Abstract

BackgroundDoxorubicin is effective in a variety of solid and hematological malignancies. Unfortunately, clinical application of doxorubicin is limited due to a cumulative dose-dependent cardiotoxicity. Dihydrotanshinone I (DHT) is a natural product from Salvia miltiorrhiza Bunge with multiple anti-tumor activity and anti-inflammation effects. However, its anti-doxorubicin-induced cardiotoxicity (DIC) effect, either in vivo or in vitro, has not been elucidated yet. This study aims to explore the anti-inflammation effects of DHT against DIC, and to elucidate the potential regulatory mechanism.MethodsEffects of DHT on DIC were assessed in zebrafish, C57BL/6 mice and H9C2 cardiomyocytes. Echocardiography, histological examination, flow cytometry, immunochemistry and immunofluorescence were utilized to evaluate cardio-protective effects and anti-inflammation effects. mTOR agonist and lentivirus vector carrying GFP-TFEB were applied to explore the regulatory signaling pathway.ResultsDHT improved cardiac function via inhibiting the activation of M1 macrophages and the excessive release of pro-inflammatory cytokines both in vivo and in vitro. The activation and nuclear localization of NF-κB were suppressed by DHT, and the effect was abolished by mTOR agonist with concomitant reduced expression of nuclear TFEB. Furthermore, reduced expression of nuclear TFEB is accompanied by up-regulated phosphorylation of IKKα/β and NF-κB, while TFEB overexpression reversed these changes. Intriguingly, DHT could upregulate nuclear expression of TFEB and reduce expressions of p-IKKα/β and p-NF-κB.ConclusionsOur results demonstrated that DHT can be applied as a novel cardioprotective compound in the anti-inflammation management of DIC via mTOR-TFEB-NF-κB signaling pathway. The current study implicates TFEB-IKK-NF-κB signaling axis as a previously undescribed, druggable pathway for DIC.

Highlights

  • Doxorubicin is effective in a variety of solid and hematological malignancies

  • We further investigated whether mammalian target of rapamycin (mTOR)-Transcription factor EB (TFEB) pathway plays a role in doxorubicin-induced cardiotoxicity (DIC)-related inflammation

  • The results showed that fraction shortening (FS) was dramatically decreased, resulting in reduced erythrocyte circulation within tail blood vessels (Fig. 1a, b, d)

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Summary

Introduction

Doxorubicin is effective in a variety of solid and hematological malignancies. clinical application of doxorubicin is limited due to a cumulative dose-dependent cardiotoxicity. Its anti-doxorubicin-induced cardiotoxicity (DIC) effect, either in vivo or in vitro, has not been elucidated yet. This study aims to explore the anti-inflammation effects of DHT against DIC, and to elucidate the potential regulatory mechanism. The rate of DOX-induced cardiotoxicity (DIC) is reported to be as high as 57%, and the mortality rate from these heart diseases is reported to be 8.2 times higher than that in healthy people [2]. There is an urgent need to identify the underlying mechanism of DIC and novel therapeutic agents that can prevent and/or reverse DOX-induced cardiovascular adverse effects. Inflammation induced by doxorubicin has been identified as a high risk factor for developing heart failure and drugs with anti-inflammatory properties are attractive therapeutics for alleviating DIC [3, 4]

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