Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
Department of Pharmacology, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic.
Hypertens Res. 2024 Nov;47(11):3126-3146. doi: 10.1038/s41440-024-01865-7. Epub 2024 Sep 9.
All anthracyclines, including doxorubicin (DOXO), the most common and still indispensable drug, exhibit cardiotoxicity with inherent risk of irreversible cardiomyopathy leading to heart failure with reduced ejection fraction (HFrEF). Current pharmacological strategies are clearly less effective for this type of HFrEF, hence an urgent need for new therapeutic approaches. The prerequisite for success is thorough understanding of pathophysiology of this HFrEF form, which requires an appropriate animal model of the disease. The aim of this study was to comprehensively characterise a novel model of HF with cardiorenal syndrome, i.e. DOXO-induced HFrEF with nephrotic syndrome, in which DOXO was administered to Ren-2 transgenic rats (TGR) via five intravenous injections in a cumulative dose of 10 mg/kg of body weight (BW). Our analysis included survival, echocardiography, as well as histological examination of the heart and kidneys, blood pressure, but also a broad spectrum of biomarkers to evaluate cardiac remodelling, fibrosis, apoptosis, oxidative stress and more. We have shown that the new model adequately mimics the cardiac remodelling described as "eccentric chamber atrophy" and myocardial damage typical for DOXO-related cardiotoxicity, without major damage of the peritoneum, lungs and liver. This pattern corresponds well to a clinical situation of cancer patients receiving anthracyclines, where HF develops with some delay after the anticancer therapy. Therefore, this study may serve as a comprehensive reference for all types of research on DOXO-related cardiotoxicity, proving especially useful in the search for new therapeutic strategies.
所有蒽环类药物,包括阿霉素(DOXO),最常见且仍然不可或缺的药物,都具有心脏毒性,存在不可逆性心肌病的固有风险,导致射血分数降低的心力衰竭(HFrEF)。目前的药理学策略对这种类型的 HFrEF 显然效果较差,因此迫切需要新的治疗方法。成功的前提是彻底了解这种 HFrEF 形式的病理生理学,这需要适当的疾病动物模型。本研究的目的是全面描述一种新型的心肾综合征心力衰竭模型,即 DOXO 诱导的伴有肾病综合征的 HFrEF,其中 DOXO 通过五次静脉注射累积剂量为 10mg/kg 体重(BW)给予 Ren-2 转基因大鼠(TGR)。我们的分析包括生存、超声心动图以及心脏和肾脏的组织学检查、血压,还包括广泛的生物标志物来评估心脏重构、纤维化、细胞凋亡、氧化应激等。我们已经表明,新模型充分模拟了被描述为“偏心室萎缩”的心脏重构和与 DOXO 相关的心脏毒性的心肌损伤,而腹膜、肺和肝没有受到重大损伤。这种模式与接受蒽环类药物的癌症患者的临床情况非常吻合,在抗癌治疗后会有一定的延迟才会出现心力衰竭。因此,这项研究可以作为所有类型的 DOXO 相关心脏毒性研究的综合参考,在寻找新的治疗策略方面尤其有用。
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