Clinically approved therapeutics
that mitigate chemotherapy-induced
cardiotoxicity, a serious adverse effect of chemotherapy, are lacking.
The aim of this study was to determine the putative protective capacity
of a novel indole alkaloid derivative B (IADB) against
5-fluorouracil (5-FU)-induced cardiotoxicity. To assess the free-radical
scavenging activities of IADB, the acetylcholine-induced
relaxation assay in rat thoracic aorta was used. Further, IADB was tested in normal and cancer cell lines with assays gauging autophagy
induction. We further examined whether IADB could attenuate
cardiotoxicity in 5-FU-treated male ICR mice. We found that IADB could serve as a novel bifunctional agent (displaying
both antioxidant and autophagy-modulating activities). Further, we
demonstrated that IADB induced production of cytosolic
autophagy-associated structures in both cancer and normal cell lines.
We observed that IADB cytotoxicity was much lower in
normal versus cancer cell lines, suggesting an enhanced potency toward
cancer cells. The cardiotoxicity induced by 5-FU was significantly
relieved in animals pretreated with IADB. Taken together, IADB treatment, in combination with chemotherapy, may lead
to reduced cardiotoxicity, as well as the reduction of anticancer
drug dosages that may further improve chemotherapeutic efficacy with
decreased off-target effects. Our data suggest that the use of IADB may be therapeutically beneficial in minimizing cardiotoxicity
associated with high-dose chemotherapy. On the basis of the redox
status difference between normal and tumor cells, IADB selectively induces autophagic cell death, mediated by reactive
oxygen species overproduction, in cancer cells. This novel mechanism
could reveal novel therapeutic targets in chemotherapy-induced cardiotoxicity.