1
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Wang Z, Yang Y, Wang N, Lu L, Xu C, Ren J, Yang L. RIP3 orchestrates oxidative stress and pyroptosis in doxorubicin-induced cardiotoxicity through regulation of AKT/Nrf2 signaling cascade. Mol Cell Biochem 2024:10.1007/s11010-024-05029-6. [PMID: 38955910 DOI: 10.1007/s11010-024-05029-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/04/2024] [Indexed: 07/04/2024]
Abstract
This study was designed to explore the role of RIP3 in DOX-induced cardiotoxicity and its underlying molecular mechanisms. Our results demonstrate that RIP3 exacerbates DOX-induced cardiotoxicity through promoting oxidative stress and pyroptosis by regulating the AKT/Nuclear factor erythroid 2-related factor 2 (Nrf2) signal pathway. Inhibition of RIP3 using GSK-872 attenuated DOX-induced cardiac remodeling and contractile dysfunction. Moreover, using GSK-872 in vivo, the results revealed that inhibition of RIP3 alleviated DOX-induced cardiotoxicity by the resulting inhibition of oxidative stress and pyroptosis. In addition, inhibition of RIP3 increased the protein levels of AKT and Nrf2 in DOX-treated mouse hearts. Furthermore, the AKT inhibitor LY294002 lessened RIP3 reduction-offered protection against DOX-induced H9c2 cell injury by moderating oxidative stress and pyroptosis. Taken together, these data demonstrate that RIP3 activation orchestrates DOX-induced cardiotoxicity through elevated oxidative stress and pyroptosis in an AKT/Nrf2-dependent manner. Those findings highlight the clinical relevance and therapeutic potential of targeting RIP3 for the treatment of DOX-induced cardiotoxicity.
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Affiliation(s)
- Zhenyi Wang
- Department of Anesthesiology, Children's Hospital Affiliated to Xi'an Jiao Tong University, Xi'an, 710003, Shaanxi, China
| | - Yitong Yang
- Department of Children's Respiratory Asthma, Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xian Yang, 712046, Shaanxi, China
| | - Nisha Wang
- Department of Anesthesiology, Children's Hospital Affiliated to Xi'an Jiao Tong University, Xi'an, 710003, Shaanxi, China
| | - Linhe Lu
- Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi'an, 710032, China
| | - Chennian Xu
- Key Laboratory of Gastrointestinal Pharmacology of Chinese Materia Medica of the State Administration of Traditional Chinese Medicine, Department of Pharmacology, School of Pharmacy, Air Force Medical University, Xi'an, 710032, Shaanxi, China
| | - Jun Ren
- Department of Cardiology and Shanghai Institute of Cardiovascular Diseases, Zhong Shan Hospital Fudan University, Shanghai, China
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, USA
| | - Lifang Yang
- Department of Anesthesiology, Children's Hospital Affiliated to Xi'an Jiao Tong University, Xi'an, 710003, Shaanxi, China.
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2
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Tuo H, Li W, Zhao W, Zhao J, Li D, Jin L. Shikonin alleviates doxorubicin-induced cardiotoxicity via Mst1/Nrf2 pathway in mice. Sci Rep 2024; 14:924. [PMID: 38195835 PMCID: PMC10776756 DOI: 10.1038/s41598-024-51675-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/08/2024] [Indexed: 01/11/2024] Open
Abstract
Doxorubicin (DOX) is a popular and potent anticancer drug, but its cardiotoxicity limits its clinical application. Shikonin has a wide range of biological functions, including antioxidant and anti-inflammatory effects. The aim of this study was to investigate the effects of shikonin on DOX-induced cardiac injury and to identify the underlying mechanisms. Mice receiving shikonin showed reduced cardiac injury response and enhanced cardiac function after DOX administration. Shikonin significantly attenuated DOX-induced oxidative damage, inflammation accumulation and cardiomyocyte apoptosis. Shikonin protects against DOX-induced cardiac injury by inhibiting Mammalian sterile 20-like kinase 1 (Mst1) and oxidative stress and activating the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway. In conclusion, shikonin alleviates DOX-induced cardiotoxicity by inhibiting Mst1 and activating Nrf2. Shikonin may be used to treat DOX-induced cardiac injury.
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Affiliation(s)
- Hu Tuo
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wenjing Li
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Zhao
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Juan Zhao
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Danni Li
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lin Jin
- Department of Orthopedics, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan, 430060, China.
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3
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He L, Wang J, Yang Y, Zou P, Xia Z, Li J. SIRT4 Suppresses Doxorubicin-Induced Cardiotoxicity by Regulating the AKT/mTOR/Autophagy Pathway. Toxicology 2022; 469:153119. [PMID: 35134463 DOI: 10.1016/j.tox.2022.153119] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 12/21/2022]
Abstract
Doxorubicin (DOX) is a potent anthracycline chemotherapeutic drug. DOX-induced cardiotoxicity (DIC) limits its application in cancer treatment, as this complication is detrimental and fatal. Reactive oxygen species (ROS) production, autophagic dysfunction and cell death are crucial factors related to DIC. Previous studies have shown that SIRT4 is associated with cardiac energy metabolism, cardiac mitochondrial dysfunction and cardiac cell death, but it is unclear whether SIRT4 affects DOX-induced cardiac injury. Our data suggested that SIRT4 overexpression in vivo and in vitro could alleviate DIC by improving cardiac function and reducing cardiomyocyte apoptosis and autophagy. However, autophagy activation by rapamycin abolished the protective effect of SIRT4 overexpression on DIC. Furthermore, in the context of DOX treatment, SIRT4 overexpression activated the Akt/mTOR signaling pathway and inhibited autophagy through the Akt/mTOR signaling pathway. Our findings indicate that SIRT4 overexpression protects against DIC by inhibiting Akt/mTOR-dependent autophagy. These findings may provide a prospective therapeutic target for DIC.
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4
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Guo Z, Tang N, Liu FY, Yang Z, Ma SQ, An P, Wu HM, Fan D, Tang QZ. TLR9 deficiency alleviates doxorubicin-induced cardiotoxicity via the regulation of autophagy. J Cell Mol Med 2020; 24:10913-10923. [PMID: 33140921 PMCID: PMC7521247 DOI: 10.1111/jcmm.15719] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/05/2020] [Accepted: 07/09/2020] [Indexed: 12/19/2022] Open
Abstract
Doxorubicin is a commonly used anthracycline chemotherapeutic drug. Its application for treatment has been impeded by its cardiotoxicity as it is detrimental and fatal. DNA damage, cardiac inflammation, oxidative stress and cell death are the critical links in DOX-induced myocardial injury. Previous studies found that TLR9-related signalling pathways are associated with the inflammatory response of cardiac myocytes, mitochondrial dysfunction and cardiomyocyte death, but it remains unclear whether TLR9 could influence DOX-induced heart injury. Our current data imply that DOX-induced cardiotoxicity is ameliorated by TLR9 deficiency both in vivo and in vitro, manifested as improved cardiac function and reduced cardiomyocyte apoptosis and oxidative stress. Furthermore, the deletion of TLR9 rescued DOX-induced abnormal autophagy flux in vivo and in vitro. However, the inhibition of autophagy by 3-MA abolished the protective effects of TLR9 deletion on DOX-induced cardiotoxicity. Moreover, TLR9 ablation suppressed the activation of p38 MAPK during DOX administration and may promote autophagy via the TLR9-p38 MAPK signalling pathway. Our study suggests that the deletion of TLR9 exhibits a protective effect on doxorubicin-induced cardiotoxicity by enhancing p38-dependent autophagy. This finding could be used as a basis for the development of a prospective therapy against DOX-induced cardiotoxicity.
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Affiliation(s)
- Zhen Guo
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, China.,Cardiovascular Research Institute of Wuhan University, Wuhan, China
| | - Nan Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, China.,Cardiovascular Research Institute of Wuhan University, Wuhan, China
| | - Fang-Yuan Liu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, China.,Cardiovascular Research Institute of Wuhan University, Wuhan, China
| | - Zheng Yang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, China.,Cardiovascular Research Institute of Wuhan University, Wuhan, China
| | - Shu-Qing Ma
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, China.,Cardiovascular Research Institute of Wuhan University, Wuhan, China
| | - Peng An
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, China.,Cardiovascular Research Institute of Wuhan University, Wuhan, China
| | - Hai-Ming Wu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, China.,Cardiovascular Research Institute of Wuhan University, Wuhan, China
| | - Di Fan
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, China.,Cardiovascular Research Institute of Wuhan University, Wuhan, China
| | - Qi-Zhu Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Metabolic and Chronic Diseases, Wuhan, China.,Cardiovascular Research Institute of Wuhan University, Wuhan, China
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5
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Asiatic Acid Protects against Doxorubicin-Induced Cardiotoxicity in Mice. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:5347204. [PMID: 32509145 PMCID: PMC7246415 DOI: 10.1155/2020/5347204] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 01/28/2020] [Indexed: 11/18/2022]
Abstract
The use of doxorubicin (DOX) can result in depression of cardiac function and refractory cardiomyopathy. Currently, there are no effective approaches to prevent DOX-related cardiac complications. Asiatic acid (AA) has been reported to provide cardioprotection against several cardiovascular diseases. However, whether AA could attenuate DOX-related cardiac injury remains unclear. DOX (15 mg/kg) was injected intraperitoneally into the mice to mimic acute cardiac injury, and the mice were given AA (10 mg/kg or 30 mg/kg) for 2 weeks for protection. The data in our study found that AA-treated mice exhibited attenuated cardiac injury and improved cardiac function in response to DOX injection. AA also suppressed myocardial oxidative damage and apoptosis without affecting cardiac inflammation in DOX-treated mice. AA also provided protection in DOX-challenged cardiomyocytes, improved cell viability, and suppressed intracellular reactive oxygen species (ROS) in vitro. Detection of signaling pathways showed that AA activated protein kinase B (AKT) signaling pathway in vivo and in vitro. Furthermore, we found that AA lost its protective effects in the heart with AKT inactivation. In conclusion, our results found that AA could attenuate DOX-induced myocardial oxidative stress and apoptosis via activation of the AKT signaling pathway.
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6
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Ni C, Ma P, Wang R, Lou X, Liu X, Qin Y, Xue R, Blasig I, Erben U, Qin Z. Doxorubicin‐induced cardiotoxicity involves IFNγ‐mediated metabolic reprogramming in cardiomyocytes. J Pathol 2019; 247:320-332. [PMID: 30426505 DOI: 10.1002/path.5192] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Chen Ni
- Medical Research Center, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou University Zhengzhou PR China
| | - Pan Ma
- Key Laboratory of Protein and Peptide Pharmaceuticals, CAS‐University of Tokyo Joint Laboratory of Structural Virology and Immunology, Institute of Biophysics, Chinese Academy of SciencesUniversity of the Chinese Academy of Sciences Beijing PR China
| | - Ruirui Wang
- Medical Research Center, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou University Zhengzhou PR China
| | - Xiaohan Lou
- Medical Research Center, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou University Zhengzhou PR China
| | - Xiaomeng Liu
- Medical Research Center, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou University Zhengzhou PR China
| | - Yue Qin
- Key Laboratory of Protein and Peptide Pharmaceuticals, CAS‐University of Tokyo Joint Laboratory of Structural Virology and Immunology, Institute of Biophysics, Chinese Academy of SciencesUniversity of the Chinese Academy of Sciences Beijing PR China
| | - Rui Xue
- Medical Research Center, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou University Zhengzhou PR China
| | - Ingolf Blasig
- Leibniz Institut für Molekulare Pharmakologie Berlin‐Buch Germany
| | - Ulrike Erben
- Medical Research Center, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou University Zhengzhou PR China
- Key Laboratory of Protein and Peptide Pharmaceuticals, CAS‐University of Tokyo Joint Laboratory of Structural Virology and Immunology, Institute of Biophysics, Chinese Academy of SciencesUniversity of the Chinese Academy of Sciences Beijing PR China
| | - Zhihai Qin
- Medical Research Center, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou University Zhengzhou PR China
- Key Laboratory of Protein and Peptide Pharmaceuticals, CAS‐University of Tokyo Joint Laboratory of Structural Virology and Immunology, Institute of Biophysics, Chinese Academy of SciencesUniversity of the Chinese Academy of Sciences Beijing PR China
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7
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Yang X, Liu N, Li X, Yang Y, Wang X, Li L, Jiang L, Gao Y, Tang H, Tang Y, Xing Y, Shang H. A Review on the Effect of Traditional Chinese Medicine Against Anthracycline-Induced Cardiac Toxicity. Front Pharmacol 2018; 9:444. [PMID: 29867456 PMCID: PMC5963334 DOI: 10.3389/fphar.2018.00444] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 04/16/2018] [Indexed: 01/29/2023] Open
Abstract
Anthracyclines are effective agents generally used to treat solid-tumor and hematologic malignancies. The use of anthracyclines for over 40 years has improved cancer survival statistics. Nevertheless, the clinical utility of anthracyclines is limited by its dose-dependent cardiotoxicity that adversely affects 10-30% of patients. Anthracycline-induced cardiotoxicity may be classified as acute/subacute or chronic/late toxicity and leads to devastating adverse effects resulting in poor quality of life, morbidity, and premature mortality. Traditional Chinese medicine has a history of over 2,000 years, involving both unique theories and substantial experience. Several studies have investigated the potential of natural products to decrease the cardiotoxic effects of chemotherapeutic agents on healthy cells, without negatively affecting their antineoplastic activity. This article discusses the mechanism of anthracycline-induced cardiotoxicity, and summarizes traditional Chinese medicine treatment for anthracycline-induced heart failure (HF), cardiac arrhythmia, cardiomyopathy, and myocardial ischemia in recent years, in order to provide a reference for the clinical prevention and treatment of cardiac toxicity.
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Affiliation(s)
- Xinyu Yang
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.,Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Nian Liu
- Department of Cardiology, Beijing Anzhen Hospital of the Capital University of Medical Sciences, Beijing, China
| | - Xinye Li
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.,Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yihan Yang
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.,Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Xiaofeng Wang
- Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Linling Li
- Department of Cardiology, Beijing Anzhen Hospital of the Capital University of Medical Sciences, Beijing, China
| | - Le Jiang
- Department of Cardiology, Beijing Anzhen Hospital of the Capital University of Medical Sciences, Beijing, China
| | - Yonghong Gao
- Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Hebin Tang
- Department of Pharmacology, School of Pharmaceutical Sciences, South-Central University for Nationalities, Wuhan, China
| | - Yong Tang
- Department of Pancreatic Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Yanwei Xing
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Hongcai Shang
- Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
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8
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Bose C, Awasthi S, Sharma R, Beneš H, Hauer-Jensen M, Boerma M, Singh SP. Sulforaphane potentiates anticancer effects of doxorubicin and attenuates its cardiotoxicity in a breast cancer model. PLoS One 2018; 13:e0193918. [PMID: 29518137 PMCID: PMC5843244 DOI: 10.1371/journal.pone.0193918] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/20/2018] [Indexed: 11/19/2022] Open
Abstract
Breast cancer is the most common malignancy in women of the Western world. Doxorubicin (DOX) continues to be used extensively to treat early-stage or node-positive breast cancer, human epidermal growth factor receptor-2 (HER2)-positive breast cancer, and metastatic disease. We have previously demonstrated in a mouse model that sulforaphane (SFN), an isothiocyanate isolated from cruciferous vegetables, protects the heart from DOX-induced toxicity and damage. However, the effects of SFN on the chemotherapeutic efficacy of DOX in breast cancer are not known. Present studies were designed to investigate whether SFN alters the effects of DOX on breast cancer regression while also acting as a cardioprotective agent. Studies on rat neonatal cardiomyocytes and multiple rat and human breast cancer cell lines revealed that SFN protects cardiac cells but not cancer cells from DOX toxicity. Results of studies in a rat orthotopic breast cancer model indicated that SFN enhanced the efficacy of DOX in regression of tumor growth, and that the DOX dosage required to treat the tumor could be reduced when SFN was administered concomitantly. Additionally, SFN enhanced mitochondrial respiration in the hearts of DOX-treated rats and reduced cardiac oxidative stress caused by DOX, as evidenced by the inhibition of lipid peroxidation, the activation of NF-E2-related factor 2 (Nrf2) and associated antioxidant enzymes. These studies indicate that SFN not only acts synergistically with DOX in cancer regression, but also protects the heart from DOX toxicity through Nrf2 activation and protection of mitochondrial integrity and functions.
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Affiliation(s)
- Chhanda Bose
- University of Arkansas for Medical Sciences, Department of Geriatrics, Little Rock, Arkansas, United States of America
| | - Sanjay Awasthi
- Texas Tech Health Sciences Center, Division of Hematology & Oncology, Department of Internal Medicine, Lubbock, Texas, United States of America
| | - Rajendra Sharma
- University of Arkansas for Medical Sciences, Department of Pharmacology and Toxicology, Little Rock, Arkansas, United States of America
| | - Helen Beneš
- University of Arkansas for Medical Sciences, Department of Neurobiology and Developmental Sciences, Little Rock, Arkansas, United States of America
| | - Martin Hauer-Jensen
- University of Arkansas for Medical Sciences, Division of Radiation Health, Little Rock, Arkansas, United States of America
| | - Marjan Boerma
- University of Arkansas for Medical Sciences, Division of Radiation Health, Little Rock, Arkansas, United States of America
| | - Sharda P. Singh
- Texas Tech Health Sciences Center, Division of Hematology & Oncology, Department of Internal Medicine, Lubbock, Texas, United States of America
- University of Arkansas for Medical Sciences, Department of Pharmacology and Toxicology, Little Rock, Arkansas, United States of America
- Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, United States of America
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9
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Sonowal H, Pal PB, Wen JJ, Awasthi S, Ramana KV, Srivastava SK. Aldose reductase inhibitor increases doxorubicin-sensitivity of colon cancer cells and decreases cardiotoxicity. Sci Rep 2017; 7:3182. [PMID: 28600556 PMCID: PMC5466629 DOI: 10.1038/s41598-017-03284-w] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/25/2017] [Indexed: 01/01/2023] Open
Abstract
Anthracycline drugs such as doxorubicin (DOX) and daunorubicin remain some of the most active wide-spectrum and cost-effective drugs in cancer therapy. However, colorectal cancer (CRC) cells are inherently resistant to anthracyclines which at higher doses cause cardiotoxicity. Our recent studies indicate that aldose reductase (AR) inhibitors such as fidarestat inhibit CRC growth in vitro and in vivo. Here, we show that treatment of CRC cells with fidarestat increases the efficacy of DOX-induced death in HT-29 and SW480 cells and in nude mice xenografts. AR inhibition also results in higher intracellular accumulation of DOX and decreases the expression of drug transporter proteins MDR1, MRP1, and ABCG2. Further, fidarestat also inhibits DOX-induced increase in troponin-I and various inflammatory markers in the serum and heart and restores cardiac function in mice. These results suggest that fidarestat could be used as adjuvant therapy to enhance DOX sensitivity of CRC cells and to reduce DOX-associated cardiotoxicity.
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Affiliation(s)
- Himangshu Sonowal
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX-77555, USA
| | - Pabitra B Pal
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX-77555, USA
| | - Jian-Jun Wen
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX-77555, USA
| | - Sanjay Awasthi
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX-79430, USA
| | - Kota V Ramana
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX-77555, USA
| | - Satish K Srivastava
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX-77555, USA.
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10
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The Utility of Point-of-Care Biomarkers to Detect Cardiotoxicity During Anthracycline Chemotherapy: A Feasibility Study. J Card Fail 2016; 22:433-8. [DOI: 10.1016/j.cardfail.2016.04.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 04/01/2016] [Accepted: 04/07/2016] [Indexed: 02/07/2023]
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11
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Valcovici M, Andrica F, Serban C, Dragan S. Cardiotoxicity of anthracycline therapy: current perspectives. Arch Med Sci 2016; 12:428-35. [PMID: 27186191 PMCID: PMC4848373 DOI: 10.5114/aoms.2016.59270] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 10/07/2014] [Indexed: 12/31/2022] Open
Abstract
Anthracyclines, especially doxorubicin and daunorubicin, are the drugs of first choice in the treatment of patients with hematologic malignancies, soft-tissue sarcomas, and solid tumors. Unfortunately, the use of anthracyclines is limited by their dose-dependent and cumulative cardiotoxicity. The molecular mechanism responsible for anthracycline-induced cardiotoxicity remains poorly understood, although experimental and clinical studies have shown that oxidative stress plays the main role. Hence, antioxidant agents, especially dexrazoxane, and also other drug classes (statins, β-blockers) proved to have a beneficial effect in protecting against anthracycline-induced cardiotoxicity. According to previous clinical trials, the major high-risk factors for anthracycline-induced cardiotoxicity are age, body weight, female gender, radiotherapy, and other diseases such as Down syndrome, familial dilated cardiomyopathy, diabetes and hypertension. Consequently, further studies are needed to elucidate the molecular pathogenesis of anthracycline-induced cardiotoxicity and also to discover new cardioprotective agents against anthracycline-induced cardiotoxicity.
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Affiliation(s)
- Mihaela Valcovici
- Cardiology Department, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Florina Andrica
- Department of Toxicology, Faculty of Pharmacy, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania; Center for Interdisciplinary Research, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Corina Serban
- Center for Interdisciplinary Research, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania; Department of Functional Sciences, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Simona Dragan
- Cardiology Department, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania; Center for Interdisciplinary Research, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
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12
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Cross MJ, Berridge BR, Clements PJM, Cove-Smith L, Force TL, Hoffmann P, Holbrook M, Lyon AR, Mellor HR, Norris AA, Pirmohamed M, Tugwood JD, Sidaway JE, Park BK. Physiological, pharmacological and toxicological considerations of drug-induced structural cardiac injury. Br J Pharmacol 2015; 172:957-74. [PMID: 25302413 PMCID: PMC4314188 DOI: 10.1111/bph.12979] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 09/30/2014] [Accepted: 10/06/2014] [Indexed: 01/01/2023] Open
Abstract
The incidence of drug-induced structural cardiotoxicity, which may lead to heart failure, has been recognized in association with the use of anthracycline anti-cancer drugs for many years, but has also been shown to occur following treatment with the new generation of targeted anti-cancer agents that inhibit one or more receptor or non-receptor tyrosine kinases, serine/threonine kinases as well as several classes of non-oncology agents. A workshop organized by the Medical Research Council Centre for Drug Safety Science (University of Liverpool) on 5 September 2013 and attended by industry, academia and regulatory representatives, was designed to gain a better understanding of the gaps in the field of structural cardiotoxicity that can be addressed through collaborative efforts. Specific recommendations from the workshop for future collaborative activities included: greater efforts to identify predictive (i) preclinical; and (ii) clinical biomarkers of early cardiovascular injury; (iii) improved understanding of comparative physiology/pathophysiology and the clinical predictivity of current preclinical in vivo models; (iv) the identification and use of a set of cardiotoxic reference compounds for comparative profiling in improved animal and human cellular models; (v) more sharing of data (through publication/consortia arrangements) on target-related toxicities; (vi) strategies to develop cardio-protective agents; and (vii) closer interactions between preclinical scientists and clinicians to help ensure best translational efforts.
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Affiliation(s)
- M J Cross
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of LiverpoolLiverpool, UK
| | - B R Berridge
- Safety Assessment, GlaxoSmithKlineResearch Triangle Park, NC, USA
| | - P J M Clements
- David Jack Centre for Research & Development, GlaxoSmithKlineWare, Herts, UK
| | - L Cove-Smith
- Clinical & Experimental Pharmacology, Cancer Research UK Manchester Institute, University of ManchesterManchester, UK
| | - T L Force
- Center for Translational Medicine and Cardiology Division, Temple University School of MedicinePhiladelphia, PA, USA
| | - P Hoffmann
- Preclinical Safety, Novartis Pharm CorpEast Hanover, NJ, USA
| | - M Holbrook
- Safety Pharmacology, Covance Laboratories, Ltd.Harrogate, North Yorkshire, UK
| | - A R Lyon
- NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital and Imperial CollegeLondon, UK
| | - H R Mellor
- Drug Safety Evaluation, Vertex Pharmaceuticals (Europe), Ltd.Abingdon, Oxfordshire, UK
| | - A A Norris
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of LiverpoolLiverpool, UK
| | - M Pirmohamed
- The Wolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of LiverpoolLiverpool, UK
| | - J D Tugwood
- Clinical & Experimental Pharmacology, Cancer Research UK Manchester Institute, University of ManchesterManchester, UK
| | - J E Sidaway
- Innovative Medicines, AstraZeneca R&DMacclesfield, UK
| | - B K Park
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of LiverpoolLiverpool, UK
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Abstract
The beta isoform of Neuregulin-1 (NRG-1β), along with its receptors (ErbB2-4), is required for cardiac development. NRG-1β, as well as the ErbB2 and ErbB4 receptors, is also essential for maintenance of adult heart function. These observations have led to its evaluation as a therapeutic for heart failure. Animal studies and ongoing clinical trials have demonstrated beneficial effects of two forms of recombinant NRG-1β on cardiac function. In addition to the possible role for recombinant NRG-1βs as heart failure therapies, endogenous NRG-1β/ErbB signaling appears to play a role in restoring cardiac function after injury. The potential mechanisms by which NRG-1β may act as both a therapy and a mediator of reverse remodeling remain incompletely understood. In addition to direct effects on cardiac myocytes NRG-1β acts on the vasculature, interstitium, cardiac fibroblasts, and hematopoietic and immune cells, which, collectively, may contribute to NRG-1β's role in maintaining cardiac structure and function, as well as mediating reverse remodeling.
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Shelburne N, Adhikari B, Brell J, Davis M, Desvigne-Nickens P, Freedman A, Minasian L, Force T, Remick SC. Cancer treatment-related cardiotoxicity: current state of knowledge and future research priorities. J Natl Cancer Inst 2014; 106:dju232. [PMID: 25210198 PMCID: PMC4176042 DOI: 10.1093/jnci/dju232] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 06/27/2014] [Accepted: 07/01/2014] [Indexed: 12/31/2022] Open
Abstract
Cardiotoxicity resulting from direct myocyte damage has been a known complication of cancer treatment for decades. More recently, the emergence of hypertension as a clinically significant side effect of several new agents has been recognized as adversely affecting cancer treatment outcomes. With cancer patients living longer, in part because of treatment advances, these adverse events have become increasingly important to address. However, little is known about the cardiovascular pathogenic mechanisms associated with cancer treatment and even less about how to optimally prevent and manage short- and long-term cardiovascular complications, leading to improved patient safety and clinical outcomes. To identify research priorities, allocate resources, and establish infrastructure required to address cardiotoxicity associated with cancer treatment, the National Cancer Institute (NCI) and National Heart, Lung and Blood Institute (NHLBI) sponsored a two-day workshop, "Cancer treatment-related cardiotoxicity: Understanding the current state of knowledge and future research priorities," in March 2013 in Bethesda, MD. Participants included leading oncology and cardiology researchers and health professionals, patient advocates and industry representatives, with expertise ranging from basic to clinical science. Attendees were charged with identifying research opportunities to advance the understanding of cancer treatment-related cardiotoxicity across basic and clinical science. This commentary highlights the key discussion points and overarching recommendations from that workshop.
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Affiliation(s)
- Nonniekaye Shelburne
- Division of Cancer Control and Population Sciences (NS, AF) and Division of Cancer Prevention (JB, LM) and Division of Cancer Treatment and Diagnosis (MD), National Cancer Institute, Rockville, MD; Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD (BA, PDN); Cancer Center, MetroHealth Medical Center and Casewestern Reserve University, Cleveland, OH (JB); Vanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN (TF); Mary Babb Randolph Cancer Center, West Virginia University (SCR), Morgantown, WV.
| | - Bishow Adhikari
- Division of Cancer Control and Population Sciences (NS, AF) and Division of Cancer Prevention (JB, LM) and Division of Cancer Treatment and Diagnosis (MD), National Cancer Institute, Rockville, MD; Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD (BA, PDN); Cancer Center, MetroHealth Medical Center and Casewestern Reserve University, Cleveland, OH (JB); Vanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN (TF); Mary Babb Randolph Cancer Center, West Virginia University (SCR), Morgantown, WV
| | - Joanna Brell
- Division of Cancer Control and Population Sciences (NS, AF) and Division of Cancer Prevention (JB, LM) and Division of Cancer Treatment and Diagnosis (MD), National Cancer Institute, Rockville, MD; Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD (BA, PDN); Cancer Center, MetroHealth Medical Center and Casewestern Reserve University, Cleveland, OH (JB); Vanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN (TF); Mary Babb Randolph Cancer Center, West Virginia University (SCR), Morgantown, WV
| | - Myrtle Davis
- Division of Cancer Control and Population Sciences (NS, AF) and Division of Cancer Prevention (JB, LM) and Division of Cancer Treatment and Diagnosis (MD), National Cancer Institute, Rockville, MD; Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD (BA, PDN); Cancer Center, MetroHealth Medical Center and Casewestern Reserve University, Cleveland, OH (JB); Vanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN (TF); Mary Babb Randolph Cancer Center, West Virginia University (SCR), Morgantown, WV
| | - Patrice Desvigne-Nickens
- Division of Cancer Control and Population Sciences (NS, AF) and Division of Cancer Prevention (JB, LM) and Division of Cancer Treatment and Diagnosis (MD), National Cancer Institute, Rockville, MD; Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD (BA, PDN); Cancer Center, MetroHealth Medical Center and Casewestern Reserve University, Cleveland, OH (JB); Vanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN (TF); Mary Babb Randolph Cancer Center, West Virginia University (SCR), Morgantown, WV
| | - Andrew Freedman
- Division of Cancer Control and Population Sciences (NS, AF) and Division of Cancer Prevention (JB, LM) and Division of Cancer Treatment and Diagnosis (MD), National Cancer Institute, Rockville, MD; Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD (BA, PDN); Cancer Center, MetroHealth Medical Center and Casewestern Reserve University, Cleveland, OH (JB); Vanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN (TF); Mary Babb Randolph Cancer Center, West Virginia University (SCR), Morgantown, WV
| | - Lori Minasian
- Division of Cancer Control and Population Sciences (NS, AF) and Division of Cancer Prevention (JB, LM) and Division of Cancer Treatment and Diagnosis (MD), National Cancer Institute, Rockville, MD; Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD (BA, PDN); Cancer Center, MetroHealth Medical Center and Casewestern Reserve University, Cleveland, OH (JB); Vanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN (TF); Mary Babb Randolph Cancer Center, West Virginia University (SCR), Morgantown, WV
| | - Thomas Force
- Division of Cancer Control and Population Sciences (NS, AF) and Division of Cancer Prevention (JB, LM) and Division of Cancer Treatment and Diagnosis (MD), National Cancer Institute, Rockville, MD; Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD (BA, PDN); Cancer Center, MetroHealth Medical Center and Casewestern Reserve University, Cleveland, OH (JB); Vanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN (TF); Mary Babb Randolph Cancer Center, West Virginia University (SCR), Morgantown, WV
| | - Scot C Remick
- Division of Cancer Control and Population Sciences (NS, AF) and Division of Cancer Prevention (JB, LM) and Division of Cancer Treatment and Diagnosis (MD), National Cancer Institute, Rockville, MD; Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD (BA, PDN); Cancer Center, MetroHealth Medical Center and Casewestern Reserve University, Cleveland, OH (JB); Vanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN (TF); Mary Babb Randolph Cancer Center, West Virginia University (SCR), Morgantown, WV
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