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Silva Lde, P., Patah, P.A., Saliba, R.M., Szewczyk, N.A., Gilman, L., Neumann, J., Han, X.Y., Tarrand, J., Ribeiro, R., Gulbis, A., Shpall, E.J., Jones, R., Popat, U., Walker, J.A., Petropoulos, D., Chiattone, A., Stewart, J., El-Zimaity, M. anderlini, P., Giralt, S., Champlin, R.E. and de Lima, M. (2010) Hemorrhagic cystitis after allogeneic hematopoietic stem cell transplants is the complex result of BK virus infection, preparative regimen intensity and donor type. Haematologica, 95, 1183-1190. doi:10.3324/haematol.2009.016758

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• TITLE: Cyclophosphamide induces an early wave of acrolein-independent apoptosis in the urothelium

  AUTHORS: Francis M. Hughes, Alexa G. Corn, Andrew R. Nimmich, Jeffery D. Pratt-Thomas, J. Todd Purves

  KEYWORDS: Cystitis; Cyclophosphamide; Apoptosis; Bladder; Urothelium

  JOURNAL NAME: Advances in Bioscience and Biotechnology, Vol.4 No.8B, August 8, 2013

  ABSTRACT: Hemorrhagic cystitis (HC) affects a significant number of patients undergoing cyclophosphamide (CP) chemotherapy despite treatment with 2-mercaptoethane sulfonate (Mesna) to inactivate the metabolite acrolein. While the mechanism is unknown, there is clearly acrolein-independent damage to the urothelium. In this study we have explored the induction of apoptosis in the urothelium as a marker of damage and the mechanism underlying the acrolein-independent apoptosis. Two waves of apoptosis (measured as caspase-3/7 activity and Poly (ADP-ribosyl) polymerase (PARP) cleavage) were detected following CP administration, one peaking at 2 h and a second at 48 h. The first wave was not blocked by Mesna, indicating it was independent of acrolein. Caspase-1 was also active at 2 h and activation of caspase-3/7 was blocked by a caspase-1 inhibitor, but not an IL-1 receptor antagonist, suggesting the direct activation of caspase-3/7 by caspase-1 without the need for IL-1 as an intermediate. Our results indicate that CP initiates an early, acrolein-independent wave of apoptosis that results from direct cleavage of caspase-3/7 by caspase-1.