N-acetylcysteine protected H9c2 cardiomyocytes from cyclophosphamide metabolite-induced cardiotoxicity by inhibiting reactive oxygen species generation, increasing aldehyde dehydrogenase activity, and decreasing acrolein concentrations.
Does N-acetylcysteine prevent cyclophosphamide metabolite-induced cytotoxicity in H9c2 cardiomyocytes?
N-acetylcysteine shows potential to prevent cyclophosphamide-induced cardiotoxicity by scavenging the toxic metabolite acrolein, reducing ROS, and preserving ALDH activity in vitro.
p-value: p=<0.05
BACKGROUND: The dose-limiting toxic effect of cyclophosphamide (CY) is cardiotoxicity. The pathogenesis of myocardial damage is poorly understood, and there is no established means of prevention. In previous studies, we suggested that for CY-induced cardiotoxicity, whereas acrolein is the key toxic metabolite, carboxyethylphosphoramide mustard (CEPM) is protective. We sought to verify that acrolein is the main cause of cardiotoxicity and to investigate whether aldehyde dehydrogenase (ALDH), which is associated with greater CEPM production, is involved in the protective effect for cardiotoxicity. We also evaluated the protective effect of N-acetylcysteine (NAC), an amino acid with antioxidant activity and a known acrolein scavenger. METHODS: H9c2 cells were exposed to CY metabolites HCY (4-hydroxy-cyclophosphamide), acrolein or CEPM. The degree of cytotoxicity was evaluated by MTT assay, lactate dehydrogenase (LDH) release, and the production of reactive oxygen species (ROS). We also investigated how the myocardial cellular protective effects of CY metabolites were modified by NAC. To quantify acrolein levels, we measured the culture supernatants using high performance liquid chromatography. We measured ALDH activity after exposure to HCY or acrolein and the same with pre-treatment with NAC. RESULTS: Exposure of H9c2 cells to CEPM did not cause cytotoxicity. Increased ROS levels and myocardial cytotoxicity, however, were induced by HCY and acrolein. In cell cultures, HCY was metabolized to acrolein. Less ALDH activity was observed after exposure to HCY or acrolein. Treatment with NAC reduced acrolein concentrations. CONCLUSIONS: Increased ROS generation and decreased ALDH activity confirmed that CY metabolites HCY and acrolein are strongly implicated in cardiotoxicity. By inhibiting ROS generation, increasing ALDH activity and decreasing the presence of acrolein, NAC has the potential to prevent CY-induced cardiotoxicity.
Kurauchi et al. (Mon,) conducted a other in Cyclophosphamide-induced cardiotoxicity. N-acetylcysteine (NAC) vs. Cyclophosphamide metabolites (HCY, acrolein) without NAC was evaluated on Cell viability and cytotoxicity (MTT assay, ROS generation, LDH release) (p=<0.05). N-acetylcysteine protected H9c2 cardiomyocytes from cyclophosphamide metabolite-induced cardiotoxicity by inhibiting reactive oxygen species generation, increasing aldehyde dehydrogenase activity, and decreasing acrolein concentrations.