Assessment of the Impact of Carvedilol Administered Together with Dexrazoxan and Doxorubicin on Liver Structure and Function, Iron Metabolism, and Myocardial Redox System in Rats

Int J Mol Sci. 2024 Feb 13;25(4):2219. doi: 10.3390/ijms25042219.

Abstract

Late cardiotoxicity is a formidable challenge in anthracycline-based anticancer treatments. Previous research hypothesized that co-administration of carvedilol (CVD) and dexrazoxane (DEX) might provide superior protection against doxorubicin (DOX)-induced cardiotoxicity compared to DEX alone. However, the anticipated benefits were not substantiated by the findings. This study focuses on investigating the impact of CVD on myocardial redox system parameters in rats treated with DOX + DEX, examining its influence on overall toxicity and iron metabolism. Additionally, considering the previously observed DOX-induced ascites, a seldom-discussed condition, the study explores the potential involvement of the liver in ascites development. Compounds were administered weekly for ten weeks, with a specific emphasis on comparing parameter changes between DOX + DEX + CVD and DOX + DEX groups. Evaluation included alterations in body weight, feed and water consumption, and analysis of NADPH2, NADP+, NADPH2/NADP+, lipid peroxidation, oxidized DNA, and mRNA for superoxide dismutase 2 and catalase expressions in cardiac muscle. The iron management panel included markers for iron, transferrin, and ferritin. Liver abnormalities were assessed through histological examinations, aspartate transaminase, alanine transaminase, and serum albumin level measurements. During weeks 11 and 21, reduced NADPH2 levels were observed in almost all examined groups. Co-administration of DEX and CVD negatively affected transferrin levels in DOX-treated rats but did not influence body weight changes. Ascites predominantly resulted from cardiac muscle dysfunction rather than liver-related effects. The study's findings, exploring the impact of DEX and CVD on DOX-induced cardiotoxicity, indicate a lack of scientific justification for advocating the combined use of these drugs at histological, biochemical, and molecular levels.

Keywords: cardiac molecular metabolism; cardioprotection; carvedilol; dexrazoxane; doxorubicin; post-anthracycline cardiotoxicity.

MeSH terms

  • Animals
  • Antibiotics, Antineoplastic / therapeutic use
  • Ascites* / pathology
  • Body Weight
  • Cardiotoxicity* / metabolism
  • Carvedilol / pharmacology
  • Doxorubicin / therapeutic use
  • Iron / metabolism
  • Lipid Peroxidation
  • Liver / metabolism
  • Myocardium / metabolism
  • NADP / metabolism
  • Rats
  • Transferrin / metabolism

Substances

  • Carvedilol
  • NADP
  • Doxorubicin
  • Antibiotics, Antineoplastic
  • Iron
  • Transferrin