Sripusanapan Adivitch, Piriyakulthorn Chotrawee, Apaijai Nattayaporn, Chattipakorn Siriporn C, Chattipakorn Nipon
Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai 50200, Thailand.
Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai 50200, Thailand; Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand.
Biochem Pharmacol. 2025 Jun;236:116881. doi: 10.1016/j.bcp.2025.116881. Epub 2025 Mar 18.
Doxorubicin (Dox) is a potent anthracycline chemotherapeutic agent. However, its efficacy is limited by its cardiotoxicity, which is driven by excessive oxidative stress, calcium overload, and mitochondrial dysfunction. These mechanisms ultimately result in cardiomyocyte death and cardiac dysfunction. Ivabradine, a hyperpolarization-activated cyclic nucleotide-gated channel blocker, has cardioprotective effects in heart failure and coronary artery disease. However, its potential for mitigating doxorubicin-induced cardiotoxicity (DIC) has not been explored. This study hypothesized that ivabradine reduces cardiac dysfunction in DIC by improving mitochondrial function, restoring calcium homeostasis, and attenuating apoptosis. For in vitro experiments, H9C2 cells were divided into four groups: control, ivabradine (3 μM), Dox (10 μM), and ivabradine co-treated with Dox, with treatments lasting 24 h. Cell viability and mitochondrial function were assessed. For in vivo experiments, male rats (n = 6 per group) were divided into control, ivabradine (10 mg/kg/day, p.o., 30 days), Dox (3 mg/kg, i.p., 6 doses), and ivabradine co-treated with Dox. Cardiac function, mitochondrial function, calcium regulatory proteins, and apoptosis were analyzed. Dox reduced cell viability, increased oxidative stress, and decreased ATP levels in vitro. Co-treatment with ivabradine increased cell viability and reduced oxidative stress but did not restore ATP levels. In rats, Dox impaired mitochondrial function, disrupted mitochondrial dynamics and mitophagy, and altered calcium homeostasis, resulting in cardiomyocyte apoptosis and left ventricular dysfunction. Ivabradine co-treatment attenuated these pathological changes and preserved cardiac function. These findings suggest the potential of ivabradine for cardioprotection against DIC.
阿霉素(Dox)是一种强效的蒽环类化疗药物。然而,其疗效受到心脏毒性的限制,这种毒性是由过度的氧化应激、钙超载和线粒体功能障碍所驱动的。这些机制最终导致心肌细胞死亡和心脏功能障碍。伊伐布雷定是一种超极化激活的环核苷酸门控通道阻滞剂,对心力衰竭和冠状动脉疾病具有心脏保护作用。然而,其减轻阿霉素诱导的心脏毒性(DIC)的潜力尚未得到探索。本研究假设伊伐布雷定通过改善线粒体功能、恢复钙稳态和减轻细胞凋亡来减轻DIC中的心脏功能障碍。在体外实验中,将H9C2细胞分为四组:对照组、伊伐布雷定(3 μM)组、阿霉素(10 μM)组和伊伐布雷定与阿霉素联合处理组,处理持续24小时。评估细胞活力和线粒体功能。在体内实验中,将雄性大鼠(每组n = 6)分为对照组、伊伐布雷定(10 mg/kg/天,口服,30天)组、阿霉素(3 mg/kg,腹腔注射,6剂)组和伊伐布雷定与阿霉素联合处理组。分析心脏功能、线粒体功能、钙调节蛋白和细胞凋亡情况。在体外,阿霉素降低细胞活力、增加氧化应激并降低ATP水平。与伊伐布雷定联合处理可增加细胞活力并降低氧化应激,但不能恢复ATP水平。在大鼠中,阿霉素损害线粒体功能、破坏线粒体动力学和线粒体自噬,并改变钙稳态,导致心肌细胞凋亡和左心室功能障碍。伊伐布雷定联合处理减轻了这些病理变化并保留了心脏功能。这些发现表明伊伐布雷定对DIC具有心脏保护潜力。