Li Wei, Xu Bin, Xu Jian, Wu Xiao-Li
Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Zhejiang, China.
Basic Clin Pharmacol Toxicol. 2009 Mar;104(3):192-7. doi: 10.1111/j.1742-7843.2008.00358.x. Epub 2009 Jan 8.
Doxorubicin is widely prescribed in the chemotherapy of haematological malignancies and solid tumours. The major side effect of doxorubicin is oxidative injury-related cardiotoxicity, which has dramatically hindered its usage. Procyanidins from grape seeds are potent free radical scavengers that have been shown to protect against anthracycline-induced cardiotoxicity. In the present study, we tested whether procyanidins would prevent the doxorubicin-induced cardiotoxicity in rats. Rats were intraperitoneally treated with doxorubicin at a cumulative dose of 15 mg/kg with and without pre-administration of procyanidins. Our data showed that doxorubicin led to cardiac function deterioration, myocardial injury and increased oxidative stress in cardiac tissues. The cardiac function deterioration by doxorubicin included increased QT-interval and ST-interval in electrocardiograph (ECG) and decreased left ventricular developed pressure. Doxorubicin-induced myocardial injury was shown by the increased creatine kinase, alanine aminotransferase and aspartate aminotransferase in serum as well as in myocardial lesions. Pretreatment with procyanidin (150 mg/kg daily) effectively hindered the adverse effects of doxorubicin, such as myocardial injury and impaired heart function. Procyanidin pretreatment attenuated cytoplasmic vacuolization, increased left ventricular developed pressure and improved the ECG. The cardioprotective effect of procyanidin corresponded to the decrease of lipid peroxidation and the increase of cardiac antioxidant potency in doxorubicin-treated rats that were also given procyanidin. An in vitro cytotoxic study showed that procyanidins did not attenuate the antineoplastic activity of doxorubicin to A549 adenocarcinoma cells. All the above lines of evidence suggest that procyanidins protect cardiomyocytes from doxorubicin-induced cardiotoxicity via suppression of oxidative stress.
阿霉素广泛应用于血液系统恶性肿瘤和实体瘤的化疗。阿霉素的主要副作用是氧化损伤相关的心脏毒性,这极大地限制了其使用。葡萄籽中的原花青素是有效的自由基清除剂,已被证明可预防蒽环类药物引起的心脏毒性。在本研究中,我们测试了原花青素是否能预防阿霉素诱导的大鼠心脏毒性。大鼠腹腔注射阿霉素,累积剂量为15 mg/kg,同时或不预先给予原花青素。我们的数据表明,阿霉素导致心脏功能恶化、心肌损伤和心脏组织氧化应激增加。阿霉素引起的心脏功能恶化包括心电图(ECG)中QT间期和ST间期增加以及左心室舒张末压降低。血清以及心肌病变中肌酸激酶、丙氨酸转氨酶和天冬氨酸转氨酶增加表明阿霉素诱导了心肌损伤。原花青素(每日150 mg/kg)预处理有效地阻碍了阿霉素的不良反应,如心肌损伤和心脏功能受损。原花青素预处理减轻了细胞质空泡化,增加了左心室舒张末压并改善了心电图。原花青素的心脏保护作用与给予原花青素的阿霉素处理大鼠中脂质过氧化的减少和心脏抗氧化能力的增加相对应。一项体外细胞毒性研究表明,原花青素不会减弱阿霉素对A549腺癌细胞的抗肿瘤活性。所有上述证据表明,原花青素通过抑制氧化应激保护心肌细胞免受阿霉素诱导的心脏毒性。