Document Detail


Direct toxicity of nonsteroidal antiinflammatory drugs for renal medullary cells.
MedLine Citation:
PMID:  11320259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Antipyretic analgesics, taken in large doses over a prolonged period, cause a specific form of kidney disease, characterized by papillary necrosis and interstitial scarring. Epidemiological evidence incriminated mixtures of drugs including aspirin (ASA), phenacetin, and caffeine. The mechanism of toxicity is unclear. We tested the effects of ASA, acetaminophen (APAF, the active metabolite of phenacetin), caffeine, and other related drugs individually and in combination on mouse inner medullary collecting duct cells (mIMCD3). The number of rapidly proliferating cells was reduced by approximately 50% by 0.5 mM ASA, salicylic acid, or APAF. The drugs had less effect on confluent cells, which proliferate slowly. Thus, the slow in vivo turnover of IMCD cells could explain why clinical toxicity requires very high doses of these drugs over a very long period. Caffeine greatly potentiated the effect of acetaminophen, pointing to a potential danger of the mixture. Cyclooxygenase (COX) inhibitors, indomethacin and NS-398, did not reduce cell number except at concentrations greatly in excess of those that inhibit COX. Therefore, COX inhibition alone is not toxic. APAF arrests most cells in late G(1) and S and produces a mixed form of cell death with both oncosis (swollen cells and nuclei) and apoptosis. APAF is known to inhibit the synthesis of DNA and cause chromosomal aberrations due to inhibition of ribonucleotide reductase. Such effects of APAF might account for renal medullary cell death in vivo and development of uroepithelial tumors from surviving cells that have chromosomal aberrations.
Authors:
G M Rocha; L F Michea; E M Peters; M Kirby; Y Xu; D R Ferguson; M B Burg
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Proceedings of the National Academy of Sciences of the United States of America     Volume:  98     ISSN:  0027-8424     ISO Abbreviation:  Proc. Natl. Acad. Sci. U.S.A.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-04-26     Completed Date:  2001-05-21     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7505876     Medline TA:  Proc Natl Acad Sci U S A     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5317-22     Citation Subset:  IM    
Affiliation:
Laboratory of Kidney and Electrolytes Metabolism, National Heart, Lung, and Blood Institute, Bethesda, MD 20892, USA.
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MeSH Terms
Descriptor/Qualifier:
Acetaminophen / toxicity
Animals
Anti-Inflammatory Agents, Non-Steroidal / toxicity*
Apoptosis / drug effects*
Aspirin / toxicity
Caffeine / toxicity
Cell Division / drug effects
Cell Line
Cyclooxygenase Inhibitors / toxicity
Drug Interactions
Flow Cytometry
Indomethacin / toxicity
Kidney Tubules, Collecting / cytology*,  drug effects*,  ultrastructure
Mice
Microscopy, Electron
Salicylic Acid / toxicity
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Cyclooxygenase Inhibitors; 103-90-2/Acetaminophen; 50-78-2/Aspirin; 53-86-1/Indomethacin; 58-08-2/Caffeine; 69-72-7/Salicylic Acid
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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