.), it was found that from 60mM the cell viability was decreased. This effect was intensified with increasing DCA concentrations. We conclude that treatment with DCA alone, at concentrations up to 60mM, or associated with metformin and omeprazole were not effective to decrease the population of canine mast cell tumors of grades 2 and 3 in vitro. The results should be disclosed and will avoid the indiscriminate use of this drug, the consequences of which could be adverse for dogs with mastocytomas.

Dichloroacetate (DCA) it a metabolic reprogramming agent that is used to target the unique metabolism of cancer cells, but is not always effective in colorectal cancer cells. In HCT116 cells, DCA was unable to induce apoptosis, but did decrease proliferation when compared to untreated cells. A decrease in full length Mcl-1 protein expression 7 hours following DCA treatment did not correspond with changes in mRNA production or changes in expression of inhibitory binding partners, but may be due to altered proteasomal degradation. Similar reduction in levels of a lower molecular weight Mcl-1 band occurred, which did not result from alternative splicing or from caspase-mediated cleavage. Mcl-1 showed primarily nuclear localization within the cell, and expression changes in full-length Mcl-1 were seen in nuclear lysate but not cytoplasmic lysate after 7 hours of DCA treatment. Changes in nuclear Mcl-1 expression did not correspond with cell cycle arrest or progression. These results suggest that proteasomal degradation of Mcl-1 may be altered following treatment with DCA, and this change may be associated with decreased proliferation, independent of cell cycle arrest. This may indicate a novel role of nuclear Mcl-1 in response of colorectal cancer to DCA exposure. / Final thesis for Leanne Delaney in partial fulfillment of requirements for the degree of Master of Science in Biomedical Sciences / NSERC

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