Anti-erbB2 treatment induces cardiotoxicity by interfering with cell survival pathways
Thea Pugatsch1, Suzan Abedat, Chaim Lotan
1The Cardiovascular Research Center, Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. pthea@hadassah.org.il
Introduction:
Cardiac dysfunction is among the serious side effects of therapy with recombinant humanized anti-erbB2 monoclonal antibody. The antibody blocks ErbB-2, a receptor tyrosine kinase and co-receptor for other members of the ErbB and epidermal growth factor families, which is over-expressed on the surface of many malignant cells. ErbB-2 and its ligands neuregulin and ErbB-3/ErbB-4 are involved in survival and growth of cardiomyocytes in both postnatal and adult hearts, and therefore the drug may interrupt the correct functioning of the ErbB-2 pathway.
Methods:
The effect of the rat-anti-erbB2 monoclonal antibody B-10 was studied in spontaneously beating primary myocyte cultures from rat neonatal hearts. Gene expression was determined by RT-PCR (reverse transcription polymerase chain reaction) and by rat stress-specific microarray analysis, protein levels by Western blot, cell contractility by video motion analysis, calcium transients by the FURA fluorescent method, and apoptosis using the TUNEL (terminal uridine nick-end labelling) assay.
Results:
B-10 treatment induces significant changes in expression of 24 out of 207 stress genes analyzed using the microarray technique. Protein levels of ErbB-2, ErbB-3, ErbB-4 and neuregulin decreased after 1 day. However, both transcription and protein levels of ErbB-4 and gp130 increased several fold. Calreticulin and calsequestrin were overexpressed after three days, inducing a decrease in calcium transients, thereby influencing cell contractility. Apoptosis was induced in 20% cells after 24 hours.
Conclusion:
Blocking ErbB-2 in cultured rat cardiomyocytes leads to changes that may influence the cell cycle and affects genes involved in heart functions. B-10 inhibits pro-survival pathways and reduces cellular contractility. Thus, it is conceivable that this process may impair the stress response of the heart.
Insights
Blocking ErbB-2 with the B-10 antibody in rat heart cells disrupts cardiomyocyte function, reduces contractility, and induces apoptosis, potentially impairing cardiac stress response.
Area of Science:
- Cardiology
- Molecular Biology
- Oncology
Background:
- Cardiac dysfunction is a serious side effect of anti-erbB2 monoclonal antibody therapy.
- The ErbB-2 pathway is crucial for cardiomyocyte survival and function.
- Targeting ErbB-2 in cancer therapy may inadvertently affect cardiac cells.
Purpose of the Study:
- To investigate the effects of the anti-erbB2 antibody B-10 on rat cardiomyocytes.
- To determine the molecular and functional consequences of ErbB-2 pathway blockade in heart cells.
Main Methods:
- Primary rat cardiomyocyte cultures were treated with the B-10 antibody.
- Gene expression analyzed by RT-PCR and microarray.
- Protein levels assessed by Western blot; contractility by video motion analysis; calcium transients by FURA; apoptosis by TUNEL assay.
Main Results:
- B-10 altered expression of 24 stress-related genes.
- ErbB-2, ErbB-3, ErbB-4, and neuregulin protein levels decreased; ErbB-4 and gp130 increased.
- Overexpression of calreticulin and calsequestrin reduced calcium transients, impaired contractility, and induced apoptosis in 20% of cells.
Conclusions:
- Blocking ErbB-2 in cardiomyocytes alters cell cycle and genes involved in heart function.
- B-10 inhibits pro-survival pathways and reduces cellular contractility.
- These effects suggest a potential impairment of the heart's stress response.
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