IMR Press / RCM / Volume 24 / Issue 7 / DOI: 10.31083/j.rcm2407192
Open Access Original Research
Sacubitril/Valsartan Ameliorates Crizotinib-Induced Cardiotoxicity in Mice
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1 Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, 300211 Tianjin, China
2 Department of Health Sciences, School of Nursing and Health Studies, Hong Kong Metropolitan University, 518057 Hong Kong, China
*Correspondence: liutongdoc@126.com (Tong Liu); tic_tjcardiol@126.com (Guangping Li)
These authors contributed equally.
Rev. Cardiovasc. Med. 2023, 24(7), 192; https://doi.org/10.31083/j.rcm2407192
Submitted: 23 November 2022 | Revised: 14 January 2023 | Accepted: 3 February 2023 | Published: 3 July 2023
(This article belongs to the Special Issue Cardio-Oncology: State-of-the-Art Reviews)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Lung cancer is one of the major cause of death globally. Crizotinib is a first-line drug used in treating non-small-cell lung cancer (NSCLC). However, the pathophysiological mechanisms underlying its cardiotoxicity are unknown. This study investigated the mechanisms of crizotinib-induced cardiotoxicity and explored whether this toxicity can be prevented by the angiotensin receptor/neprilysin inhibitor sacubitril/valsartan. Methods: Male C57BL/6 mice were randomly divided into three groups: control, crizotinib (40 mgkg-1d-1 for four weeks), and crizotinib + sacubitril/valsartan (40 mgkg-1d-1/60 mgkg-1d-1 for four weeks). Expression of genes in myocardial tissue were detected by transcriptomic sequencing, with verification of the differentially expressed genes (DEGs) using Real time-polymerase chain reaction (RT-PCR). Blood pressure (BP) and cardiac function of animals were measured using non-invasive monitoring and echocardiography approaches. Ventricular refractory period (RP), as well as the induction rate and score of ventricular arrhythmias (VAs) were detected by in vivo electrophysiology. Epicardial conductance was measured by mapping. Expression of Myh7 in myocardium was detected by western blot and RT-PCR. Results: DEGs detected using transcriptomic sequencing included 10 up-regulated and 20 down-regulated genes. The first 5 DEGs identified were Myh7, Ngp, Lcn2, Ciart and Ptgds. Kyoto Encyclopedia of Genes and Genomes (KEGG) result indicated that Myh7 is involved in myocarditis, cardiomyopathy, and cardiac muscle contraction. Crizotinib treatment increased blood pressure, prolonged QTc interval, shortened ventricular RP, increased the incidence and score of right VAs, and increased Myh7 expression. Most of these responses were limited by sacubitril/valsartan. Conclusions: Crizotinib induced a range of cardiotoxic side effects in a mouse model and increased Myh7 expression represents a biomarker for this response. These cardiovascular toxic responses can be largely prevented by sacubitril/valsartan.

Keywords
cardiotoxicity
crizotinb
sacubitril/valsartan
Myh7
Funding
82100342/National Natural Science Foundation of China
16JCQNJC12000/Tianjin Natural Science Foundation
2016M601274/China Postdoctoral Science Foundation
2019ZDSYS14/Key Laboratory of Scientific Research Foundation of the Second Hospital of Tianjin Medical University
TJYXZDXK-029A/Tianjin Key Medical Discipline (Specialty) Construction Project
Figures
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