title: Concomitant low-dose doxorubicin treatment and exercise.
abstract: Cardiotoxicity is a side effect for cancer patients treated with doxorubicin (DOX). We tested the hypothesis that low-intensity aerobic exercise concomitant with DOX treatment would offset DOX-induced cardiotoxicity while also improving the therapeutic efficacy of DOX on tumor progression. B16F10 melanoma cells (3 × 10(5)) were injected subcutaneously into the scruff of 6- to 8-wk-old male C57BL/6 mice (n = 48). A 4 mg/kg cumulative dose of DOX was administered over 2 wk, and exercise (EX) consisted of treadmill walking (10 m/min, 45 min/day, 5 days/wk, 2 wk). Four experimental groups were tested: 1) sedentary (SED) + vehicle, 2) SED + DOX, 3) EX + vehicle, and 4) EX + DOX. Tumor volume was attenuated in DOX and lowest in EX + DOX. DOX-treated animals had less gain in body weight, reduced heart weights (HW), smaller HW-to-body weight ratios, and shorter tibial lengths by the end of the protocol; and exercise did not reverse the cardiotoxic effects of DOX. Despite decreased left ventricular (LV) mass with DOX, cardiomyocyte cross-sectional area, β-myosin heavy chain gene expression, and whole heart systolic (fractional shortening) and diastolic (E/A ratio) function were similar among groups. DOX also resulted in increased LV fibrosis with lower LV end diastolic volume and stroke volume. Myocardial protein kinase B activity was increased with both DOX and EX treatments, and tuberous sclerosis 2 (TSC2) abundance was reduced with EX. Downstream phosphorylation of TSC2 and mammalian target of rapamycin were similar across groups. We conclude that exercise increases the efficacy of DOX in inhibiting tumor growth without mitigating subclinical DOX-induced cardiotoxicity in a murine model of melanoma.
authors.affiliation: University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania; and.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Sturgeon
authors.affiliation: University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania; and.
authors.forename: Keri
authors.initials: K
authors.lastname: Schadler
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Geetha
authors.initials: G
authors.lastname: Muthukumaran
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Dennis
authors.initials: D
authors.lastname: Ding
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Akinyemi
authors.initials: A
authors.lastname: Bajulaiye
authors.affiliation: University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania; and.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Thomas
authors.affiliation: University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania; and.
authors.forename: Victor
authors.initials: V
authors.lastname: Ferrari
authors.affiliation: University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania; and.
authors.forename: Sandra
authors.initials: S
authors.lastname: Ryeom
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania jlibonat@nursing.upenn.edu.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Libonati
mesh_terms: D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000633:toxicity*; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage* / Q000633:toxicity*; D004334:Drug Administration Schedule; D005081:Exercise Therapy; D005355:Fibrosis; D006331:Heart Diseases / Q000139:chemically induced* / Q000235:genetics / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008546:Melanoma, Experimental / Q000188:drug therapy* / Q000473:pathology; D051379:Mice; D008810:Mice, Inbred C57BL; D032383:Myocytes, Cardiac / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D010766:Phosphorylation; D051057:Proto-Oncogene Proteins c-akt / Q000378:metabolism; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013318:Stroke Volume / Q000187:drug effects; D058570:TOR Serine-Threonine Kinases / Q000235:genetics / Q000378:metabolism; D013997:Time Factors; D000077005:Tuberous Sclerosis Complex 2 Protein; D047368:Tumor Burden / Q000187:drug effects; D025521:Tumor Suppressor Proteins / Q000235:genetics / Q000378:metabolism; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D000903:Antibiotics, Antineoplastic; C000624654:Tsc2 protein, mouse; D000077005:Tuberous Sclerosis Complex 2 Protein; D025521:Tumor Suppressor Proteins; D004317:Doxorubicin; C546843:mTOR protein, mouse; D051057:Proto-Oncogene Proteins c-akt; D058570:TOR Serine-Threonine Kinases
keywords: cardiotoxicity; drug therapy; heart; neoplasm