Doxorubicin induces cardiotoxicity through upregulation of death receptors mediated apoptosis in cardiomyocytes

Sci Rep. 2017 Mar 16:7:44735. doi: 10.1038/srep44735.

Abstract

Doxorubicin is a highly effective anticancer agent but causes cardiotoxicity in many patients. The mechanisms of doxorubicin-induced cardiotoxicity remain incompletely understood. Here we investigated doxorubicin-induced cytotoxicity in human induced pluripotent stem cells-derived cardiomyocytes (iPS-CMs). We found that doxorubicin and related anthracycline agents (e.g., daunorubicin, idarubicin, and epirubicin) significantly upregulated the expression of death receptors (DRs) (TNFR1, Fas, DR4 and DR5) in iPS-derived cardiomyocytes at both protein and mRNA levels. The resulting iPS-CMs cells underwent spontaneous apoptosis which was further enhanced by physiologically relevant death ligands including TNF-related apoptosis inducing ligand (TRAIL). Furthermore, TRAIL potentiated doxorubicin-induced decrease in beating rate and amplitude of iPS-derived cardiomyocytes. These data demonstrate that the induction of death receptors in cardiomyocytes is likely a critical mechanism by which doxorubicin causes cardiotoxicity.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anthracyclines / pharmacology
  • Apoptosis* / drug effects
  • Cardiotoxicity / metabolism*
  • Cardiotoxicity / pathology*
  • Cell Line
  • Doxorubicin / adverse effects*
  • Electrophysiological Phenomena / drug effects
  • Fas Ligand Protein / pharmacology
  • Humans
  • Induced Pluripotent Stem Cells / drug effects
  • Induced Pluripotent Stem Cells / metabolism
  • Models, Biological
  • Myocytes, Cardiac / drug effects
  • Myocytes, Cardiac / metabolism*
  • Myocytes, Cardiac / pathology*
  • Receptors, Death Domain / genetics*
  • Receptors, Death Domain / metabolism
  • TNF-Related Apoptosis-Inducing Ligand / pharmacology
  • Tumor Necrosis Factor-alpha / pharmacology
  • Up-Regulation / drug effects
  • Up-Regulation / genetics*

Substances

  • Anthracyclines
  • Fas Ligand Protein
  • Receptors, Death Domain
  • TNF-Related Apoptosis-Inducing Ligand
  • Tumor Necrosis Factor-alpha
  • Doxorubicin