Exploring the cardioprotective effects of canagliflozin against cisplatin-induced cardiotoxicity: Role of iNOS/NF-κB, Nrf2, and Bax/cytochrome C/Bcl-2 signals

J Biochem Mol Toxicol. 2023 Apr;37(4):e23309. doi: 10.1002/jbt.23309. Epub 2023 Jan 16.

Abstract

Cardiotoxicity is a severe considerable side effect of cisplatin (CDDP) that requires much medical attention. The current study investigates the cardioprotective effects of canagliflozin (CA) against CDDP-induced heart toxicity. Rats were allocated to the control group; the CA group was administered CA 10 mg/kg/day orally for 10 days; the CDDP group was injected with 7 mg/kg, intraperitoneal as a single dose on the 5th day, and the CDDP + CA group. Compared to the CDDP-treated group, CA effectively attenuated CDDP-induced heart injury as evidenced by a decrease of serum aspartate aminotransferase, alkaline phosphatase, creatine kinase-MB, and lactate dehydrogenase enzymes and supported by the alleviation of histopathological changes in cardiac tissues. Biochemically, CA attenuated cardiac oxidative injury through upregulation of the nuclear factor-erythroid 2 related factor 2 (Nrf2) signal. CA suppressed inflammation by decreasing cardiac NO2 - , MPO, iNOS, nuclear factor kappa B (NF-κB), tumor necrosis factor-alpha, and interleukin 1-beta levels. Besides, CA significantly upregulated cardiac levels of phosphoinositide 3-kinase (PI3K), protein kinase B (AKT), and p-AKT proteins. Moreover, CA remarkably mitigated CDDP-induced apoptosis via modulation of Bax, cytochrome C, and Bcl-2 protein levels. Together, the present study revealed that CA could be a good candidate for preventing CDDP-induced cardiac injury by modulating iNOS/NF-κB, Nrf2, PI3K/AKT, and Bax/cytochrome C/Bcl-2 signals.

Keywords: canagliflozin; cardiotoxicity; cisplatin; inflammation; oxidative stress.

MeSH terms

  • Animals
  • Apoptosis
  • Canagliflozin / pharmacology
  • Canagliflozin / therapeutic use
  • Cardiotoxicity / drug therapy
  • Cardiotoxicity / etiology
  • Cardiotoxicity / prevention & control
  • Cisplatin / toxicity
  • Cytochromes c / metabolism
  • Heart Injuries* / chemically induced
  • NF-E2-Related Factor 2 / metabolism
  • NF-kappa B* / metabolism
  • Oxidative Stress
  • Phosphatidylinositol 3-Kinases / metabolism
  • Proto-Oncogene Proteins c-akt / metabolism
  • Rats
  • bcl-2-Associated X Protein / metabolism

Substances

  • NF-kappa B
  • Cisplatin
  • Proto-Oncogene Proteins c-akt
  • Canagliflozin
  • Phosphatidylinositol 3-Kinases
  • NF-E2-Related Factor 2
  • Cytochromes c
  • bcl-2-Associated X Protein