DISCRIMINATION OF LOCAL ANESTHETIC STEREOISOMERS BY THEIR ENANTIOSPECIFIC
INTERACTIVITIES WITH CHIRAL MEMBRANE LIPIDS
Hironori Tsuchiya
Department of Dental Basic Education, Asahi University School of Dentistry, 1851 Hozumi, Mizuho,
Gifu 501-0296, Japan
Abstract:
Background: Since the pharmacotoxicological properties of drugs significantly differ depending on
their stereostructures, one enantiomer is preferred over its antipode and racemate for decreasing the
adverse effects of drug stereoisomers. While the structure-specific interactions of drugs with
receptors, channels and enzymes are emphasized as the mode of enantioselective action, the
stereospecificity of membrane lipids has not been fully explored. The membrane interactivities of
cardiotoxic stereoisomers were compared to get a novel clue to investigate less toxic drugs.
Methods: Local anesthetic bupivacaine and ropivacaine (S(-)-, racemic and R(+)-, 5-200 µM for each) were reacted
with biomimetic lipid bilayer membranes which were prepared with cardiolipin, different phospholipids and chiral
steroids of varying compositions, followed by measuring fluorescence polarization to determine their comparative
membrane interactivities.
Results: All the tested stereoisomers acted on lipid bilayers to modify the membrane fluidity as one of cardiotoxic
mechanisms. By increasing its membrane composition (0-40 mol%), cholesterol with several chiral centers produced
stereospecific membrane interactions of local anesthetics with the potency of being R(+)-enantiomer > racemate > S(-)-
enantiomer at cardiotoxically-relevant concentrations, which agreed with their relative cardiotoxic effects. 5α-Cholestan-
3β-ol also showed the same membrane interactivity of being R(+)-bupivacaine > racemic bupivacaine > S(-)-
bupivacaine as cholesterol (3β-cholest-5-en-3-ol). On the other hand, 5β-cholestan-3α-ol showed the reversed rank order
of membrane interactivity to be S(-)-bupivacaine > racemic bupivacaine > R(+)-bupivacaine. Neither the membranes
consisting of an equimolar mixture of 5α-cholestan-3β-ol and 5β-cholestan-3α-ol nor the membranes without containing
any chiral steroids could discriminate bupivacaine stereoisomers.
Conclusion: The opposite configurations are likely to allow drug enantiomers to be discriminated by stereospecifically
interacting with chiral lipid molecules in biomembranes. The present results support the clinical use of S(-)-enantiomers
for reducing the cardiotoxicity of local anesthetics and may provide a possible mechanistic index for developing less
toxic drugs.