EPAC1 inhibition protects the heart from doxorubicin-induced toxicity
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Curated by eLife
eLife assessment
This fundamental work substantially contributes to our understanding of the mechanisms underlying doxorubicin-induced cardiotoxicity. The evidence supporting the role of EPAC1 inhibition in this context is compelling, using rigorous molecular biology techniques. The work will be of broad interest to scientists and clinicians working in the field of oncology and cardiovascular medicine.
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Abstract
Anthracyclines, such as doxorubicin (Dox), are widely used chemotherapeutic agents for the treatment of solid tumors and hematologic malignancies. However, they frequently induce cardiotoxicity leading to dilated cardiomyopathy and heart failure. This study sought to investigate the role of the exchange protein directly activated by cAMP (EPAC) in Dox-induced cardiotoxicity and the potential cardioprotective effects of EPAC inhibition. We show that Dox induces DNA damage and cardiomyocyte cell death with apoptotic features. Dox also led to an increase in both cAMP concentration and EPAC1 activity. The pharmacological inhibition of EPAC1 (with CE3F4) but not EPAC2 alleviated the whole Dox-induced pattern of alterations. When administered in vivo , Dox-treated WT mice developed a dilated cardiomyopathy which was totally prevented in EPAC1 knock-out (KO) mice. Moreover, EPAC1 inhibition potentiated Dox-induced cell death in several human cancer cell lines. Thus, EPAC1 inhibition appears as a potential therapeutic strategy to limit Dox-induced cardiomyopathy without interfering with its antitumoral activity.
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eLife assessment
This fundamental work substantially contributes to our understanding of the mechanisms underlying doxorubicin-induced cardiotoxicity. The evidence supporting the role of EPAC1 inhibition in this context is compelling, using rigorous molecular biology techniques. The work will be of broad interest to scientists and clinicians working in the field of oncology and cardiovascular medicine.
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Joint Public Review
Although several biochemical pathways have been proposed for doxorubicin-induced cardiotoxicity, the exact causal mechanisms remain elusive. Enhanced knowledge of these mechanisms would allow the identification of new therapeutic targets to prevent doxorubicin cardiac adverse effects and thus, extend its use in cancer treatment. Mazevet et al. investigated the role of the exchange protein directly activated by cAMP (EPAC) in doxorubicin-induced cardiotoxicity. The authors found that doxorubicin elicited an increase in EPAC1 isoform expression and activity in neonatal cardiac myocytes and that EPAC1 genetic and pharmacological inhibition successfully reduced doxorubicin-induced DNA damage, mitochondrial dysfunction, and apoptotic cell death. These findings were confirmed in in vivo studies using EPAC1 KO mice, which …
Joint Public Review
Although several biochemical pathways have been proposed for doxorubicin-induced cardiotoxicity, the exact causal mechanisms remain elusive. Enhanced knowledge of these mechanisms would allow the identification of new therapeutic targets to prevent doxorubicin cardiac adverse effects and thus, extend its use in cancer treatment. Mazevet et al. investigated the role of the exchange protein directly activated by cAMP (EPAC) in doxorubicin-induced cardiotoxicity. The authors found that doxorubicin elicited an increase in EPAC1 isoform expression and activity in neonatal cardiac myocytes and that EPAC1 genetic and pharmacological inhibition successfully reduced doxorubicin-induced DNA damage, mitochondrial dysfunction, and apoptotic cell death. These findings were confirmed in in vivo studies using EPAC1 KO mice, which did not show the deteriorated cardiac function observed in WT mice after doxorubicin treatment. Moreover, the authors showed that doxorubicin-induced cytotoxicity in two cancer cell lines was not altered or even potentiated by pharmacological EPAC1 inhibition. Overall the results of this paper suggest that EPAC1 inhibition is a novel strategy to alleviate doxorubicin-induced cardiotoxicity.
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