Abstract

This study investigated the effect of anthracycline antibiotics, mitomycin C, and menadione on oxygen consumption and hydrogen peroxide production by intact, beating, rat heart myocytes. Doxorubicin produced a dose-dependent increase in the rate of cyanide-resistant respiration by beating myocytes. The anthracycline analogs 4-demethoxydaunorubicin, 4′-epidoxorubicin, 4′-deoxydoxorubicin, and menogaril, as well as the anticancer quinones mitomycin C and menadione, also significantly increased oxygen consumption by cardiac myocytes. However, 5-iminodaunorubicin (which has a substituted quinone group) and mitoxantrone (which is not easily reduced by flavin dehydrogenases) had no effect on cardiac respiration. Both catalase (43%) and acetylated cytochrome c (19%) significantly decreased oxygen consumption that had been stimulated by doxorubicin; furthermore, extracellular hydrogen peroxide production was increased from undetectable control levels to 1.30 ± 0.02 nmol/min/107 myocytes (n = 4, P < 0.01) in the presence of 400 μM doxorubicin. These experiments suggest that the anthracycline antibiotics and other anticancer quinones stimulate cardiac oxygen radical production in intact heart myocytes; such a free radical cascade could contribute to the cardiac toxicity of these drugs.

Highlights

  • The anticancer quinones, including the anthracycline antibiotics and mitomycin C, are widely used for the treatment of hematopoietic malignancies and cancers of the breast and bladder [1]

  • Several lines of evidence support the possibility that stimulation of superoxide anion, hydrogen peroxide, and a chemical species with the characteristics of the hydroxyl radical in the heart after reduction of the quinone moiety by complex I of the mitochondrial electron transport chain [9], NADPH:cytochrome P-450 reductase associated with the sarcoplasmic reticular membrane, or cytoplasmic xanthine dehydrogenase [10] plays an important role in the mechanism of anthracycline cardiac toxicity [11, 12]

  • If reactive oxygen species are produced at these intracellular sites in intact heart cells [13], oxidative stress itself might explain the characteristic picture of mitochondrial swelling, sarcotubular vacuolization, and myofibrillar loss produced by anthracycline quinones [1]

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Summary

Introduction

The anticancer quinones, including the anthracycline antibiotics and mitomycin C, are widely used for the treatment of hematopoietic malignancies and cancers of the breast and bladder [1]. Many different hypotheses have been suggested to explain the myocardial injury produced by antineoplastic quinones [5, 6] These hypotheses include the observation that the formation of a doxorubicin-iron complex may enhance the formation of strong oxidants toxic to the heart [7]; cardiac toxicity could occur through drug-induced effects on iron-binding proteins [8]. Several lines of evidence support the possibility that stimulation of superoxide anion, hydrogen peroxide, and a chemical species with the characteristics of the hydroxyl radical in the heart after reduction of the quinone moiety by complex I of the mitochondrial electron transport chain [9], NADPH:cytochrome P-450 reductase associated with the sarcoplasmic reticular membrane, or cytoplasmic xanthine dehydrogenase [10] plays an important role in the mechanism of anthracycline cardiac toxicity [11, 12]. Drug-induced oxygen radical formation appears to be at least one mechanism involved in the toxicity of anthracyclines for neonatal heart cells

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