Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (8): 14-22.doi: 10.6040/j.issn.1671-7554.0.2022.0250

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Protective effects and molecular mechanism of puerarin on sorafenib-induced cardiotoxicity

JIANG Hui1, WEI Tian2, LI Jianping1, WANG Cong3   

  1. 1. Department of Pediatrics, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong, China;
    2. Department of Gastrointestinal Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong, China;
    3. Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong, China
  • Published:2022-07-27

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Abstract: Objective To elucidate the protective effects and molecular mechanism of puerarin on sorafenib-induced cardiotoxicity via inhibiting the ferroptosis of cardiomyocytes. Methods In the cell study, primary cardiomyocytes were isolated and treated with dimethyl sulfoxide(DMSO), sorafenib, sorafenib+deferoxamine, sorafenib+ferrostatin-1(Fer-1), and sorafenib+puerarin, respectively. The cell viability, lactate dehydrogenase(LDH)release, lipid ROS, and malondialdehyde(MDA)level were measured. The cell morphology was observed with microscopy. At 0, 12, 24, 36, 48, 60 and 72 h after treatment, cardiomyocytes were harvested and the classic marker of endoplasmic reticulum(ER)stress, glucose-regulated protein 78(GRP78)protein was detected with Western blotting. Cardiomyocytes were treated with sorafenib, sorafenib+puerarin, sorafenib+puerarin+thapsigargin, and sorafenib+puerarin+thapsigargin, respectively. The cell viability, LDH release, lipid ROS, MDA level and GRP78 level were measured. In the mice study, 40 C57BL/6J mice were divided into the control, puerarin, sorafenib, and sorafenib+puerarin groups. The level of serum creatine kinase MB isoenzyme(CK-MB)was determined with ELISA. The heart weight/tibia length(HW/TL)was evaluated. The cross-sectional area(CSA)was measured after Masson staining. The ROS, MDA and GRP78 levels of cardiac tissue were measured. Results In the cell study, compared to the DMSO group, the sorafenib group had decreased cell viability, increased LDH release, increased lipid ROS, MDA and GRP78 levels(all P<0.01). Compared with the sorafenib group, the sorafenib+Fer-1 group, sorafenib+deferroamine group and sorafenib+puerarin group had increased cell viability, decreased LDH release, decreased vacuolation, decreased lipid ROS, MDA and GRP78 levels(all P<0.05). The interactions between ER stress inducers thapsigargin and puerarin on GRP78 level, cell viability, LDH release and MDA level were statistically significant(all P<0.05). In the mice study, sorafenib administration caused elevated CK-MB level, decreased HW/TL, larger CSA of surviving cardiomyocytes, increased lipid ROS level and MDA content, and upregulated level of GRP78, which could all be inhibited by puerarin(all P<0.05). Compared with the sorafenib group, the sorafenib+puerarin group had decreased level of CK-MB, increased HW/TL, decreased CSA, decreased ROS, MDA and GRP78 levels(all P<0.05). Conclusion Puerarin inhibits sorafenib-induced ferroptosis of cardiomyocytes via inhibiting ER stress, which might be triggered by lipid ROS. Puerarin has a promising role in alleviating sorafenib-related cardiotoxicity.

Key words: Sorafenib, Cardiotoxicity, Puerarin, Ferroptosis, Endoplasmic reticulum stress

CLC Number: 

  • R541.9
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