In vitro photobehavior of tyrosine kinase inhibitors in solution and within skin cells
- Autores: Meryem El Ouardi el Hamidy
- Directores de la Tesis: Miguel Ángel Miranda Alonso (dir. tes.), Inmaculada Andreu Ros (dir. tes.)
- Lectura: En la Universitat Politècnica de València ( España ) en 2024
- Idioma: inglés
- Tribunal Calificador de la Tesis: Julia Pérez Prieto (presid.), Virginie Lhiaubet (secret.), Fabrizio Palumbo (voc.)
- Programa de doctorado: Programa de Doctorado en Química por la Universitat de València (Estudi General) y la Universitat Politècnica de València
- Materias:
- Enlaces
- Tesis en acceso abierto en: RiuNet
- Resumen
In recent decades, the emerge of tyrosine kinase inhibitors (TKIs) as a new class of targeted therapy has substantially enhanced the quality of life and survival rates for cancer patients. However, associated adverse effects, such as dermatological reactions, remain a challenge to sustained therapy. In light of our research group established insights into the photophysical and photobiological aspects of some TKIs, this thesis follows a similar multidisciplinary approach to investigate other photoactive drugs within the TKI family. In the initial stage, four TKIs, gefitinib, axitinib, dasatinib, and avapritinib, were selected based on their ability to absorb in the UVA region of the solar spectrum and their phototoxic potential. Consequently, photophysical and photobiological studies were conducted on these TKIs.
Gefitinib (GFT) is a TKI with a quinazoline moiety, in which modifications resulting from metabolism significantly alter the phototoxicity potential. Dealkylation of the propoxy-morpholine side chain (DMOR-GFT) exhibited the highest photoirritant value (PIF), reaching approximately 48, while the demethylated metabolite (DMT-GFT) displayed much lower phototoxicity (PIF ~7), nearly half the PIF value of the parent drug (ca. 13). In contrast, replacing the fluorine substituent with OH (DF-GFT) resulted in the absence of phototoxic activity. Surprisingly, only DMOR-GFT was confirmed to induce lipid photoperoxidation which occurred through a Type I oxidative mechanism, based on the weak singlet oxygen production and the efficient quenching of the triplet excited state by a lipid model. Furthermore, protein photooxidation was evident for GFT and, to a lesser extent, for DMOR-GFT, but negligible for DMT-GFT. However, unlike the parent drug, DNA photodamage induced by the demethylated metabolite exhibited limited repair even after several hours.
Axitinib (AXT), commercially available as (E)-AXT, showed a tendency for photoisomerization to (Z)-AXT, particularly within proteins. Thus, two phototoxicity mechanisms were unveiled. Firstly, the transformation of the initially non-cytotoxic (E)-AXT into the cytotoxic (Z)-AXT upon radiation. Secondly, the intrinsic phototoxicity exhibited by (Z)-AXT. Moreover, protein photooxidation was unequivocally attributed to the (Z)-isomer due to the similarity in carbonyl content between E/Z-isomers and the high protein affinity of the (Z)-isomer. Finally, the photogenotoxicity was only revealed through the detection of ¿-H2AX histone foci.
Dasatinib (DAS) is a TKI suggested for topical treatment of dermatological diseases. Given this context and having determined a PIF value ca. 5, an evaluation of DAS phototoxicity in reconstructed human epidermis (RhE) was conducted. DAS formulated in an oil-in-water emulsion exhibited high phototoxicity, which was substantially reduced upon incorporating a broad-spectrum sunscreen. DAS, capable to generate both singlet oxygen and radicals, triggered photooxidation in both lipids and proteins. Similarly, DNA photodamage was evidenced through comet assay and H2AX foci detection.
Avapritinib (AVP), a newly approved TKI, was proven to be a phototoxic drug with a PIF value ca. 11, which was highly photooxidative toward proteins and capable to induce DNA photodamage.
All in all, the study of skin toxicity of TKIs in combination with sunlight was achieved through a comprehensive evaluation of their photobehavior both in solution and within skin cells. The aim is to provide healthcare professionals with updated information on photo(geno)toxicity and encourage them to assess and implement photoprotection strategies for patients undergoing TKI-based therapy.
