Chronic anthracycline cardiotoxicity: molecular and functional analysis with focus on nuclear factor erythroid 2-related factor 2 and mitochondrial biogenesis pathways.
Anthracycline anticancer drugs (e.g., doxorubicin or daunorubicin) can induce chronic cardiotoxicity and heart failure (HF), both of which are believed to be based on oxidative injury and mitochondrial damage. In this study, molecular and functional changes induced by chronic anthracycline treatment with progression into HF in post-treatment follow-up were analyzed with special emphasis on nuclear factor erythroid 2-related factor 2 (Nrf2) and peroxisome proliferator-activated receptor-γ coactivator-1α (PGC1α) pathways. Chronic cardiotoxicity was induced in rabbits with daunorubicin (3 mg/kg, weekly for 10 weeks), and the animals were followed for another 10 weeks. Echocardiography revealed a significant drop in left ventricular (LV) systolic function during the treatment with marked progression to LV dilation and congestive HF in the follow-up. Although daunorubicin-induced LV lipoperoxidation was found, it was only loosely associated with cardiac performance. Furthermore, although LV oxidized glutathione content was increased, the oxidized-to-reduced glutathione ratio itself remained unchanged. Neither Nrf2, the master regulator of antioxidant response, nor the majority of its target genes showed up-regulation in the study. However, down-regulation of manganese superoxide dismutase and NAD(P)H dehydrogenase [quinone] 1 were observed together with heme oxygenase 1 up-regulation. Although marked perturbations in mitochondrial functions were found, no induction of PGC1α-controlled mitochondrial biogenesis pathway was revealed. Instead, especially in the post-treatment period, an impaired regulation of this pathway was observed along with down-regulation of the expression of mitochondrial genes. These results imply that global oxidative stress need not be a factor responsible for the development of anthracycline-induced HF, whereas suppression of mitochondrial biogenesis might be involved.
Department of Pharmacology, Faculty of Medicine in Hradec Králové, Charles University in Prague, Šimkova 870, Hradec Králové, 500 38, Czech Republic.
Eduard
E
Jirkovsky
Olga
O
Popelová
Pavla
P
Kriváková-Stanková
Anna
A
Vávrová
Milos
M
Hroch
Pavlína
P
Hasková
Eva
E
Brcáková-Dolezelová
Stanislav
S
Micuda
Michaela
M
Adamcová
Tomás
T
Simůnek
Zuzana
Z
Cervinková
Vladimír
V
Gersl
Martin
M
Sterba
D000818:Animals; D018943:Anthracyclines / Q000633:toxicity*; D000903:Antibiotics, Antineoplastic / Q000633:toxicity*; D002467:Cell Nucleus / Q000187:drug effects / Q000378:metabolism; D003630:Daunorubicin / Q000494:pharmacology; D004452:Echocardiography; D005978:Glutathione / Q000378:metabolism; D006331:Heart Diseases / Q000139:chemically induced* / Q000378:metabolism*; D006334:Heart Function Tests; D006352:Heart Ventricles / Q000187:drug effects / Q000378:metabolism; D015227:Lipid Peroxidation / Q000187:drug effects; D008297:Male; D008929:Mitochondria, Heart / Q000187:drug effects / Q000378:metabolism*; D009206:Myocardium / Q000473:pathology; D051267:NF-E2-Related Factor 2 / Q000096:biosynthesis*; D018384:Oxidative Stress / Q000187:drug effects; D011817:Rabbits; D060888:Real-Time Polymerase Chain Reaction; D013534:Survival; D014157:Transcription Factors / Q000378:metabolism; D020107:Troponin T / Q000378:metabolism
D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D051267:NF-E2-Related Factor 2; D014157:Transcription Factors; D020107:Troponin T; C111264:peroxisome-proliferator-activated receptor-gamma coactivator-1; D005978:Glutathione; D003630:Daunorubicin