This study tested the hypothesis that administration of immunosuppressive doses of prednisone in conjunction with ultralow-dose aspirin (0.5 mg/kg/day) would result in gastroduodenal lesion scores similar to those found in dogs administered only immunosuppressive doses of prednisone, but that the gastroduodenal scores from both of these treatment groups would be significantly higher than placebo when administered to healthy dogs for 27 days. Eighteen healthy adult purpose-bred dogs were divided randomly into three groups. Group I received placebo capsules and placebo suspension, Group II received prednisone capsules (mean 2.3 mg/kg, range 2.0-2.4) and placebo suspension, and Group III received prednisone capsules (mean 2.3 mg/kg, range 2.3-2.5) and aspirin suspension (0.5 mg/kg) by mouth once daily for 27 days. Gastroduodenoscopy was performed on days -7 (baseline), 5, 14, and 27 of treatment. Four regions of the stomach (angularis incisura, body, pylorus, and cardia) and the proximal descending duodenum were systematically scored on a scale of 1 (normal) to 11 (perforating ulcer) by an experienced observer who was blinded to the treatment groups and clinical signs of each subject. Dogs were observed every 8 hours for vomiting, diarrhea, and inappetence. Feces were scored on a scale of 1-5 with diarrhea defined as a fecal score <4. Lesion scores for each group, at each location, and total scores, at each time period were evaluated for the effects of time and treatment using a Kruskal-Wallis test. Total dog days of vomiting and dog days of diarrhea in each group were compared using a Wilcoxon rank sums test. Significance was determined at p<0.05. There were no significant differences in median total gastric lesion scores between any of the groups at any time during the study. There was no location effect on regional gastroduodenal lesion scores and there was no significant change in gastroduodenal lesion scores over time in any of the groups during treatment. Significantly more dog-days of diarrhea occurred within the prednisone and aspirin group during the experimental period (Period 2) in comparison to Period 1. However, no significant differences were found between any of the groups for dog-days of vomiting, diarrhea or inappetence at any time in the study. / Master of Science

Yes / Conference abstract

Yes / Urinary prostaglandin (PG) E metabolite (PGE-M) and 11-dehydro (d)-thromboxane (TX) B2 are biomarkers of cyclooxygenase-dependent prostanoid synthesis. We investigated (1) the effect of aspirin 300 mg daily and eicosapentaenoic acid (EPA) 2000 mg daily, alone and in combination, on urinary biomarker levels and, (2) whether urinary biomarker levels predicted colorectal polyp risk, during participation in the seAFOod polyp prevention trial. Urinary PGE-M and 11-d-TXB2 were measured by liquid chromatography-tandem mass spectrometry. The relationship between urinary biomarker levels and colorectal polyp outcomes was investigated using negative binomial (polyp number) and logistic (% with one or more polyps) regression models. Despite wide temporal variability in PGE-M and 11-d-TXB2 levels within individuals, both aspirin and, to a lesser extent, EPA decreased levels of both biomarkers (74% [P ≤ .001] and 8% [P ≤ .05] reduction in median 11-d-TXB2 values, respectively). In the placebo group, a high (quartile [Q] 2-4) baseline 11-d-TXB2 level predicted increased polyp number (incidence rate ratio [IRR] [95% CI] 2.26 [1.11,4.58]) and risk (odds ratio [95% CI] 3.56 [1.09,11.63]). A low (Q1) on-treatment 11-d-TXB2 level predicted reduced colorectal polyp number compared to placebo (IRR 0.34 [0.12,0.93] for combination aspirin and EPA treatment) compared to high on-treatment 11-d-TXB2 values (0.61 [0.34,1.11]). Aspirin and EPA both inhibit PGE-M and 11-d-TXB2 synthesis in keeping with shared in vivo cyclooxygenase inhibition. Colorectal polyp risk and treatment response prediction by 11-d-TXB2 is consistent with a role for platelet activation during early colorectal carcinogenesis. The use of urinary 11-d-TXB2 measurement for a precision approach to colorectal cancer risk prediction and chemoprevention requires prospective evaluation. / Efficacy and Mechanism Evaluation Programme. Grant Number: NIHR128210. Cancer Research UK. Grant Number: C23434/A24939

Inositol phosphates (IPs) are important signalling molecules with various biological roles in a cell. One such role it is often associated with is DNA repair. The DNA repair process following DNA insult is considered crucial for the genomic integrity and stability. Failure to perform this task will result in mutations and possibly disease. Thus, it is important that we expand our knowledge on how these repair processes occur and identify the key factors involved in its regulation. The aim of this project was to investigate whether DNA repair was mediated by inositol diphosphates (IDPs). Using a family of yeast knockout mutants with modulated levels of IPs, it was found that IDPs are crucial in repair of DNA following insult with bleomycin and 5-fluorouracil. The observed sensitivity of the mutants was thought to be due to lack of functional repair protein, UDG-like or APE-like, in the absence of essential cofactor such as IDPs. Experiments conducted revealed that the hypersensitive kcs1Δ contain both the repair proteins required to process the DNA lesions. However, extreme extraction methods were required to access these proteins, suggesting that the proteins are mislocalised and unavailable to access the damage site and perform DNA repair. GFP-tagging the proteins Ung1, Apn1 and Rad52 in kcs1Δ proved to be of little use as it failed to show exact localisation, movement and functionality status of these proteins following bleomycin insult. The enzymes accountable for the dephosphorylation of the IDPs in vivo are the diphosphoinositol polyphosphate phosphohydrolases (DIPPs). Little is known regarding the Michaelis-Menten kinetics parameters for Ddp1p/DIPPs. In this study, using improved methods for the enzymatic synthesis and electrophoretic purification of 1-InsP7, 5-InsP7 and InsP8, the DIPP family has been kinetically characterised. Each DIPP was found to ii display similar Km values for every substrate tested (range: 35-148 nM). The rank order of Kcat values (1-InsP7 > 5-InsP7 = InsP8) was identical for each enzyme, although DIPP-1 activity was observed to be 10- to 60-fold more than DIPP-2α/β and DIPP-3α/β, irrespective of the substrate. This study reveals that Ddp1, the yeast DIPP, is capable of hydrolysing not only 5-InsP7 but also 1-InsP7 and InsP8 to a single product, InsP6. The HPLC data found InsP7 accumulation to be relatively little during InsP8 breakdown by DIPPs. Such low build-up was found to be due to rapid conversion of InsP7 to InsP6. Through this study it is also clear that InsP8 prefers to dephosphorylate through 1-InsP7. In contrary, metabolically and functionally significant steady-state route of InsP8 synthesis was observed to be via 5-InsP7. Oesophageal cancer is considered as one of the deadliest cancers worldwide because of its aggressive nature and low survival rate. Epidemiologic studies have shown that low-dose daily intake of aspirin can decrease the incidence of oesophageal cancer. The data presented in this study show the effects of a number of in-house synthesized novel aspirin analogues on oesophageal cancer cell lines, squamous cell carcinoma (SSC) and adenocarcinoma (ADC). The aspirin analogues, fumaryldiaspirin (PN517) and benzoylsalicylates (PN524, PN528 and PN529), were observed to be more potent against the oesophageal cell lines than aspirin itself. Both, quantitative and qualitative apoptosis experiments conducted revealed that these compounds largely induced apoptosis, although some necrosis was evident with PN528 and PN529. Failure to recover following the treatment with these analogues emphasized that these drugs are largely cytotoxic in nature. The SSC cells (oe21) displayed increased sensitivity to the aspirin analogues compared to the ADC cell lines (flo-1 and oe33). The anticancer properties of these novel aspirin compounds appear to not involve the COX-enzymes at the tested concentrations. These initial findings support further studies into the potential of these aspirin analogues as chemotherapeutic agents against oesophageal cancer.

published_or_final_version / abstract / Medicine / Master / Master of Philosophy

Colorectal cancer (CRC), which includes cancer of the large bowel and rectum is the third most common cancer in men and the second in women and there is a poorer survival rate in less developed regions of the world such as West Africa mainly due to the ‘out of reach’ costs of chemotherapy. Evidence suggests that aspirin, a non-steroidal anti-inflammatory drug (NSAID) has the potential to decrease incidence of, or mortality from, a number of cancers including CRC through several mechanisms of action. However, this evidence is dampened by aspirin’s gastrointestinal (GI) toxicity, which have been found to be mostly age-dependent. The search for potential aspirin-related compounds with the same or better cytotoxic effects against cancer cells accompanied by a safer toxicity profile has been ongoing over the years and led to us to synthesise a number of novel aspirin analogues. One of the mechanisms of action suggested for the anticancer property of aspirin is the COX-dependent pathway. In this thesis SW480 cell line, a CRC cell line that is COX-2 negative and mismatch repair (MMR) proficient was used to study the possible COX-independent mechanism of action for aspirin, its analogues and diflunisal at 0.5 mM. Diflunisal was included in this study because it is also a salicylate with reports of having cytotoxic effects. OE33 and FLO1 oesophageal cancer cells were also employed in the epidermal growth factor receptor (EGFR) and synergy experiments to show effects were not just specific to SW480 cells alone. These aspirin analogues were synthesised, identified using nuclear magnetic resonance (NMR) and infra-red (IR) spectroscopy, and tested for purity using thin layer chromatography (TLC) and melting point. The findings of this study suggest that these compounds breakdown into salicylates and perturb epidermal growth factor (EGF) internalization with PN517 (fumaryldiaspirin) and PN590 (ortho-thioaspirin) also driving EGF co-localization with early-endosome antigen-1 (EEA1). The perturbation of the internalization of EGF by aspirin and PN517 was also observed by a time-lapse assay using live confocal imaging. These compounds also had specific effects on different tyrosine phosphorylation sites of the EGFR, with none but PN590 inhibiting 4 phosphorylation at Y1068, and all but PN502 (ortho-aspirin), PN548 (meta-aspirin) and PN549 (para-aspirin) inhibiting phosphorylation at Y1045 and Y1173. Given that the EGF internalization assay involved the cells being treated with compounds for 2 h, cells were also treated for this same time period and probed with pEGFR 1045, which resulted in the compounds having no significant effect on phosphorylation at that site which is responsible for the ubiquitination of the EGFR. Most of these compounds were apoptotic with some showing a combination of apoptosis and necrosis. Aspirin and its isomers drove apoptotic cell death in SW480 cells via the BCL2-BAX pathway while the thioaspirins appear to follow the p21 pathway by decreasing the expression of the protein. In addition, it was shown that PN502 (aspirin), PN517 and PN590 had synergistic effects when used in combination with oxaliplatin at ED50, ED75 and ED90 in SW480 CRC cells. The cytotoxicity of these compounds individually or in combination was determined using MTT assay followed by the use of the CompuSyn and CalcuSyn software to calculate combination index (CI), which indicated whether a drug combination was synergistic, antagonistic or additive. PN517 and PN524 were synergistic when used in combination with cisplatin in OE33 oesophageal cancer cells. Effect of these compounds on the EGFR indicates a delay or disruption of the signalling pathway involved in the proliferation of cancer cells, thus, translating into protection against tumour formation or progression while the synergistic effects of these compounds when used in combination with platinum compounds can provide patients with less toxic chemotherapeutic regimen especially in patients with CRC tumours that harbour mutant TP53 gene and normally resistant to oxaliplatin. It is therefore proposed that the perturbation of EGF internalization is a novel mechanism of action for aspirin and its analogues in cancer therapy. These positive findings shed light on the understanding of the possible mechanism of action for aspirins and gives hope for a more affordable, less toxic therapy for the prevention, treatment and management of cancer.

The UK has experienced an increase in the incidence of oesophageal adenocarcinoma (OAC) in recent years. The prognosis for patients with OAC remains poor with currently available treatments prompting a search for alternative ‘chemopreventive’ treatments that inhibit oesophageal carcinogenesis. Both non-steroidal anti-inflammatory drugs (NSAIDS) and flavonoids are associated with a significant risk reduction for developing OAC in epidemiological studies. The aim of this study was to validate Levrat’s surgical model of OAC in the rat, and assess the chemopreventive effects of the NSAID aspirin, and the flavonoid quercetin on the development of OAC in the validated rat model. METHODS: Levrat’s model was validated in a time course experiment. Morphological and molecular events occurring in the distal oesophagus during disease progression were determined and compared to human disease. The effect of aspirin and quercetin on disease initiation and progression was determined by commencing treatment either before the onset of reflux, or 4-weeks afterwards. The incidence of Barrett’s oesophagus (BO) and OAC within each group was determined, along with methylation levels of the ESR-1, p16 and HPP1 gene promoter regions. RESULTS: The morphological and molecular changes in the distal oesophagus of the rat model are broadly consistent with those reported in human disease. The incidence of OAC was significantly lower in aspirin treated rats. A non-significant reduction in incidence of OAC was observed with quercetin treatment. Timing of treatment with regard to onset of reflux had no significant effect on OAC development in either treatment group. Neither treatment significantly effected methylation levels within the gene promoters examined. CONCLUSION: Use of Levrat’s model as a model of human OAC seems justified. Aspirin inhibits development of oesophageal adenocarcinoma induced by reflux in this rat model. No additional reduction in cancer incidence is observed if treatment is commenced prior to inception of reflux disease.

Background: The role of aspirin (100 mg daily) and omega-3 fatty acids (FA) (1 g daily) for primary prevention of cardiovascular disease in diabetes is being investigated in the 2x2 factorial design ASCEND trial. To support the interpretation of the trial's efficacy findings, it is important to compare self-reported compliance by participants with measures of the biochemical effects of each intervention. The previous data on the effect of supplementation with omega-3 FA on coronary heart disease is uncertain. Methods: The ASCEND trial randomly allocated 15480 people with diabetes (94% type 2 DM) who do not already have diagnosed occlusive arterial disease to receive aspirin or placebo and to omega-3 FA or placebo. Blood and urine samples were collected by mail at baseline and after 3 years follow-up. The effectiveness of aspirin to suppress urinary thromboxane B2 (UTxB2), a marker of platelet activity, and, of omega-3 FA supplements to increase red cell membrane omega-3 index were assessed. A systematic review of previous trials of omega-3 FA was conducted to summarize the prior evidence for the effects of omega-3 FA supplements on major vascular events (MVEs). Results: Aspirin reduced UTxB2 levels by 67% (63-70%) (p < 0.0001) compared with placebo, from 3453 pg/mg (95% CI 3061-3895) at baseline to 1190 pg/mg (1100-1287) on those allocated to aspirin during the trial. During follow-up, the omega-3 index increased by 33% (95% CI 26%-39%) in those allocated omega-3 FA compared to placebo (p < 0.0001). The meta-analysis of previous studies of omega-3 FA showed no effect on MVEs (HR 0.97; [0.93-1.01]) overall or in any pre-specified sub-groups. Conclusions: Low dose aspirin and omega-3 FA are biochemically effective at reducing UTxB2 and increasing the omega-3 index, respectively. Previous trials show that supplementation with omega-3 FA had no significant effect on MVEs. The results of the ASCEND trial, assessing the effects of both aspirin and omega-3 FA on MVEs, will be available in 2018.

Metastasis is the major cause of cancer related mortality, due to a poor understanding of the metastatic process and a subsequent lack of effective anti-metastatic therapies. Evidence from experimental studies and clinical trials has shown that aspirin reduces the incidence of distant metastases. It is well established that aspirin inhibits cyclooxygenase (COX)-1 and COX-2, triggering anti-thrombotic and anti-inflammatory effects, respectively. However, the mechanisms underlying the anti-metastatic effect of aspirin are still largely unknown. By using an experimental model of pulmonary metastasis, we have found that the anti-metastatic effect of aspirin is associated with the inhibition of COX-1. In support of this, metastasis establishment was impaired in COX-1 deficient mice, suggesting a pivotal role of this isoform in the metastatic process. Looking in more detail into the metastatic cascade, we found that COX-1 contributes to the intravascular phase of metastasis and promotes the early persistence of tumour cells in the lung vasculature. In particular, COX-1 inhibition decreased the interaction of platelets with tumour cells and was associated with the reduction of endothelial activation, of tumour cell adhesion to the endothelium, of recruitment of metastasis-promoting monocytes/macrophages and of transendothelial migration. We have identified platelet-derived thromboxane A₂ (TXA₂) as the main product of COX-1 responsible for its permissive effect on metastasis. Indeed, TXA₂ delivered to mice in combination with aspirin was able to abrogate the anti-metastatic effect of aspirin. Taken together, our data suggest that the inhibition of COX-1:TXA₂ axis by aspirin is sufficient to exert an anti-metastatic effect. In particular, the inhibition of platelet-derived TXA₂ seems to affect multiple early steps of the haematogenous transit of tumour cells. In this perspective, TXA₂ might represent a more selective therapeutic target for the prevention of metastasis.

Supramolecular chemistry and crystal engineering seek to control molecular packing in the solid state to influence the physical and chemical properties of crystalline solid materials. A goal of supramolecular chemistry that seeks to control molecular packing in the solid state focuses on exploiting non-covalent interactions to assemble molecules into desirable arrangements. Strategies implemented to control molecular packing rely on strong, directional interactions such as hydrogen bonding, halogen bonding, and metal coordination to direct localized arrangement of molecules in solids. In this context, small molecules can be used as linear templates in co-crystals to assemble reactive alkenes into specific geometries allowing reactivity in the solid state. A linear template method has been used to achieve [2+2] photocycloadditions of discrete assemblies containing alkenes to afford cyclobutanes in high stereospecificity and in quantitative yield. Herein, we describe the use of a nonlinear template, in the form of 1,4-butynediol (1,4-bd), to pre-organize alkenes in the solid state. The nonlinear template of 1,4-bd hydrogen-bonds to the alkene 1,2-bis(N-pyridyl)ethene (where N = 3 or 4) to form 1D hydrogen-bonded polymers. The hydrogen-bonded polymer chains form infinite stacks which are sustained by C-H···O interactions occurring between polymer chains. The stacked alkenes undergo a UV-induced [2+2] photocycloaddition to produce rctt-tetrakis(N-pyridyl)cyclobutane photoproducts (where N = 3 and 4) in non-quantitative yields. The yield of the photoreaction is increased to nearly quantitative by applying a supramolecular catalysis approach with the 1,4-bd template. Functional groups on reactant molecules can compete via non-covalent interactions with templates employed for the self-assembly process. One method to inhibit competition between functional groups involves chemically modifying a functional group employing a supramolecular protecting group. Here, we describe an acetyl supramolecular protecting group approach employed to mask alkenes containing phenolic and pyridyl functional groups. The acetyl protecting group prevents the phenolic substituents of the targeted alkene from participating in non-covalent interactions employed for the template-mediated self-assembly process. Thus, a cyclobutane molecule was obtained using the novel acetyl supramolecular protecting group strategy applied to a solid-state [2+2] photodimerization that affords a head-to-head cyclobutane. After deprotection, the resulting cyclobutane possessed tetrahedrally-disposed cis-hydrogen-bond-donor and cis-hydrogen-bond-acceptor groups. Thus, a purely organic three-dimensional hydrogen-bonded network based on a rare Michael O'Keeffe (mok) topology was constructed using an organic molecule synthesized in the organic solid state. The phenolic substituents of the cyclobutane adopt different orientations (syn-, anti-, and gauche-) to conform to the structural requirements of the mok net. A challenge surrounding template-directed solid-state reactivity requires alkenes to be lined with functional groups that coordinate (or bind through other non-covalent interactions) to the template. Herein, we describe a dual approach of supramolecular assistance to covalent bond formation that utilizes a combination of imine and metal-organic chemistry to generate cyclobutanes lined with aldehyde groups. Specifically, dynamic imine chemistry was implemented to install a temporary recognition site on an aldehyde-containing alkene of cinnamaldehyde for a template-directed [2+2] photocycloaddition in the solid state. The resulting modified alkene aligns using Ag(I) ions into desirable arrangements for the covalent-bond-forming [2+2] photocycloaddition. The result is a 1D coordination polymer undergoes a UV-induced, regio-controlled [2+2] photocycloaddition in the solid state. The photoreaction proceeds stereospecifically with quantitative yield of the corresponding aldehyde-functionalized photodimer, α-truxilaldehyde. Additionally, we investigate the influence of the Ag(I) counterions on the assembly of imine containing alkenes to generate reactive assemblies for the purpose of producing aldehyde-containing cyclobutanes. This dissertation also encompasses research pertaining to pharmaceutical solids and mechanical properties of organic molecular crystals. Specifically, we describe the discovery of two polymorphic co-crystals containing acetylsalicylic acid (aspirin) combined with 4,4’-bipyridine. The initial discovery of the form I polymorph was aided by mechanical dry-grinding, while an additional form II polymorph was revealed by rapid cooling in ethanol. The polymorphs differ by relative twists of carboxylic acid groups of the aspirin molecules and of the pyridyl rings of 4,4’-bipyridine. Additionally, the form I polymorph contains aspirin molecules that are linked via discrete catemeric methyl C-H···O interactions, while the form II polymorph is linked via both infinite methyl C-H···O catemers and centrosymmetric dimers. These results demonstrate the importance of dry mechanical grinding for the discovery of pharmaceutical co-crystals and polymorphs.