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Updated: Jan 5, 2026

Analytical Techniques for Assaying Nitric Oxide Bioactivity
Published on: June 18, 2012
Nitrite may serve as a combination partner and a biomarker for the anti-cancer activity of RRx-001
Selma Cirrik1, Elif Ugurel2, Ali Cenk Aksu2
1Ordu University, Faculty of Medicine, Department of Physiology, Ordu, Turkey.
Background:
RRx-001 is an anti-cancer immunotherapeutic that increases the sensitivity of drug resistant tumors via multiple mechanisms which involve binding to hemoglobin and enhancing nitrite reductase activity of deoxyhemoglobin.
Objective:
In the present study, the effect of clinically used doses of RRx-001 on erythrocyte deformability was examined.
Methods:
A dose dependent effect of RRx-001 (1-1000 micro molar) on erythrocyte deformability was measured by ektacytometer under hypoxia (n = 8). Low dose RRx-001 (20 micro molar) in the presence of ODQ (1H-[1,2,4]Oxadiazolo[4,3-a]quinoxalin-1-one), L-NAME (L-NG-Nitroarginine methyl ester) or nitrite were examined both in normoxia and hypoxia. Intracellular nitric oxide (NO) levels were measured fluorometrically with DAF-FM-DA.
Results:
Higher doses of RRx-001 (100, 1000 micro molar) significantly decreased erythrocyte deformability under hypoxia (p < 0.01; p < 0.05, respectively). RRx-001 (20 micro molar), alone or in combination with ODQ or L-NAME, did not change deformability. However, RRx-001 and nitrite caused an increase in deformability (p < 0.01) under hypoxia. RRx-001 induced NO production was more pronounced in the presence of nitrite (p < 0.05).
Conclusions:
Co-administration of RRx-001 and nitrite under hypoxic conditions results in a significant increase in erythrocyte deformability that is related to increased NO production. We suggest that measurement of serum nitrite level in RRx-001 treated cancer patients should be routinely undertaken and supplemented if levels are low for maximal activity.
Insights
RRx-001, an anti-cancer immunotherapeutic, can alter red blood cell deformability. Combining RRx-001 with nitrite under hypoxia significantly enhances erythrocyte deformability by increasing nitric oxide production.
Area of Science:
- Oncology
- Immunotherapy
- Hematology
Background:
- RRx-001 is an anti-cancer immunotherapeutic agent.
- It enhances tumor sensitivity to chemotherapy through hemoglobin binding and nitrite reductase activity.
- The study investigates RRx-001's impact on red blood cell (RBC) function.
Purpose of the Study:
- To examine the effect of RRx-001 on erythrocyte deformability at clinically relevant doses.
- To assess the role of nitric oxide (NO) in mediating these effects.
- To explore potential therapeutic strategies involving RRx-001 and nitrite.
Main Methods:
- Erythrocyte deformability was measured using ektacytometry under normoxic and hypoxic conditions.
- RRx-001 was tested at various concentrations (1-1000 micro molar).
- Intracellular NO levels were quantified using DAF-FM-DA, and effects of ODQ and L-NAME were assessed.
Main Results:
- Higher doses of RRx-001 (100, 1000 micro molar) significantly reduced erythrocyte deformability under hypoxia.
- Low-dose RRx-001 (20 micro molar) did not alter deformability alone or with ODQ/L-NAME.
- RRx-001 combined with nitrite significantly increased erythrocyte deformability under hypoxia, correlating with elevated NO production.
Conclusions:
- Co-administration of RRx-001 and nitrite under hypoxia enhances erythrocyte deformability via increased NO production.
- Monitoring and supplementing serum nitrite levels in cancer patients treated with RRx-001 may optimize therapeutic efficacy.
- This suggests a potential adjunctive role for nitrite in RRx-001 cancer immunotherapy.
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