2000-2003 Masters of Science: Graduate Biochemistry and Organic Research at The University of Northern Colorado

Research Advisor: Richard M. Hyslop



Investigations into Synthesis of 6-Thiopurine (6TP) Analogs, Development of HPLC & LC/MS Methods for the Assessment of UDP-Glucose Dehydrogenase (UDPGDH) in vivo & in vitro, and Inhibition Studies of 6-TP and its Metabolites towards UDPGDH.



The research conducted at UNC (Greeley) is threefold:  HPLC & LC/MS Methodologies for UDPGDH Assessment, Synthesis of 6-Thiopurine Analogs and Inhibition Studies of 6-TP and Metabolites toward UDPGDH.

Background:  The drug 6-thiopurine (6TP) is used as a standard treatment for childhood, non-B, acute lymphocytic leukemia (ALL) and non-Hogkins lymphoblastic leukemia, and has been, for the past 50 years (Elion et al., 1952; Burchenal et al., 1953).  The administration of this drug does allow beneficial therapeutic effects, however, several side effects are also associated with its use.

In 1951 Gertrude Elion first synthesized 6TP as part of a program that was initiated by G.H. Hitchings of the Wellcome Research Laboratories.  The goal of the research was to synthesize compounds that were structurally analogous to naturally occurring nucleic acid bases (Elion, 1986).  Upon its synthesis, 6TP was evaluated utilizing the microorganism Lactobacillus casei.  This microorganism requires a source of nitrogen, normally supplied from media containing purines and thymine or folic acid for the nitrogen source (Hitching et al., 1945).  Results of the evaluation showed that 6TP was a potent inhibitor of L. casei growth (Elion, 1953).  Further testing was performed on S-180 Cocker mouse sarcoma systems at the Sloan-Kettering Institute.  Testing showed that 6TP inhibited growth, which was unusual compared to other purine antagonists. 

Clarke et al. (1952) conducted experiments demonstrating that tumor size decreased with the administration of 6TP.  Also, along with decreased tumor size, tumors became non-viable.  Burchenal et al. (1953) confirmed these findings.  Observations in mice tumors specifically showed that 6TP was active.  Burchenal and colleagues also reported that 6TP caused the remission of acute lymphocytic leukemia (ALL) in children.  In 1953, 6TP was approved as an antileukemic agent. 

There are three major routes of metabolism for 6TP, which are thought to be associated with its cytotoxicity.  Firstly, 6TP can be metabolized via several intermediates to 6-thioguanosine-S-mono (di or tri) phosphate.  This compound can then be incorporated into DNA (Elion, 1986).  A second route is the metabolism of 6TP to S-methyl-6-thioinosine-5’-monophosphate (MeTIMP).  MeTIMP has been shown to be a potent inhibitor of purine synthesis (Zhang et al., 1998).  Thirdly, 6TP can be oxidized via cytochrome P450 to purine-6-sulfenic acid.  This compound can bind to proteins that possess a thiol group (SH), which may produce a conformational change in the protein structure.  This change in structure can potentially lead to cell destruction (Hyslop and Jardine, 1981). 

6TP can be degraded metabolically to 6-thiouric acid (6TU) by the enzyme xanthine oxidase.  6TU is far more polar than 6TP and hence more excretable.  Due to its polarity, 6TU is found in urine as a major metabolite of 6TP in humans (Hamiliton and Elion, 1954; 1967) and in animals, such as rats and rabbits (Elion et al., 1954; 1961).  The drugs allopurinal and methotrexate have been demonstrated to inhibit xanthine oxidase (Zimm et al., 1983).  Allopurinal was shown to increase the amount of 6TP available in the body (Zimm et al., 1983), while methotrexate was shown to only marginally increase the amount (Balis et al., 1987).  The conversion of 6TP to 6TU was completely inhibited when allopurinal was administered in conjunction with 6TP (Coffey, 1972).  The use of these inhibitors should allow for a lower dosage of 6TP required, hence decreasing side effects associated with the administration of the drug.  

Toxicity studies of 6TP have shown that side effects are associated with its therapeutic effects against ALL.  Reticulocytopenia, leukopenia, and depletion of cellularity in bone marrow was observed after the administration of 6TP in mice, rats, and dogs (Clarke et al., 1953).  Similar studies have shown that 6TP did in fact allow remission of ALL, but in those cases the patients did exhibit signs of some degree of hepatic toxicity (Burchenal et al., 1953; Gaffney & Cooper, 1954; Frei et al., 1958).  Toxicity of 6TP in humans was observed as side effects including jaundice, hepatic necrosis, anorexia, and diarrhea (Clarke et al., 1953; Philips et al., 1954).  Shorey and colleagues (1968) observed that 5-40% of patients treated with 6TP developed jaundice conditions.  The symptoms of jaundice disappeared once 6TP treatment was terminated (Bach, 1972).  Symptoms reoccurred, at a faster rate than the initial, when treatment was resumed (Einhorn et al., 1964). 

Jaundice, characterized by skin and the white of the eyes turning yellowish in color, is the result of an increased concentration of bilirubin in the blood.  When an erythrocyte is degraded, the heme contained within must be degraded and excreted, a process known as the bilirubin pathway.  Once the heme is released, it is converted to bilirubin; which is a large non-polar molecular.  In order for bilirubin to be excreted, it must be conjugated or made more polar using UDP-glucuronic acid via the microsomal enzyme UDP-glucuronosyl transferase.  Once conjugated, the bilirubin-glucuronic acid complex can be excreted.  UDP-glucuronic acid is produced from UDP-glucose by the enzyme UDP-glucose dehydrogenase (UDPGDH). 

It has been postulated that jaundice is caused by the inhibition of the enzyme UDPGDH when 6TP is administered.  Eliott and Hyslop (1979) reported that both 6TP and 6TU could inhibit UDPGDH, 6TU was observed to be a more potent inhibitor.  Young and Hyslop (1997) reported that both 6TP and 6TU are noncompetitive inhibitors of UDPGH.  In addition, they reported that 6TU inhibits approximately 10 times more potently than 6TP at comparable concentrations. 


HPLC and LC/MS Methodologies for the Assessment of UDP-Glucose Dehydrogenase
 
Previous Work: Two fluorescence procedures have been developed to assay the activity of UDPGDH (Burrows and Cintron, 1983; Singh et al., 1980).  The enzyme incubation was performed identically, following the protocols of Singh et al. for their enzymatic production of UDPGA.  Tissue extracts were incubated at 35 °C for 10 min in 0.1 mL of 5 mM glycine and 20 mM sodium phosphate, pH 8.7, with various concentrations of substrates in a total volume of 3 mL.  Once 10 min elapsed from the addition of UDPGDH, 0.1 mL of 0.1 M Tris-HCl, pH 7.3, containing 20 mM MgCl2, 0.1% Triton X-100, 0.2 mM UDP-Xylose, 0.05 mM 3-hydroxybenzo[a]pyrene, and 0.5 mg/mL guinea pig liver microsomal protein was added to each incubation medium and allowed to incubated for an additional 30 minutes.  Both studies require the derivization of UPDGA, which is performed by 3-hydroxybenzo-[a]pyrene in methanol to yield the corresponding glucuronylbenzo[a]-pyrene.  Unreacted 3-hydroxybenzo[a]pyrene was extracted by the addition of 0.8 mL of 0.4 M NaCl and 6 mL of 2:1 chloroform:methanol.  The aqueous phase was removed and analyzed via fluorometry.  Burrows and Clintron (1983) reported the optimal wavelengths for the derivatived glucuronic acid to be 382 nm and 424 nm for excitation and emission, respectively.  Singh et al. reported optimal wavelengths for the glucuronic acid derivative to be 378 nm and 425 nm for excitation and emission, respectively.  The only difference that might address the excitation wavelength difference is that Burrows and Clintron performed a second chloroform/methanol extraction. 

Gainey and Phelps (1975) performed kinetic studies upon UDPGDH via UV detection.  Enzymatic activity was assessed in a 1 cm cuvette at 31 °C containing 100 μmol glycine-NaOH buffer, pH 8.7, 1 μmol of NAD+, 1 μmol of UDPG and variable amounts of UDPGDH to a final volume of 1 mL.  The cuvette was preincubated at the desired temperature for 2.5 minutes prior to the addition of UPDG, which initiated the reaction.  Kinetics determination was performed by monitoring the change in absorbance at 340 nm, the optimal wavelength for NADH.

Grubb et al. (1993) developed an HPLC method for the separation and detection of UDPGA in 45 minutes.  The method, unlike its predecessors, did not require the derivatization of UDPGA, nor allow for possible purine interferences in monitoring the production of NADH due to is chromatographic separation.  Incubation protocols required the addition of homogenate equivalent to 5x105 cells to be placed in a 2 mL glass vial that contained 0.1 M glycine buffer, pH 8.7, and 1.25 mM NAD+.  The reaction was initiated by the addition of UDPGA to give a final concentration of 250 μM and a final volume of 275 μL.  The vial was capped and vortexed for 10 s and placed in a shaking water bath at 37 °C for 1 hour.  Termination of the reaction was done by heat treatment at 100 °C for 2 min with the vial cap still in place.  A 40 μL aliquot of the incubation sample was injected onto an Alltech Hypersil ODS (4.5 x 150 mm) C-18 analytical column for separation of the substrates and products from the enzymatic reaction.  Chromatographic separation was achieved by gradient elution, which used two mobile phase systems.  System A comprised of 40 mM ammonium phosphate and 5 mM tetrabutyl ammonium dihydrogen sulfate, pH 7.16 and system B was comprised of system A containing 50% acetonitrile (v/v).  Separation of substrates and products was performed with a gradient program at a flow rate of 0.5 mL/min.  Mobile phase composition was 95% system A and 5% system B for the first 25 minutes.  After which system B was increased to 35% over a ten minute period and returned to 5% over ten minutes.  Kinetics were determined based upon the production of UDPGA, eluted at 24 minutes, with monitoring the wavelength 262 nm with a UV detector. 

Higley and Hyslop (1998) performed kinetics studies upon UDPGDH using the method developed by Grubb (1993) with modifications.  System A was comprised of    80 mM ammonium phosphate and 10 mM tetrabutyl ammonium dihydrogen sulfate, pH 7.16.  System B was prepared by adding 500 mL of acetonitrile to 500 mL of system A, thus having this system at 40 mM ammonium phosphate and 5 mM tetrabutyl ammonium dihydrogen sulfate.  Therefore, system B was comprised of 40 and 5 mM for the ammonium phosphate and ion-pairing agent, respectively, which is double the concentration as the protocol outlined by Grubb (1993).  The remaining 500 mL of system A was diluted to 1 liter with nanopure water.  Chromatography was preformed on a Supleco LC-18-DB (4.6 x 150 mm) analytical column rather than an Alltech Hypersil ODS C-18 analytical column, at a flow rate of 1.0 mL/min in comparison to the flow rate of 0.5 mL/min.  An isocratic program, 80% system A and 20% system B, was used to separate analytes.  Detection of UDPGA was done with a UV-detector set at 262 nm.  UDPGA eluted from the column within a range of 5.38 to 5.66 minutes.

Current Work:  The reverse-phase HPLC methodology developed employed a Discovery C18® analytical column, and allowed base line separation of all substrates and products as well as column regeneration within 14 minutes.  In addition to a faster and more enviromentally friendly separation method (mobile phase consisting of imidazole rather than acetonitrile), detection limits were increased by nearly 70% compared to previously developed methodologies. 


LC/MS Methodologies were also investigated and allowed separation of substrates and products with quantification and dection based upon UDPGA fragmentation in negative ESI mode of acquition.  Detection limits were further increased into fmol compared to the rHPLC methodologies also developed.  The only set back in method development was the inability of detecting the UDPGA fragment at in high (umol) and low concentrations (pmol or fmol).  Thus, LC/MS methodology for the assessment of UDPGDH activity based upon UDPGA detection requires two standard curves.  Futher investigation in currently underway to correct this issue.






Enzymatic methodologies for the assessment of UDPGDH activity, utilizing HPLC, have also been development.  The methodologies for assessment are currently being written for publication.  The method development allows a for a 4 minute assay window of UDPGDH activity towards 6TP, it's metabolites and analogs.

Synthesis of 6-Thiopurine Analogs

Current being written up for publication. 


Inhibition Studies of Various 6-TP analogs and Metabolites towards UDP-Glucose Dehydrogenase
 
To assess synthesized analogs of 6TP ability to reduce jaundice onset, a UV spectrophotometric method was developed to determine inhibitor constants for 6TP, its metabilities and analogs.  The method development utlitizies a glycylgylcine medium at UDPGDH's optimium pH to assess activity (specific methodology is currently being written for publication).  It was found that 6-thiouric acid (6TU) inhibits UDPGDH 10 times more potently than 6TP.  6-Thioxanthine (6TX) and 6-thioguanine (6TG) have also been assessed for inhibitor activity towards UDPGDH.  Results are currently being drafted for publication concerning 6TX adn 6TG.  Inhibitor data suggested that position 8 of the purine ring is key to inhibition, whereas position 2 barely effects UDGPDH activity.

















References

Acker, D. S. and Castle, J. E.  (1958).  A Convenient Laboratory Synthesis of Certain 6-Hydroxypurines and 7-Hydroxy-v-trizolo[d]pyrimidines.  J. Org. Chem. 23,  2010-2011.

Albert, A. and Brown, D. J.  (1954).  Purine studies.  Part I.  Stability to acid and alkali.  Solubility.  Ionization.  Comparison with pteridines.  J. Chem. Soc., 2060-2071.

Apffel, A., Chakel, J. A., Fischer, S., Lichtenwalter, K., and Hancock, W. S.  (1997).  New procedure for the use of high-performance liquid chromatography-electrospray ionization mass spectrometry for the analysis of nucleotides and oligonucleotides.  J. Chrom. A., 3-21.

Atkinson, M. R., Morton, R. K., and Murray, A. W.  (1963).  Inhibition of inosine 5′-phosphate dehydrogenase from Ehrlich ascites-tumor cells by 6-thioinosine-5′-phosphate.  Biochem. J. 89, 167-172.

Auriola, S., Frith, J., Rogers, M. J., Koivumiemi, A., and Monkkonen, J.  (1997).  Identification of adenine nucleotide-containing metabolites of bisphosphonate drugs using ion-pair liquid chromatography-electrospray mass spectrometry.  J. Chrom. B, 704, 187-195.

Beaman, A. G.  (1954).  New synthesis of purines.  J. Am. Chem. Soc. 76, 5633-5636.

Beaman, A. G. and Robins, R. K.  (1962).  The synthesis of 6-fluoro-9-methylpurine.  J. Med. Chem. 5, 1067-1074.

Becher, H., and Lohr, G.  (1979).  Inosine 5’phosphate dehydrogenase activity in normal and leukemic blood cells.  Klin. Wochenschr. 57, 1109-1115.

Bennett, L., Brockman, R., Schnebli, H., Chumley, S., Dixon, G., and Schabel, F. (1965).  Activity and mechanism of action of 6-mercaptopurine ribonucleoside in cancer cells resistant to 6-mercaptopurine.  Nature 205, 1276-1279.

Bennett, L. L., and Allen, P. W. (1971).  Formation and significance of 6-methyl-thiopurine ribonucleotide as a metabolite of 6-mercaptopurine.  Cancer Res. 31, 152-158.

Berenbaum, M. C. (1971).  Is azathioprine a better immunosuppressive than 6-mercaptopurine?  Clin. Exp. Immunol.  8, 1-9.

Berk, N.  (1994).  Bilirubin and hyperbilirubinemia.  Seminars in Liver Disease 14 (4), 331-343.

Bieber, S., Dietrich, L. S., Elion, G. B., Hitchings, G. H., and Martin, D. S.  (1961).  The incorporation of 6-mercaptopurine-35S into the nucleic acids of sensitive and nonsensitive transplantable mouse tumor.  Cancer Res. 21, 228-231.

Brett, E. M., Hicks, J. M., Powers, D. M., and Rand, R. N.  (1984).  Delta bilirubin in pediatric patients:  Correlations with age and disease.  Clin. Chem. 30, 1561-1564.

Brodersen, R. (1982).  Physical chemistry of bilirubin:  binding to macromolecules and membranes.  Bilirubin 1, 75-123.

Burchenal, J. H., Murphy, M. L., Ellison, R. R., Sykes, M. P., Tan, T. C., Leone, L. A., Karnofsky, D. A., Craver, L. F., Dargeon, H. W., and Rhoads, C. P.  (1953).  Clinical evaluation of new antimetabolic, 6-mercaptopurine, in treatment of leukemia and allied diseases.  Blood 8, 965-999.

Burrows, R. B. and Cintron, C.  (1983).  A microassay for UDP-Glucose Dehydrogenase.  Anal. Biochem. 130, 376-378.

Calne, R. Y. and Murray, J. E.  (1966).  Inhibition of the rejection of renal homografts in dogs by Burroughs Wellcome 57-322.  Surg. Forum, 12, 118-129.

Campbell, R. E.  (2000).  The Structure and Mechanism of UDP-Glucose Dehydrogenase.  (University of British Columbia)  Unpublished Doctoral Thesis..

Cavalieri, L. F., Blair, V. E., and Brown, G. B.  (1948a).  The synthesis of uric acid containing isotopic nitrogen.  J. Am. Chem. Soc. 70, 1240-1242.

Cavalieri, L. F., Tinker, J. F., and Brown, G. B.  (1948b).  Degradations in the purine series studied with isotopes of nitrogen and carbon.  J. Am. Chem. Soc. 71, 3973-3976.

Chan, G. L., Canafax, D M., and Johnson, C. A.,  (1987).  The therapeutic use of azathioprine in renal transplantation. Pharmacotherapy 7 (5), 165-177.

Chan, L. C., Erdmann, G. R., Gruber, S. A., Stock, P., Chen, S., Ascher, N. L., and

Canafax, D. M.  (1990).  Azathioprine metabolism:  Pharmacokinetics of 6-mercaptopurine, 6-thiouric acid and 6-thioguanine nucleotides in renal transplant patients. J. Clin. Pharmacol.  30, 358-363.


Chalmers, A. H., Knight, P. R., and Atkinson, M. R.  (1969).  Conversion of azathioprine into mercaptopurine and mercaptoimidazole derivatives in vitro and during immunosuppressive therapy.  Aust. J. Exp. Biol Med. Sci. 45, 681-692.


Christie, N., Drake, S., Meyn, R., and Nelson, J.  (1984).  6-Thioguanine-induced DNA damage as a determinant of cytoxicity in cultured Chinese hamster ovary cells.  Cancer Res. 44, 3665-3671.

Clark, P. A., Hsia, Y. E., and Huntsman, R. G.  (1960).  Toxic complications of treatment with 6-mercaptopurine:  Two cases with hepatic necrosis and intestinal ulceration.  Br. Med. J. 1, 393-395.

Clarke, D. A., Philips, F. S., Sternberg, S. S., Stock, C. C., Elion, G. B., and Hitchings, G. H.  (1953).  6-Mercaptopurine:  Effects in mouse Sarcoma 180 and in normal animals.  Cancer Res. 13, 593-605.

Clarke, D. A., Elion, G. B., Hitchings, G. H., and Stock, C. C.  (1958).  Structure-activity relationships among purines related to 6-mercaptopurine.  Cancer Res. 18, 445-456.

Coffey, J. J., White, C. A., Lesk, A. B., Rodgers, W. I., and Serpick, A. A.  (1972).  Effect of allopurinol on the pharmacokinetics of 6-mercaptopurine in cancer patients.  Cancer Res. 32, 1283-1289.

Cook, A. H. and Smith, E.  (1949a).  Studies in the azole series.  Part XX.  Some novel syntheses of purines and thiazolopyrimidines.  J. Chem. Soc., 2329-2333.

Cook, A. H. and Smith, E.  (1949b).  Studies in the azole series.  Part XXIII.  A new synthesis of 6-aminopurines.  J. Chem. Soc., 3001-3007.

Cook, A. H. and Thomas, G. H.  (1950).  Studies in the azole series.  Part XXX.  New syntheses of 2- and 8-aminopurines.  J. Chem. Soc., 1888-1891.

Covey, J., D’Incalci, M., and Kohn, W.  (1986).  Production of DNA-protein crosslinks (DPC) by 6-thioguanine (TG) and 2’-doxy-6-thioguanosine (TGdR) in L1210 cells in vitro.  Proc. Am. Assoc. Cancer Res. 27, 17.

Crawford, J. M., Hauser, S. C., and Gollan, J. L.  (1988).  Formation, hepatic metabolism and transport of bile pigments.  Semin. Liver Dis. 8, 105-118.

De Abreu, R., Lambooy, L., Stet, E., Vogels-Mentink T., and van den Heuvel, L.  (1995).  Thiopurine induced disturbance of DNA methylation in human malignant cells.  Adv. Enzyme Regul. 35, 251-263.

De Abreu, R. A., Bokkerink, J. P. M., Keuzenkamp-Jansen, C. W., Stet, E. H., Trijbels, J. F. M.  (1998).  Thiopurine treatment in Childhood Leukemia.  Purine and Pyrimidine Metabolism in Max IX.  Plenum Press, New York (1998).

Doumas, B. T., Wu, T. W., and Jendrzejczak, B.  (1984).  The reaction of bilirubin firmly bound to protien (γ-bilirubin) with diazo reagent.  Clin. Chem. 30, 971.

Dubinsky, M.C., Lamothe, S., Yang, H. Y., Targan, S. R., Sinnett, D., Theoret, Y., and Seidman, E. G. (2000).  Pharmacogenomics and metabolite measurement for 6-mercaptopurine therapy in inflammatory bowel disease.  Gastroenterology 118, 705-713.

Einhorn, M., and Davidsohn, I.  (1964).  Hepatotoxicity of 6-mercaptopurine.  J. Am. Med. Assoc. 188, 802-806.

Elion, G. B., Burgi, E., and Hitchings, G. H.  (1952).  Studies on condensed pyrimidine systems.  IX.  The synthesis of some 6-substituted purines.  J. Am. Chem. Soc. 74, 411-414.

Elion, G. B., Singer, S., and Hitchings, G. H.  (1953).  The purine metabolism of a 6-mercaptopurine-resistant Lactobacillus casei.  J. Biol. Chem.  204, 35-41.

Elion, G. B., Bieber, S., and Hitchings, G. H.  (1954) The fate of 6-mercaptopurine in mice.  Ann. N. Y. Acad. Sci. 60, 297-303.

Elion, G. B., Mueller, S., and Hitchings, G.H.  (1959).  Studies on condensed pyrimidine systems.  XXI. The isolation and synthesis of 6-mercapto-2,8-purinediol (6-thiouric acid).  J. Am. Chem. Soc. 81, 3042-3045.

Elion, G. B., Callahan, S., Rundles, R. W., and Hitchings, G. H.  (1963).  Relationship between metabolic fates and antitumor activities of thiopurines.  Cancer Res. 23, 1207-1217.

Elion, G. B. (1967).  The biochemistry and pharmacology of purine analogs.  Fed. Proc. 26 (3), 898-904.

Elion, G. B. (1972).  Significance of azathioprine metabolites.  Proc. Roy. Soc. Med.  65, 257-261.

Elion, G.B.  (1986).  Historical background of 6-mercaptopurine.  Toxicology and Industrial Health 2 (2), 1-9.

Elliott, W. L., and Hyslop, R. M.  (1979).  Inhibition of bovine UDP-glucose dehydrogenase by 6-thiopurine in vitro.  ACS National Graduate Student Symposium, Buffalo, New York.
Ellison, R. R., Silver, R. T., and Engle, R. L.  (1959).  Comparative study of 6-chloropurine and 6-mercaptopurine in acute leukemia in adults.  Ann. Intern. Med. 51, 322.

Evans, W. E., Horner, M. H., Chu, Y. Q., Kalwinsky D., and Roberts, W. M.  (1991).  Altered mercaptopurine metabolism, toxic effects, and dosage requirement in a thiopurine methyltransferase deficient child with acute lymphoblastic leukemia.  J. Pediatrics. 119, 985-989.

Farber, S.  (1954).  Summary of experience with 6-mercaptopurine.  Ann. N.Y. Acad. Sci. 60, 412-415.

First, M. R., Alexander, J. W., and Wadhwa, N.  (1986).  The use of low doses of cyclosporin, azathioprine, and prednisone in renal transplantation.  Transplant. Proc. 18 (suppl. 1) 132-135.

Frei, E.  (1958).  A comparative study of two regimens of combination chemotherapy in acute leukemia.  Blood 13, 1126-1147.

Fung, E. N., Cai, Z., Burnete, T. C., and Sinhababu, A. K.  (2001).  Simultaneous determination of Ziagen and its phosphorylated metabolites by ion-pair high-performance liquid chromatography-tandem mass spectrometry.  J. Chrom. B. 754, 285-295.

Gaffney, P. C. and Cooper, W. M. (1954).  Clinical study of 6-mercaptopurine.  Ann. N. Y. Acad. Sci. 60, 478-482.

Gainey, P. A. and Phelps, C. F.  (1975).  Interactions of Uridine Diphosphate Glucose Dehydrogenase with the Inhibitor Uridine Diphosphate Xylose.  Biochem. J. 145, 129-134.

Giverhaug, T., Loennechen, T, and Aarbakke, J.  (1999).  The interactions of 6-mercaptoopurine (6-MP) and methotrexate (MTX).  Gen. Pharm. 33, 341-346.

Gollan, J. L., and Schmid, R. (1985).  Bilirubin metabolism and hyperbilirubinemic disorders.  Liver and Biliary Disease, 2nd ed. London Bailliere-Tindall, 301-357.

Grubb, M. F., Kasofsky, J., and Strong, J.  (1993).  Serum stimulation of UDP-glucose dehydrogenase activity in Swiss 3T3 fibroblasts.  Biochem & Molecular Biology International  30,819-827.

Higley, T. J. and Hyslop, R. M. (1998).  The determination of UDP-glucose dehydrogenase activity in the presence and absence of purine analogs measured by high-performance liquid chromatography.  (University of Northern Colorado)  Unpublished Master's Thesis.
Hitching, G.H., Falco, E. A., and Sherwood, M. B.  (1945).  The effects of pyrimidines on the growth of Lactobacillus casei.  Science 102, 251-252.

Hyslop, R. M., and Jardine, I.  (1978).  Cytochrome P-450 dependent irreversible binding of 6-thiopurine to rat liver microsomal protein in vitro and protection by glutathione.  Res. Commun. Chem. Pathol. Pharmacol. 22 (1), 163-173.

Hyslop, R. M., and Jardine, I.  (1981a).  Metabolism of 6-thiopurine I.  Irreversible binding of a metabolite of 6-thiopurine to mammalian hepatic protein in vitro.  J. Pharmacol. Exp. Ther. 218 (3), 621-628.

Hyslop, R. M., and Jardine, I.  (1981b).  Metabolism of 6-thiopurine II.  Covalent binding of a 6-thiopurine metabolite to mammalian tissue protein in vivo.  J. Pharmacol. Exp. Ther. 218 (3), 629-635.

Kawahata, R. T., Chuang, L. F., Holmberg, C. A., Osburn, B. I., and Chuang, R.  (1983).  Inhibition of Human Lymphoma DNA-dependent RNA Polymerase Activity by 6-Mercaptopurine Ribonucleoside Triphosphate.  Can. Res. 43, 3655-3659.

Keuzenkamp-Jansen, C. W., Bokkerink, J. P. M., and Trijbels, J. M. F.  (1995).  Purine and Pyrimidine Metabolism in Man VIII.  Plenum Press, New York.

Krawitt, E. L., Stein, J. H., Kirkendall, W. M., and Clifton, J. A.  (1967).  Mercaptopurine hepatotoxicity in a patient with chronic active hepatitis.  Arch. Intern. Med. 120, 729-734.

Lennard, L., and Maddocks, J. L.  (1983).  Assay of 6-thioguanine nucleotide, a major metabolite of azathioprine, 6-thiopurine and 6-thioguanine, in human red blood cells.  J. Pharm. Pharmacol. Ther. 41, 18-25.

Lennard, L., Welch, J. C., and Lilleyman, J. S.  (1997).  Thiopurine drugs in the treatment of childhood leukemia: the influence of inherited thiopurine methyltransferase activity on drug metabolism and cytotoxicity.  Br. J. Clin. Pharmacol. 44, 455-461.

LePage, G.A., and Jones, M.  (1961).  Purinethiols as feedback inhibitors of purine synthesis in ascites tumor cells.  Cancer Res. 21, 642-649.

Levin, G., Kalmus, A., and Bergmann, F.  (1960).  Synthesis of 6-thiouric acid and its derivatives.  J. Org. Chem. 25, 1752-1754.

Leyva, A., Holmes, E. W., and Kelley, W. N.  (1976).  Effect of 6-mercaptopurine on inosinic acid dehydrogenase in cultured human fibroblasts.  Biochem. Pharmacol., 527-532.

Lewis, A. F., Beaman, A. G., and Robins, R. K.  (1963).  The preparation and reaction of some simple 2,8 disubstituted purines and related derivatives.  Can. J. Chem.,  41(7), 1808-1812.

Lyons, S. D., and Christopherson, R. I.  (1985).  Regulation of hamster carbomyl-phosphate synthease II by 5-phospho-D-ribosyl-1-diphosphate and uridine 5’-triphosphate.  Eur. J. Biochem. 147, 587-592.

Maddocks, J. L., Lennard, L., Amess, J., Amos, R., and Thomas, M.  (1986).  Azathioprine and severe bone marrow depression.  Lancet 1, 156.

Maeda, M., Nushi, K., and Kawazoe, Y.  (1974).  Studies on Chemical Alterations of Nucleic Acid and their components-VII.  Tetrahedron 30,  2677.

Markowitz, J., Grancher, K., Kohn, n., Lesser, M., and Daum, F. (2000).  A multicenter trial of 6-TP and prednisone in children with newly diagnosed Crohn’s disease.  Gastroenterology 119, 895-902.

McCollister, R. J., Gilbert, W. R., and Wyngaarden, J. B.  (1962).  Pseudofeedback inhibition of purine synthesis by 6-mercaptopurine and other purine analogues.  J. Clin. Invest. 41, 1383.

Molz, R. J., and Danishefsky, I.  (1971).  Uridine diphosphate glucose dehydrogenase of rat tissue.  Biochim. Biophys. Acta 250, 6-13.

Montgomery, J. A.  (1956).  Synthesis of potential anticancer agents.  I. Chloropurines.  J. Am. Chem. Soc. 78, 1928-1930.

Montgomery, J. A., and Hewson, K.  (1959).  Synthesis of potential anticancer agents.  XX. 2-Flouropurines.  J. Am. Chem. Soc. 82, 463-468.

Nathan, H. C., Bieber, S., Elion, G. B., and Hitchings, G. H.  (1961).  Detection of agents which interfere with the immune response.  Proc. Soc. Exp. Biol. 107, 796-803.

Niessen, W. M. A. (1999) Liquid Chromatography-Mass Spectrometry, 2nd Edition.  Marcel Dekker, Inc., New York.

Nelson, J. A., Carpenter, J. W., Rose, L.M., and Adamson, D. J.  (1975).  Mechanism of action of 6-thioguanine, 6-mercaptopurine, and 8-azaguanine.  Cancer Res. 35, 2872-2878.

Noell, W. C., and Robins, R. K.  (1959).  Potential purine antagonists.  XVII. Synthesis of some 2-methyl- and 2-methylthio-6,8-disubstituted purines.  J. Org. Chem. 27, 320-323.

Odell, G. B., Cukier, J. O., and Ostrea, E.M.  (1977)  The influence of fatty acids on the binding of bilirubin to albumin.  J. Lab. Med. 89, 295-307.

Old, C. W., Flannery, E. P., Grogan, T. M., Stone, W. H., and San Antonio, R. P.  (1978).  Azathioprine-induced pure red blood cell aplasia.  J. Am. Med. Assoc.240, 552-554.

Pan, B., and Nelson J.  (1990).  Characterization of the DNA damage in 6-thioguanine-treated cells.  Biochem. Pharmacol. 40,  1063-1069.

Philips, F. S., Sternberg, S. S., Hamilton, L., and Clarke, D. A.  (1954).  The toxic effects of 6-mercaptopurine and related compounds.  Ann. N. Y. Acad. Sci. 60, 283-296.

Piquette, J. and Hyslop, R. M. (2000).  The Preparation of Various 6-Thiopurine Analogs using a modified Traube Synthesis.  (University of Northern Colorado)  Unpublished Master's Thesis.

Potts, K. T.  (1984).  Five membered rings with two or more nitrogen atoms.  Part 4a of Comprehensive Heterocyclic Chemistry, vol. 5 Katritzky, A. R. and Rees, C. W. (eds.).  Pergamon Press.  New York.

Price G., Hoffbrand, V., Taheri, M., and Evans, J.  (1987).  Inosine monophosphate dehydrogenase activity in acute leukemia.  Leukemia Res. 11, 525-528.

Remy, C. N.  (1963).  Metabolism of thiopyrimidines and thiopurines.  J. Biol. Chem. 238, 1078-1084.

Richter, E., Loeffler, J. E., and Taylor, E. C.  (1960).  Studies in purine chemistry.  VIII.  A convenient synthesis of hypoxanthines and adenines.  J. Am. Chem. Soc. 82, 3144-3146.

Rosen, R., Integlia, M. J., and Bousvaros, A.  (2002).  Severe Pancytopenia from thiopurine methyltransferase deficiency: A preventable complication of 6-mercaptopurine therapy in children with Crohn’s disease.  J. Pediatric Gastroenterology and Nutrition 35, 695-699.

Rowland, K., Lennard, L., and Lilleyman, J.S.  (1999).  In vitro metabolism of 6-mercaptopurine by human liver cytosol.  Xenobiotica., 615-628.

Sasaki, H., Tsuri, K., and Nakamura, J. et al.  (1987).  Effect of allopurinol on the first-pass metabolism of 6-mercaptopurine in rat.  Biochem. Pharmacol. 36, 4175-4176.

Scannell, J. P., and Hitchings, G. H.  (1966).  Thioguanine in deoxyribonucleic acid from tumors of 6-mercaptopurine-treated mice.  Proc. Soc. Exp. Biol. Med. 122, 627-629.

Schmiegelow, K. and Bretton-Meyer, U.  (2001).  6-Mercaptopurine dosage and pharmacokinetics influence the degree of bone marrow toxicity following high-dose methotrexate in children with acute lymphoblastic leukemia.  Leukemia 15, 74-79.

Shaw, E.  (1950).  A new synthesis of the purines adenine, hypoxanthine, xanthine, and isoguanine.  J. Biol. Chem. 185, 439-447.

Shaw, G. and Butler, D. N.  (1959).  Purines, pyrimidines, and glyoxalines.  Part XIV.  The preparation and some reactions of α-amino-α-cyanothioacetamide, leading to 6-mercaptopurines and adenines.  J. Chem. Soc., 4040-4045.

Shaw, G., and Wilson, D. V.  (1962).  Purines, pyrimidines, and imidazoles.  Part XVIII.  Synthesis of some 5-aminoimidazole-4-carboxylic acids and 5-amino-1-β-D-ribofuranosylimidazole.  J. Chem. Soc., 2937-2943.

Shorey, J., Schenker, S. Suki, W. N., and Comber, B.  (1968).  Hepatotoxicity of mercaptopurine.  Arch. Intern. Med. 122, 54-58.

Silverstein, R., Bassler, G., and Morrill, T.  (1998).  Spectrometric Identification of Organic Compounds, Sixth Edition.  John Wiley & Sons, Inc., New York.

Singh, J., Schwarz, L. R., and Wiebel, F. J.  (1980).  A rapid enzymic procedure for the determination of picomole amounts of UDP-glucuronic acid.  Biochem. J. 189, 369-372.

Speer, J. H. and Raymond, A. L.  (1953).  Some alkyl homologs of theophylline.  J. Am. Chem. Soc. 75, 114-115.

Spreafico, F., Donelli, M. G., Bossi, A., Vecchi, A., Standen, S., Garattini, S.  (1973).  Immunodepressant activity and 6-mercaptopurine levels after administration of 6-mercaptopurine and azathioprine.  Transplation 16, 269-275.

Szumlanski, C. L., Honchel, R., Scott, M. C., and Weinshilboum.  (1992).  Human liver thiopurine methyltransferase pharmacogenetics: biochemical properties, liver-erythrocyte correlation and presence of isozymes.  Pharmacogenetics 2, 148-159.

Szumlanski, C., Otterness, D., Her, C., Lee, D., Brandiff Kelsell, D., Spurr, N., Lennard, L., Wieben, E., and Weinshilboum, R. M.  (1996).  Thiopurine methyltransferase pharmacogenetics: human gene cloning and characterization of a common genetic polymorphism.  DNA and Cell Biology 15, 17-30.
Temple, C., and Montgomery, J. A. (1966).  Some unusual reactions of 6-chloropurines with thioureas.  6-Alkylthiopurines and 2,2-diamino-2H-thiazolo[3,4,5-gh]purines from 2-(purin-6-yl)-2-thiopseudoureas.  J. Org. Chem. 31, 1417-1422.

Tidd, D. M., and Paterson, A. R. P.  (1974a).  A biochemical mechanism for the delayed cytotoxic reaction of 6-mercaptopurine.  Cancer Res. 34, 738-746.

Tidd, D. M., and Paterson, A. R. P.  (1974b).  Distinction between inhibition of purine nucleotide synthesis and the delayed cytotoxic reaction of 6-mercaptopurine.  Cancer Res. 34, 733-737.

Van den Bergh, A. A. H., and Snapper, J.  (1913).  Die Farbenstoffe des Blutserums, Dtsch. Arch. Klin. Med. 110, 540-541.

Van Scoik, K. G., Johnson, C. A., and Porter, W. R. (1985).  The pharmacology and metabolism of the thiopurine drug 6-mercaptopurine and azathioprine.  Drug Metab. Rev. 16, 157-174.

Walker, R. I., Horvath, W. L., Rule, W. S., Herion, J. C., and Palmer, J. G.  (1973).  The failure of allopurinol to enhance 6-mercaptopurine toxicity in rabbits.  Cancer Res. 33, 755-758.

Weinshilboum, R. M., and Sladek, S. L. (1980).  Mercaptopurine pharmacogenetics: monogenic inheritance of erythrocyte thiopurine methyltransferase activity.  Amer. J. Human Genetics 32, 651-662.

Weinshilboum, R. M.  (1992).  Methylation pharmacogenetics: thiopurine methyltransferase as a model system.  Xenobiotica 22, 1055-1071.

White, A., Handler, P., Smith, E. L., Hill, R. H., and Lehman, I. R.  (1978)  Principles of Biochemistry 6th Edition.  McGraw-Hill, [New York]  p.990.

White, J. C., and Goldman, I. D.  (1976).  Mechanism of action of methotrexate.  Free intracellulare methotrexate required no suppress dihydrofolate reduction to tetrahydrofolate by Erlich ascites tumor cells in vitro.  Mol. Pharmacol. 12, 711-719.

Witters, E., Dongen, W. V., Esmans, E. L., and Van Onckelen, H. A.  (1997).  Ion-pair liquid chromatography-electrospray mass spectrometry for the analysis of cyclic nucleotides.  J. Chrom. B, 694, 55-63.

Yamazaki, A., Kamashiro, I., and Takenishi, T.  (1967).  A simple method for the synthesis of inosine, 2-alkylinosine, and xanthosine from 5-amino-1-β-D-ribofuranosyl-4-imidazole carboxamide.  J. Org. Chem. 32, 3258-3260.

Young, T., and Hyslop, R. M.  (1997)  UDP-glucose dehydrogenase:  Kinetic inhibition by 6-thiopurine and 6-thiouric acid.  Co-Wy Acad. Sci. vol. XXIX p. 25.

Zady, M. F., and Wong, J. L.  (1977).  Kinetics and Mechanism of Carbon-8 Methylation of Purine Bases and Nucleosides by Methyl Radicals.  J. Amer. Chem. Soc.  99, 5096.

Zady, M. F., and Wong, J. L.  (1979).  Regioselective Radical Methylation of Carbon-2 and Carbon-8 of 6 and 3,6-Substituted Purines.  J. Org. Chem. 44, 1450.

Zalitis, J., and Feingold, D. S.  (1968)  The mechanism of action of UDP-glucose dehydrogenase.  Biochem. Biophys. Res. Commun. 31, (5), 693-698.

Zalitis, J., Uram. M., Bowser, A. M., and Feingold, D. S.  (1973).  UDP-Glucose dehydrogenase form beef liver.  Methods Enzymol. XXVIII, 430-435.

Zhang, S., Lyons, S., and Christopherson, R. I.  (1998).  Metabolic effects of thiopurine derivatives against human CCRP-CEM leukaemia cells.  The International J. Biochem. & Cell Biol.  30, 885-895.

Zimm, S., Collins, J. M., O’Neill, D., Chabner, B. A., and Poplack, D. G.  (1983).  Inhibition of first-pass metabolism in cancer chemotherapy: Interaction of 6-mercaptopurine and allopurinol.  Clin. Pharmacol. Ther. 34, 810-817.