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Ogilvie LM, Coyle-Asbil B, Brunt KR, Petrik J, Simpson JA. Therapy-naïve malignancy causes cardiovascular disease: a state-of-the-art cardio-oncology perspective. Am J Physiol Heart Circ Physiol 2024; 326:H1515-H1537. [PMID: 38639740 DOI: 10.1152/ajpheart.00795.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/15/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
Cardiovascular disease (CVD) and cancer are the leading causes of mortality worldwide. Although generally thought of as distinct diseases, the intersectional overlap between CVD and cancer is increasingly evident in both causal and mechanistic relationships. The field of cardio-oncology is largely focused on the cardiotoxic effects of cancer therapies (e.g., chemotherapy, radiation). Furthermore, the cumulative effects of cardiotoxic therapy exposure and the prevalence of CVD risk factors in patients with cancer lead to long-term morbidity and poor quality of life in this patient population, even when patients are cancer-free. Evidence from patients with cancer and animal models demonstrates that the presence of malignancy itself, independent of cardiotoxic therapy exposure or CVD risk factors, negatively impacts cardiac structure and function. As such, the primary focus of this review is the cardiac pathophysiological and molecular features of therapy-naïve cancer. We also summarize the strengths and limitations of preclinical cancer models for cardio-oncology research and discuss therapeutic strategies that have been tested experimentally for the treatment of cancer-induced cardiac atrophy and dysfunction. Finally, we explore an adjacent area of interest, called "reverse cardio-oncology," where the sequelae of heart failure augment cancer progression. Here, we emphasize the cross-disease communication between malignancy and the injured heart and discuss the importance of chronic low-grade inflammation and endocrine factors in the progression of both diseases.
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Affiliation(s)
- Leslie M Ogilvie
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Bridget Coyle-Asbil
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Keith R Brunt
- Department of Pharmacology, Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada
- IMPART Investigator Team Canada, Saint John, New Brunswick, Canada
| | - Jim Petrik
- Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Jeremy A Simpson
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
- IMPART Investigator Team Canada, Saint John, New Brunswick, Canada
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Hammond ST, Baumfalk DR, Parr SK, Butenas AL, Scheuermann BC, Turpin VRG, Behnke BJ, Hashmi MH, Ade CJ. Impaired microvascular reactivity in patients treated with 5-fluorouracil chemotherapy regimens: Potential role of endothelial dysfunction. IJC HEART & VASCULATURE 2023; 49:101300. [PMID: 38173789 PMCID: PMC10761309 DOI: 10.1016/j.ijcha.2023.101300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/27/2023] [Accepted: 11/06/2023] [Indexed: 01/05/2024]
Abstract
Background 5-fluorouracil (5-FU) is the second most common cancer chemotherapy associated with short- and long-term cardiotoxicity. Although the mechanisms mediating these toxicities are not well understood, patients often present with symptoms suggestive of microvascular dysfunction. We tested the hypotheses that patients undergoing cancer treatment with 5-FU based chemotherapy regimens would present with impaired microvascular reactivity and that these findings would be substantiated by decrements in endothelial nitric oxide synthase (eNOS) gene expression in 5-FU treated human coronary artery endothelial cells (HCAEC). Methods We first performed a cross-sectional analysis of 30 patients undergoing 5-FU based chemotherapy treatment for cancer (5-FU) and 32 controls (CON) matched for age, sex, body mass index, and prior health history (excluding cancer). Cutaneous microvascular reactivity was evaluated by laser Doppler flowmetry in response to endothelium-dependent (local skin heating; acetylcholine iontophoresis, ACh) and -independent (sodium nitroprusside iontophoresis, SNP) stimuli. In vitro experiments in HCAEC were completed to assess the effects of 5-FU on eNOS gene expression. Results 5-FU presented with diminished microvascular reactivity following eNOS-dependent local heating compared to CON (P = 0.001). Iontophoresis of the eNOS inhibitor L-NAME failed to alter the heating response in 5-FU (P = 0.95), despite significant reductions in CON (P = 0.03). These findings were corroborated by lower eNOS gene expression in 5-FU treated HCAEC (P < 0.01) compared to control. Peak vasodilation to ACh (P = 0.58) nor SNP (P = 0.39) were different between groups. Conclusions The present findings suggest diminished microvascular function along the eNOS-NO vasodilatory pathway in patients with cancer undergoing treatment with 5-FU-based chemotherapy regimens and thus, may provide insight into the underlying mechanisms of 5-FU cardiotoxicity.
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Affiliation(s)
- Stephen T. Hammond
- Department of Kinesiology, Kansas State University, Manhattan, KS, USA
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Shannon K. Parr
- Department of Kinesiology, Kansas State University, Manhattan, KS, USA
| | - Alec L.E. Butenas
- Department of Kinesiology, Kansas State University, Manhattan, KS, USA
| | | | | | - Bradley J. Behnke
- Department of Kinesiology, Kansas State University, Manhattan, KS, USA
- Johnson Cancer Research Center, Kansas State University, Manhattan, KS, USA
| | | | - Carl J. Ade
- Department of Kinesiology, Kansas State University, Manhattan, KS, USA
- Johnson Cancer Research Center, Kansas State University, Manhattan, KS, USA
- Physicians Associates Studies, Kansas State University, Manhattan, KS, USA
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Uurasmaa TM, Streng T, Alkio M, Karikoski M, Heinonen I, Anttila K. Subcutaneous B16 melanoma impairs intrinsic pressure generation and relaxation of the heart, which are not restored by short-term voluntary exercise in mice. Am J Physiol Heart Circ Physiol 2022; 322:H1044-H1056. [PMID: 35486476 DOI: 10.1152/ajpheart.00586.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to investigate whether subcutaneous melanoma impairs intrinsic cardiac function and hypoxia tolerance in mice. Additionally it was investigated whether these changes could be prevented by voluntary running-wheel exercise. The role of different molecular pathways were also analysed. Male mice (C57Bl/6NCrl) were divided into unexercised tumor-free group, unexercised melanoma group and exercised melanoma group. Experiment lasted 2.7±0.1 weeks (determined by the tumor size) after which the heart function was measured in different oxygen levels ex vivo using Langendorff method. All the melanoma mice had lower pressure amplitude (50.3%), rate of pressure production (54.1%) and decline (52.5%) in hearts ex vivo as compared to tumor-free group. There were no functional differences between the two melanoma groups. All the groups had similar weight change, heart weights, cardiomyocyte sizes, levels of Ca2+-channels, energy metabolism enzyme activities, lipid peroxidation and reactive oxygen species in their cardiac tissue homogenates. However, all the melanoma mice had 7.4% lower superoxidase dismutase activity compared to the control animals, which might reduce the ability of the heart to react to changes in oxidative stress. The exercising melanoma group had 28.6% higher average heart capillary density compared to the unexercised melanoma group. Short-term wheel running did not affect the tumor growth. In conclusion, subcutaneous melanoma seems to impair intrinsic heart function even prior to cachexia and these functional alterations were not caused by any of the measured molecular markers. Short-term voluntary running-wheel exercise was insufficient to alleviate the intrinsic cardiac impairments caused by melanoma.
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Affiliation(s)
- Tytti-Maria Uurasmaa
- Laboratory of Animal Physiology, Department of Biology, University of Turku, Turku, Finland
| | - Tomi Streng
- Laboratory of Animal Physiology, Department of Biology, University of Turku, Turku, Finland
| | - Milla Alkio
- Laboratory of Animal Physiology, Department of Biology, University of Turku, Turku, Finland.,Poznan University of Medical Sciences, Poland
| | - Marika Karikoski
- MediCity Research Laboratory, Faculty of Medicine, University of Turku, Turku, Finland
| | - Ilkka Heinonen
- Turku PET Centre, University of Turku, and Turku University Hospital, Turku, Finland.,Rydberg Laboratory of Applied Sciences, University of Halmstad, Halmstad, Sweden
| | - Katja Anttila
- Laboratory of Animal Physiology, Department of Biology, University of Turku, Turku, Finland
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Dufresne S, Richard C, Dieumegard A, Orfila L, Delpon G, Chiavassa S, Martin B, Rouvière L, Escoffre JM, Oujagir E, Denis de Senneville B, Bouakaz A, Rioux-Leclercq N, Potiron V, Rébillard A. Voluntary Wheel Running Does Not Enhance Radiotherapy Efficiency in a Preclinical Model of Prostate Cancer: The Importance of Physical Activity Modalities? Cancers (Basel) 2021; 13:cancers13215402. [PMID: 34771565 PMCID: PMC8582584 DOI: 10.3390/cancers13215402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022] Open
Abstract
Physical activity is increasingly recognized as a strategy able to improve cancer patient outcome, and its potential to enhance treatment response is promising, despite being unclear. In our study we used a preclinical model of prostate cancer to investigate whether voluntary wheel running (VWR) could improve tumor perfusion and enhance radiotherapy (RT) efficiency. Nude athymic mice were injected with PC-3 cancer cells and either remained inactive or were housed with running wheels. Apparent microbubble transport was enhanced with VWR, which we hypothesized could improve the RT response. When repeating the experiments and adding RT, however, we observed that VWR did not influence RT efficiency. These findings contrasted with previous results and prompted us to evaluate if the lack of effects observed on tumor growth could be attributable to the physical activity modality used. Using PC-3 and PPC-1 xenografts, we randomized mice to either inactive controls, VWR, or treadmill running (TR). In both models, TR (but not VWR) slowed down tumor growth, suggesting that the anti-cancer effects of physical activity are dependent on its modalities. Providing a better understanding of which activity type should be recommended to cancer patients thus appears essential to improve treatment outcomes.
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Affiliation(s)
- Suzanne Dufresne
- Movement, Sport and Health Sciences Laboratory (M2S)-EA7470, University of Rennes, F-35000 Rennes, France; (S.D.); (C.R.); (A.D.); (L.O.); (B.M.)
| | - Cindy Richard
- Movement, Sport and Health Sciences Laboratory (M2S)-EA7470, University of Rennes, F-35000 Rennes, France; (S.D.); (C.R.); (A.D.); (L.O.); (B.M.)
| | - Arthur Dieumegard
- Movement, Sport and Health Sciences Laboratory (M2S)-EA7470, University of Rennes, F-35000 Rennes, France; (S.D.); (C.R.); (A.D.); (L.O.); (B.M.)
| | - Luz Orfila
- Movement, Sport and Health Sciences Laboratory (M2S)-EA7470, University of Rennes, F-35000 Rennes, France; (S.D.); (C.R.); (A.D.); (L.O.); (B.M.)
| | - Gregory Delpon
- Centre René Gauducheau, Institut de Cancérologie de l’Ouest, F-44805 Saint Herblain, France; (G.D.); (S.C.)
| | - Sophie Chiavassa
- Centre René Gauducheau, Institut de Cancérologie de l’Ouest, F-44805 Saint Herblain, France; (G.D.); (S.C.)
| | - Brice Martin
- Movement, Sport and Health Sciences Laboratory (M2S)-EA7470, University of Rennes, F-35000 Rennes, France; (S.D.); (C.R.); (A.D.); (L.O.); (B.M.)
| | - Laurent Rouvière
- IRMAR-UMR CNRS 6625, University of Rennes, F-35000 Rennes, France; (L.R.); (V.P.)
| | - Jean-Michel Escoffre
- UMR 1253, iBrain, INSERM, Université de Tours, F-37032 Tours, France; (J.-M.E.); (E.O.); (A.B.)
| | - Edward Oujagir
- UMR 1253, iBrain, INSERM, Université de Tours, F-37032 Tours, France; (J.-M.E.); (E.O.); (A.B.)
| | | | - Ayache Bouakaz
- UMR 1253, iBrain, INSERM, Université de Tours, F-37032 Tours, France; (J.-M.E.); (E.O.); (A.B.)
| | - Nathalie Rioux-Leclercq
- Department of Pathological Anatomy and Cytology, Université Rennes 1, F-35000 Rennes, France;
| | - Vincent Potiron
- IRMAR-UMR CNRS 6625, University of Rennes, F-35000 Rennes, France; (L.R.); (V.P.)
- LaBCT, CRCINA INSERM U1232, Université de Nantes, Université d’Angers, F-44000 Nantes, France
| | - Amélie Rébillard
- Movement, Sport and Health Sciences Laboratory (M2S)-EA7470, University of Rennes, F-35000 Rennes, France; (S.D.); (C.R.); (A.D.); (L.O.); (B.M.)
- Institut Universitaire de France (IUF), F-75231 Paris, France
- Correspondence: ; Tel.: +33-29-009-1587
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Dufresne S, Guéritat J, Chiavassa S, Noblet C, Assi M, Rioux‐Leclercq N, Rannou‐Bekono F, Lefeuvre‐Orfila L, Paris F, Rébillard A. Exercise training improves radiotherapy efficiency in a murine model of prostate cancer. FASEB J 2020; 34:4984-4996. [DOI: 10.1096/fj.201901728r] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/23/2019] [Accepted: 01/22/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Suzanne Dufresne
- Movement, Sport, and Health Sciences Laboratory EA 1274 Université Rennes 2 ENS Rennes Bruz France
| | - Jordan Guéritat
- Movement, Sport, and Health Sciences Laboratory EA 1274 Université Rennes 2 ENS Rennes Bruz France
| | - Sophie Chiavassa
- CRCINA INSERM Université de Nantes Université d'Angers Nantes France
- Institut de Cancérologie de l'Ouest Centre René Gauducheau Saint Herblain France
| | - Caroline Noblet
- CRCINA INSERM Université de Nantes Université d'Angers Nantes France
- Institut de Cancérologie de l'Ouest Centre René Gauducheau Saint Herblain France
| | - Mohamad Assi
- Movement, Sport, and Health Sciences Laboratory EA 1274 Université Rennes 2 ENS Rennes Bruz France
| | | | - Françoise Rannou‐Bekono
- Movement, Sport, and Health Sciences Laboratory EA 1274 Université Rennes 2 ENS Rennes Bruz France
| | - Luz Lefeuvre‐Orfila
- Movement, Sport, and Health Sciences Laboratory EA 1274 Université Rennes 2 ENS Rennes Bruz France
| | - François Paris
- CRCINA INSERM Université de Nantes Université d'Angers Nantes France
- Institut de Cancérologie de l'Ouest Centre René Gauducheau Saint Herblain France
| | - Amélie Rébillard
- Movement, Sport, and Health Sciences Laboratory EA 1274 Université Rennes 2 ENS Rennes Bruz France
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Patel DI, Wallace D, Abuchowski K, Rivas P, Gallegos A, Musi N, Kumar AP. Nexrutine ® preserves muscle mass similar to exercise in prostate cancer mouse model. Physiol Rep 2019; 7:e14217. [PMID: 31456341 PMCID: PMC6712237 DOI: 10.14814/phy2.14217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 12/31/2022] Open
Abstract
Muscle loss is a debilitating side effect to prostate cancer (PCa) experienced by nearly 60% of men. The purpose of this study was to test the hypothesis that Nexrutine® , a bark extract from the Phellodendrum amurense, can protect against prostate cancer induced muscle loss in a similar manner as exercise, using the transgenic adenocarcinoma of mouse prostate (TRAMP) model. Forty-five, 8- to 10-week old TRAMP mice were randomized to either control, Nexrutine® (600 mg/kg pelleted in chow) or exercise (voluntary wheel running). Mice were serially sacrificed at weeks 4, 8, 12, and 20, at which time either the left or right gastrocnemius muscle was harvested, weighted, and frozen. Proteolysis inducing factor (PIF), ubiquitin, and NF-κB concentrations were quantified using ELISA kits. Nexrutine® and exercise were equally able to protect TRAMP mice against PCa-induced muscle loss (P = 0.04). Both interventions decreased intramuscular PIF concentrations at 20 weeks compared to control (P < 0.05). A treatment effect was also observed when all time points were combined with exercise significantly lowering PIF concentrations (P < 0.01). Exercise significantly lowered intramuscular ubiquitin concentrations in weeks 4, 8, and 20 compared to control mice (P < 0.001). A treatment effect was also observed with exercise significantly lowering ubiquitin compared to control mice (P < 0.001). No significant changes were observed for NF-κB. The results of this investigation demonstrate that PCa-induced muscle loss can be attenuated with the herbal supplement Nexrutine® . This investigation provides preliminary evidence to support continued research into Nexrutine® as a potential exercise analog in protecting against muscle loss.
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Affiliation(s)
- Darpan I. Patel
- School of NursingUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
- Barshop Institute for AgingUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
- Mays Cancer Center at UT Health San AntonioSan AntonioTexas
| | - Derek Wallace
- School of NursingUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Kira Abuchowski
- School of NursingUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Paul Rivas
- Department of Urology, School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Amber Gallegos
- School of NursingUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Nicolas Musi
- Barshop Institute for AgingUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
| | - Addanki Pratap. Kumar
- Mays Cancer Center at UT Health San AntonioSan AntonioTexas
- Department of Urology, School of MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioTexas
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