1
|
Lin X, Ma X, Zhao S, Yao J, Han L, Jing Y, Xue X. Cardiovascular toxicity in antitumor therapy: biological and therapeutic insights. Trends Cancer 2024:S2405-8033(24)00144-4. [PMID: 39097431 DOI: 10.1016/j.trecan.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/28/2024] [Accepted: 07/12/2024] [Indexed: 08/05/2024]
Abstract
The evolution of antitumor therapies has significantly improved cancer prognosis but has concurrently resulted in cardiovascular toxicities. Understanding the biological mechanisms behind these toxicities is crucial for effective management. Immunotherapy-related cardiovascular toxicities are primarily mediated by immune cells and secreted cytokines. Chemotherapy may cause cardiovascular damage through autophagy disruption and mitochondrial dysfunction. Targeted therapies can induce toxicity through endothelin-1 (ET-1) production and cardiac signaling disruption. Radiotherapy may lead to cardiomyopathy and myocardial fibrosis by affecting endothelial cells, triggering inflammatory responses and accelerating atherosclerosis. This review provides insights into these mechanisms and strategies, aiming to enhance the clinical prevention and treatment of cardiovascular toxicities.
Collapse
Affiliation(s)
- Xuwen Lin
- Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Xidong Ma
- Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Sheng Zhao
- Department of Cardiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Yao
- Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Leng Han
- Brown Center for Immunotherapy, School of Medicine, Indiana University, Indianapolis, IN 46202, USA; Department of Biostatistics and Health Data Science, School of Medicine, Indiana University, Indianapolis, IN 46202, USA.
| | - Ying Jing
- Center for Intelligent Medicine Research, Greater Bay Area Institute of Precision Medicine (Guangzhou), School of Life Sciences, Fudan University, Guangzhou, China.
| | - Xinying Xue
- Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China; Department of Respiratory and Critical Care, Shandong Second Medical University, Weifang, China.
| |
Collapse
|
2
|
Iborra M, Moret I, Busó E, García-Giménez JL, Ricart E, Gisbert JP, Cabré E, Esteve M, Márquez-Mosquera L, García-Planella E, Guardiola J, Pallardó FV, Serena C, Algaba-Chueca F, Domenech E, Nos P, Beltrán B. The Genetic Diversity and Dysfunctionality of Catalase Associated with a Worse Outcome in Crohn's Disease. Int J Mol Sci 2022; 23:ijms232415881. [PMID: 36555526 PMCID: PMC9785615 DOI: 10.3390/ijms232415881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 12/05/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022] Open
Abstract
Chronic gut inflammation in Crohn’s disease (CD) is associated with an increase in oxidative stress and an imbalance of antioxidant enzymes. We have previously shown that catalase (CAT) activity is permanently inhibited by CD. The purpose of the study was to determine whether there is any relationship between the single nucleotide polymorphisms (SNPs) in the CAT enzyme and the potential risk of CD associated with high levels of oxidative stress. Additionally, we used protein and regulation analyses to determine what causes long-term CAT inhibition in peripheral white mononuclear cells (PWMCs) in both active and inactive CD. We first used a retrospective cohort of 598 patients with CD and 625 age-matched healthy controls (ENEIDA registry) for the genotype analysis. A second human cohort was used to study the functional and regulatory mechanisms of CAT in CD. We isolated PWMCs from CD patients at the onset of the disease (naïve CD patients). In the genotype-association SNP analysis, the CAT SNPs rs1001179, rs475043, and rs525938 showed a significant association with CD (p < 0.001). Smoking CD patients with the CAT SNP rs475043 A/G genotype had significantly more often penetrating disease (p = 0.009). The gene expression and protein levels of CAT were permanently reduced in the active and inactive CD patients. The inhibition of CAT activity in the PWMCs of the CD patients was related to a low concentration of CAT protein caused by the downregulation of CAT-gene transcription. Our study suggests an association between CAT SNPs and the risk of CD that may explain permanent CAT inhibition in CD patients together with low CAT gene and protein expression.
Collapse
Affiliation(s)
- Marisa Iborra
- Gastroenterology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain
- Correspondence:
| | - Inés Moret
- Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain
| | - Enrique Busó
- Central Unit for Research in Medicine (UCIM), Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - José Luis García-Giménez
- INCLIVA Biomedical Research Institute, Spanish Institute of Health Carlos III, Department of Physiology, Faculty of Medicine and Dentistry, University of Valencia, Center for Biomedical Research Network on Rare Diseases (CIBERER), 46010 Valencia, Spain
| | - Elena Ricart
- Inflammatory Bowel Disease Unit, Gastroenterology Department, Hospital Clìnic de Barcelona, CIBEREHD, IDIBAPS, 08036 Barcelona, Spain
| | - Javier P. Gisbert
- Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), CIBEREHD, 28006 Madrid, Spain
| | - Eduard Cabré
- Gastroenterology Department, Hospital Germans Trias i Pujol, CIBEREHD, 08916 Badalona, Spain
| | - Maria Esteve
- Gastroenterology Department, Hospital Universitari Mutua de Terrassa, CIBEREHD, 08221 Barcelona, Spain
| | - Lucía Márquez-Mosquera
- Servei de Digestiu, Hospital del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | - Esther García-Planella
- Gastroenterology Department, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - Jordi Guardiola
- Gastroenterology Department, Hospital Universitari de Bellvitge, Hospital de Llobregat-Barcelona, 08901 Barcelona, Spain
| | - Federico V. Pallardó
- INCLIVA Biomedical Research Institute, Spanish Institute of Health Carlos III, Department of Physiology, Faculty of Medicine and Dentistry, University of Valencia, Center for Biomedical Research Network on Rare Diseases (CIBERER), 46010 Valencia, Spain
| | - Carolina Serena
- Institut d’Investigació Sanitària Pere Virgili, Hospital Universitari Joan XXIII, 43007 Tarragona, Spain
| | | | - Eugeni Domenech
- Gastroenterology Department, Hospital Germans Trias i Pujol, CIBEREHD, 08916 Badalona, Spain
| | - Pilar Nos
- Gastroenterology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain
| | - Belén Beltrán
- Hospital Vithas Virgen del Consuelo, 46007 Valencia, Spain
| |
Collapse
|
3
|
Altena R, Bajalica-Lagercrantz S, Papakonstantinou A. Pharmacogenomics for Prediction of Cardiovascular Toxicity: Landscape of Emerging Data in Breast Cancer Therapies. Cancers (Basel) 2022; 14:cancers14194665. [PMID: 36230587 PMCID: PMC9563074 DOI: 10.3390/cancers14194665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Pharmacogenomics is an emerging field in oncology, one that could provide valuable input on identifying patients with inherent risk of toxicity, thus allowing for treatment tailoring and personalization on the basis of the clinical and genetic characteristics of a patient. Cardiotoxicity is a well-known side effect of anthracyclines and anti-HER2 agents, although at a much lower incidence for the latter. Data on single-nucleotide polymorphisms related to cardiotoxicity are emerging but are still scarce, mostly being of retrospective character and heterogeneous. A literature review was performed, aiming to describe current knowledge in pharmacogenomics and prediction of cardiotoxicity related to breast cancer systemic therapies and radiotherapies. Most available data regard genes encoding various enzymes related to anthracycline metabolism and HER2 polymorphisms. The available data are presented, together with the challenges and open questions in the field.
Collapse
Affiliation(s)
- Renske Altena
- Department of Oncology-Pathology, Karolinska Institutet, 17 177 Stockholm, Sweden
- Department of Breast cancer, Endocrine tumors and Sarcoma, Theme Cancer, Karolinska University Hospital, 17 176 Stockholm, Sweden
| | - Svetlana Bajalica-Lagercrantz
- Department of Oncology-Pathology, Karolinska Institutet, 17 177 Stockholm, Sweden
- Department of Pathology and Cancer Diagnostics, Karolinska University Hospital, 17 176 Stockholm, Sweden
| | - Andri Papakonstantinou
- Department of Oncology-Pathology, Karolinska Institutet, 17 177 Stockholm, Sweden
- Department of Breast cancer, Endocrine tumors and Sarcoma, Theme Cancer, Karolinska University Hospital, 17 176 Stockholm, Sweden
- Breast Cancer Group, Vall D’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
- Correspondence:
| |
Collapse
|
4
|
Podlesnikar T, Berlot B, Dolenc J, Goričar K, Marinko T. Radiotherapy-Induced Cardiotoxicity: The Role of Multimodality Cardiovascular Imaging. Front Cardiovasc Med 2022; 9:887705. [PMID: 35966531 PMCID: PMC9366112 DOI: 10.3389/fcvm.2022.887705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/05/2022] [Indexed: 12/04/2022] Open
Abstract
Radiotherapy (RT) is one of the pillars of cancer therapy. High-dose radiation exposure on the thorax is mainly used in the context of adjuvant RT after breast surgery, in lung and esophageal cancer, and as a complement to systemic treatment in lymphoma. Due to the anatomical proximity, the heart inevitably receives some radiation that can result in acute and chronic cardiotoxicity, leading to heart failure, coronary artery disease, pericardial and valvular heart disease. Current evidence suggests there is no safe radiation dose to the heart, which poses a need for early recognition of RT-induced cardiac injury to initiate cardioprotective treatment and prevent further damage. Multimodality cardiac imaging provides a powerful tool to screen for structural and functional abnormalities secondary to RT. Left ventricular ejection fraction, preferably with three-dimensional echocardiography or cardiovascular magnetic resonance (CMR), and global longitudinal strain with speckle-tracking echocardiography are currently the key parameters to detect cardiotoxicity. However, several novel imaging parameters are tested in the ongoing clinical trials. CMR parametric imaging holds much promise as T1, T2 mapping and extracellular volume quantification allow us to monitor edema, inflammation and fibrosis, which are fundamental processes in RT-induced cardiotoxicity. Moreover, the association between serum biomarkers, genetic polymorphisms and the risk of developing cardiovascular disease after chest RT has been demonstrated, providing a platform for an integrative screening approach for cardiotoxicity. The present review summarizes contemporary evidence of RT-induced cardiac injury obtained from multimodality imaging—echocardiography, cardiovascular computed tomography, CMR and nuclear cardiology. Moreover, it identifies gaps in our current knowledge and highlights future perspectives to screen for RT-induced cardiotoxicity.
Collapse
Affiliation(s)
- Tomaž Podlesnikar
- Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia
- *Correspondence: Tomaž Podlesnikar,
| | - Boštjan Berlot
- Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Jure Dolenc
- Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Katja Goričar
- Pharmacogenetics Laboratory, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tanja Marinko
- Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|