Why the study?
Anthracyclines like doxorubicin frequently cause cardiotoxicity leading to dilated cardiomyopathy and heart failure, prompting investigation into the role of EPAC and EPAC inhibition.
Does EPAC1 inhibition prevent doxorubicin-induced cardiotoxicity without compromising its antitumoral efficacy?
Does EPAC1 inhibition prevent doxorubicin-induced cardiotoxicity without compromising its antitumoral efficacy?
EPAC1 inhibition represents a potential therapeutic strategy to prevent doxorubicin-induced cardiomyopathy without reducing its antitumoral efficacy.
Should not yet change practice; leaves open EPAC1 inhibition as a cardioprotective adjunct that may enhance doxorubicin efficacy.
Anthracyclines, such as doxorubicin (Dox), are widely used chemotherapeutic agents for the treatment of solid tumors and hematologic malignancies. However, they frequently induce cardiotoxicity leading to dilated cardiomyopathy and heart failure. This study sought to investigate the role of the exchange protein directly activated by cAMP (EPAC) in Dox-induced cardiotoxicity and the potential cardioprotective effects of EPAC inhibition. We show that Dox induces DNA damage and cardiomyocyte cell death with apoptotic features. Dox also led to an increase in both cAMP concentration and EPAC1 activity. The pharmacological inhibition of EPAC1 (with CE3F4) but not EPAC2 alleviated the whole Dox-induced pattern of alterations. When administered in vivo , Dox-treated WT mice developed a dilated cardiomyopathy which was totally prevented in EPAC1 knock-out (KO) mice. Moreover, EPAC1 inhibition potentiated Dox-induced cell death in several human cancer cell lines. Thus, EPAC1 inhibition appears as a potential therapeutic strategy to limit Dox-induced cardiomyopathy without interfering with its antitumoral activity.
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Mazevet et al. (2023) studied this question.
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