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Ma W, Rousseau Z, Slavkovic S, Shen C, Yousef GM, Ni H. Doxorubicin-Induced Platelet Activation and Clearance Relieved by Salvianolic Acid Compound: Novel Mechanism and Potential Therapy for Chemotherapy-Associated Thrombosis and Thrombocytopenia. Pharmaceuticals (Basel) 2022; 15:ph15121444. [PMID: 36558895 PMCID: PMC9788583 DOI: 10.3390/ph15121444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/04/2022] [Accepted: 11/15/2022] [Indexed: 11/24/2022] Open
Abstract
Doxorubicin (Dox) is a widely utilized chemotherapeutic; however, it carries side effects, including drug-induced immune thrombocytopenia (DITP) and increased risk of venous thromboembolism (VTE). Currently, the mechanisms for Dox-associated DITP and VTE are poorly understood, and an effective inhibitor to relieve these complications remains to be developed. In this study, we found that Dox significantly induced platelet activation and enhanced platelet phagocytosis by macrophages and accelerated platelet clearance. Importantly, we determined that salvianolic acid C (SAC), a water-soluble compound derived from Danshen root traditionally used to treat cardiovascular diseases, inhibited Dox-induced platelet activation more effectively than current standard-of-care anti-platelet drugs aspirin and ticagrelor. Mechanism studies with tyrosine kinase inhibitors indicate contributions of phospholipase C, spleen tyrosine kinase, and protein kinase C signaling pathways in Dox-induced platelet activation. We further demonstrated that Dox enhanced platelet-cancer cell interaction, which was ameliorated by SAC. Taken together, these findings suggest SAC may be a promising therapy to reduce the risk of Dox-induced DITP, VTE, and the repercussions of amplified platelet-cancer interaction in the tumor microenvironment.
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Affiliation(s)
- Wenjing Ma
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Laboratory Medicine, LKSKI-Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto Platelet Immunobiology Group, Toronto, ON M5B 1W8, Canada
| | - Zackary Rousseau
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Laboratory Medicine, LKSKI-Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto Platelet Immunobiology Group, Toronto, ON M5B 1W8, Canada
| | - Sladjana Slavkovic
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Laboratory Medicine, LKSKI-Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto Platelet Immunobiology Group, Toronto, ON M5B 1W8, Canada
| | - Chuanbin Shen
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Laboratory Medicine, LKSKI-Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto Platelet Immunobiology Group, Toronto, ON M5B 1W8, Canada
- School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, China
| | - George M. Yousef
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Laboratory Medicine, LKSKI-Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto Platelet Immunobiology Group, Toronto, ON M5B 1W8, Canada
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Heyu Ni
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Laboratory Medicine, LKSKI-Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto Platelet Immunobiology Group, Toronto, ON M5B 1W8, Canada
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada
- Canadian Blood Services Centre for Innovation, Toronto, ON M5G 2M1, Canada
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A1, Canada
- Correspondence:
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Bi Y, Wang Z, Feng S, Wang Y, Zhao Y, Li H, Yu J, Liu Q, Zhu C, Li M. Correction: Dynamic trajectory of platelet counts after the first cycle of induction chemotherapy in AML patients. BMC Cancer 2022; 22:647. [PMID: 35698079 PMCID: PMC9190074 DOI: 10.1186/s12885-022-09715-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Yazhen Bi
- Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China
| | - Zhaohui Wang
- Department of Hematology, Haici Medical Group Qingdao, Qingdao, Shandong, China
| | - Saran Feng
- Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China
| | - Yan Wang
- Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China
| | - Yang Zhao
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hong Li
- Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China
| | - Jingyi Yu
- Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China
| | - Qian Liu
- Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China
| | - Chuansheng Zhu
- Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China. .,Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China.
| | - Mingzhuo Li
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China.
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