Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia.
Eur J Pharmacol. 2013 Aug 15;714(1-3):472-7. doi: 10.1016/j.ejphar.2013.06.040. Epub 2013 Jul 5.
Anthracycline therapy is limited by a cardiotoxicity that may eventually lead to chronic heart failure which is thought to be prevented by ACE inhibitors (ACEi). However, the protective effect of ACEi in early stages of this specific injury remains elusive. Activated nuclear transcription factors peroxisome proliferator-activated receptors (PPAR) regulate cellular metabolism, but their involvement in anthracycline cardiomyopathy has not been investigated yet. For this purpose, Wistar rats were administered with daunorubicin (i.p., 3 mg/kg, in 48 h intervals) or co-administered with daunorubicine and enalaprilat (i.p., 5 mg/kg in 12 h intervals). Control animals received vehicle. Left ventricular function was measured invasively under anesthesia. Cell-shortening was measured by videomicroscopy in isolated cardiomyocytes. Expression of PPARs mRNA in cardiac tissue was measured by Real-Time PCR. Although the hemodynamic parameters of daunorubicin-treated rats remained altered upon ACEi co-administration, ACEi normalized daunorubicin-induced QT prolongation. On cellular level, ACEi normalized altered basal and isoproterenol-stimulated cardiac cell shortening in daunorubicine-treated group. Moreover, anthracycline administration significantly up-regulated heart PPARα mRNA and its expression remained increased after ACEi co-administration. On the other hand, the expression of cardiac PPARβ/δ was not altered in anthracycline-treated animals, whereas co-administration of ACEi increased its expression. Conclusively, effect of ACEi can be already detected in sub-acute phase of anthracycline-induced cardiotoxicity. Altered expression of heart PPARs may suggest these nuclear receptors as a novel target in anthracycline cardiomyopathy.
蒽环类药物治疗受到心脏毒性的限制,最终可能导致慢性心力衰竭,而血管紧张素转换酶抑制剂(ACEi)被认为可以预防这种心力衰竭。然而,ACEi 在这种特定损伤的早期阶段的保护作用仍然难以捉摸。激活的核转录因子过氧化物酶体增殖物激活受体(PPAR)调节细胞代谢,但它们在蒽环类心肌病中的作用尚未得到研究。为此,将 Wistar 大鼠用柔红霉素(腹腔内,3mg/kg,间隔 48 小时)或柔红霉素和依那普利拉(腹腔内,间隔 12 小时,5mg/kg)共同给药。对照动物接受载体。在麻醉下通过侵入性测量左心室功能。通过视频显微镜测量分离的心肌细胞中的细胞缩短。通过实时 PCR 测量心脏组织中 PPARs mRNA 的表达。尽管在 ACEi 共同给药时,柔红霉素处理大鼠的血流动力学参数仍然改变,但 ACEi 使柔红霉素诱导的 QT 延长正常化。在细胞水平上,ACEi 使柔红霉素处理组中改变的基础和异丙肾上腺素刺激的心脏细胞缩短正常化。此外,蒽环类药物给药显著上调心脏 PPARα mRNA 的表达,并且在 ACEi 共同给药后其表达仍然增加。另一方面,在蒽环类药物处理的动物中,心脏 PPARβ/δ 的表达没有改变,而 ACEi 的共同给药增加了其表达。总之,ACEi 的作用在蒽环类药物诱导的心脏毒性的亚急性阶段就已经可以检测到。心脏 PPARs 的改变表达可能表明这些核受体是蒽环类心肌病的一个新的靶标。