Cinnamaldehyde alleviates doxorubicin-induced cardiotoxicity by decreasing oxidative stress and ferroptosis in cardiomyocytes

PLoS One. 2023 Oct 12;18(10):e0292124. doi: 10.1371/journal.pone.0292124. eCollection 2023.

Abstract

Although doxorubicin (DOX) is an efficient chemotherapeutic drug for human tumors, severe cardiotoxicity restricts its clinical use. Cinnamaldehyde (CA), a bioactive component isolated from Cinnamonum cassia, possesses potent anti-oxidative and anti-apoptotic potentials. The major aim of this study was to evaluate the protective role of CA against DOX-induced cardiotoxicity. To this end, cardiomyocyte injury models were developed using DOX-treated H9c2 cells and DOX-treated rats, respectively. Herein, we found that CA treatment increased cardiomyocyte viability and attenuated DOX-induced cardiomyocyte death in vitro. CA further protected rats against DOX-induced cardiotoxicity, as indicated by elevated creatine kinase (CK) and lactate dehydrogenase (LDH) levels, myocardium injury, and myocardial fibrosis. CA alleviated DOX-induced myocardial oxidative stress by regulating reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione (GSH) levels. Mechanistically, CA markedly accelerated nuclear translocation of nuclear erythroid factor 2-related factor 2 (Nrf2) and increased heme oxygenase-1 (HO-1) expression. Consequently, CA decreased DOX-induced cardiomyocyte ferroptosis, while Erastin (a ferroptosis agonist) treatment destroyed the effect of CA on increasing cardiomyocyte viability. Taken together, the current results demonstrate that CA alleviates DOX-induced cardiotoxicity, providing a promising opportunity to increase the clinical application of DOX.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Apoptosis
  • Cardiotoxicity / drug therapy
  • Cardiotoxicity / etiology
  • Cardiotoxicity / prevention & control
  • Doxorubicin / metabolism
  • Doxorubicin / toxicity
  • Ferroptosis*
  • Glutathione / metabolism
  • Humans
  • Myocytes, Cardiac* / metabolism
  • Oxidative Stress
  • Rats

Substances

  • cinnamaldehyde
  • Doxorubicin
  • Glutathione

Grants and funding

Supported by the Collaboration Pilot Project of Clinical Integration of Chinese and Western Medicine in the 2019 Annual of the Shanghai Municipal Health Commission (no. zxyxz-201903) and the National Natural Science Foundation of China (81873264). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.