Protection of cells from methotrexate toxicity by 7-hydroxymethotrexate

Cell growth survival studies have revealed that 7-OH methotrexate is two orders of magnitude less cytotoxic to human melanoma and human acute lymphoblastic leukaemia (ALL) cells in vitro than methotrexate. The influence of 7-OH methotrexate on methotrexate toxicity was investigated by studying cell growth in the presence of methotrexate and its 7-OH metabolite and by studying [3H]-methotrexate movement across the plasma membrane of isolated human cells. Transport was followed for net entry of the drug into drug-free cells, net exit of drug into drug-free medium and for unidirectional exit fluxes with drug and/or metabolite in the extracellular medium (exchange exit). Results indicate that 7-OH methotrexate (10(-6) M) interacts with melanoma cells to reduce the initial cellular uptake rate of [3H]-methotrexate but that no such interaction occurs with ALL cells. Efflux measurements revealed that a stimulatory effect of extracellular methotrexate on [3H]-methotrexate exit was apparent and that extracellular 7-OH methotrexate had a less stimulatory effect. Overall, loss of intracellular drug was greater from melanoma cells than from ALL cells. The results suggest that the drug resistance encountered following high dose therapy may be due to reduced cellular uptake and/or increased efflux of methotrexate from cells, both events being enhanced by 7-OH methotrexate. In addition, there is an apparently endogenous resistance of the melanomas to methotrexate as regards time of exposure to this agent which could also contribute to the lack of clinical response when compared to ALL.