Supplementary Table 1. Example of cationic drugs that can be considered triethylamine derivatives. concentration that vacuolizes cells in 4 h or less

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1 Marceau et al., Data Supplement Supplementary Table 1. Example of cationic drugs that can be considered triethylamine derivatives. Cationic drug a logp pk a Threshold concentration that vacuolizes cells in 4 h or less Thresold concentration that causes LC3 II accumulation in cells in 4 h Main clinical use reference triethanolamine mm 1 mm Heavily used H H H H H 2 Morissette et in cosmetics al., 27b ; unpublished Morissette et procainamide mm 2.5 mm Antiarrhythmic al., 24; 28b triethylamine mm Morissette et al., 25 lidocaine mm.5-1 mm Local H anesthetic, etc. Bawolak et al., 21

2 imatinib H ~ µm µm (1 µm for 8 h) Antineoplasic Ertmer et al, 27; Gupta H et al., 21 H H F CH3 chloroquine Cl µm Antimalarial, etc. astemizole µm 5 µm Antihistamine (H1 receptor antagonist) Morissette et al., 28b Morissette et al., 28a quinacrine µm µm Anti-malarial Marceau et al., 29 H CH3 Cl dronedarone µm 2 µm Anti- Piccoli et al., arrhythmic 211 H S

3 I I amiodarone 7.9 ~9 1 µm 5-1 µm (24 h) Antiarrhythmic Morissette et al., 29 ; unpublished a. Most logp values are from The highest value is cited when more than one function is protonable.

4 Supplementary Table 2. Example of cationic drugs that can be considered 2,2-dimethylaminoethanol (DMAE) derivatives. Cationic drug logp Threshold Thresold concentration Main clinical reference concentration that that causes LC3 II use vacuolizes cells in 4 accumulation in cells in h or less 4 h DMAE mm 2.5 nm Used in Morissette et al., cosmetics 27b ; H diphenhydramine µm 2 µm Anti-histamine (H1 receptor unpublished Morissette et al., 28a antagonist) tamoxifen µm (24 h) 5 µm (24 h) Anti-neoplasic unpublished

5 nmol / 75 cm 2 flask nmol / 75-cm 2 flask Supplementary Fig. 1 H H 2 c a b A. Uptake of methoxamine, 2.5 mm (n = 2-5) 1 c 8 b d d a time (h) e f + bafilomycin A1 3 nm + washout at 2 h + bafilo at 2 h e f B. Uptake of methoxamine, 3 min (n = 3) [methoxamine] (mm) C (n = 6) methoxamine 2.5 mm (DMS vehicle) antimycin 1 µm + oligomycin 5 µm (-15 min) bafilomycin A1 3 nm (- 4 h) phenoxybenzamine 5 µm (- 4 h). * Supplementary figure 1. Uptake of the α-adrenoceptor agonist methoxamine by confluent human umbilical artery smooth muscle cells as measured by cell-associated fluorescence (unpublished data obtained with methods identical to those applied to measure procainamide uptake by Morissette et al., 28b). Each experimental point is derived from a confluent 75-cm 2 flask of

6 cells containing 8 ml of culture medium and an estimated 25 µl cell volume. Values are mean ± s.e.m. of the number of replicates indicated by n. A. Time course of drug uptake and drug retention upon washout or bafilomycin A1 (3 nm) addition for a 2.5 mm drug concentration. Photographic insets represent typical cell morphologies for specific treatments and time periods indicated by lower-case letters (phase contrast, original magnification 1 ). B. Effect of drug concentration on uptake during a 3-min period. Calculated apparent K M 5.52 mm, extrapolated V max 229 nmol/3 min. C. Methoxamine uptake (3 min) by confluent human umbilical artery smooth muscle cells analyzed using co-treatments (the metabolic inhibitors or the irreversible α- adrenoceptor antagonist phenoxybenzamine were introduced in the cell culture medium either 15 min or 4 h before the cationic drugs, as indicated). AVA indicated that the experimental groups were significantly heterogeneous (P<1-4 ). Dunnett s test further indicated significantly different values from the uptake values (* P<.1)

7 threshold concentration (µm) Supplementary Fig logp pk a 1 11 Supplementary figure 2. Threshold concentration for drug-induced vacuolization of rabbit aortic smooth muscle cells as a function of logp and pk a for 15 chemicals (1 amiodarone, 2 pimozide, 3 imipramine, 4 chloroquine, 5 haloperidol, 6 diphenhydramine, 7 lidocaine, 8 sotalol, 9 rimantadine, 1 metoclopramine, 11 procaine, 12 amantadine, 13 nicotine, 14 procainamide, 15 triethanolamine). From our original, unpublished observations.

8 nuclear fluorescence intensity Supplementary Fig. 3 MG63 osteoblastoma cells quinacrine 2.5 μm, 4 h + bafilomycin A1 1 nm (- 5 h) green fluorescence phase contrast Supplementary figure 3. Quinacrine redistribution in MG63 human osteoblastoma cells treated with the V-ATPase inhibitor bafilomycin A1. Cells were treated as indicated (original magnification 4 ). The median nuclear fluorescence intensity was determined in manually outlined nuclei using the Photoshop software in multiple fields (number of nuclei indicated on each bar). Values are presented as means ± s.e.m. They differed in the 3 groups (Kruskall-Wallis test, P<.1). Dunn s multiple comparison test further showed that all 3 possible pairs of values differed between them (P<.1), thus that bafilomycin A1 pretreatment increased significantly the nuclear fluorescence associated with quinacrine.

9 Supplementary Fig. 4. Transferrin- Alexa fluor min + procainamide 2.5 mm -2 h + bafilomycin A1 3 nm -2 h Supplementary figure 4. Vacuolization with procainamide or treatment with bafilomycin A1 treatment prevents the endocytosis of fluorophore-labeled transferrin in human umbilical artery smooth muscle cells (unpublished).

10 Supplementary Fig. 5 vehicle (DMS) +bafilomycin A1 1 nm 3% salmeterol xinafoate 1 μm 27% 6% 5 μm 66% some toxicity 25 μm 55% 25 μm 4% salmeterol 25 μm, 4 h phase contrast GFP-rab7 GFP-CD63 GFP-LC3 Supplementary figure 5. Cellular effects of salmeterol. Top: vacuolization of human umbilical artery smooth muscle cells (4 h treatments). Concentrations refer to the drug, percentage numbers indicate the proportion of cells exhibiting vacuolization under each experimental condition. Bottom: Large vacuoles induced by salmeterol in HEK 293a cells are labeled in part by markers for late endosomes/lysosomes and macroautophagy (6 ).

11 tamoxifen 5 µm tamoxifen 1 µm DMAE 2.5 mm bafilomycin A1 1 nm -estradiol 1 µm -estradiol + tamoxifen 5 µm TGF ng/ml rapamycin 1 nm tamoxifen 5 µm count / 35-mm dish relative expression (TGF- 1 / GAPDH).1 mm.25 mm.5 mm 1 mm 2.5 mm.25 µm 1 µm 2.5 µm 5 µm 1 µm bafilomycin A1 1 nm Supplementary Fig. 6 A. B. tamoxifen 24-h treatments, GFP-LC3 vector-transfected phase contrast green fluo (DMS vehicle) LC3 I II β-actin tamoxifen 5 µm PARP DMAE DMAE 2.5 mm LC3 I II β-actin PARP C. HT18 cell proliferation D. ER-α (329 bp) MCF7 HT18 tamoxifen 5 µm, 24 h RT: S. ER-β (475 bp) 1 8 E. 1.5 QPCR (n = 4) ** 22 ** 5 * 12 ** * treatment (last 24 h) treatment (last 48 h)

12 Supplementary figure 6. Response of HT18 (human fibrosarcoma) cells to tamoxifen and DMAE (drug structure in Supplementary table 2). HT-18 cells were maintained in DMEM supplemented with 1% fetal bovine serum, fresh glutamine and antibiotics. A. Vacuolization of cells and vacuolar translocation of GFP-LC3 (original magnification 4 ). B. Processing of endogenous LC3 and cleavage of PARP in cells subjected to the indicated treatments for 24 h. LC3 I is not detected most of the time. β-actin immunoblot was also performed to document equal loading. PARP is a caspase-3 substrate that is cleaved only in response to bafilomycin. C. Effect of drugs on the proliferation of cells. 1, cells were seeded in petri dishes 72 h before counts (drugs present for the last 48 h). AVA, P<.1. Tukey-Kramer s test vs. : * P<.1; ** P<.1. The anti-proliferative effect of tamoxifen is not reversed by estradiol cotreatment. D. RT-PCR for estrogen receptors (ER)-α and β (MCF7 cells are positive s for the latter). HT18 cells are negative for estrogen receptors. ligos used for the ER amplification were: ER-α forward 5 -tgagagctgccaacctttggcc- 3 ; ER-α reverse 5 -gcgccagacgagaccaatcatc-3 ; ER-β forward 5 -cggcagaccacaagcccaaatg-3 ; ER-β reverse 5 -caaggcggtacccacatctctc-3. E. LAMP1 and phospho-mtor in drug-treated cells (24 h). Amine drugs or bafilomycin do not inhibit mtor phosphorylation, unlike starvation or rapamycin treatment, on the contrary. From our original, unpublished observations.