Cardiotoxicity that is associated with doxorubicin (DOX) treatment limits the therapeutic efficiency of this drug. Using cultured cardiomyocytes, we found that the A3 adenosine selective agonist Cl-IB-MECA (2-chloro-N(6)-(3-iodobenzyl) adenosine-5′-N-methyluronamide) reduces DOX cardiotoxicity. We wished to determine if the protection demonstrated by Cl-IB-MECA attenuates cardiac depression in experiments in-vivo and to validate the combined effects of Dox and Cl-IB-MECA on sarcoplasmic reticulum (SR) and intra-mitochondrial Ca2+ accumulation. Control, DOX, Cl-IB-MECA and DOX+Cl-IB-MECA rat groups were tested. DOX (2.5 mg/kg i.p.) and Cl-IB-MECA (33 μg/kg i.v.) were injected 6 times on alternate days. Left ventricular functions (LVF), SR Ca2+ uptake, cytosolic and intra mitochondrial calcium and release were measured at the end of the injection period and 2 weeks post-injection period. Echocardiography data have shown that left ventricular end systolic diameter was higher and fractional shortening was significantly lower in DOX treated animals compared to the control groups (35%, 54%) (p<0.01). Improved LVF resulted when DOX was combined with Cl-IB-MECA. At the cellular level, DOX increased Ca2+ levels in the cytosol and mitochondria through diminishing SR Ca2+ reuptake. The addition of Cl-IB-MECA to DOX significantly improved SERCA2a efficiency. DOX, combined with Cl-IB-MECA resulted in improved cardiac hemodynamic function. This protection is partially caused through the decrease of calcium overload and activation of SR Ca2+ uptake.
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