Development of water-soluble prodrugs of the bisdioxopiperazine topoisomerase IIβ inhibitor ICRF-193 as potential cardioprotective agents against anthracycline cardiotoxicity

Sci Rep. 2021 Feb 24;11(1):4456. doi: 10.1038/s41598-021-83688-x.

Abstract

The bisdioxopiperazine topoisomerase IIβ inhibitor ICRF-193 has been previously identified as a more potent analog of dexrazoxane (ICRF-187), a drug used in clinical practice against anthracycline cardiotoxicity. However, the poor aqueous solubility of ICRF-193 has precluded its further in vivo development as a cardioprotective agent. To overcome this issue, water-soluble prodrugs of ICRF-193 were prepared, their abilities to release ICRF-193 were investigated using a novel UHPLC-MS/MS assay, and their cytoprotective effects against anthracycline cardiotoxicity were tested in vitro in neonatal ventricular cardiomyocytes (NVCMs). Based on the obtained results, the bis(2-aminoacetoxymethyl)-type prodrug GK-667 was selected for advanced investigations due to its straightforward synthesis, sufficient solubility, low cytotoxicity and favorable ICRF-193 release. Upon administration of GK-667 to NVCMs, the released ICRF-193 penetrated well into the cells, reached sufficient intracellular concentrations and provided effective cytoprotection against anthracycline toxicity. The pharmacokinetics of the prodrug, ICRF-193 and its rings-opened metabolite was estimated in vivo after administration of GK-667 to rabbits. The plasma concentrations of ICRF-193 reached were found to be adequate to achieve cardioprotective effects in vivo. Hence, GK-667 was demonstrated to be a pharmaceutically acceptable prodrug of ICRF-193 and a promising drug candidate for further evaluation as a potential cardioprotectant against chronic anthracycline toxicity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anthracyclines / adverse effects*
  • Cardiotonic Agents / chemistry
  • Cardiotonic Agents / pharmacology*
  • Cardiotoxicity / drug therapy*
  • Cardiotoxicity / metabolism
  • DNA Topoisomerases, Type II / metabolism*
  • Dexrazoxane / chemistry
  • Dexrazoxane / pharmacology
  • Diketopiperazines / chemistry
  • Diketopiperazines / pharmacology*
  • Male
  • Myocytes, Cardiac / drug effects
  • Myocytes, Cardiac / metabolism
  • Piperazine / chemistry
  • Piperazine / pharmacology*
  • Prodrugs / chemistry
  • Prodrugs / pharmacology
  • Rabbits
  • Razoxane / chemistry
  • Razoxane / pharmacology
  • Topoisomerase II Inhibitors / chemistry
  • Topoisomerase II Inhibitors / pharmacology*
  • Water / chemistry

Substances

  • Anthracyclines
  • Cardiotonic Agents
  • Diketopiperazines
  • Prodrugs
  • Topoisomerase II Inhibitors
  • Dexrazoxane
  • Water
  • Piperazine
  • 4,4'-(1,2-dimethyl-1,2-ethanediyl)bis-2,6-piperazinedione
  • Razoxane
  • DNA Topoisomerases, Type II