Atorvastatin protects cardiomyocyte from doxorubicin toxicity by modulating survivin expression through FOXO1 inhibition

J Mol Cell Cardiol. 2020 Jan:138:244-255. doi: 10.1016/j.yjmcc.2019.12.007. Epub 2019 Dec 19.

Abstract

Background: Survivin has an anti-apoptotic effect against anthracycline-induced cardiotoxicity. Clinically, statin use is associated with a lower risk for heart failure in breast cancer patients with anthracycline chemotherapy. So, the purpose of our study was to investigate whether survivin mediates the protective effect of statin against anthracycline-induced cardiotoxicity.

Methods: Mice were treated once a week with 5 mg/kg doxorubicin for 4 weeks with or without atorvastatin 20 mg/kg every day then heart tissues were analyzed. Molecular and cellular biology analyses were performed with H9c2 cell lysates.

Results: Doxorubicin suppressed survivin expression via activation of FOXO1 in H9c2 cardiomyocytes. Whereas, atorvastatin inhibited FOXO1 by increasing phosphorylation and inhibiting nuclear localization. Doxorubicin induced FOXO1 binding to STAT3 and prevented STAT3 from interacting with Sp1. However, atorvastatin inhibited these interactions and stabilized STAT3/Sp1 transcription complex. Chromatin immunoprecipitation analysis demonstrated that doxorubicin decreased STAT3/Sp1 complex binding to survivin promoter, whereas atorvastatin stabilized this binding. In mouse model, atorvastatin rescued doxorubicin-induced reduction of survivin expression and of heart function measured by cardiac magnetic resonance imaging.

Conclusions: Our study suggested a new pathophysiologic mechanism that survivin mediated protective effect of atorvastatin against doxorubicin-induced cardiotoxicity via FOXO1/STAT3/Sp1 transcriptional network.

Keywords: Apoptosis; Cardiotoxicity; Statin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Atorvastatin / pharmacology*
  • Cardiotonic Agents / pharmacology*
  • Cell Line
  • Cell Nucleus / drug effects
  • Cell Nucleus / metabolism
  • Cytoprotection* / drug effects
  • Disease Models, Animal
  • Doxorubicin / toxicity*
  • Forkhead Box Protein O1 / antagonists & inhibitors*
  • Forkhead Box Protein O1 / metabolism
  • Male
  • Mice, Inbred C57BL
  • Myocytes, Cardiac / drug effects
  • Myocytes, Cardiac / metabolism*
  • Myocytes, Cardiac / pathology
  • Phosphatidylinositol 3-Kinases / metabolism
  • Protein Transport / drug effects
  • Proto-Oncogene Proteins c-akt / metabolism
  • Rats
  • Signal Transduction / drug effects
  • Sp1 Transcription Factor / metabolism
  • Survivin / metabolism*
  • Transcription, Genetic / drug effects
  • Transcriptional Activation / drug effects

Substances

  • Birc5 protein, mouse
  • Cardiotonic Agents
  • Forkhead Box Protein O1
  • Sp1 Transcription Factor
  • Survivin
  • Doxorubicin
  • Atorvastatin
  • Proto-Oncogene Proteins c-akt