Why the study?
Late-onset anthracycline cardiotoxicity increases morbi-mortality in cancer survivors, and adult co-morbidities such as type 1 diabetes may affect the heart and unmask this chemotherapy-induced cardiotoxicity.
Does streptozotocin-induced hyperglycemia unmask cardiotoxicity in doxorubicin-pretreated mice?
Does streptozotocin-induced hyperglycemia unmask cardiotoxicity in doxorubicin-pretreated mice?
In a murine model, type 1 diabetes unmasks and exacerbates subclinical doxorubicin-induced cardiotoxicity, leading to increased mortality, cardiac dysfunction, and fibrosis.
Answers are grounded in this paper and cite their sources.
Diabetes may unmask late anthracycline cardiotoxicity in survivors; hypothesis-generating and requires clinical confirmation.
Late-onset cardiotoxicity induced by anthracyclines occurs years to decades after completion of anti-cancer therapy and is associated with increased morbi-mortality of cancer survivors. Chemotherapy at the time of treatment probably causes cardiac damages for which the juvenile heart compensate. Co-morbidities happening in the adulthood such as type 1 diabetes (DT1), affect the heart and thus can unmask chemotherapy induced cardiotoxicity. To prove our hypothesis, we induced hyperglycemia [Streptozotocin treatment (STZ), 50 mg/kg/day for 5 days] in 11 weeks old mice who previously received doxorubicin treatment (Dox, 3 mg/kg) when they were six-weeks old. Interestingly, streptozotocin-induced hyperglycemia in Dox-pretreated mice (Dox-STZ) induced a higher mortality (p < 0.05) and more severe cardiac dysfunction (p < 0.0001) when compared with mice receiving Dox or STZ alone. Apoptosis evaluated by caspase 3 protein expression and Bax/Bcl2 genes expression was higher in Dox-STZ mice compared to STZ or Dox alone. While Dox and STZ independently induced capillary rarefaction, cardiomyocytes atrophy was only induced by STZ. Furthermore, Sirius-red staining of cardiac sections showed higher fibrosis levels (p < 0.0001) in Dox-STZ compared to Dox or STZ alone. All together, these results demonstrate that STZ precipitates and unmask cardiac dysfunction in previously treated Dox animals.
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Nicol et al. (2025) studied this question.
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