title: Early effects of doxorubicin in perfused heart: transcriptional profiling reveals inhibition of cellular stress response genes.
abstract: Doxorubicin (DXR) belongs to the most efficient anticancer drugs. However, its clinical application is limited by the risk of severe cardiac-specific toxicity, for which an efficient treatment is missing. Underlying molecular mechanisms are not sufficiently understood so far, but nonbiased, systemic approaches can yield new clues to develop targeted therapies. Here, we applied a genome-wide transcriptome analysis to determine the early cardiac response to DXR in a model characterized earlier, that is, rat heart perfusion with 2 muM DXR, leading to only mild cardiac dysfunction. Single-gene and gene set enrichment analysis of DNA microarrays yielded robust data on cardiac transcriptional reprogramming, including novel DXR-responsive pathways. Main characteristics of transcriptional reprogramming were 1) selective upregulation of individual genes or gene sets together with widespread downregulation of gene expression; 2) repression of numerous transcripts involved in cardiac stress response and stress signaling; 3) modulation of genes with cardiac remodeling capacity; 4) upregulation of "energy-related" pathways; and 5) similarities to the transcriptional response of cancer cells. Some early responses like the induction of glycolytic and Krebs cycle genes may have compensatory function. Only minor changes in the cardiac energy status or the respiratory activity of permeabilized cardiac fibers have been observed. Other responses potentially contribute to acute and also chronic toxicity, in particular, those in stress-responsive and cardiac remodeling transcripts. We propose that a blunted response to stress and reduced "danger signaling" is a prime component of toxic DXR action and can drive cardiac cells into pathology.
authors.affiliation: Université Joseph Fourier, Grenoble cedex 9, France. malgorzata.tokarska-schlattner@ujf-grenoble.fr
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Tokarska-Schlattner
authors.forename: Eliana
authors.initials: E
authors.lastname: Lucchinetti
authors.forename: Michael
authors.initials: M
authors.lastname: Zaugg
authors.forename: Laurence
authors.initials: L
authors.lastname: Kay
authors.forename: Séverine
authors.initials: S
authors.lastname: Gratia
authors.forename: Rita
authors.initials: R
authors.lastname: Guzun
authors.forename: Valdur
authors.initials: V
authors.lastname: Saks
authors.forename: Uwe
authors.initials: U
authors.lastname: Schlattner
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D002952:Citric Acid Cycle / Q000187:drug effects / Q000235:genetics; D015536:Down-Regulation / Q000187:drug effects; D004317:Doxorubicin / Q000494:pharmacology*; D020869:Gene Expression Profiling; D006019:Glycolysis / Q000187:drug effects / Q000235:genetics; D006321:Heart / Q000187:drug effects / Q000502:physiology*; D008297:Male; D008928:Mitochondria / Q000187:drug effects / Q000502:physiology; D020929:Mitogen-Activated Protein Kinase Kinases / Q000235:genetics; D009693:Nucleic Acid Hybridization; D020411:Oligonucleotide Array Sequence Analysis; D010101:Oxygen Consumption / Q000187:drug effects; D010725:Phosphocreatine / Q000378:metabolism; D016133:Polymerase Chain Reaction; D012313:RNA / Q000235:genetics / Q000302:isolation & purification; D012333:RNA, Messenger / Q000235:genetics; D051381:Rats; D017208:Rats, Wistar; D014158:Transcription, Genetic / Q000187:drug effects*; D015854:Up-Regulation / Q000187:drug effects
chemical_list: D012333:RNA, Messenger; D010725:Phosphocreatine; D012313:RNA; D004317:Doxorubicin; D000255:Adenosine Triphosphate; D020929:Mitogen-Activated Protein Kinase Kinases