Modulation of the Rho/ROCK pathway in heart and lung after thorax irradiation reveals targets to improve normal tissue toxicity

Curr Drug Targets. 2010 Nov;11(11):1395-404. doi: 10.2174/1389450111009011395.

Abstract

The medical options available to prevent or treat radiation-induced injury are scarce and developing effective countermeasures is still an open research field. In addition, more than half of cancer patients are treated with radiation therapy, which displays a high antitumor efficacy but can cause, albeit rarely, disabling long-term toxicities including radiation fibrosis. Progress has been made in the definition of molecular pathways associated with normal tissue toxicity that suggest potentially effective therapeutic targets. Targeting the Rho/ROCK pathway seems a promising anti-fibrotic approach, at least in the gut; the current study was performed to assess whether this target was relevant to the prevention and/or treatment of injury to the main thoracic organs, namely heart and lungs. First, we showed activation of two important fibrogenic pathways (Smad and Rho/ROCK) in response to radiation-exposure to adult cardiomyocytes; we extended these observations in vivo to the heart and lungs of mice, 15 and 30 weeks post-irradiation. We correlated this fibrogenic molecular imprint with alteration of heart physiology and long-term remodelling of pulmonary and cardiac histological structures. Lastly, cardiac and pulmonary radiation injury and bleomycin-induced pulmonary fibrosis were successfully modulated using Rho/ROCK inhibitors (statins and Y-27632) and this was associated with a normalization of fibrogenic markers. In conclusion, the present paper shows for the first time, activation of Rho/ROCK and Smad pathways in pulmonary and cardiac radiation-induced delayed injury. Our findings thereby reveal a safe and efficient therapeutic opportunity for the abrogation of late thoracic radiation injury, potentially usable either before or after radiation exposure; this approach is especially attractive in (1) the radiation oncology setting, as it does not interfere with prior anti-cancer treatment and in (2) radioprotection, as applicable to the treatment of established radiation injury, for example in the case of radiation accidents or acts of terrorism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amides / pharmacology
  • Animals
  • Bleomycin / pharmacology
  • Connective Tissue Growth Factor / genetics
  • Connective Tissue Growth Factor / metabolism
  • Cytoskeleton / metabolism
  • Cytoskeleton / pathology
  • Endomyocardial Fibrosis / metabolism
  • Endomyocardial Fibrosis / prevention & control*
  • Female
  • Heart / drug effects
  • Heart / physiopathology
  • Heart / radiation effects
  • Lung / drug effects
  • Lung / metabolism
  • Lung / pathology
  • Lung / radiation effects
  • Mice
  • Mice, Inbred C57BL
  • Myocytes, Cardiac / metabolism
  • Myocytes, Cardiac / pathology
  • Myocytes, Cardiac / radiation effects
  • Pravastatin / pharmacology
  • Protein Kinase Inhibitors / pharmacology
  • Protein Serine-Threonine Kinases / genetics
  • Protein Serine-Threonine Kinases / metabolism
  • Pyridines / pharmacology
  • Radiation Injuries / metabolism
  • Radiation Injuries / prevention & control*
  • Radiation Pneumonitis / metabolism
  • Radiation Pneumonitis / prevention & control
  • Receptor, Transforming Growth Factor-beta Type II
  • Receptors, Transforming Growth Factor beta / genetics
  • Receptors, Transforming Growth Factor beta / metabolism
  • Simvastatin / pharmacology
  • Smad Proteins / genetics
  • Smad Proteins / metabolism
  • Thorax / radiation effects*
  • rho-Associated Kinases / antagonists & inhibitors
  • rho-Associated Kinases / genetics
  • rho-Associated Kinases / metabolism*
  • rhoB GTP-Binding Protein / genetics
  • rhoB GTP-Binding Protein / metabolism

Substances

  • Amides
  • CCN2 protein, mouse
  • Protein Kinase Inhibitors
  • Pyridines
  • Receptors, Transforming Growth Factor beta
  • Smad Proteins
  • Bleomycin
  • Y 27632
  • Connective Tissue Growth Factor
  • Simvastatin
  • Protein Serine-Threonine Kinases
  • rho-Associated Kinases
  • Receptor, Transforming Growth Factor-beta Type II
  • rhoB GTP-Binding Protein
  • Pravastatin