A Toxicogenomic Approach to Drug-Induced Phospholipidosis: Analysis of Its Induction Mechanism and Establishment of a Novel in Vitro Screening System

Hiroshi Sawada*,1, Kenji Takami{dagger} and Satoru Asahi{ddagger}

* Biomedical Research Laboratories, {dagger} Discovery Research Center, and {ddagger} Development Research Center, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Osaka 532-8686, Japan

Received August 2, 2004; accepted August 8, 2004


    ABSTRACT
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Phospholipidosis is a lipid storage disorder in which excess phospholipids accumulate within cells. Some cationic amphiphilic compounds are known to have the potential to induce phospholipidosis. This study was undertaken to examine the molecular mechanisms that contribute to the development of phospholipidosis and to identify specific markers that might form the basis of an in vitro screening test. Specifically, we performed a large-scale gene expression analysis using DNA microarrays on human hepatoma HepG2 cells after they were treated with each of 12 compounds known to induce phospholipidosis. In electron microscopy, HepG2 cells developed lamellar myelin-like bodies in their lysosomes, the characteristic change of phospholipidosis, after treatment with these compounds for 72 h. DNA microarray analysis performed 6 and 24 h after treatment showed alterations in gene expression reflecting the inhibition of lysosomal phospholipase activity and lysosomal enzyme transport, and the induction of phospholipid and cholesterol biosynthesis. Seventeen genes that showed a similar expression profile following treatment were selected as candidate markers. Real-time PCR analysis confirmed that 12 gene markers showed significant concordance with lamellar myelin-like body formation. Furthermore, the average fold change values of these markers correlated well with the magnitude of this pathological change. In conclusion, microarray analysis revealed that factors such as alterations in lysosomal function and cholesterol metabolism were involved in the induction of phospholipidosis. Furthermore, comprehensive gene expression analysis enabled us to identify biomarkers of this condition that we then used to develop a rapid and sensitive in vitro screening test for drug-induced phospholipidosis.

Key Words: drug-induced phospholipidosis; DNA microarray; real-time PCR; HepG2 cells; toxicogenomics; in vitro screening test.


    INTRODUCTION
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Phospholipidosis is a lipid storage disorder in which phospholipids accumulate in lysosomes. More than 50 cationic amphiphilic drugs (CADs), including antidepressants as well as antianginal, antimalarial, and cholesterol-lowering agents, have been reported to induce phospholipidosis (Lullmann et al., 1978Go; Halliwell, 1997Go, Reasor, 1989Go). While CADs are thought to induce phospholipidosis by inhibiting lysosomal phospholipase activity, the mechanism by which this occurs has not been extensively studied and is not well understood (Hostetler and Matsuzawa, 1981Go; Joshi et al., 1988Go; Reasor and Kacew, 2001Go; Xia et al., 2000Go). Electron microscopy has been the most reliable method for identifying phospholipidotic cell damage (Drenckhahn et al., 1976Go), but because it is a time-consuming and expensive procedure, its use is impractical as a rapid screening tool. It was recently reported that phospholipidotic cell damage could be rapidly assessed in a human monocyte-derived U937 cell line using a Nile red fluorescent stain with a high affinity for lipids (Casartelli et al., 2003Go).

DNA microarray technology enables investigators to monitor and quantify the expression of thousands of genes simultaneously. Use of this technology in combination with conventional tools is rapidly contributing to our understanding of the mechanisms underlying cellular toxicity, and has emerged as the field of "toxicogenomics" (Aardema and MacGregor, 2002Go). DNA microarray technology has the potential to more comprehensively contribute to our understanding of toxicity than any available traditional approach, since toxic changes in cells generally result from alterations not just in a single or few molecules, but in many molecular cascades. It may also help to identify early, sensitive biomarkers of toxicity, since alterations in cellular molecules are thought to precede the toxic outcome. These markers could then be used to develop screening tests to predict the toxicity of particular compounds. In pharmaceutical research, such tests are an invaluable tool for cost-effectively selecting candidate drugs, prioritization and compound modification, especially in the early stages of their development.

The present study was undertaken to examine the molecular mechanisms that contribute to the development of phospholipidosis and to identify specific markers that might form the basis of an in vitro screening test. Specifically, we performed a large-scale gene expression analysis using DNA microarrays on human hepatoma HepG2 cells after they were treated with one of the following 12 compounds known to induce phospholipidosis: amiodarone (Lewis et al., 1990Go; Martin and Standing, 1988Go; Reasor, 1989Go), amitriptyline (Drenckhahn et al., 1976Go), AY-9944 (Sakuragawa et al., 1977Go), chlorcyclizine (Lullmann-Rauch and Stoermer, 1982Go), chlorpromazine (Drenckhahn et al., 1976Go; Lullmann-Rauch, 1974Go), clomipramine (Lullmann-Rauch, 1974Go; Lullmann-Rauch and Scheid, 1975Go; Xia et al., 2000Go), fluoxetine (Gonzalez-Rothi et al., 1995Go), imipramine (Lullmann-Rauch, 1974Go; Lullmann-Rauch and Scheid, 1975Go), perhexiline (Hauw et al., 1980Go; Pessayre et al., 1979Go), tamoxifen (Drenckhahn et al., 1983Go; Lullmann and Lullmann-Rauch, 1981Go), thioridazine (Lullmann-Rauch, 1974Go), and zimelidine (Bockhardt and Lullmann-Rauch, 1980Go). HepG2 cells were used because they are widely accepted as a good model for in vitro toxicology studies. In vitro phospholipidosis was confirmed by electron microscopic observation of lamellar myelin-like bodies in the lysosomes of these cells.


    MATERIALS AND METHODS
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Materials. The following compounds were purchased from the following vendors: amiodarone and clozapine from ICN Biomedicals (Irvine, CA); imipramine, clarithromycin, disopyramide, erythromycin, haloperidol, ketoconazole, quinidine, sertraline, and sulfamethoxazole from Wako Pure Chemicals (Osaka, Japan); amitriptyline, AY-9944, chlorcyclizine, chlorpromazine, clomipramine, fluoxetine, perhexiline, tamoxifen, thioridazine, zimelidine, acetaminophen, flecainide, ofloxacin, and sotalol from Sigma (St. Louis, MO); levofloxacin from Apin Chemicals (Abingdon, U.K.); loratadine and sumatriptan from KEMPROTEC (Middlesbrough, U.K.); pentamidine from Toronto Research Chemicals (North York, Canada), and procainamide from Aldrich Chemical (Milwaukee, WI). All other chemicals and solvents were of the highest grade commercially available.

Cell culture and drug treatment. The human hepatocellular carcinoma cell line (HepG2) was purchased from the American Type Culture Collection (ATCC, Manassas, VA). Cells in their log growth-phase were seeded (2 x 105 cells) in 24-well plates and incubated with 8.3 or 25 µmol/l of a particular compound in 0.25% dimethylsulfoxide (vehicle) in Dulbecco's modified Eagle's medium (DMEM; Gibco BRL, Grand Island, NY) supplemented with 5% heat-inactivated fetal calf serum (FCS; Bio Whittaker, Walkersville, MD), 100 U/ml penicillin, and 100 g/ml streptomycin (Gibco BRL). Cells were incubated in a 37°C incubator in an atmosphere of 5% CO2 and 95% air, and were cultured for 72 h, 6 and 24 h, or 24 h, depending on whether they were being used for electron microscopy, DNA microarray analysis, or real-time PCR, respectively.

Transmission electron microscopy. Following incubation, cells were fixed in 1% glutaraldehyde for 2 h after which they were washed with sodium phosphate buffer and post-fixed with 2% osmium tetroxide for 2 h. They were then dehydrated in increasing concentrations of ethanol and embedded in epoxy resin (Quetol 812). Ultrathin sections (80 nm) were cut using an ultramicrotome (LKB-8800 Ultrotome), double stained with uranyl acetate and lead acetate, and observed in an electron microscope (H-300; Hitachi, Tokyo, Japan). The pathological changes indicative of phospholipidosis (formation of lamellar myelin-like bodies in lysosomes) were scored on a scale of 0 to 3 (– = none, + = slight, ++ = moderate, and +++ = severe) in a blinded fashion.

RNA preparation. Following incubation with a test compound, cells were harvested and stored at –80°C until their RNA was extracted using an RNeasy Mini Kit (QIAGEN, Hilden, Germany). For the microarray analysis, RNA was extracted from similarly treated cells that were harvested from six wells and pooled. The concentration and purity of their total RNA were determined by measuring absorbance at 260 and 280 nm with an Ultrospec 2000 spectrophotometer (Amersham Biosciences, Piscataway, NJ). The integrity of the purified total RNA was confirmed using an RNA 6000 Nano Assay kit and Agilent 2100 Bioanalyzer (Agilent Technologies, Berlin, Germany). RNA samples were stored at –80°C until assayed.

Microarray experiments. Microarray analysis was carried out using the GeneChip System (Affymetrix, Santa Clara, CA). The targets of GeneChip analysis were prepared as described in the Expression Analysis Technical Manual. Briefly, total RNA (5 µg) was converted into double-stranded cDNA using a Super Script Choice cDNA synthesis kit (Invitrogen, Carlsbad, CA) with an oligo(dT)24 primer containing a T7 polymerase promoter site at its 3' end (Amersham Biosciences). Biotin-labeled cRNA was generated from double-stranded cDNA using a BioArray HighYield RNA transcript labeling kit (Enzo Biochem, Farmingdale, NY) and was purified using a GeneChip Sample Cleanup Module (QIAGEN). Each cRNA sample (20 µg) was fragmented and hybridized with the Human Genome Array containing 22283 human specific probe sets (HG-U133A; Affymetrix, Santa Clara, CA) for 16 h at 45°C with rotation at 60 rpm. Each array was then washed and detected by consecutive exposure to phycoerythrin-streptavidin (Molecular Probes, Eugene, OR), biotinylated antibodies to streptavidin (Vector Laboratories, Burlingame, CA), and phycoerythrin-streptavidin, after which each array was washed again with a nonstringent wash buffer. All washing and staining procedures were performed with a Fluidics Station 400 (Affymetrix). The array was scanned using a confocal microscope scanner (Hewlett-Packard). To achieve wider signal dynamic range, each chip was scanned three times: before, after the first, and after the second signal amplification using an anti-streptavidin antibody.

The output fluorescence was captured using Affymetrix Microarray Analysis Suite 5.0 software (Affymetrix). This software qualitatively rates the abundance of mRNA of genes (detection call) as present, marginal, or absent, and can also perform comparative analyses between vehicle and drug treated samples at each time point to provide a change call (increased, decreased, marginally increased, marginally decreased, no change) and to generate a signal log ratio (SLR), i.e., the change in expression level for a transcript. This SLR was expressed as the log 2 ratio. A SLR of 1 is the same as a fold change of 2.

Probe sets that satisfied all of the following three conditions in two or three of the three scan data were extracted as up-regulated probe sets: (1) more than 0.6 in their SLR; (2) assigned as "increased"; and (3) determined as "present in the drug-treated data." Similarly, probe sets that satisfied the following three conditions in two or three of the three scan data were extracted as down-regulated genes: (1) less than –0.6 in their SLR; (2) assigned as "decreased"; and (3) determined as "present in vehicle-treated data."

All probe sets representing genes of interest for this study were functionally annotated by the NetAffx database (Affymetrix) and HumanPSD (Incyte, Beverly, MA).

Reverse transcription and real-time PCR analysis. Reverse transcription (RT) was performed using total RNA (1 µg) and oligo-dT oligonucleotide primer in 100 µl volumes using standard methods with MultiScribe Transcriptase in order to synthesize cDNA (TaqMan Reverse Transcription Reagent; Applied Biosystems).

Primers and TaqMan probes (SigmaGenosys, Hokkaido, Japan) used in this study were designed with Primer Express version 1.5 software (PE Applied Biosystems, Foster City, CA). The mRNA sequences used to design the primer and probe sets were obtained from the Affymetrix database (NetAffx). The TaqMan probes had 6-carboxyfluorescein (6-FAM) as the reporter dye and 6-carboxytetramethylrhodamine (6-TAMRA) as the quencher dye at their 5' and 3' ends, respectively. The primer and TaqMan probe sequences used in this assay are listed in Table 1.


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TABLE 1 List of Candidate Markers for Phospholipidosis and Sequence of Forward Primers, Reverse Primers, and TaqMan Probes for Quantitative Real-Time PCR Analysis

 
Quantitative real-time PCR was performed using 5 µl of the cDNA solution, 1x TaqMan Universal PCR Master Mix, and 200 nM of primer/probe set or 1x TaqMan GAPDH control reagents (PE Applied Biosystems) in an ABI PRISM 7000 Sequence Detection System with the following schedule: 2 min at 50°C and 10 min at 95°C, followed by 40 cycles of denaturation for 15 s at 95°C, and annealing and elongation for 1 min at 60°C in a final volume of 50 µl. Relative gene expression levels were normalized to the expression of the housekeeping gene glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and calculated using the comparative Ct method, described in User Bulletin #2 that was provided with the ABI PRISM 7700 Sequence Detection System. The expression data represent the average values from three replicates in a given experiment.


    RESULTS
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Electron Microscopy
The ability of thirty compounds to induce phospholipidosis in HepG2 cells was evaluated by electron microscopy. Ultrastructural analysis of cells treated with vehicle revealed an extensive endoplasmic reticulum, numerous mitochondria and glycogen granules, and a few small lysosomes with an internal structure that consisted of thin, parallel, concentric lamellae. No lysosomal abnormalities were found in, and only a few lipid droplets were seen in the cytoplasm of, cells that were treated with vehicle or each of 13 of our test compounds (Fig. 1A). However, treatment with 17 compounds, including all of the 12 compounds used in the DNA microarray analysis portion of the study, resulted in an increased number and size of abnormal lysosomes that contained electron-dense deposits and membraneous structures arranged in whorled arrays (myelin figures) suggestive of lysosomal phospholipidosis (Figs. 1B and 1C). The phospholipidotic pathology scores for these compounds are listed in Table 2.



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FIG. 1. Electron micrographs of HepG2 cells that were treated with vehicle (A), 8.3 µmol/l amiodarone (B), or 25 µmol/l amitriptyline (C) for 72 h. Arrows indicate abnormal lysosomes containing electron-dense deposits and membraneous structures arranged in whorled arrays (myelin figures), which are pathological changes that are characteristic of phospholipidosis (panels B, C). Bar = 5 µM.

 

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TABLE 2 List of Compounds and Their Respective Phospholipidotic Pathology Scores

 
Large-Scale DNA Microarray Gene Expression Analysis and Nomination of Candidate Markers for Phospholipidosis
Probe sets that were up- or down-regulated by the 12 test compounds that induced phospholipidosis in HepG2 cells were determined based on the criteria described in Materials and Methods. The number of probe sets that were up- or down-regulated is listed in Table 3.


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TABLE 3 Number of Probe Sets that were Up- or Down-Regulated in HepG2 Cells by 12 Compounds Known to Induce Phospholipidosis, as Determined by DNA Microarray Analysis

 
Probe sets that were up- or down-regulated by more than 6 out of 12 compounds at each time point were identified as phospholipidosis-related genes; these probe sets are listed and categorized in Tables 4 and 5. Major functional categories included lipid metabolism, cell cycle/proliferation/death, transport, proteolysis and peptidolysis, and endopeptidase inhibition. Genes involved in lipid metabolism were particularly numerous and included those that mediated phospholipid degradation, and cholesterol and fatty acid biosynthesis.


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TABLE 4 Category/Function of Up-Regulated Phospholipidosis-Related Genes

 

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TABLE 5 Category/Function of Down-Regulated Phospholipidosis-Related Genes

 
The number of phospholipidosis-related genes was greater in cells that were treated for 24 h, compared to those that were treated for only 6 h. Accordingly, 17 genes from various functional categories were nominated as candidate markers for phospholipidosis from the group of phospholipidosis-related genes that were identifiable after 24 h of treatment (Table 1).

Real-Time PCR Analysis of Candidate Markers for Phospholipidosis and Selection of Phospholipidosis Markers
The relative expression levels of the candidate markers for phospholipidosis are shown in Table 6. The expression of five genes (PHYH; phytanoyl-CoA hydroxylase [Refsum disease], INHBE; activin beta E, P8; p8 protein [candidate of metastasis 1], ASNS; asparagine synthetase, AP1S1; adaptor-related protein complex 1, sigma 1 subunit) did not correspond well to the pathology score of the HepG2 cells. On the other hand, the following 12 genes were selected as phospholipidosis markers: ASAH1—N-acylsphingosine amidohydrolase (acid ceramidase) 1; MGC4171—hypothetical protein MGC4171; LSS—lanosterol synthase (2,3-oxidosqualene-lanosterol cyclase); NR0B2—nuclear receptor subfamily 0, group B, member 2; FABP1—fatty acid binding protein 1, liver; HPN—hepsin (transmembrane protease, serine 1); SERPINA3—serine (or cysteine) proteinase inhibitor; clade A (alpha-1 antiproteinase, antitrypsin), member 3—C10orf10—chromosome 10 open reading frame 10; FLJ10055mdash;hypothetical protein FLJ10055 FRCP1—likely ortholog of mouse fibronectin type III repeat containing protein 1; SLC2A3—solute carrier family 2 (facilitated glucose transporter) member 3; and TAGLN—transgelin.


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TABLE 6 Fold Change Values of Candidate Phospholipidosis Markers in HepG2 Cells Determined by Real-Time PCR and Pathological Analysis

 
Establishment and Validation of an in Vitro Screening System
In order to establish a representative value for phospholipidosis markers, we calculated average fold change values and referred to them as the phospholipidosis mRNA scores. There was a significant correlation between these mRNA scores and the pathological scores obtained from electron microscopic analysis of the HepG2 cells (Fig. 2).



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FIG. 2. Correlation between phospholipidosis mRNA and pathology scores. The data from thirty compounds were sorted in descending order of their pathology scores (– = none, + = slight, ++ = moderate, and +++ = severe) by electron microscopic analysis of HepG2 cells after treatment for 72 h. Each bar represents the average fold change values of phospholipidosis markers as determined by real-time PCR analysis that was carried out in HepG2 cells after 24 h of treatment.

 
In order to validate these mRNA scores, we examined the mRNA and pathology scores twice more on another set of 14 compounds. Three of these compounds that had an mRNA score of <1.5 failed to induce pathology in the HepG2 cells, while the 11 compounds that had a score above 1.5 induced phospholipidotic changes in these cells. These results were highly reproducible (Fig. 3).



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FIG. 3. Reproducibility of phospholipidosis mRNA scores. Fourteen compounds were examined twice to obtain this validation. The graph plots the average fold change values of phospholipidosis markers obtained by real-time PCR analysis in HepG2 cells after 24 h of treatment.

 

    DISCUSSION
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 REFERENCES
 
Ultrastructural analysis revealed lamellar myelin-like bodies in the lysosomes of HepG2 cells after they were treated with 12 compounds that were reported to cause phospholipidosis (Bockhardt and Lullmann-Rauch, 1980Go; Drenckhahn et al., 1976Go, 1983Go; Gonzalez-Rothi et al., 1995Go; Hauw et al., 1980Go; Lewis et al., 1990Go; Lullmann and Lullmann-Rauch, 1981Go; Lullmann-Rauch, 1974Go; Lullmann-Rauch and Scheid, 1975Go; Lullmann-Rauch and Stoermer, 1982Go; Martin and Standing, 1988Go; Pessayre et al., 1979Go; Reasor, 1989Go; Sakuragawa et al., 1977Go; Xia et al., 2000Go). These findings validated the use of these cells as an in vitro study model for the assessment of the phospholipidosis-inducing potential of various compounds.

In this study, we examined the molecular mechanisms that contribute to the development of phospholipidosis and identified specific markers that might form the basis of an in vitro screening test. Specifically, we performed a large-scale gene expression analysis using DNA microarrays on human hepatoma HepG2 cells after they were treated with each of 12 compounds known to induce phospholipidosis. Probe sets that were up- or down-regulated by at least six compounds were identified as phospholipidosis-related genes, a large number of which were genes that played a role in lipid metabolism (Tables 4 and 5). Functional annotation and categorization of these genes suggested that the following four processes were involved in the induction of phospholipidosis (Fig. 4): (1) Inhibition of lysosomal phospholipase activity—this is generally regarded as the primary mechanism of induction, as confirmed by the up-regulation of phospholipid degradation-related genes such as N-acylsphingosine amidohydrolase 1 (ASAH1), sphingomyelin phosphodiesterase (SMPDL3A), and hypothetical protein MGC4171 (MGC4171). (2) Inhibition of lysosomal enzyme transport, as demonstrated by the down-regulation of genes involved in lysosomal enzyme transport such as adaptor-related protein complex 1 sigma 1 subunit (AP1S1). AP1S1 is responsible for the transport of newly synthesized lysosomal enzymes between the trans-golgi network and lysosomes (Zhu et al., 1999Go). (3) Enhanced phospholipid biosynthesis, which is supported by the up-regulation of fatty acid biosynthesis-related genes such as ELOVL family member 6 (ELOVL6) and stearoyl-CoA desaturase (SCD). (4) Enhanced cholesterol biosynthesis, as shown by the up-regulation of cholesterol biosynthesis-related genes such as 3-hydroxy-3-methylglutaryl-Coenzyme A synthase 1 (HMGCS1), 3-hydroxy-3-methylglutaryl-Coenzyme A reductase (HMGCR), squalene epoxidase (SQLE), lanosterol synthase (LSS), and 7-dehydrocholesterol reductase (DHCR7).



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FIG. 4. Hypothetical mechanism of drug-induced phospholipidosis. Our data suggest that the inhibition of lysosomal phospholipase activity and enzyme transport, and promotion of phospholipid and cholesterol biosynthesis are involved in the induction of phospholipidosis. Cell proliferation and intracellular transport may be secondarily inhibited in this condition by increased intracellular phospholipid.

 
Inhibition of lysosomal phospholipase activity and lysosomal enzyme transport, coupled with enhanced phospholipid biosynthesis could directly trigger phospholipidosis. Increased cholesterol biosynthesis is considered to be an indirect trigger for the following two reasons: (1) The accumulation of sphingomyelin occurs concurrently with the increase in cholesterol in visceral tissues (e.g., spleen) in patients with Niemann-Pick type C disease (NPC), which is caused by a genetic defect in the cholesterol trafficking protein NPC1 or, in far fewer patients, the sterol regulating protein HE1 (Blanchette-Mackie, 2000Go; Harzer et al., 2003Go; Vanier, 1983Go). (2) The induction of lamellar myelin-like bodies and the accumulation of free cholesterol occur in cultured mouse macrophages that have been incubated with acetylated low density lipoprotein or acyl-CoA:cholesterol acyltransferase inhibitor (McGookey and Anderson, 1983Go; Robenek and Schmitz, 1988Go). In addition, the up- or down-regulation of transporter genes (e.g., facilitated glucose transporter) and genes that control the cell cycle (e.g., cyclin G2) may also be involved, but modification of the expression of these genes likely reflects secondary changes that occur as a result of an increase in cellular phospholipids.

An important, practical goal of our study was to identify phospholipidosis specific gene markers that could be used for the establishment of an in vitro screening test. Using DNA microarray and real-time PCR analyses, we identified 12 phospholipidosis marker genes. The average fold change values of these gene markers were calculated and termed their phospholipidosis mRNA scores, the latter of which correlated well with the cells' pathological scores. Since these phospholipidosis markers included genes whose functions included phospholipid degradation, cholesterol biosynthesis, fatty acid transport, proteolysis and peptidolysis, and endopeptidase inhibition, among others, by monitoring these 12 marker genes, we were able to also monitor multiple intracellular events that were involved in the induction of phospholipidosis. Our results showed that the mRNA score was a good index of phospholipidosis induction potential for a given compound and as such, we went ahead to establish a novel in vitro real-time PCR screening test.

The in vitro screening test required a far lower amount of the test compound and shorter periods than did conventional in vivo toxicity studies, and was readily able to detect the phospholipidosis induction potential of multiple compounds. The assay also provided a more detailed ranking score than electron microscopy that can be useful in structure-activity relationship studies by sorting compounds in the order of their phospholipidosis induction potential. This rapid and sensitive system should facilitate the efficient screening of new compounds for their potential for inducing phospholipidosis at an early developmental stage. Finally, transferring our PCR-based screening system into a 96- or 384-well microplate-based mRNA measuring format such as Array Plate (High Throughput Genomics, Tucson, AZ) and QuantiGene branched DNA (Bayer Diagnostics, Tarrytown, NY), should improve its throughput and cost-efficiency.

The toxicogenomics approach used in this study should be helpful in the examination of the mode of action and identification of gene markers for other toxic conditions as well. The hope is that in the near future new toxic gene markers will be identified that will allow for the testing of multiple drug toxicities simply by measuring gene expression.

In conclusion, microarray analysis revealed that factors such as alterations in lysosomal function and cholesterol metabolism were involved in the induction of phospholipidosis. Furthermore, comprehensive gene expression analysis enabled us to identify biomarkers of this condition that we then used to develop a rapid and sensitive in vitro screening test for drug-induced phospholipidosis.


    ACKNOWLEDGMENTS
 
We thank Dr. Yoshinobu Yoshimura, Dr. Kenji Okonogi, and Dr. Tetsuo Miwa for encouragement. We are grateful to our toxicogenomics and in vitro toxicology team members for their invaluable suggestions and helpful discussions. We would like to thank Mr. Kazuo Takabe for his excellent technical assistance.


    NOTES
 

1 To whom correspondence should be addressed at Biomedical Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, 2-17-85 Juso-Honmachi Yodogawa-ku, Osaka 532-8686, Japan. Fax: +81-6-6300-6306. E-mail: Sawada_Hiroshi{at}takeda.co.jp


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 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
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