Division of Drug Safety Research, Food and Drug Administration Silver Spring, Maryland.
Singulex, Inc. Alameda, California.
Pharmacol Res Perspect. 2014 Feb;2(1):e00015. doi: 10.1002/prp2.15. Epub 2014 Mar 3.
Imatinib (Imb) is a tyrosine kinase inhibitor with cardiotoxic activity (decreases in left ventricular function and congestive heart failure) in patients. Currently, clinical diagnosis of Imb cardiotoxicity relies primarily on evaluation of left ventricular function, Imb also induces cardiac lesions in rats.
This study, in rats, sought to determine whether monitoring biochemical markers would be a sensitive means to detect Imb-induced changes in cardiomyocyte morphology.
Groups of male Sprague-Dawley rats were dosed orally with 50, 100, 200 mg kg(-1) Imb or water daily for 28 days. Tissues and blood samples were collected 24 h after the last dosing. Cardiac biomarkers such as cardiac troponin I (cTnI), cardiac troponin T (cTnT), and fatty acid binding protein 3 (FABP3) were monitored by the Erenna, Elecsys, and Meso Scale immunoassay systems.
Imb caused microscopic myocardial lesions (myofibrillar loss, cytoplasmic vacuolization, and necrosis) at all doses as determined by unbiased histopathology analysis. The severity of the alterations was dose-related with mean lesion scores (based on a scale of 0-3) of 1.2 (50 mg kg(-1)), 2.1 (100 mg kg(-1)) and 2.9 (200 mg kg(-1)). However, the increases in cTnI, cTnT, and FABP3 levels were noted primarily in high-dose Imb treated animals.
The occurrence of myocardial alterations in animals without consistent changes in cardiac troponin and FABP3 concentrations raises questions regarding the utility of these biomarkers as early indicators of Imb-induced cardiotoxicity. Due to limited numbers of animals the reasons for this discrepancy could not be determined.
伊马替尼(Imb)是一种具有心脏毒性活性(左心室功能下降和充血性心力衰竭)的酪氨酸激酶抑制剂,可在患者中引起。目前,Imb 心脏毒性的临床诊断主要依赖于左心室功能的评估,伊马替尼也会在大鼠中引起心脏病变。
本研究在大鼠中旨在确定监测生化标志物是否是检测伊马替尼诱导的心肌细胞形态变化的敏感手段。
雄性 Sprague-Dawley 大鼠分为 50、100、200mg/kg Imb 或水组,每日口服给药,连续 28 天。末次给药后 24 小时收集组织和血样。通过 Erenna、Elecsys 和 Meso Scale 免疫分析系统监测心脏生物标志物,如肌钙蛋白 I(cTnI)、肌钙蛋白 T(cTnT)和脂肪酸结合蛋白 3(FABP3)。
通过无偏倚组织病理学分析确定,伊马替尼在所有剂量下均引起微小的心肌病变(肌原纤维丧失、细胞质空泡化和坏死)。改变的严重程度与剂量相关,平均病变评分(基于 0-3 级)分别为 1.2(50mg/kg)、2.1(100mg/kg)和 2.9(200mg/kg)。然而,cTnI、cTnT 和 FABP3 水平的升高主要见于高剂量 Imb 治疗的动物。
在动物中发生心肌改变而心脏肌钙蛋白和 FABP3 浓度没有一致变化,这使得这些生物标志物作为伊马替尼诱导的心脏毒性的早期指标的实用性受到质疑。由于动物数量有限,无法确定这种差异的原因。