Metals in Medicine Flashcards
What are the problems with photofrin?
- Drug purity - exist as a mixture of compounds
- Drug targeting and cytotoxicity - localises in both cancerous and healthy cells, slowing leaves body.
- Light interaction - absorbs strongly in blue region, for PDT blue light has little tissue penetration so red light is more efficient.
there is a limitation to shifting the wavelength of light absorption further into the red.The photosensitiser triplet state drops, and eventually is not sufficient to generate singlet oxygen, range = >600 nm - <900 nm
what is purpurin and why is it being studied in PDT?
Purpurin is a porphyrin derivative found in chlorophyll
It has a strong absorption at 600 nm and long lived triplet excited state so is a good singlet oxygen generator.
When Sn bounds abs shifted by 30 nm so has excellent optical properties.
What are metallotexaphryin and advantages and disadvantages?
extended porphryins that contain longer bridges between heterocyclic rings.
When M is Zn or Cd, these show excellent PS (photosensitiser) properties.
intense abs at 730-770
high triplet state yields
low fluorescence yields.
List the most common elements in the body and elements present in trace amounts.
O,C,N and H are the most common. other elements include Fe, Ca, K, P and Na. Zn and Cu exist in trace amounts for enzymes function.
Describe the does response for any essential element
- survival
- deficiency
- optimal
- toxicity
- lethaility
How can unnatural elements be used in treatment?
As Antagonism. They function biologically as they are recognised by the body as natural metal elements.
what are the attractive properties of metals?
- flexible bond orders and geometries - unique geometries an a number of connectivities
- charged (cationic and anionic) so are water soluble.useful for water soluble metallo - intercalations
- paramagentic/ radioactive - used in imaging and trageted radiotherapy
- redox active
- Lewis acids/ electrophillic so can bind to many e rich sites eg DNA base sites
what is the therapeutically active form of arsenic?
Arsenic oxide
How do arsenoxides help HAT?
HAT is sleeping sickness. Parasite invades CNS and causes exhaustion and torpor and sleep like unconsciousness. Used a masked form of an arsenic that crosses the blood brain barrier. (draw this compound)
how does glutathione protect the cell from oxidative stress?
reacts with reactive oxygen species that cause oxidative stress. GSH + ROOR - GSSG + ROH
how do trypnosomes work?
They carry out the function og glutathione but use tyrponothione antimonal - drugs will interfere with the enzyme that produces antimonal and therefore target the parasite an d not the drug
how do trypnosomes work?
They carry out the function og glutathione but use tyrponothione antimonal - drugs will interfere with the enzyme that produces antimonal and therefore target the parasite and not the drug
how does APL cause cancer?
Genetic mutation that leads to the production of a protein that blocked the expression of the genes involved in the differentiation of white blood cells
how does ATRA/As203 work against APL?
disrupts APL proteins so get differentiation
Arsenic increases ROS conc which leads to apoptosis
how does soft tissue imaging work?
uses radioactive isotope
what is the role of radio pharmaceuticals?
Uses gamma photons in single photon emission computerized tomography. Couples 2D images to make 3D images. Radionucletide provide output and pharmaceutical provides selectivity.
what are the requirements for diagnostic imaging?
Penetrate body - alpha is too ionising and beta does damage.
short half life but live long enough to be detected and synthesised.
Detectable outside the body - needs a camera and have a high emission energy
Should be relatively cheap
what is wrong with Carbon (11)?
It is too expensive as it has to be made in a cyclotron.
what are the benefits of Tc?
has 20 known isotopes but 99mTc is most common as it is:
Readily available through 99Mo/99mTc generator
has a 6 hr half life and displays gamma emission at 140 KeV so an expensive instrument is not required
wide range of oxidation states
How does the Tc generator work?
Mo decays into Tc (Mo from uranium in nuclear fission)
Tc increase charge of nucleus and is less held to the column. Elute column with Nacl and CL ions displace TC ions
what are the problems with Tc?
Concentration is too dilute, so structure can not be inferred by NMR. the other isotope is used for that. HPLC used to infere the structure of Tc(99).
Chemistry is complex due to variable oxidation states and coordination numbers. Each ligand has to be tailored to each ion
The imaging complex needs to be produced in one step.
what are the problems with Tc?
Concentration is too dilute, so structure can not be inferred by NMR. the other isotope is used for that. HPLC used to infere the structure of Tc(99).
Chemistry is complex due to variable oxidation states and coordination numbers. Each ligand has to be tailored to each ion
The imaging complex needs to be produced in one step.
what are the two classifcation of radiopharmaceuticals?
Biological distribution is determined by perfusion or ultimately determined by specific interactions.
what is perfusion?
Passage of fluid through the circulatory or lymphatic system.
there are two way RFC can be if they are biologically distrubuted by specific interaction. what are they?
so RPC can be metal essential - distribution depends on properties of coordination complex
or Metal tagged - properties of carrier molecule determine distribution
what are first generation Tc imaging agents?
They are biologically distributed by blood perfusion and this distribution is due to properties of the coordination complex. METAL ESSENTIAL. they target heart, liver, brain, bone and kidneys.
what are the two criteria for cerebral imaging agents?
must cross the BBB so must be neutral and fairly lipophillic?
how does TcOPnAO form a macrocycle?
It can deprotonate at neutral pH. coordination to metal centre makes it more acidic. Hydrogen bond forms an you get macrocylcle?
what is the benfits andproblem with TcOPnAO?
known to corss BBB and be taken up by the brain but diffuses out the brain too quickly
why does ceretec and neurolite cross the BBB?
They are lipophillic
how important is the stereochem of neurolite in imaging the brain?
V important. If the ester group is pointing down it wont work. wont image brain or even cross BBB
How does neurolite accumulate in the brain?
Esterase present in the brain whcih breaks down ester group in neurolite to an CA, this makes it more hydropillic so it accumulates in the brain
What do Tc cebral images show?
Using single photon emission computerised tomography.
High Tc conc will appear red indicating good blood flow (2D images) and where there is poor blood flow or non at all will appear as holes (3D image)
what are the uses for Tc based spec?
Diagnosing reduced blood flow areas form conditions such as a stroke.
Imagining the locus of epileptic seizures for more precise treatment
facilitating the diagnosis of psychiatric disorders such as schizophrenia.
How is cardolite an improvement to t- butylisonitrile?
the latter was too readily absorbed by liver and clearance. the methoxy groups in Cardolite and hydrolysed which increases hydrophilicity and faster liver clearance.
How does cardiolite and myoview end uo in the heart
At first monocationic Tc complexes used as K+ ions analogues to be used to ATP driven K+ active transport but now thought to passively diffuse and electrostatically bind to mitochondria.
how does Tc-MAG3 image kidney function
the very polar and anionic complex is rapidly transported to the kidnet and cleared from the body through urine. used to test kidney function as it will accumulate in kidney if kidney is not healthy.
What are second generation Tc agents?
All biologically distributed by highly specific interactions. They are designed to bind to ther target with high affinities. Distribution may or may not be dependent on the coordination complex itself.
They are classified according to their receptor site or the biological function they target.
what are the requirements for targeting neuroreceptors ?
these are associated with a number of disorders. to target sites you need a Tc complex that is the right size, charge and lipophilicity and one that has a binding site.
describe the dopamine system?
Dopamine receptor sites called Dopamine transporters (DAT) are found in nuerons involved in dopamine signalling. Dopamine is associated with parkinsons and schizophrenia.
how is the dopamine system imaged?
using neutral 99mTc - TRODAT- 1 which crosse BBB and images dopamine receptors.
this consists of diaminodithiol ligand coordinated to a TcO3+ core
what is hypoxic tissue and what is needed to image it?
Tissue with low oxygent content, hypoxia is associated with heart disease and solid cancer tumours. Cause it has a low ox content it is more reducing that normal tissue so a redox active marker is needed to image hypoxia such as imidazole.
what us wrong with 18F-labelled imidazole imagine agents for hypoxic tissue?
it is too costly
why is Bru - 52 better at imaging hypoxic tissue?
More hydrophillic and shows better targeting
draw the structure of HL 92 and what is the significance of this compound?
it shows better imaging results that imaidazole derivatives.
how are tumors imaged using folic acid?
humans need folic acid for cell division and since cancerous cells are rapidly developing they need more and so overexpress the folate receptor compared to human cells. Attach a folic acid molecule to Tc imaging agent.
how are tumors imaged using folic acid?
humans need folic acid for cell division and since cancerous cells are rapidly developing they need more and so overexpress the folate receptor compared to human cells. Attach a folic acid molecule to Tc imaging agent.
What are MDR
multidrug resistance. MDR tumors can pump out cytotoxic material They overexpress glycoprotein Pgp which is a trans membrane pump. they are active against lipophilic moncationic complexes
what are MDR modulators?
Agents which block the action of PgP
how are MDR cells imaged
monocationic Tc complexes used to image the heart can be used as they are subsrtates for pgp recognition. The peripheral methoxy groups enhance pgp recogniton. this has eld to the develpment of complexes that target MDR cells. They are taken up by MDR cells but will only image in the presencs of a MDR modulator
Can antibodies bind to natural and non natural targets?
Yes only if they have been engineered to.
How are Tc agents bound to antibodies?
By attaching a Tc centre to reduced disulfide linkages. The anitbody is a protein so there are lots of disulphide bridges and this can be reduced so Tc can coordinate.
what are the benefits of using antibodies?
They are v specific and bind to their target with high affinity.
what are blood clots and what feature means that they can be detected?
aggregation of fibrin, platelets and red blood cells. a D- dimer protein is found on the surface of a active clot (express this once clotting starts)