口服细菌膜蛋白纳米药物通过减轻肠道屏障受损来改善阿霉素心脏毒性。

An orally administered bacterial membrane protein nanodrug ameliorates doxorubicin cardiotoxicity through alleviating impaired intestinal barrier.

作者信息

Li Zhen, Xing Junyue, Ma Xiaohan, Zhang Wanjun, Wang Chuan, Wang Yingying, Qi Xinkun, Liu Yanhui, Jian Dongdong, Cheng Xiaolei, Zhu Yanjie, Shi Chao, Guo Yongjun, Zhao Huan, Jiang Wei, Tang Hao

机构信息

National Health Commission Key Laboratory of Cardiovascular Regenerative Medicine, Central China Subcenter of National Center for Cardiovascular Diseases, Henan Cardiovascular Disease Center, Fuwai Central-China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, 450046, China.

Henan Key Laboratory of Chronic Disease Management, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, 451464, China.

出版信息

Bioact Mater. 2024 Apr 25;37:517-532. doi: 10.1016/j.bioactmat.2024.03.027. eCollection 2024 Jul.

Abstract

The cardiotoxicity caused by Dox chemotherapy represents a significant limitation to its clinical application and is a major cause of late death in patients undergoing chemotherapy. Currently, there are no effective treatments available. Our analysis of 295 clinical samples from 132 chemotherapy patients and 163 individuals undergoing physical examination revealed a strong positive correlation between intestinal barrier injury and the development of cardiotoxicity in chemotherapy patients. We developed a novel orally available and intestinal targeting protein nanodrug by assembling membrane protein Amuc_1100 (obtained from intestinal bacteria ), fluorinated polyetherimide, and hyaluronic acid. The protein nanodrug demonstrated favorable stability against hydrolysis compared with free Amuc_1100. The in vivo results demonstrated that the protein nanodrug can alleviate Dox-induced cardiac toxicity by improving gut microbiota, increasing the proportion of short-chain fatty acid-producing bacteria from the family, and further enhancing the levels of butyrate and pentanoic acids, ultimately regulating the homeostasis repair of lymphocytes in the spleen and heart. Therefore, we believe that the integrity of the intestinal barrier plays an important role in the development of chemotherapy-induced cardiotoxicity. Protective interventions targeting the intestinal barrier may hold promise as a general clinical treatment regimen for reducing Dox-induced cardiotoxicity.

摘要

多柔比星化疗引起的心脏毒性是其临床应用的一个重大限制,也是化疗患者晚期死亡的主要原因。目前,尚无有效的治疗方法。我们对132例化疗患者和163例体检者的295份临床样本进行分析,发现化疗患者肠道屏障损伤与心脏毒性的发生之间存在很强的正相关。我们通过组装膜蛋白Amuc_1100(从肠道细菌中获得)、氟化聚醚酰亚胺和透明质酸,开发了一种新型的口服且靶向肠道的蛋白质纳米药物。与游离的Amuc_1100相比,该蛋白质纳米药物表现出良好的抗水解稳定性。体内结果表明,该蛋白质纳米药物可通过改善肠道微生物群、增加来自该家族的短链脂肪酸产生菌的比例,并进一步提高丁酸和戊酸水平,最终调节脾脏和心脏中淋巴细胞的稳态修复,从而减轻多柔比星诱导的心脏毒性。因此,我们认为肠道屏障的完整性在化疗诱导的心脏毒性发展中起重要作用。针对肠道屏障的保护性干预措施有望成为减少多柔比星诱导的心脏毒性的通用临床治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13f4/11063951/99a6b8300ce7/ga1.jpg

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