Prokineticin receptor-1 signaling inhibits dose- and time-dependent anthracycline-induced cardiovascular toxicity via myocardial and vascular protection.
ObjectivesThis
study investigated how different concentrations of doxorubicin (DOX)
can affect the function of cardiac cells. This study also examined
whether activation of prokineticin receptor (PKR)-1 by a nonpeptide
agonist, IS20, prevents DOX-induced cardiovascular toxicity in mouse
models.BackgroundHigh
prevalence of heart failure during and following cancer treatments
remains a subject of intense research and therapeutic interest.MethodsThis
study used cultured cardiomyocytes, endothelial cells (ECs), and
epicardium-derived progenitor cells (EDPCs) for in vitro assays,
tumor-bearing models, and acute and chronic toxicity mouse models for
in vivo assays.ResultsBrief
exposure to cardiomyocytes with high-dose DOX increased the
accumulation of reactive oxygen species (ROS) by inhibiting a
detoxification mechanism via stabilization of cytoplasmic nuclear
factor, erythroid 2. Prolonged exposure to medium-dose DOX induced
apoptosis in cardiomyocytes, ECs, and EDPCs. However, low-dose DOX
promoted functional defects without inducing apoptosis in EDPCs and ECs.
IS20 alleviated detrimental effects of DOX in cardiac cells by
activating the serin threonin protein kinase B (Akt) or
mitogen-activated protein kinase pathways. Genetic or pharmacological
inactivation of PKR1 subdues these effects of IS20. In a chronic mouse
model of DOX cardiotoxicity, IS20 normalized an elevated serum marker of
cardiotoxicity and vascular and EDPC deficits, attenuated apoptosis and
fibrosis, and improved the survival rate and cardiac function. IS20 did
not interfere with the cytotoxicity or antitumor effects of DOX in
breast cancer lines or in a mouse model of breast cancer, but it did
attenuate the decreases in left ventricular diastolic volume induced by
acute DOX treatment.ConclusionsThis
study identified the molecular and cellular signature of
dose-dependent, DOX-mediated cardiotoxicity and provided evidence that
PKR-1 is a promising target to combat cardiotoxicity of cancer
treatments.