The novel butyrate derivative phenylalanine-butyramide protects from doxorubicin-induced cardiotoxicity

Eur J Heart Fail. 2019 Apr;21(4):519-528. doi: 10.1002/ejhf.1439. Epub 2019 Mar 6.


Aims: Butyric acid (BUT), a short chain fatty acid produced daily by the gut microbiota, has proven beneficial in models of cardiovascular diseases. With advancements in cancer survival, an increasing number of patients are at risk of anticancer drug cardiotoxicity. Here we assess whether the novel BUT derivative phenylalanine-butyramide (FBA) protects from doxorubicin (DOXO) cardiotoxicity, by decreasing oxidative stress and improving mitochondrial function.

Methods and results: In C57BL6 mice, DOXO produced left ventricular dilatation assessed by echocardiography. FBA prevented left ventricular dilatation, fibrosis and cardiomyocyte apoptosis when co-administered with DOXO. DOXO increased atrial natriuretic peptide, brain natriuretic peptide, connective tissue growth factor, and matrix metalloproteinase-2 mRNAs, which were not elevated on co-treatment with FBA. DOXO, but not FBA + DOXO mice, also showed higher nitrotyrosine levels, and increased inducible nitric oxide synthase expression. Accordingly, DOXO hearts showed lower levels of intracellular catalase vs. sham, while pre-treatment with FBA prevented this decrease. We then assessed for reactive oxygen species (ROS) emission: DOXO induced increased activity of mitochondrial superoxide dismutase and higher production of H2 O2 , which were blunted by FBA pre-treatment. FBA also ameliorated mitochondrial state 3 and state 4 respiration rates that were compromised by DOXO. Furthermore, in DOXO animals, the mitochondrial degree of coupling was significantly increased vs. sham, while FBA was able to prevent such increase, contributing to limit ROS production, Finally, FBA reduced DOXO damage in human cellular models, and increased the tumour-killing action of DOXO.

Conclusions: Phenylalanine-butyramide protects against experimental doxorubicin cardiotoxicity. Such protection is accompanied by reduction in oxidative stress and amelioration of mitochondrial function.

Keywords: Doxorubicin cardiotoxicity; Heart failure; Oxidative and nitrosative stress; Phenylalanine-butyramide.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amides / pharmacology*
  • Animals
  • Antibiotics, Antineoplastic / adverse effects
  • Antibiotics, Antineoplastic / pharmacology
  • Apoptosis / drug effects
  • Butyrates / pharmacology
  • Butyric Acid / metabolism
  • Cardiotoxicity / diagnosis
  • Cardiotoxicity / etiology
  • Cardiotoxicity / metabolism
  • Cardiotoxicity / prevention & control
  • Disease Models, Animal
  • Doxorubicin / adverse effects*
  • Doxorubicin / pharmacology
  • Echocardiography / methods
  • Mice
  • Mice, Inbred C57BL
  • Mitochondria / drug effects
  • Mitochondria / metabolism
  • Myocytes, Cardiac* / drug effects
  • Myocytes, Cardiac* / metabolism
  • Oxidative Stress / drug effects*
  • Phenylalanine / pharmacology*
  • Protective Agents / pharmacology
  • Treatment Outcome


  • Amides
  • Antibiotics, Antineoplastic
  • Butyrates
  • Protective Agents
  • Butyric Acid
  • Phenylalanine
  • Doxorubicin
  • butyramide