4
82 Chem. Res. Toxicol., Vol. 9, No. 2, 1996
Goodwin et al.
noted, however, that AP and other toxic drugs have been
found in some imported herbal pain remedies and that
use of these remedies has also caused agranulocytosis
Ack n ow led gm en t. This work was supported by
NIEHS Grant ES05056. D.C.G. is generously supported
by a Willard Eccles Family Foundation Fellowship. The
authors thank Isao Yamazaki for helpful discussions,
Curtis Takemoto and J oseph Benson for excellent techni-
cal assistance, and Terri Maughan for excellent secre-
tarial assistance.
(30). While the exact mechanism of toxicity of AP has
not been elucidated, some have suggested that it may
•
+
arise from the formation of AP (15, 19, 31). Thus,
stimulation of the production of this intermediate by
other chemicals acting as peroxidase substrates may
dramatically increase the toxicity of AP. Furthermore,
the toxicity and/or the carcinogenicity of many other
aromatic compounds is also thought to occur through
free-radical intermediates generated by peroxidases (31-
Refer en ces
(
(
(
(
1) Dunford, H. B., and Stillman, J . S. (1976) On the function and
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3). The rate of formation of these radicals by peroxi-
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It is known that CPZ•+ is a potent oxidant capable of
7
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oxidizing a wide range of organic compounds including
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•
+
observed that CPZ can oxidize N,N-dimethylanaline,
(
5) Dunford, H. B. (1982) Peroxidases. Adv. Inorg. Biochem. 41, 41-
dimethyl-p-toluidine, isoniazid, iproniazid, and other
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(
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and similar chemicals by HRP (34, 35) suggest that the
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chemicals. Thus, the production of many free-radical
intermediates could be accomplished through the oxida-
tion of CPZ by peroxidases.
1
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(
7) Kelder, P. P., de Mol, N. J ., Fischer, M. J . E., and J anssen, L. H.
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component of many medications used as antipsychotics,
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tics, and tranquilizers (36). Phenothiazines are also
widely known to act as good peroxidase substrates (7,
(
8) Yamazaki, I., Mason, H. S., and Piette, L. (1960) Identification,
by electron paramagnetic resonance spectroscopy, of free radicals
generated by peroxidase. J . Biol. Chem. 235, 2444-2449.
(9) Yamazaki, I. (1959) The oxidoreductive feature of intermediates
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2
7, 37). Moreover, the one-electron reduction potentials
of many of these compounds are sufficient to carry out
oxidation of many drugs, xenobiotics, and other chemi-
cals. Indeed, we have shown that many phenothiazine
compounds can replace CPZ as redox mediators. We
suggest that redox mediation, similar to that observed
between CPZ and AP, may play an important role in the
toxicity of some medications and xenobiotics. This would
suggest that peroxidases may also be involved in the
activation of these foreign compounds to toxic (or possibly
carcinogenic) intermediates. Indeed, peroxidases (par-
ticularly myeloperoxidase) have been implicated as a
causal factor for the toxic side effects of many medica-
tions, including a number of idiosyncratic drug reactions
(
(
(
(
12) Chung, N., and Aust, S. D. (1995) Veratryl alcohol mediated
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Biophys. 316, 733-737.
13) Yamazaki, I. (1977) Free radicals in enzyme-substrate reactions.
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2
18, Academic Press, Inc., New York.
(14) Madison, F. W., and Squier, T. L. (1934) The etiology of primary
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7
55-759.
(
15) Kalyanaraman, B., and Solne, P. G. (1985) Generation of free
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(29, 38). It is possible that these or similar side effects
may be amplified by other compounds that can act as
efficient peroxidase substrates and redox mediators. The
mechanism proposed here also suggests that compounds
with no known toxic side effects may become toxic in the
presence of other simultaneously administered chemicals.
As such, this may represent a new mechanism for
adverse drug-drug interactions.
(16) Uetrecht, J . P., Ma, H. M., MacKnight, E., and McClelland, R.
(
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In conclusion, redox mediation in peroxidase catalysis
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cally stimulated. We have shown that CPZ, acting as a
redox mediator, can stimulate peroxidase-catalyzed oxi-
dation of AP by up to 1000-fold. This type of interaction
may have implications for the toxicity and/or carcinoge-
nicity of many xenobiotics or medications whose toxicity
is thought to occur due to the production of reactive free-
radical species.
(18) Griffin, B. W. (1977) Free radical intermediate in the N-de-
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(
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(
coefficients of H
2 2
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3
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(
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2
Goodwin, D. C., Aust, S. D., and Grover, T. A., unpublished ob-
servations.