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微小 RNA 在阿霉素诱导的心脏毒性中的作用:临床前模型和癌症患者概述。

Role of microRNAs in doxorubicin-induced cardiotoxicity: an overview of preclinical models and cancer patients.

机构信息

Immunology and Functional Genomics Unit, Centro Cardiologico Monzino IRCCS, via Parea 4, 20138, Milan, Italy.

Department of Health Science, Cardiology Unit, San Gerardo Hospital, Monza, Italy.

出版信息

Heart Fail Rev. 2018 Jan;23(1):109-122. doi: 10.1007/s10741-017-9653-0.

Abstract

Cardiotoxicity is a well-known side effect of doxorubicin (DOX), but the mechanisms leading to this phenomenon are still not completely clear. Prediction of drug-induced dysfunction onset is difficult and is still largely based on detection of cardiac troponin (cTn), a circulating marker of heart damage. In the last years, several investigations focused on the possible involvement of microRNAs (miRNAs) in DOX-induced toxicity in vitro, with contrasting results. Recently, several groups employed animal models to mimic patient's condition, investigate the biological pathways perturbed by DOX, and identify diagnostic markers of cardiotoxicity. We reviewed the results from several studies investigating cardiac miRNAs expression in rodent models of DOX-treatment. We also discussed the data from two publications indicating the possible use of circulating miRNA as biomarkers of DOX-induced cardiotoxicity. Unfortunately, limited information was derived from these studies, as selection methods of candidate-miRNAs and heterogeneity in cardiotoxicity assessment greatly hampered the novelty and robustness of the findings. Nevertheless, at least one circulating miRNA, miR-1, showed a good potential as early biomarker of drug-mediated cardiac dysfunction onset. The use of animal models to investigate DOX-induced cardiotoxicity surely helps narrowing the gap between basic research and clinical practice. Despite this, several issues, including selection of relevant miRNAs and less-than-optimal assessment of cardiotoxicity, greatly limited the results obtained so far. Nonetheless, the association of patients-based studies with the use of preclinical models may be the key to address the many unanswered questions regarding the pathophysiology and early detection of cardiotoxicity.

摘要

心脏毒性是阿霉素(DOX)的已知副作用,但导致这种现象的机制仍不完全清楚。预测药物引起的功能障碍的发生是困难的,并且仍然主要基于检测心脏肌钙蛋白(cTn),这是一种心脏损伤的循环标志物。在过去的几年中,有几项研究集中在 microRNAs(miRNAs)在体外 DOX 诱导毒性中的可能作用上,结果相互矛盾。最近,几个小组使用动物模型来模拟患者的情况,研究 DOX 引起的生物学途径紊乱,并确定心脏毒性的诊断标志物。我们综述了几篇研究啮齿动物模型中 DOX 治疗后心脏 miRNA 表达的研究结果。我们还讨论了两篇表明循环 miRNA 可能作为 DOX 诱导的心脏毒性生物标志物的出版物的数据。不幸的是,这些研究得出的信息有限,因为候选 miRNA 的选择方法和心脏毒性评估的异质性极大地阻碍了发现的新颖性和稳健性。然而,至少一种循环 miRNA,miR-1,作为药物介导的心脏功能障碍发生的早期生物标志物显示出良好的潜力。使用动物模型研究 DOX 诱导的心脏毒性确实有助于缩小基础研究和临床实践之间的差距。尽管如此,包括相关 miRNA 的选择和心脏毒性评估不理想在内的几个问题极大地限制了迄今为止获得的结果。尽管如此,将基于患者的研究与临床前模型的使用结合起来可能是解决关于心脏毒性的病理生理学和早期检测的许多未回答问题的关键。

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