Protective Effects of Dimethyl-Fumarate Against Doxorubicin-induced Cardiac Injury in Rats

Authors

  • Sara A. Al-Kenany Ministry of Health, Baghdad, Iraq
  • Nada N. Al-Shawi Department of Pharmacology and Toxicology, College of Pharmacy, University of Baghdad, Iraq

DOI:

https://doi.org/10.31351/vol33iss4pp140-149

Abstract

Doxorubicin is a wide-range antineoplastic agent; nonetheless, doxorubicin's related cardiotoxic adverse effect that is mediated via oxidative damage restricts clinical use. Dimethyl-Fumarate an agent to manage multiple sclerosis exhibited an anti-oxidant, and anti-inflammatory activity by stimulating Nrf-2-pathway. The current investigation was developed to examine how likely DMF protect against Dox-related cardiac injury in rats. Males and females Wistar rats treated by DMF-only (15 mg/kg /day)for 14 days orally or before DOX IP-inj. at (15mg\kg – single-dose on day 14) to prompt cardiac injury. Results revealed that DMF considerably alleviated DOX-related cardiotoxicity, by decreasing CK-MB and LDH serum concentrations & ameliorated histological alterations. Also, there was a significant inhibition in cardiac OS thru reducing MDA-level, increasing GSH, SOD, CAT and Gpx-1; upregulated Nrf2 protein and gene level, promoting HO_1 gene plus protein synthesis, reduced Keap1 and NF-kB genes expression; furthermore, DMF reduced TNF-a, IL-1b significantly, and suppressed apoptotic cell death.

In conclusion, the current study established that DMF alleviated the cardiac injury stimulated by DOX via modulating apoptotic responses and reaction to oxidants by stimulating Nrf-2; suggesting that DMF might be used as a possible chemotherapeutic-adjuvant to improve anthracyclines-related cardiotoxicity.

How to Cite

1.
Sara A. Al-Kenany, Nada N. Al-Shawi. Protective Effects of Dimethyl-Fumarate Against Doxorubicin-induced Cardiac Injury in Rats. Iraqi Journal of Pharmaceutical Sciences [Internet]. 2024 Dec. 20 [cited 2024 Dec. 21];33(4):140-9. Available from: https://bijps.uobaghdad.edu.iq/index.php/bijps/article/view/2898

Publication Dates

Received

2023-08-19

Revised

2023-08-23

Accepted

2023-10-24

Published Online First

2024-12-20

References

Young RC, Ozols RF MC. The anthracycline antineoplastic drugs. N Engl J Med. 1981;305:139–53.

Kiyomiya K, Matsuo S, Mechanism of Specific Nuclear Transport of Adriamycin: The Mode of Nuclear Translocation of Adriamycin-Proteasome Complex1. Cancer Res. 2001 Mar 3;61(6):2467–71.

Chen, Tzu, Wu, Yan, Chung, Yu, Hwu, Yeukuang,. Probing Dynamics of DOX-DNA Intercalation during the Initial Activation of Apoptosis by Fluorescence Lifetime Imaging Microscopy (FLIM). PLoS One 2012;7:(9): e44947.

Quiles J, Huertas J, Battino M, Mataix J, Ramirez-Tortosa M. Antioxidant nutrients and adriamycin toxicity. Toxicology. 2002 Nov 1;180:79–95.

Swift L, Rephaeli A, Nudelman A, Phillips D, Cutts S. Doxorubicin-DNA Adducts Induce a Non-Topoisomerase II-Mediated Form of Cell Death. Cancer Res. 2006 Jun 1;66:4863–71.

Hitchcock-Bryan S, Gelber RD, Cassady JR SS. The impact of induction anthracycline on long-term failure-free survival in childhood acute lymphoblastic leukaemia. Med Pediatr Oncol. 1986;14:211–5.

Karim S, Bhandari U, Kumar H, Salam A, Siddiqui MAA, Pillai K. Doxorubicin-induced cardiotoxicity and its modulation by drugs. Indian J Pharmacol. 2001 Jan 1;33:203–7.

Hajra S, Patra AR, Basu A, Bhattacharya S. Prevention of doxorubicin (DOX)-induced genotoxicity and cardiotoxicity: Effect of plant derived small molecule indole-3-carbinol (I3C) on oxidative stress and inflammation. Biomed Pharmacother, 2018;101:228–43.

Rocca C, Pasqua T, Cerra MC, Angelone T. Cardiac Damage in Anthracyclines Therapy: Focus on Oxidative Stress and Inflammation. Antioxid Redox Signal. 2020 Jan 13;32(15):1081–97

Rawat PS, Jaiswal A, Khurana A, Bhatti JS, Navik U. Doxorubicin-induced cardiotoxicity: An update on the molecular mechanism and novel therapeutic strategies for effective management. Biomed Pharmacother. 2021;139:111708.

Li J, Ichikawa T, Janicki JS, Cui T. Targeting the Nrf2 pathway against cardiovascular disease. Expert Opin Ther Targets. 2009 Jul 1;13(7):785–94.

Dundar HA, Kiray M, Kir M, Kolatan E, Bagriyanik A, Altun Z, et al. Protective Effect of Acetyl-L-Carnitine Against Doxorubicin-induced Cardiotoxicity in Wistar Albino Rats. Arch Med Res. 2016;47(7):506–14.

Gu J, Huang H, Liu C, Jiang B, Li M, Liu L, et al. Pinocembrin inhibited cardiomyocyte pyroptosis against doxorubicin-induced cardiac dysfunction via regulating Nrf2/Sirt3 signalling pathway. Int Immunopharmacol]. 2021;95:107533.

Reichardt P, Tabone M-D, Mora J, Morland B, Jones RL. Risk–benefit of dexrazoxane for preventing anthracycline-related cardiotoxicity: re-evaluating the European labeling. Futur Oncol]. 2018 May 11;14(25):2663–76.

Dallons M, Schepkens C, Dupuis A, Tagliatti V, Colet J-M. New Insights About Doxorubicin-Induced Toxicity to Cardiomyoblast-Derived H9C2 Cells and Dexrazoxane Cytoprotective Effect: Contribution of In Vitro1H-NMR. Vol. 11, Frontiers in Pharmacology. 2020.

Xu Z, Zhang F, Sun F, Gu K, Dong S, He D. Dimethyl fumarate for multiple sclerosis. Cochrane Database Syst Rev, 2015;(4).

Mori S, Kurimoto T, Maeda H, Nakamura M. Dimethyl Fumarate Promotes the Survival of Retinal Ganglion Cells after Optic Nerve Injury, possibly through the Nrf2/HO-1 Pathway. Vol. 22, International Journal of Molecular Sciences. 2021.

Cuadrado A, Kügler S, Lastres-Becker I. Pharmacological targeting of GSK-3 and NRF2 provides neuroprotection in a preclinical model of tauopathy. Redox Biol. 2018; 14:522–34.

Piroli GG, Manuel AM, Patel T, et al. Novel Protein Targets of Dimethyl Fumarate Modification in Neurons and Astrocytes Reveals Actions Independent of Nrf2. Mol Cell Proteomics. 2019;18(3):504–19.

Manai F, Amadio M. Dimethyl Fumarate Triggers the Antioxidant Defense System in Human Retinal Endothelial Cells through Nrf2 Activation. Vol. 11, Antioxidants. 2022.

Yamaguchi Y, Kanzaki H, Katsumata Y, Itohiya K, Fukaya S, Miyamoto Y, et al. Dimethyl fumarate inhibits osteoclasts via attenuation of reactive oxygen species signalling by augmented antioxidation. J Cell Mol Med. 2018 Feb 1;22(2):1138–47.

Campolo M, Casili G, Biundo F, Crupi R, Cordaro M, Cuzzocrea S, et al. The Neuroprotective Effect of Dimethyl Fumarate in an MPTP-Mouse Model of Parkinson’s Disease: Involvement of Reactive Oxygen Species/Nuclear Factor-κB/Nuclear Transcription Factor Related to NF-E2. Antioxid Redox Signal. 2016 Dec 23;27(8):453–71.

Meseguer-Ripolles J, Lucendo-Villarin et al. DMF reduces hepatocyte senescence following paracetamol exposure. iScience. 2021 Jun 25;24(6).

Sirwi A, Shaik RA, Alamoudi AJ, Eid BG, Elfaky MA, Ibrahim SRM, et al. Mokko Lactone Alleviates Doxorubicin-Induced Cardiotoxicity in Rats via Antioxidant, Anti-Inflammatory, and Antiapoptotic Activities. Vol. 14, Nutrients. 2022.

Oh CJ, Park S, Kim J-Y, et al. DMFattenuates restenosis after vascular injury by cell-specific and Nrf2- mechanisms. Redox Biol. 2014;2:855–64.

Hu X, Li C, Wang Q, Wei Z, Chen T, Wang Y, et al. Dimethyl Fumarate Ameliorates Doxorubicin-Induced Cardiotoxicity By Activating the Nrf2 Pathway. Vol. 13, Frontiers in Pharmacology. 2022.

Hassan AF, Abbas RF, Al-shawi NN, Numan IT. Evaluation of the Genoprotective and Cytoprotective Activity of Vitamin K-7 Against Doxorubicin in Bone Marrow Cells and Spleen Cells of Rats. Medico-Legal Update. 2020;20(4):963–8.

Mahmood S, Hassan A. The_Anti-Inflammatory_Effect_of_Omega-7_Against_Ci.pdf. Iraqi J Vet Med. 2022;46(2):48–52.

Mahde S, Kathem SH. Anti-Inflammatory Effect of L-carvone on Lipopolysaccharide-Induced Acute Lung Injury. 2023;32:125–32.

Kathem SH, Abdulsahib WK, Zalzala MH. Berbamine and thymoquinone exert protective effects against immune-mediated liver injury via NF-κB dependent pathway. Vol. 9, Frontiers in Veterinary Science. 2022.

Al-Kenany SA, Al-Shawi NN. Protective effect of cafestol against doxorubicin-induced cardiotoxicity in rats by activating the Nrf2 pathway.Vol. 14, Frontiers in Pharmacology . 2023.

Kanda T, Takahashi T, Kudo S, Takeda T, Tsugawa H, Takekoshi N. Leptin deficiency enhances myocardial necrosis and lethality in a murine model of viral myocarditis. Life Sci [Internet]. 2004;75(12):1435–47.

Skovgaard D, Hasbak P, Kjaer A. BNP Predicts Chemotherapy-Related Cardiotoxicity and Death: Comparison with Gated Equilibrium Radionuclide Ventriculography. PLoS One. 2014 May 6;9(5):e96736.

Khudhair AR, Al-Shawi NN, Hassan AF. Impact of Omega 3 on the Genotoxicity of Irinotecan on Bone Marrow and Spleen of Rats: in-vivo Study. Iraqi J Pharm Sci. 2023;32(1):53–8.

Wu X, Wei J, Yi Y, Gong Q, Gao J. Activation of Nrf2 signaling: A key molecular mechanism of protection against cardiovascular diseases by natural products. Vol. 13, Frontiers in Pharmacology. 2022.

Saha S, Buttari B, Panieri E, Profumo E, Saso L. An Overview of Nrf2 Signaling Pathway and Its Role in Inflammation. Vol. 25, Molecules. 2020.

Zhou P, Gao G, Zhao C, Li J, Peng J, Wang S, et al. In vivo and in vitro protective effects of shengmai injection against doxorubicin-induced cardiotoxicity. Pharm Biol. 2022 Dec 31;60(1):638–51.

Ridha A, Alshawi N. Impacts of Pyridoxine on the Biomarkers, Aspartate Aminotransferase, lactate Dehydrogenase and Total Antioxidant Capacity in Doxorubicin-Induced Cardiotoxicity.Iraqi J Pharm Sci. 2019 Feb 26;26:12–21.

Baechler BL, Bloemberg D, Quadrilatero J. Mitophagy regulates mitochondrial network signaling, oxidative stress, and apoptosis during myoblast differentiation. Autophagy [Internet]. 2019 Sep 2;15(9):1606–19.

Huisman E, Papadimitropoulou K, Jarrett J, Bending M, Firth Z, Allen F, et al. Systematic literature review and network meta-analysis in highly active relapsing–remitting multiple sclerosis and rapidly evolving severe multiple sclerosis. BMJ Open .2017 Mar 1;7(3):e013430.

Akino N, Wada-Hiraike O, Terao H, Honjoh H, Isono W, Fu H, et al. Activation of Nrf2 might reduce oxidative stress in human granulosa cells. Mol Cell Endocrinol .2018;470:96–104

Zhen X, Jindong L, Yang Z, Yashi R, Wei G, Wei J, et al. Activation of Nrf2 Pathway by Dimethyl Fumarate Attenuates Renal Ischemia-Reperfusion Injury. Transplant Proc. 2021;53(7):2133–9.

Shekarchi S, Roushandeh AM, Roudkenar MH, Bahadori MH. Dimethyl fumarate prevents cytotoxicity and apoptosis mediated by oxidative stress in human adipose-derived mesenchymal stem cells. Mol Biol Rep. 2021;48(9):6375–85.

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Published

2024-12-20