Purpose: Pharmacologic concentrations of ascorbate may be effective in cancer therapeutics. We hypothesized that ascorbate concentrations achievable with i.v. dosing would be cytotoxic in pancreatic cancer for which the 5-year survival is <3%.Experimental Design: Pancreatic cancer cell lines were treated with ascorbate (0, 5, or 10 mmol/L) for 1 hour, then viability and clonogenic survival were determined. Pancreatic tumor cells were delivered s.c. into the flank region of nude mice and allowed to grow at which time they were randomized to receive either ascorbate (4 g/kg) or osmotically equivalent saline (1 mol/L) i.p. for 2 weeks.Results: There was a time-and dose-dependent increase in measured H 2 O 2 production with increased concentrations of ascorbate. Ascorbate decreased viability in all pancreatic cancer cell lines but had no effect on an immortalized pancreatic ductal epithelial cell line. Ascorbate decreased clonogenic survival of the pancreatic cancer cell lines, which was reversed by treatment of cells with scavengers of H 2 O 2 . Treatment with ascorbate induced a caspase-independent cell death that was associated with autophagy. In vivo, treatment with ascorbate inhibited tumor growth and prolonged survival.Conclusions: These results show that pharmacologic doses of ascorbate, easily achievable in humans, may have potential for therapy in pancreatic cancer. Clin Cancer Res; 16(2); 509-20.

Summary Pharmacological ascorbate has been proposed as a potential anti-cancer agent when combined with radiation and chemotherapy. The anti-cancer effects of ascorbate are hypothesized to involve the autoxidation of ascorbate leading to increased steady-state levels of H2O2; however, the mechanism(s) for cancer cell-selective toxicity remain unknown. The current study shows that alterations in cancer cell mitochondrial oxidative metabolism resulting in increased levels of O2•− and H2O2 are capable of disrupting intracellular iron metabolism thereby selectively sensitizing non-small cell lung cancer (NSCLC) and glioblastoma (GBM) cells to ascorbate through pro-oxidant chemistry involving redox active labile iron and H2O2. In addition, preclinical studies and clinical trials demonstrate the feasibility, selective toxicity, tolerability, and potential efficacy of pharmacological ascorbate in GBM and NSCLC therapy.

Background Treatment of pancreatic cancer with pharmacological ascorbate (ascorbic acid, vitamin C) decreases tumor progression in pre-clinical models. A phase I clinical trial was performed to establish safety and tolerability of pharmacological ascorbate combined with gemcitabine in patients with biopsy-proven stage IV pancreatic adenocarcinoma. Design Nine subjects received twice weekly intravenous ascorbate (15–125 g) employing Simon’s Accelerated Titration design to achieve a targeted post-infusion plasma level of ≥ 350 mg/dL (≥20 mM). Subjects received concurrent gemcitabine. Disease burden, weight, performance status, hematologic and metabolic labs, time to progression and overall survival were monitored. Results Mean plasma ascorbate trough levels were significantly higher than baseline (1.46 ± 0.02 vs. 0.78 ± 0.09 mg/dL, i.e. 83 vs. 44μM, p < 0.001). Adverse events attributable to the drug combination were rare and included diarrhea (n = 4) and dry mouth (n = 6). Dose-limiting criteria were not met for this study. Mean survival of subjects completing at least 2 cycles (8 weeks) of therapy was 13 ± 2 months. Conclusions Data suggest pharmacologic ascorbate administered concurrently with gemcitabine is well-tolerated. Initial data from this small sampling suggest some efficacy. Further studies powered to determine efficacy should be conducted.

The discovery of oxygen is considered by some to be the most important scientific discovery of all time – from both physical-chemical/astrophysics and biology/evolution viewpoints. One of the major developments during evolution is the ability to capture dioxygen in the environment and deliver it to each cell in the multicellular, complex mammalian body -- on demand, i.e. just-in-time. Humans use oxygen to extract approximately 2550 Calories (10.4 MJ) from food to meet daily energy requirements. This combustion requires about 22 moles of dioxygen per day, or 2.5 × 10-4 mol s-1. This is an average rate of oxygen utilization of 2.5 × 10-18 mol cell-1 s-1, i.e. 2.5 amol cell-1 s-1. Cells have a wide range of oxygen utilization, depending on cell type, function, and biological status. Measured rates of oxygen utilization by mammalian cells in culture range from <1 to >350 amol cell-1 s-1. There is a loose positive linear correlation of the rate of oxygen consumption (OCR) by mammalian cells in culture with cell volume and cell protein. The use of oxygen by cells and tissues is an essential aspect of the basic redox biology of cells and tissues. This type of quantitative information is fundamental to investigations in quantitative redox biology, especially redox systems biology.

Ascorbate (AscH−) functions as a versatile reducing agent. At pharmacological doses (P-AscH−; [plasma AscH−] ≥≈20 mM), achievable through intravenous delivery, oxidation of P-AscH− can produce a high flux of H2O2 in tumors. Catalase is the major enzyme for detoxifying high concentrations of H2O2. We hypothesize that sensitivity of tumor cells to P-AscH− compared to normal cells is due to their lower capacity to metabolize H2O2. Rate constants for removal of H2O2 (kcell) and catalase activities were determined for 15 tumor and 10 normal cell lines of various tissue types. A differential in the capacity of cells to remove H2O2 was revealed, with the average kcell for normal cells being twice that of tumor cells. The ED50 (50% clonogenic survival) of P-AscH− correlated directly with kcell and catalase activity. Catalase activity could present a promising indicator of which tumors may respond to P-AscH−.

Oxidizability of lipids in homogeneous solution varies linearly with the extent of their unsaturation. In vitro cellular, as well as in vivo, studies of oxidizability have generally relied upon chemical indicators of peroxidation such as thiobarbituric acid-reactive substances. To examine the oxidizability of lipids in cells, we have measured oxygen uptake and, using electron paramagnetic resonance spin trapping with alpha-(1-oxo-4-pyridyl)-N-tert-butylnitrone (POBN), the real time generation of lipid-derived free radicals. We have used our experimental in vitro cellular lipid modification model to examine the rate and extent of lipid peroxidation versus the degree of lipid unsaturation in L1210 murine leukemia cells. Lipid peroxidation was stimulated using the prooxidants iron, ascorbate, and the ether lipid compound 1-O-octadecyl-2-O-methyl-rac-glycero-3-phosphocholine. We did a total cellular lipid analysis to determine the number of lipid carbon-carbon double bonds contained in L1210 cells enriched with eight fatty acids of different degrees of unsaturation. We found in cellular lipids that (i) lipid chain length had no apparent effect on the rate or extent of radical formation; (ii) the maximum amount of lipid radical generated increases with the total number of bis-allylic positions in the cellular lipids; and, most importantly, (iii) the rate of cellular lipid peroxidation increases exponentially with the number of bis-allylic positions. Our quantitative results clearly demonstrate, for the first time, that the number of bis-allylic positions contained in the cellular lipids of intact cells determines their susceptibility, i.e., oxidizability, to free radical-mediated peroxidative events.

SUMMARY Pharmacological ascorbate has been proposed as a potential anti-cancer agent when combined with radiation and chemotherapy. The anti-cancer effects of ascorbate are hypothesized to involve the autoxidation of ascorbate leading to increased steady-state levels of H2O2; however, the mechanism(s) for cancer cell-selective toxicity remain unknown. The current study shows that alterations in cancer cell mitochondrial oxidative metabolism resulting in increased levels of O2.− and H2O2 are capable of disrupting intracellular iron metabolism, thereby selectively sensitizing non-small-cell lung cancer (NSCLC) and glioblastoma (GBM) cells to ascorbate through pro-oxidant chemistry involving redox-active labile iron and H2O2. In addition, preclinical studies and clinical trials demonstrate the feasibility, selective toxicity, tolerability, and potential efficacy of pharmacological ascorbate in GBM and NSCLC therapy.

The reactions of glutathione (GSH) with polychlorinated biphenyl (PCB) quinones having different degrees of chlorination on the quinone ring were examined. EPR spectroscopy and MS revealed 2 types of reactions yielding different products: (i) a nonenzymatic, nucleophilic displacement of chlorine on the quinone ring yielding a glutathiylated conjugated quinone and (ii) Michael addition of GSH to the quinone, a 2-electron reduction, yielding a glutathiylated conjugated hydroquinone. The pKa of parent hydroquinone decreased by 1 unit as the degree of chlorination increased. This resulted in a corresponding increase in the oxidizability of these chlorinated hydroquinones. The reaction with oxygen appears to be first-order each in ionized hydroquinone and dioxygen, yielding hydrogen peroxide stoichiometrically. The generation of semiquinone radicals, superoxide, and hydroxyl radicals was observed by EPR; however, the mechanisms and yields vary depending on the degree of the chlorination of hydroquinone/quinone and the presence or absence of GSH. Our discovery that chlorinated quinones undergo a rapid, nonenzymatic dechlorination upon reaction with GSH opens a different view on mechanisms of metabolism and the toxicity of this class of compounds.dechlorination ͉ EPR ͉ superoxide ͉ semiquinone ͉ hydrogen peroxide P olychlorinated biphenyls (PCBs) are ubiquitous environmental pollutants (1, 2). Many PCBs are poorly biodegradable and thus accumulate and are amplified through the food chain (3). Several congeners, including lower chlorinated PCBs, act as tumor promoters (4). Mechanisms involving reactive metabolites have been proposed in the initiating action of PCBs. Lower-chlorinated biphenyls can be metabolized by cytochrome P450 1A1, 1A2, 2B1/2B2, via arene oxides to mono-and dihydroxylated intermediates and further to quinones (5, 6). Quinones are reactive electrophiles, which can readily undergo Michael addition with a multitude of intracellular nucleophiles, such as amino acids, glutathione (GSH), proteins, and nucleic acids. Quinones can also be reduced to highly reactive semiquinone radicals, which in turn, lead to the formation of reactive oxygen species (ROS), causing oxidative stress and toxicity (7).GSH is the major nonprotein sulfhydryl in cells (8). As a nucleophile, it will conjugate with electrophiles both enzymatically and nonenzymatically; conjugation with various xenobiotics and/or their metabolic intermediates typically converts them into less toxic products. These reactions can be complex because of the possible involvement of a variety of free radicals (9, 10). Here, we evaluate the redox properties and mechanisms of the reactions of GSH with PCB quinones. We have discovered that certain chlorinated quinones not only undergo Michael addition reactions with GSH, but also GSH can nonenzymatically displace chlorine on the quinone ring. Results and DiscussionGlutathione can react with quinone rings via Michael addition forming corresponding hydroquinones (11, 12), Q ϩ GSH 3 GS-H 2 Q.[1]These hydroquinon...