Chloroacetaldehyde (CAA), one of the main products of ifosfamide (IFO) hepatic metabolism, is considered as responsible of IFO nephrotoxicity. The mechanisms of this nephrotoxicity are not completely known. In the first part of this study, we tried to clarify the pathophysiological mechanisms of CAA toxicity using precision-cut rat renal cortical slices, then, in the second part, we looked for a possible anticancerous effect of CAA on human breast cancer cells (MCF-7). Using clinically-relevant concentrations (0-75 µM), CAA nephrotoxicity was demonstrated by the depletion of ATP and glutathione and by the inhibition of lactate metabolism. Some of the gluconeogenic enzymes, mainly glyceraldehyde 3-phosphate dehydrogenase, were inhibited by CAA. The complex I of the mitochondrial respiratory chain as well as lactate oxidation were also inhibited by CAA. On the other hand, CAA (10 and 25 µM) inhibited MCF-7 cell proliferation which was not accompanied by cellular ATP depletion. Glucose transport and metabolism as well as some of the glycolytic enzymes were also inhibited by CAA. Hexokinase seems to be the rate-limiting enzyme of glycolysis. In conclusion, CAA is implied in the mechanisms of IFO-induced nephrotoxicity; furthermore, it could, via the inhibition of the glycolytic pathway, contribute to the therapeutic effect of IFO.
