1
|
Teperikidis E, Boulmpou A, Charalampidis P, Tsavousoglou C, Giannakoulas G, Papadopoulos CE, Vassilikos V. 5-Fluorouracil, capecitabine and vasospasm: a scoping review of pathogenesis, management options and future research considerations. Acta Cardiol 2022; 77:1-13. [PMID: 33683181 DOI: 10.1080/00015385.2021.1873548] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND 5-Fluorouracil (5-FU) is a widely used chemotherapeutic agent that can cause cardiotoxicity manifesting, among others, as chest pain. Capecitabine is an oral prodrug of 5-FU, with reported preferential activation in malignant cells that may also cause cardiotoxic reactions. Standard treatment of 5-FU and capecitabine induced chest pain with vasodilators is mostly effective, but there are several cases of patients unresponsive to these agents. METHODS We performed a PubMed search on 31st May 2020. We used a three keyword search strategy using Boolean search operators. More specifically, we included fluorouracil or 5-FU or capecitabine and chest pain or angina and mechanism or treatment or management. We included primary reports of clinical and non-clinical data, as well as systematic reviews. Narrative reviews, expert opinions, letters to the editor and other forms of non-primary literature were excluded. RESULTS Our search yielded a total of 1595 reports. Of these, 1460 were narrative reviews or irrelevant to the topic and were excluded. A total of 135 reports were used for our review. We used 81 reports for data extraction, which included 13 clinical trials, 4 retrospective reports, 61 case reports, and 3 systematic reviews. CONCLUSION We report the incidence and predisposing factors, the value of available diagnostic procedures, and standard medical and invasive treatments. We also speculate on the potential benefit of arginine as a promising option both in prevention as well as treatment of 5-FU-induced chest pain. Finally, gaps of evidence are identified and proposals are made in terms of future research.
Collapse
Affiliation(s)
- Eleftherios Teperikidis
- Third Department of Cardiology, Ιppokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aristi Boulmpou
- Third Department of Cardiology, Ιppokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis Charalampidis
- Third Department of Cardiology, Ιppokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
- St Luke’s Hospital, Thessaloniki, Greece
| | - Chalil Tsavousoglou
- Third Department of Cardiology, Ιppokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Giannakoulas
- First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christodoulos E. Papadopoulos
- Third Department of Cardiology, Ιppokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilios Vassilikos
- Third Department of Cardiology, Ιppokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
2
|
Bala A, Panditharadyula SS. Role of Nuclear Factor Erythroid 2-Related Factor 2 (NRF-2) Mediated Antioxidant Response on the Synergistic Antitumor Effect of L-Arginine and 5-Fluro Uracil (5FU) in Breast Adenocarcinoma. Curr Pharm Des 2019; 25:1643-1652. [DOI: 10.2174/1381612825666190705205155] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 06/19/2019] [Indexed: 02/08/2023]
Abstract
Breast adenocarcinoma (BAC) in glandular tissue cells have excessive metastasis and invasion capability.
The major challenges for the chemotherapy used for the management of BAC include chemoresistance and
auto-immunosuppression in BAC. The 5-fluro uracil (5-FU) based therapy promotes the immune activation in
BAC by targeting the regulatory T cells and myeloid-derived suppressor cells (MDSC). The beneficial effect of
the combination of L-Arginine with 5-FU strives to be established in different pre-clinical and clinical conditions
and explored in the scientific literature. L-Arginine induces NO production and potentiates the anticancer effect
of 5-FU. NO-mediated signaling is regulated by nuclear factor erythroid 2-related factor 2 (NRF-2) mediated
antioxidant response. NRF-2 mediated antioxidant mechanism always suppresses the formation of superoxide
(O2
-) as well as other reactive oxygen species (ROS). Thus the utilization of NO by O2
- will be minimum in this
combination therapy. The regulatory role of NRF-2 in regulation to Antioxidant Response Element (ARE) mediated
cytoprotective gene expression in BAC remains unexplored. The present review summarizes the role of
NRF-2 mediated antioxidant response on the synergistic antitumor effect of L-Arginine and 5-FU in BAC. This
review brought new insight into the management of BAC and in the same context, a hypothesis is raised on the
use of reduced glutathione (GSH) or N-Acetyl Cysteine as it may be an added adjuvant in the combination of 5-
FU and L-Arginine for management of BAC.
Collapse
Affiliation(s)
- Asis Bala
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, EPIP, Industrial Area, Vaishali 844102, Bihar, India
| | - Shravani Sripathi Panditharadyula
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, EPIP, Industrial Area, Vaishali 844102, Bihar, India
| |
Collapse
|
3
|
Mafra CADCC, Vasconcelos RC, de Medeiros CACX, Leitão RFDC, Brito GADC, Costa DVDS, Guerra GCB, de Araújo RF, Medeiros AC, de Araújo AA. Gliclazide Prevents 5-FU-Induced Oral Mucositis by Reducing Oxidative Stress, Inflammation, and P-Selectin Adhesion Molecules. Front Physiol 2019; 10:327. [PMID: 30971955 PMCID: PMC6445135 DOI: 10.3389/fphys.2019.00327] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/11/2019] [Indexed: 12/27/2022] Open
Abstract
Oral mucositis (OM) is one of the main side effects of the head and neck cancer treatment, particularly radiotherapy and/or chemotherapy. OM is characterized by ulcers, erythema, dysphagia, xerostomia, and increased susceptibility to opportunistic infections. In the perspective of finding pharmacological therapies to prevent inflammation and ulceration of OM, the investigation of the pleiotropic effect of commercial drugs is needed, among them gliclazide, an antidiabetic drug. This study aimed to evaluate the effect of gliclazide in an experimental OM model induced by 5-fluorouracil. Male hamsters were pre-treated with oral gliclazide (1, 5, or 10 mg/kg) for 10 days. Cheek pouch samples were subjected to histopathological and immunohistochemical analysis (COX2, iNOS, MMP-2, NFκB P65, GPx) and imunofluorescence (P-selectin). IL-1β and TNF-α levels, Myeloperoxidase activity (MPO) and malondialdehyde (MDA) levels were investigated by ultraviolet-visible spectroscopy analysis. NFκB NLS P50 protein levels were analyzed by western blotting. The group treated with gliclazide at a dose of 10 mg/kg showed presence of erythema, no evidence of erosion, and absence of mucosal ulceration with a score of 1 (1–2) (p < 0.01). Histopathological data for the group treated with gliclazide 10 mg/kg showed re-epithelialization, discrete mononuclear inflammatory infiltrate and absence of hemorrhage, edema, ulcers and abscesses with a score of 1 (1–1) (p < 0.01). Treatment with gliclazide 10 mg/kg reduced MPO activity (p < 0.001), MDA levels (p < 0.001) and NFκB NLS P50 (p < 0.05) protein levels, resulting in low immunostaining to Cox-2, iNOS (p < 0.05), NFκB P65 (p < 0.05), and negative immunoreaction to MMP-2 (p < 0.001). However, it appeared that for Gpx1, the staining was restored in the GLI 10-FUT group compared with 5FUT/saline (p < 0.05). Immunofluorescence revealed decreased levels of P-selectin (p < 0.001) after treatment with gliclazide 10 mg/kg (p < 0.05). In summary, gliclazide accelerated mucosal recovery and reduced oxidative stress and inflammation in the 5-FU-induced OM in hamsters.
Collapse
Affiliation(s)
| | | | - Caroline Addison Carvalho Xavier de Medeiros
- Department of Biophysics and Pharmacology, UFRN, Natal, Brazil.,Postgraduate Program in Biological Science and Rede Nordeste de Biotecnologia/Renorbio, Federal University of Rio Grande Norte, Natal, Brazil
| | - Renata Ferreira de Carvalho Leitão
- Postgraduate Programs in Pharmacology and Morphology, Department of Morphology/Pharmacology, Federal University of Ceará, Fortaleza, Brazil
| | - Gerly Anne de Castro Brito
- Postgraduate Programs in Pharmacology and Morphology, Department of Morphology/Pharmacology, Federal University of Ceará, Fortaleza, Brazil
| | - Deiziane Viana da Silva Costa
- Postgraduate Programs in Pharmacology and Morphology, Department of Morphology/Pharmacology, Federal University of Ceará, Fortaleza, Brazil
| | - Gerlane Coelho Bernardo Guerra
- Postgraduate Programs in Postgraduate Program in Biological Science/Pharmaceutical Science, Department of Biophysical and Pharmacology, UFRN, Natal, Brazil
| | - Raimundo Fernandes de Araújo
- Postgraduate Programs in Functional and Structural Biology and Health Science, Department of Morphology, UFRN, Natal, Brazil
| | - Aldo Cunha Medeiros
- Postgraduate Programs in Health Science, Department of Surgery, UFRN, Natal, Brazil
| | - Aurigena Antunes de Araújo
- Postgraduate Oral Science, Postgraduate Programs in Pharmaceutical Science, Department of Biophysics and Pharmacology, Federal University of Rio Grande Norte, Natal, Brazil
| |
Collapse
|
4
|
Jahani M, Azadbakht M, Rasouli H, Yarani R, Rezazadeh D, Salari N, Mansouri K. L-arginine/5-fluorouracil combination treatment approaches cells selectively: Rescuing endothelial cells while killing MDA-MB-468 breast cancer cells. Food Chem Toxicol 2019; 123:399-411. [DOI: 10.1016/j.fct.2018.11.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 11/03/2018] [Accepted: 11/07/2018] [Indexed: 12/14/2022]
|
5
|
Gu C, Yao J, Sun P. Dynamin 3 suppresses growth and induces apoptosis of hepatocellular carcinoma cells by activating inducible nitric oxide synthase production. Oncol Lett 2017; 13:4776-4784. [PMID: 28599479 PMCID: PMC5453014 DOI: 10.3892/ol.2017.6057] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 02/23/2017] [Indexed: 01/08/2023] Open
Abstract
Dynamin 3 (DNM3) is candidate tumor suppressor against hepatocellular carcinoma (HCC). Downregulation of DNM3 is more frequently identified in HCC tissues than in normal liver tissues. However, the mechanism underlying DNM3-mediated inhibition of HCC remains unclear. The present study demonstrated that DNM3 expression was decreased in human HCC tissues and cell lines. The downregulation of DNM3 promoted cell proliferation by increasing cell cycle-associated proteins, including cyclin D1, cyclin-dependent kinase (CDK) 2 and CDK4. The upregulation of DNM3 induced HCC cell apoptosis and inhibited tumor growth. The present study also revealed that overexpression of DNM3 induced nitric oxide (NO) production and intracellular reactive oxygen species (ROS) accumulation. DNM3 overexpression also increased the protein expression level of inducible nitric oxide synthase (iNOS) in HCC cells and subcutaneous HCC tumor xenografts. The inhibition of iNOS by L-canavanine attenuated the DNM3-induced ROS accumulation and apoptotic cell death. In conclusion, the results indicate that DNM3 overexpression may induce apoptosis and inhibit tumor growth of HCC by activating iNOS production and the subsequent NO-ROS signaling pathways.
Collapse
Affiliation(s)
- Chao Gu
- Department of General Surgery, Jinshan Hospital, Fudan University, Shanghai 201508, P.R. China
| | - Junliang Yao
- Department of General Surgery, Jinshan Hospital, Fudan University, Shanghai 201508, P.R. China
| | - Peilong Sun
- Department of General Surgery, Jinshan Hospital, Fudan University, Shanghai 201508, P.R. China
| |
Collapse
|
6
|
Liu H, Li Q, Wang Y, Hong H, Chen M, Wang Y, Hong F, Yang S. Elevated nitric oxide levels associated with hepatic cell apoptosis during liver injury. Hepatol Res 2017; 47:178-185. [PMID: 27489194 DOI: 10.1111/hepr.12783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 07/08/2016] [Accepted: 07/25/2016] [Indexed: 12/30/2022]
Abstract
Hepatic injury is a major event in liver surgery such as liver transplantation and it always leads to hepatic cell apoptosis. Nitric oxide (NO) is a key signaling regulation molecule. Many researchers have shown that increased NO level can influence liver cell apoptosis by promoting or inhibiting the relative signaling pathways that are involved in the caspase family, Bax/Bcl-2, mitochondria, oxidative stress, death receptors, and mitogen-activated protein kinases. Elucidating the relationships between NO and hepatic cell apoptosis is necessary for ameliorating prognosis of liver surgery. This article reviews the newest research progress in the relationships between higher NO levels and hepatic cell apoptosis in liver injury.
Collapse
Affiliation(s)
- Hui Liu
- Department of Physiology, College of Medicine, Nanchang University, Nanchang, China
| | - Qian Li
- Department of Physiology, College of Medicine, Nanchang University, Nanchang, China
| | - Ying Wang
- Department of Physiology, College of Medicine, Nanchang University, Nanchang, China
| | - Huimin Hong
- Department of Physiology, College of Medicine, Nanchang University, Nanchang, China
| | - Mengting Chen
- Department of Physiology, College of Medicine, Nanchang University, Nanchang, China
| | - Yingyi Wang
- Department of Physiology, College of Medicine, Nanchang University, Nanchang, China
| | - Fenfang Hong
- Department of Experimental Teaching, Nanchang University, Nanchang, China
| | - Shulong Yang
- Department of Physiology, College of Medicine, Nanchang University, Nanchang, China
| |
Collapse
|
7
|
Zhang N, Yin Y, Xu SJ, Chen WS. 5-Fluorouracil: mechanisms of resistance and reversal strategies. Molecules 2008; 13:1551-69. [PMID: 18794772 PMCID: PMC6244944 DOI: 10.3390/molecules13081551] [Citation(s) in RCA: 453] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Revised: 07/01/2008] [Accepted: 07/15/2008] [Indexed: 11/24/2022] Open
Abstract
The purpose of this work is to review the published studies on the mechanisms of action and resistance of 5-fluorouracil. The review is divided into three main sections: mechanisms of anti-tumor action, studies of the resistance to the drug, and procedures for the identification of new genes involved in resistance with microarray techniques. The details of the induction and reversal of the drug resistance are also described.
Collapse
Affiliation(s)
- Ning Zhang
- Department of Orthopaedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, #88 Jiefang Road, Hangzhou, 310009, P.R. China; E-mail:
| | - Ying Yin
- Institute of Clinical Research, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, #3 East Qingchun Road, Hangzhou, 310016, P.R. China; E-mails: ;
| | - Sheng-Jie Xu
- Institute of Clinical Research, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, #3 East Qingchun Road, Hangzhou, 310016, P.R. China; E-mails: ;
| | - Wei-Shan Chen
- Department of Orthopaedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, #88 Jiefang Road, Hangzhou, 310009, P.R. China; E-mail:
- Author to whom correspondence should be addressed; E-Mail:
| |
Collapse
|