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Doxorubicin (DOX) is an effective anticancer drug, but its clinical utility is limited mainly by cardiotoxicity causing cardiomyocyte ferroptosis and apoptosis. While DOX-induced cardiotoxicity (DIC) involves epigenetic changes, no systematic epigenetic intervention studies have been reported. Here, we identified BRD4770 as a potential small molecule against DIC through the Epigenetics Compound Library screening. BRD4770 inhibited DOX-induced cardiomyocyte ferroptosis and apoptosis by reducing reactive oxygen species (ROS) production and lipid peroxidation and maintaining glutathione homeostasis. BRD4770 treatment alleviated DIC without affecting the antitumor effects of DOX. Mechanistically, BRD4770 promoted nuclear factor erythroid 2-related factor 2 (Nrf2)/activating transcription factor 4 (ATF4)-solute carrier family 7 member 11 (SLC7A11) signaling and suppressed DOX-induced cardiomyocyte death by reducing methylation of lysine 9 on histone 3. Last, we constructed a ROS-responsive nanoliposome loaded with BRD4770 and conjugated with the cardiac-targeting peptide for primary cardiomyocyte, which provided better protection against DIC. These findings suggest that BRD4770 has the potential to prevent cardiomyocyte death-related cardiomyopathy.
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http://dx.doi.org/10.1126/sciadv.adw1720 | DOI Listing |
Redox Biol
September 2025
National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General Hospital, 100853, Beijing, China; Institute of Geriatric Medicine, The Second Medical Center, Chinese PLA General Hospital, 100853, Beijing, China.
Small extracellular vesicles (sEVs) critically orchestrate inter-tissue and inter-organ communications and may play essential roles in heart-tumor interaction. However, whether cancer-secreted sEVs affect the progression of doxorubicin-induced cardiotoxicity (DOXIC) via orchestrating the tumor cell-cardiomyocyte crosstalk has not yet been explored. Herein, we reveal that Doxorubicin (DOX)-treated breast cancer cells secrete sEVs (D-BCC-sEVs) that exacerbate DOX-induced ferroptosis of human iPSC-derived cardiomyocytes (hiCMs).
View Article and Find Full Text PDFInt J Mol Med
November 2025
Department of Anesthesiology, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, P.R. China.
Doxorubicin (DOX)‑induced cardiotoxicity (DIC) remains a critical challenge in cancer therapy, significantly limiting its use in clinical practice. The underlying mechanisms involve disruptions in cardiac metabolism and mitochondrial dysfunction. The heart relies on mitochondrial oxidative phosphorylation to produce ATP, which is essential for maintaining both contraction and relaxation.
View Article and Find Full Text PDFCirc Heart Fail
September 2025
Department of Cardiology, Center for Translational Medicine, Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. (J.W., K.L., Y.Y., X.X., T.X., H.X., H.Z., T.D., Y.L., C.L., X.L., Y.D., J.-S.O., Y.C., Z.-P.H.).
Background: Doxorubicin (DOX) cardiotoxicity increases cardiovascular risk in cancer patients, mainly through mitochondrial damage. However, the underlying mechanisms remain unclear, and whether mitochondrial short open reading frame-encoded peptides can mitigate DOX-induced cardiotoxicity is unknown.
Methods: Five adeno-associated viruses expressing mitochondrial short open reading frame-encoded peptides under the cardiac troponin T promoter, including MODICA (mito-SEP protector against DOX-induced cardiac injury), were screened in a DOX-induced cardiotoxicity mouse model (n=3-5 per group).
Adv Sci (Weinh)
September 2025
Department of Pharmacy at the Second Affiliated Hospital, Harbin Medical University, Harbin, 150086, China.
The clinical utility of the anticancer agent doxorubicin (DOX) is limited by its dose-dependent cardiotoxicity. ALYREF, a nuclear protein that preserves genomic stability through interactions with intranuclear components or as an m⁵C-binding regulator of mRNA maturation and export, has not been previously implicated in DOX-induced cardiotoxicity (DIC). Here, the role and underlying mechanisms of ALYREF in the pathogenesis of DIC are investigated.
View Article and Find Full Text PDFToxicol Rep
December 2025
Department of Physiology, Faculty of Basic Medical Sciences, University of Calabar, Calabar, Nigeria.
Naringenin, a major flavonoid in oranges, grapefruit, tomato skin and apocynin a polyphenolic compound isolated from plants, such as are known to possess anti-oxidant, anti-inflammatory, and anti-cancer properties. Doxorubicin (DOX) is an antibiotic, effective in the treatment of cancer, but notorious for its propensity to cause cardiotoxicity. This study investigated the combined effects of naringenin and apocynin in DOX-induced cardiac toxicity.
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