Affiliation(s): 1School of Life Science and Technology, Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing 210096, China
2Department of Hematology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
3Department of Geriatrics Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
4The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361102, China
5School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
6State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Air Force Medical University, Xi'an 710032, China
Abstract: Mitochondrial dynamics, including mitochondrial fusion and fission, have been identified as a critical regulator of heart function. Doxorubicin (Dox) is a highly effective chemotherapeutic agent that has demonstrated broad-spectrum activity against a variety of tumor types, whereas its application is limited due to cardiotoxic effects. Rhein, a medicinal active ingredient found in rhubarb, possesses a wide range of pharmacological activities. However, whether it exerts a cardioprotective role in Dox-induced cardiotoxicity by regulating mitochondrial dynamics remains to be investigated. In this study, we found that Dox treatment promoted mitochondrial fission and elevated the expression of dynamin-related protein 1 (Drp1) in cardiomyocytes. In addition, Drp1 deletion reduced mitochondrial fission and mitochondrial ROS, and attenuated Dox-induced cardiotoxicity both in vitro and in vivo. Furthermore, rhein treatment rescued Dox-induced cardiac damage in vivo. Mechanistically, rhein attenuated Dox-induced cardiotoxicity by regulating Drp1-mediated mitochondrial fission and mitochondrial ROS in cardiomyocytes. Moreover, it alleviated the Dox-induced upregulation of Drp1 by activating phosphoinositide 3-kinase (PI3K)/Akt signaling pathway. In conclusion, our findings demonstrate that rhein attenuates Dox-induced cardiotoxicity by regulating Drp1-mediated mitochondrial fission and mitochondrial ROS via the PI3K/Akt pathway.
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