Yu Wei, Qin Xing, Zhang Yuchen, Qiu Peng, Wang Linge, Zha Wenliang, Ren Jun
Department of Pharmacology, Hubei University of Science and Technology, Xianning, China.
Department of Cardiology, Xijing Hospital, the Air Force Military Medical University, Xi'an, China.
Cardiovasc Diagn Ther. 2020 Aug;10(4):752-769. doi: 10.21037/cdt-19-707.
Doxorubicin (DOX) is one of the most effective anti-neoplastic drugs although its clinical use is limited by the severe cardiotoxicity. Apoptosis and defective autophagy are believed to contribute to DOX-induced cardiotoxicity. Here we explored the effect of curcumin (Cur) on DOX-induced cardiac injury and the mechanism involved with a focus on oxidative stress, autophagy and pyroptosis.
Kunming mice were challenged with DOX (3 mg·kg, i.p. every other day) with cohorts of mice receiving Cur at 50, 100, 200 and 400 mg·kg via gavage daily. Serum levels of cardiac enzymes, such as aspartate amino transferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), and heart homogenate oxidative stress markers, such as superoxide dismutase (SOD) and malondialdehyde (MDA) were determined. Echocardiographic and cardiac contraction were examined. Apoptosis, pyroptosis, autophagy and Akt/mTOR-signalling proteins were detected using western blot or electron microscopy. Cardiac contractile properties were assessed including peak shortening, maximal velocity of shortening/relengthening (± dL/dt), time-to-PS, and time-to-90% relengthening (TR90). Superoxide levels were evaluated using DHE staining. GFP-LC3 was conducted to measure autophagosomes.
Our study showed that Cur protected against cardiotoxicity manifested by a significant decrease in serum myocardial enzymes and improvement of anti-oxidative capacity. Cur inhibited autophagy and offered overt benefit for cardiomyocyte survive against DOX-induced toxicity. Cur attenuated DOX-induced cardiomyocyte pyroptosis as evidenced by NLR family pyrin domain containing 3 (NLRP3), Caspase-1, and interleukin-18 levels. DOX impaired cardiac function (reduced fractional shortening, ejection fraction, increased plasma cTnI level and TR90, decreased PS and ± dL/dt), the effects of which were overtly reconciled by 100 mg·kg but not 50 mg·kg Cur. H9c2 cells exposure to DOX displayed increased intracellular reactive oxygen species (ROS) and autophagy, the effects of which were nullified by Cur. Autophagy activator rapamycin cancelled off Cur-induced protective effects.
Our finding suggested that Cur rescued against DOX-induced cardiac injury probably through regulation of autophagy and pyroptosis in a mTOR-dependent manner.
阿霉素(DOX)是最有效的抗肿瘤药物之一,但其临床应用因严重的心脏毒性而受到限制。细胞凋亡和自噬缺陷被认为与DOX诱导的心脏毒性有关。在此,我们探讨了姜黄素(Cur)对DOX诱导的心脏损伤的影响及其机制,重点关注氧化应激、自噬和细胞焦亡。
昆明小鼠每隔一天腹腔注射DOX(3mg·kg),另一组小鼠每天经口灌胃给予50、100、200和400mg·kg的Cur。测定血清中心肌酶如天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)的水平,以及心脏匀浆中氧化应激标志物如超氧化物歧化酶(SOD)和丙二醛(MDA)的水平。进行超声心动图和心脏收缩功能检查。使用蛋白质印迹法或电子显微镜检测细胞凋亡、细胞焦亡、自噬和Akt/mTOR信号蛋白。评估心脏收缩特性,包括峰值缩短、缩短/再延长的最大速度(±dL/dt)、达到峰值缩短的时间和达到90%再延长的时间(TR90)。使用二氢乙锭(DHE)染色评估超氧化物水平。进行绿色荧光蛋白-微管相关蛋白1轻链3(GFP-LC3)检测以测量自噬体。
我们的研究表明,Cur可预防心脏毒性,表现为血清心肌酶显著降低和抗氧化能力提高。Cur抑制自噬,并为心肌细胞抵抗DOX诱导的毒性提供明显益处。Cur减轻了DOX诱导的心肌细胞焦亡,这通过含NLR家族pyrin结构域蛋白3(NLRP3)、半胱天冬酶-1和白细胞介素-18的水平得到证实。DOX损害心脏功能(降低缩短分数、射血分数,增加血浆心肌肌钙蛋白I水平和TR90,降低PS和±dL/dt),100mg·kg的Cur可明显改善这些影响,但50mg·kg的Cur则无此作用。H9c2细胞暴露于DOX后,细胞内活性氧(ROS)和自噬增加,而Cur可消除这些影响。自噬激活剂雷帕霉素抵消了Cur诱导的保护作用。
我们的研究结果表明,Cur可能通过以mTOR依赖的方式调节自噬和细胞焦亡来挽救DOX诱导的心脏损伤。