Abstract Body: Introduction
Promotion of cardiomyocyte survival upon insult is mandatory to allow maintenance of ventricular function and dam development of severe heart dysfunction. Recently, through an in vivo functional screening of the mouse secretome we identified potent mediators of cardiomyocyte survival among 1200 soluble factors expressed by AAV vectors. The cardiac overexpression of the most effective cytokines (Chrdl1, Fam3c and Fam3b) maintained cardiac function after myocardial infarction by blunting oxidative damage, decreasing cell death, promoting autophagy, and inhibiting myofibroblast activation (Ruozi, Bortolotti et al. 2022. Sci Transl Med 14, eabo0699)
Aim
We investigated the effect of cardioactive proteins in a mouse anthracycline model of cardiotoxicity.
Material and methods
Mimicking clinical chronic therapeutic regimens, doxorubicin (24 mg/kg) was administered to C57/BL6 female mice one week after AAV9-driven cardiac overexpression of Chrdl1, Fam3b or Fam3c. Echocardiography was performed after 6 and 8 weeks and was followed by histology and molecular analysis. Apoptosis, autophagy and mitochondrial function was analysed in primary cardiomyocytes along with pathway investigation.
Results
AAV9-mediated overexpression of Chrdl1, Fam3b and Fam3c markedly improved animal survival. Echocardiographic assessment revealed significant reduction of left ventricular ejection fraction and marked heart dilatation in control animals, while all treated animals maintained functional and anatomical parameters. Treated mice showed normal cardiac mass and cardiomyocyte cross-sectional area, reduced interstitial collagen deposition and decreased expression of profibrotic genes. In both rodents and human cardiomyocytes, Chrdl1, Fam3b and Fam3c factors decreased doxorubicin induced apoptosis, induced protective macroautophagy and preserved mitochondrial morphology. Chrdl1 prevented doxorubicin-mediated BMP upregulation and autophagy engulfment through the inhibition of a detrimental molecular pathway downstream the BMP receptor.
Conclusions
The development of biotherapeutics that act as pro-survival factors for cardiomyocytes offers significant translational perspectives in cardio-oncology.