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2014 ; 6
(266
): 266ra170
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Visnagin protects against doxorubicin-induced cardiomyopathy through modulation
of mitochondrial malate dehydrogenase
#MMPMID25504881
Liu Y
; Asnani A
; Zou L
; Bentley VL
; Yu M
; Wang Y
; Dellaire G
; Sarkar KS
; Dai M
; Chen HH
; Sosnovik DE
; Shin JT
; Haber DA
; Berman JN
; Chao W
; Peterson RT
Sci Transl Med
2014[Dec]; 6
(266
): 266ra170
PMID25504881
show ga
Doxorubicin is a highly effective anticancer chemotherapy agent, but its use is
limited by its cardiotoxicity. To develop a drug that prevents this toxicity, we
established a doxorubicin-induced cardiomyopathy model in zebrafish that
recapitulates the cardiomyocyte apoptosis and contractility decline observed in
patients. Using this model, we screened 3000 compounds and found that visnagin
(VIS) and diphenylurea (DPU) rescue the cardiac performance and circulatory
defects caused by doxorubicin in zebrafish. VIS and DPU reduced
doxorubicin-induced apoptosis in cultured cardiomyocytes and in vivo in zebrafish
and mouse hearts. VIS treatment improved cardiac contractility in
doxorubicin-treated mice. Further, VIS and DPU did not reduce the
chemotherapeutic efficacy of doxorubicin in several cultured tumor lines or in
zebrafish and mouse xenograft models. Using affinity chromatography, we found
that VIS binds to mitochondrial malate dehydrogenase (MDH2), a key enzyme in the
tricarboxylic acid cycle. As with VIS, treatment with the MDH2 inhibitors
mebendazole, thyroxine, and iodine prevented doxorubicin cardiotoxicity, as did
treatment with malate itself, suggesting that modulation of MDH2 activity is
responsible for VIS' cardioprotective effects. Thus, VIS and DPU are potent
cardioprotective compounds, and MDH2 is a previously undescribed, druggable
target for doxorubicin-induced cardiomyopathy.