Abstract

Background: Doxorubicin is a widely used and effective chemotherapy, but the major limiting side effect is cardiomyopathy which in some patients leads to congestive heart failure. Genetic variants in TRPC6 have been associated with the development of doxorubicin-induced cardiotoxicity, suggesting that TRPC6 may be a therapeutic target for cardioprotection in cancer patients.Methods: Assessment of Trpc6 deficiency to prevent doxorubicin-induced cardiac damage and function was conducted in male and female B6.129 and Trpc6 knock-out mice. Mice were treated with doxorubicin intraperitoneally every other day for a total of 6 injections (4 mg/kg/dose, cumulative dose 24 mg/kg). Cardiac damage was measured in heart sections by quantification of vacuolation and fibrosis, and in heart tissue by gene expression of Tnni3 and Myh7. Cardiac function was determined by echocardiography.Results: When treated with doxorubicin, male Trpc6-deficient mice showed improvement in markers of cardiac damage with significantly reduced vacuolation, fibrosis and Myh7 expression and increased Tnni3 expression in the heart compared to wild-type controls. Similarly, male Trpc6-deficient mice treated with doxorubicin had improved LVEF, fractional shortening, cardiac output and stroke volume. Female mice were less susceptible to doxorubicin-induced cardiac damage and functional changes than males, but Trpc6-deficient females had improved vacuolation with doxorubicin treatment. Sex differences were observed in wild-type and Trpc6-deficient mice in body-weight and expression of Trpc1, Trpc3 and Rcan1 in response to doxorubicin.Conclusions: Trpc6 promotes cardiac damage following treatment with doxorubicin resulting in cardiomyopathy in male mice. Female mice are less susceptible to cardiotoxicity with more robust ability to modulate other Trpc channels and Rcan1 expression.

Highlights

  • Doxorubicin is a widely used and effective chemotherapy agent for multiple adult and pediatric cancers

  • Deficiency in Trpc6 improved survival after doxorubicin treatment in males, (p = 0.003, Figure 1). These findings suggest that Trpc6 contributes to mortality following doxorubicin therapy in male mice

  • Mice were weighed immediately prior to each injection of doxorubicin to ensure the correct dose was used. Both wild-type and Trpc6deficient males treated with doxorubicin progressively lost body-weight relative to control mice (p < 0.0001, Figure 2A), while wild-type and Trpc6-deficient control males maintained their weight over the duration of the experiment (p = 0.724, Figure 2A)

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Summary

Introduction

Doxorubicin is a widely used and effective chemotherapy agent for multiple adult and pediatric cancers. The only FDA-approved cardioprotective drug for doxorubicin-induced cardiomyopathy is the iron chelating agent, Dexrazoxane, which is thought to deplete topoisomerase IIb [16, 17] and prevent mitochondrial iron-catalyzed ROS damage [7]. For a therapy to be useful in mediating cardioprotection it is important that it does not counteract the anti-tumor effect of the chemotherapy agent, and there are concerns that Dexrazoxane may interfere with the antitumor efficacy of doxorubicin [18]. Doxorubicin is a widely used and effective chemotherapy, but the major limiting side effect is cardiomyopathy which in some patients leads to congestive heart failure. Genetic variants in TRPC6 have been associated with the development of doxorubicin-induced cardiotoxicity, suggesting that TRPC6 may be a therapeutic target for cardioprotection in cancer patients

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