Skip to main content
Japanese Journal of Cancer Research : Gann logoLink to Japanese Journal of Cancer Research : Gann
. 1999 Jul;90(7):765–774. doi: 10.1111/j.1349-7006.1999.tb00813.x

Prevention by Chitosan of Myelotoxicity, Gastrointestinal Toxicity and Immunocompetent Organic Toxicity Induced by 5‐Fluorouracil without Loss of Antitumor Activity in Mice

Yoshiyuki Kimura 1,, Hiromichi Okuda 1
PMCID: PMC5926136  PMID: 10470290

Abstract

We examined the antitumor activity and side effects (myelotoxicity, immunocompetent organic toxicity and gastrointestinal toxicity) of combined treatment with the cancer chemotherapy drug 5‐fluorouracil (5‐FU) and dietary fiber chitosan in sarcoma 180‐bearing mice. 5‐FU (12.5 mg/kg×2/ day) plus chitosan (150, 375 and 750 mg/kg×2/day) inhibited the tumor growth as well as 5‐FU alone. Chitosan (150 and 750 mg/kg×2/day) blocked the reduction of blood leukocyte number caused by 5‐FU administration, and it prevented the injury of the small intestinal mucosa membrane and delayed the onset of diarrhea induced by 5‐FU. Furthermore, chitosan (750 mg/kg×2/ day) prevented the reduction of spleen weight induced by 5‐FU in sarcoma 180‐bearing mice, and the reduction of lymphocyte and CD8+ T cell numbers induced by 5‐FU was also prevented by the oral administration of chitosan (750 mg/kg×2/day) in C57BL/6 mice. Chitosan (150 and/or 750 mg/kg×2/day) reduced the 5‐FU incorporation into RNA fractions of small intestine and spleen without affecting the 5‐FU incorporation into the tumor in sarcoma 180‐bearing mice. These findings suggest that prevention of the 5‐FU side effects by chitosan might be partly due to the selective inhibition of 5‐FU uptake into the small intestine and spleen, resulting in the reduction of immune function toxicity, myelotoxicity and gastrointestinal toxicity of 5‐FU. Therefore, it is concluded that the combination of chitosan and 5‐FU might be useful for the prevention of side effects such as gastrointestinal toxicity, immunotoxicity and myelotoxicity caused by 5‐FU.

Keywords: 5‐Fluorouracil, Chitosan, Antitumor activity, Prevention of side effects

Full Text

The Full Text of this article is available as a PDF (216.8 KB).

REFERENCES

  • 1).Zhou , A. , Matsuura , Y. and Okuda , H.Chitosan augments cytolytic activity of mouse lymphocytes . J. Tradit. Med. , II , 62 – 64 ( 1994. ). [Google Scholar]
  • 2).Kato , H. , Taguchi , T. , Okuda , H. , Kondo , M. and Takara , M.Antihypertensive effect of chitosan in rats and humans . J. Tradit. Med. , 11 , 198 – 205 ( 1994. ). [Google Scholar]
  • 3).Han , L.‐K. , Kimura , Y. and Okuda , H.Reduction in fat storage during chitin‐chitosan treatment in mice fed a high‐fat diet . Int. J. Obes. , 23 , 174 – 179 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 4).Duschinsky , R. , Pleven , E. and Heidelberg , C.The synthesis of 5‐fluoropyrimidines . J. Am. Chem. Soc. , 79 , 4559 – 4560 ( 1957. ). [Google Scholar]
  • 5).Heidelberg , C. and Ansfield , F. J.Experimental and clinical use of fluorinated pyrimidines in cancer chemotherapy . Cancer Res. , 23 , 1226 – 1243 ( 1963. ). [PubMed] [Google Scholar]
  • 6).Seifert , P. , Baker , H. L. and Reed , M. L.Comparison of continuously infused 5‐fluorouracil with bolus injection in treatment of patients with colorectal adenocarcinoma . Cancer , 36 , 123 – 128 ( 1975. ). [DOI] [PubMed] [Google Scholar]
  • 7).Shah , A. , MacDonald , W. , Goldie , J. , Gudauskas , G. and Brisebois , B.5‐FU infusion in advanced colorectal cancer: comparison of three dose schedules . Cancer Treat. Rep. , 69 , 739 – 742 ( 1985. ). [PubMed] [Google Scholar]
  • 8).Caballero , G. A. , Ausma , R. K. and Quebbema , E. J.Long‐term, ambulatory, continuous infusion of 5‐FU for the treatment of advanced adenocarcinomas . Cancer Treat. Rep. , 69 , 13 – 15 ( 1985. ). [PubMed] [Google Scholar]
  • 9).Houghton , J. A. , Houghton , P. J. and Wooten , R. S.Mechanism of induction of gastrointestinal toxicity in the mouse by 5‐fluorouracil, 5‐fluorouridine and 5‐fluoro‐2′‐deoxyuridine . Cancer Res. , 39 , 2406 – 2413 ( 1979. ). [PubMed] [Google Scholar]
  • 10).Schetz , J. D. , Wallance , H. J. and Diasio , R. B.5‐Fluoro‐uracil incorporation into DNA of CF‐1 mouse bone marrow cells as a possible mechanism of toxicity . Cancer Res. , 44 , 1358 – 1363 ( 1984. ). [PubMed] [Google Scholar]
  • 11).Kimura , Y. , Okuda , H. and Arichi , H.Effects of geniposide isolated from Gardenia jasminoides on metabolic alterations in high sugar diet‐fed rats . Chem. Pharm. Bull. , 30 , 4444 – 4447 ( 1982. ). [DOI] [PubMed] [Google Scholar]
  • 12).Kimura , Y. , Okuda , H. and Arichi , S.Effects of non‐sugar fraction in black sugar on lipid and carbohydrate metabolism; part I . Planta Med. , 50 , 465 – 468 ( 1984. ). [DOI] [PubMed] [Google Scholar]
  • 13).Schneider , W. C.Phosphorus compounds in animal tissues. III. Comparison of methods for the estimation of nucleic acid . J. Biol. Chem. , 164 , 747 – 751 ( 1946. ). [PubMed] [Google Scholar]
  • 14).Ikenaka , K. , Shirasaka , T. , Kitano , S. and Fujii , S.Effects of uracil on metabolism of 5‐fluorouracil in vitro . Jpn. J. Cancer Res. , 70 , 353 – 359 ( 1979. ). [PubMed] [Google Scholar]
  • 15).Ninomiya , Y. , Ryu , M. , Matsuura , N. , Fujimoto , K. , Miwa , M. and Ishitsuka , H.Antitumor activity and the toxicity on the immune system and the intestine of fluorinated pyrimidines, FUra, 5′‐DFUR, Tegafur and UFT . Jpn. J. Cancer Chemother. , 15 , 1747 – 1754 ( 1988. ). [PubMed] [Google Scholar]
  • 16).Kouchi , Y. , Maeda , Y. , Morinaga , H. and Ohuchida , A.Immunotoxic effects of a new antineoplastic agent S‐1 in mice. Comparison with S‐1, UFT and 5‐FU . J. Toxicol. Sci. , 21 , 691 – 701 ( 1996. ). [DOI] [PubMed] [Google Scholar]
  • 17).Inoue , T. , Anderson , T. D. , Hayes , T. J. and Horii , T.Comparative immunotoxicity assessment of N4‐trimethoxyben‐zoyl‐5′‐deoxy‐5‐fluorouridine (5′‐DFUR) in BDF1 mice . J. Toxicol. Sci. , 21 , 29 – 39 ( 1996. ). [DOI] [PubMed] [Google Scholar]
  • 18).Boistea , V. , Jern , I. and Lupasco , V.The characteristics of the pathogenesis and immunomodulator treatment in the postoperative period in pseudophakia patients , Ophthalmologia , 40 , 210 – 213 ( 1996. ). [PubMed] [Google Scholar]
  • 19).Ophir , R. M. , Pecht , M. , Keisari , Y. , Rashid , G. , Lourie , S. , Meshore , A. , Ben‐Efraim , S. , Trainin , N. and Burstem , Y.Thymic humoral factor‐γ 2 (THF‐γ 2) immunotherapy reduces the metastatic load and restores immunocompetence in 3LL tumor‐bearing mice receiving anticancer chemotherapy . Immunopharmacol. Immunotoxicol. , 18 , 209 – 236 ( 1996. ). [DOI] [PubMed] [Google Scholar]
  • 20).Fujii , S. , Ikenaka , K. , Fukushima , M. and Shirasaka , T.Effect of uracil and its derivatives on antitumor activity of 5‐fluorouracil and 1‐(2‐tetrahydrofuryl)‐5‐fluorouracil . Gann , 69 , 763 – 772 ( 1978. ). [PubMed] [Google Scholar]
  • 21).Ishitsuka , H. , Miwa , M. , Takemoto , K. , Fukuoka , K. , Itoga , A. and Maruyama , H. B.Role of uridine phosphorylase for antitumor activity of 5′‐deoxy‐5‐fluorouridine . Gann , 71 , 112 – 123 ( 1980. ). [PubMed] [Google Scholar]
  • 22).Fujii , S. , Fukushima , M. , Shimamoto , Y. , Ohshimo , H. , Imaoka , T. and Shirasaka , T.Antitumor activity of BOF‐A2, a new 5‐fluorouracil derivative . Jpn. J. Cancer Res. , 80 , 173 – 181 ( 1989. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23).Shirasaka , T. , Fukushima , M. , Shimamoto , Y. , Kimura , Y. , Ohshimo , H. , Imaoka , T. , Kimura , A. , Utsunomiya , T. and Fujii , S.Metabolic characteristics and antitumor activity of BOF‐A2, a new 5‐fluorouracil derivative . Jpn. J. Cancer Chemother. , 17 , 1051 – 1058 ( 1990. ). [PubMed] [Google Scholar]
  • 24).Ardalam , B. , Luis , R. , Jaime , M. and Franceschi , D.Bio‐modulation of fluorouracil in colorectal cancer . Cancer Invest. , 16 , 237 – 251 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 25).Kohne , C. H. , Harstrick , A. , Hiddemann , W. , Schoffski , P. , Wilke , H. , Bokemeyer , C. , Dorken , B. and Schmoll , H. J.Modulation of 5‐fluorouracil with methotrexate and low‐dose N‐(phosphonacetyl)‐L‐aspartate in patients with advanced colorectal cancer. Results of a phase II study . Eur. J. Cancer , 33 , 1896 – 1899 ( 1997. ). [DOI] [PubMed] [Google Scholar]
  • 26).Hartmann , J. T. , Kohne , G. H. , Schmoll , H. J. , Daikeler , T. , Kanz , L. and Bokemeyer , C.Is continuous 24‐hour infusion of 5‐fluorouracil plus high‐dose folinic acid effective in patients with progressive or recurrent colorectal cancer? A phase II study . Oncology , 55 , 320 – 325 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 27).Rustum , Y. M. , Cao , S. and Zhang , Z.Rationale for treatment design: biochemical modulation of 5‐fluorouracil by leucovorin . Cancer J. Sci. Am. , 4 , 12 – 18 ( 1998. ). [PubMed] [Google Scholar]
  • 28).Gamelin , E. , Boisdrom‐Celle , P. E. , Delva , R. , Regimbeau , C. , Cailleux , P. E. , Alleaume , C. , Maillet , M. L. , Goudier , M. J. , Sire , M. , Person‐Joly , M. C. , Maigre , M. , Maillart , P. , Fety , R. , Burtin , P. , Lortholary , A. , Dumensnil , Y. , Picon , L. , Geslin , J. , Gesta , P. , Danquechin‐Dorval , E. , Larra , F. and Robert , J.Long‐term weekly treatment of colorectal metastatic cancer with fluorouracil and leucovorin: results of a multicentric prospective trial of fluorouracil dosage optimization by pharmacokinetic monitoring in 152 patients . J. Clin. Oncol. , 16 , 1470 – 1478 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 29).Scanlon , K. J. , Newman , E. M. and Priest , D. G.Biochemical basis for cisplatin and 5‐fluorouracil synergism in human ovarian carcinoma cells . Proc. Natl. Acad. Sci. USA , 83 , 8923 – 8925 ( 1986. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 30).Shirasaka , T. , Shimamoto , Y. , Ohshimo , H. , Saito , H. and Fukushima , M.Metabolic basis of the synergistic antitumor activities of 5‐fluorouracil and cisplatin in rodent tumor model in vivo . Cancer Chemother. Pharmacol. , 32 , 167 – 172 ( 1993. ). [DOI] [PubMed] [Google Scholar]
  • 31).DeBraud , F. , Munzone , E. , Nole , F. , De‐Pas , T. , Biffi , R. , Brienza , S. and Aapro , M. S.Synergistic activity of oxalipatin and 5‐fluorouracil in patients with metastatic colorectal cancer with progressive diseases while on or after 5‐fluorouracil . Am. J. Clin. Oncol. , 21 , 279 – 283 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 32).Clevas , A. D. , Busse , P. M. , Norris , C. M. , Fried , M. , Tishler , R. B. , Poulin , M. , Fabian , R. L. , Fitzgerald , T. J. , Dreyfuss , A. , Peters , E. S. , Adak , S. , Costello , R. , Barton , J. J. and Ponsner , M. R.Induction chemotherapy with docetaxel, cisplatin, fluorouracil, and leucovorin for squamous cell carcinoma of the head and neck: a phase I/II trial . J. Clin. Oncol. , 16 , 1331 – 1339 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 33).Barone , C. , Corsi , D. C. , Pozzo , C. , Cassano , A. , Fontana , T. , Noviello , M. R. , Landriscina , M. , Colloca , G. and Astone , A.Treatment of patients with advanced gastric carcinoma with a 5‐fluorouracil‐based or a cisplatin‐based regimen: two parallel randomized phase II studies . Cancer , 82 , 1460 – 1467 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 34).Meropol , N. J. , Blumenson , L. E. and Creaven , P. J.Octreotide does not prevent diarrhea in patients treated with weekly 5‐fluorouracil plus high‐dose leucovorin . Am. J. Clin. Oncol. , 21 , 135 – 138 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 35).Shirasaka , T. , Shimamoto , Y. and Fukushima , M.Inhibition by oxonic acid of gastrointestinal toxicity of 5‐fluorouracil without loss of its antitumor activity in rats . Cancer Res. , 53 , 4004 – 4009 ( 1993. ). [PubMed] [Google Scholar]
  • 36).Sato , M. , Onishi , H. , Takahara , J. , Machida , Y. and Nagai , T.In vivo drug release and antitumor characteristics of water‐soluble conjugates of mitomycin C with glycol‐chitosan and N‐succinyl‐chitosan . Biol. Pharm. Bull. , 19 , 1170 – 1177 ( 1996. ). [DOI] [PubMed] [Google Scholar]
  • 37).Fujii , S. , Shimamoto , Y. , Ohshimo , H. , Imaoka , T. , Motoyama , M. , Fukushima , M. and Shirasaka , T.Effects of the plasma concentration of 5‐fluorouracil and the duration of continuous venous infusion of 5‐fluorouracil with an inhibitor of 5‐fluorouracil degradation on Yoshida sarcomas in rats . Jpn. J. Cancer Res. , 80 , 167 – 172 ( 1989. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38).Caballero , G. A. , Ausman , R. K. and Quebbeman , E. J.Long‐term, ambulatory, continuous iv infusion of 5‐FU for the treatment of advanced adenocarcinomas . Cancer Treat. Rep. , 69 , 13 – 15 ( 1985. ). [PubMed] [Google Scholar]
  • 39).Schipper , N. G. , Varum , K. M. and Artursson , P.Chitosans as absorption enhancers for poorly absorbable drugs. 1: Influence of molecular weight and degree of acetylation on drug transport across human intestinal epithelial (Caco‐2) cells . Pharm. Res. , 13 , 1686 – 1692 ( 1996. ). [DOI] [PubMed] [Google Scholar]
  • 40).Schipper , N. G. , Olsson , S. , Hoogstraate , J. A. , deBoer , A. G. , Varum , K. M. and Artursson , P.Chitosans as absorption enhancers for poorly absorbable drugs 2: mechanism of absorption enhancement . Pharm. Res. , 14 , 923 – 929 ( 1997. ). [DOI] [PubMed] [Google Scholar]
  • 41).Tozaki , H. , Komoike , J. , Tada , C. , Maruyama , T. , ter abe , A. , Suzuki , T. , Yamamoto , A. and Muranishi , S.Chitosan capsules for colon‐specific drug delivery: improvement of insulin absorption from the rat colon . J. Pharm. Sci. , 86 , 1016 – 1021 ( 1997. ). [DOI] [PubMed] [Google Scholar]
  • 42).Miekka , S. I. , Jameson , T. , Singh , M. , Woolverton , C. , Lin , H. M. , Krajcik , R. , MacPhee , M. and Drohan , W. N.Novel delivery systems for coagulation proteins . Haemophilia , 4 , 436 – 442 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 43).Sugimoto , K. , Yoshida , M. , Yata , T. , Higaki , K. and Kimura , T.Evaluation of poly(vinyl alcohol)‐gel spheres containing chitosan as dosage form to control gastrointestinal transit time of drugs . Biol. Pharm. Bull. , 21 , 1202 – 1206 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 44).Singh , U. V. and Udupa , N.Methotrexate loaded chitosan and chitin microspheres‐ in vitro characterization and pharmacokinetics in mice bearing Ehrlich ascites carcinoma . J. Microencapsul. , 15 , 581 – 594 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 45).Al‐Helw , A. A. , Al‐Angary , A. A. , Mahrous , G. M. and Al‐Dardari , M. M.Preparation and evaluation of sustained release cross‐linked chitosan microspheres containing phenobarbitone . J. Microencapsul. , 15 , 373 – 382 ( 1998. ). [DOI] [PubMed] [Google Scholar]
  • 46).Lim , B. O. , Yamada , K. , Nonaka , M. , Kuramoto , Y. , Hung , P. and Sugano , M.Dietary fibers modulate indices of intestinal immune function in rats . J. Nutr. , 27 , 663 – 667 ( 1997. ). [DOI] [PubMed] [Google Scholar]
  • 47).Shibata , Y. , Foster , L. A. , Metzger , W. J. and Myrvik , Q. N.Alveolar macrophages priming by intravenous administration of chitin particles, polymers of N‐acetyl‐D‐glucosamine, in mice . Infect. Immun. , 65 , 1734 – 1741 ( 1997. ). [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Japanese Journal of Cancer Research : Gann are provided here courtesy of Wiley

RESOURCES