Doxorubicin treatment reduces expression of cardiac iron transporters

Abstract

Doxorubicin (DOX) is an effective anticancer therapy. Unfortunately, the toxicity of DOX is not limited to cancerous cells, with the heart particularly prone to DOX-induced damage. While the mechanisms of DOX cardiotoxicity remain unclear, accumulation of iron within the heart may exacerbate the detrimental effects of DOX. Thus, understanding the effects of DOX on iron transport and storage protein expression would provide further insight on the mechanisms of disrupted iron handling and may lead to potential therapeutic targets for cardioprotection. Our goal was to investigate changes in gene expression of iron transporters in a preclinical model of DOX-induced cardiotoxicity. Female Sprague Dawley rats (2-3 month-old) were randomly divided to receive DOX or saline consistent with standard clinical treatment (i.e., intravenous infusion once every 3 weeks for 4 total cycles and a cumulative dose of ~160 mg/m2). One week following the fourth cycle measures of cardiac function, assessed by echocardiography, and cardiorespiratory capacity, determined by a graded exercise tolerance test, were completed. Cardiac tissue was also collected and cardiac mitochondria were isolated for measurement of reactive oxygen species production. At endpoint, DOX treatment resulted in a lower heart weight to tibia length ratio, reduced cardiorespiratory capacity, impaired ventricular fractional shortening and greater cardiac mitochondrial hydrogen peroxide emission. We found significant reductions in expression of transmembrane/cytoplasmic iron transporters (transferrin receptor 1 and divalent metal transporter 1) and the inner mitochondrial membrane transporter mitoferrin-2 with DOX treatment compared to saline. Expression of genes encoding for ferroportin-1, mitoferrin-1, ABCB8 and ferrochelatase were also downregulated in the DOX-treated group compared to saline, but these did not reach statistical significance. These findings are the first to describe changes in gene expression of proteins involved in iron homeostasis in a clinically relevant model of DOX-induced cardiotoxicity. Further studies are needed to investigate interventional approaches that improve cardiac iron handling to determine if they provide cardioprotection during DOX treatment. This research was funded by the National Institute of Health (NIH), R01 HL144858. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.