Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA.
Department of Biomedical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA.
J Vet Intern Med. 2020 May;34(3):1260-1271. doi: 10.1111/jvim.15762. Epub 2020 Apr 7.
BACKGROUND: Long-term use of doxorubicin (DOX) is limited by cumulative dose-dependent cardiotoxicity. OBJECTIVES: Identify plasma extracellular vesicle (EV)-associated microRNAs (miRNAs) as a biomarker for cardiotoxicity in dogs by correlating changes with cardiac troponin I (cTnI) concentrations and, echocardiographic and histologic findings. ANIMALS: Prospective study of 9 client-owned dogs diagnosed with sarcoma and receiving DOX single-agent chemotherapy (total of 5 DOX treatments). Dogs with clinically relevant metastatic disease, preexisting heart disease, or breeds predisposed to cardiomyopathy were excluded. METHODS: Serum concentration of cTnI was monitored before each treatment and 1 month after the treatment completion. Echocardiography was performed before treatments 1, 3, 5, and 1 month after completion. The EV-miRNA was isolated and sequenced before treatments 1 and 3, and 1 month after completion. RESULTS: Linear mixed model analysis for repeated measurements was used to evaluate the effect of DOX. The miR-107 (P = .03) and miR-146a (P = .02) were significantly downregulated whereas miR-502 (P = .02) was upregulated. Changes in miR-502 were significant before administration of the third chemotherapeutic dose. When stratifying miRNA expression for change in left ventricular ejection fraction, upregulation of miR-181d was noted (P = .01). Serum concentration of cTnI changed significantly but only 1 month after treatment completion, and concentrations correlated with left ventricular ejection fraction and left ventricular internal dimension in diastole. CONCLUSION AND CLINICAL SIGNIFICANCE: Downregulation of miR-502 was detected before significant changes in cTnI concentrations or echocardiographic parameters. Further validation using a larger sample size will be required.
背景:多柔比星(DOX)的长期使用受到累积剂量依赖性心脏毒性的限制。
目的:通过与心脏肌钙蛋白 I(cTnI)浓度以及超声心动图和组织学发现相关联,鉴定血浆细胞外囊泡(EV)相关 microRNA(miRNA)作为犬心脏毒性的生物标志物。
动物:9 只患有肉瘤并接受 DOX 单药化疗(共 5 次 DOX 治疗)的患犬进行了前瞻性研究。患有临床相关转移性疾病、先前存在的心脏病或易患心肌病的品种的犬被排除在外。
方法:在每次治疗前和治疗完成后 1 个月监测血清 cTnI 浓度。在治疗前 1、3、5 次和完成后 1 个月进行超声心动图检查。在治疗前 1 和 3 次以及完成后 1 个月分离和测序 EV-miRNA。
结果:使用重复测量线性混合模型分析评估 DOX 的效果。miR-107(P =.03)和 miR-146a(P =.02)明显下调,而 miR-502(P =.02)上调。在给予第三次化疗剂量之前,miR-502 的变化是显著的。当对左心室射血分数变化的 miRNA 表达进行分层时,观察到 miR-181d 的上调(P =.01)。血清 cTnI 浓度显著变化,但仅在治疗完成后 1 个月,浓度与左心室射血分数和舒张期左心室内径相关。
结论和临床意义:在 cTnI 浓度或超声心动图参数发生显著变化之前,检测到 miR-502 的下调。需要使用更大的样本量进行进一步验证。
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