A new anti-tumor therapeutic approach with lower cardiotoxicity

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A new anti-tumor therapeutic approach with lower cardiotoxicity

Friday, 18.11.2016

Tania Martins-Marques 1,2, Maria Joao Pinho 1,2, Monica Zuzarte 1,2, Carla Oliveira 3,4,5, Paulo Pereira 6, Joost P. G. Sluijter 7,8, Celia Gomes 2,9,10, Henrique Girao 1,2*

1Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal;

2CNC.IBILI, University of Coimbra, Coimbra, Portugal; 

3Expression Regulation in Cancer Group, Instituto de Investigação e Inovação em Saúde (i3S), Porto, Portugal; 

4Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal; 

5Department of Pathology and Oncology, Faculty of Medicine, University of Porto, Porto, Portugal; 

6Chronic Diseases Research Center (CEDOC), NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisboa, Portugal; 

7Department of Cardiology, Division of Heart & Lungs, University Medical Center Utrecht, Utrecht, The Netherlands; 

8Interuniversity Cardiology Institute Netherlands (ICIN), Utrecht, The Netherlands; 

9Laboratory of Pharmacology and Experimental Therapeutics, IBILI, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; 

10Center of Investigation in Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal


Extracellular vesicles (EVs) are major conveyors of biological information, mediating local and systemic cell-to-cell communication under physiological and pathological conditions. These endogenous vesicles have been recognized as prominent drug delivery vehicles of several therapeutic cargoes, including doxorubicin (dox), presenting major advantages over the classical approaches. Although dox is one of the most effective anti-tumor agents in the clinical practice, its use is very often hindered by its consequent dramatic cardiotoxicity. Despite significant advances witnessed in the last few years, more comprehensive studies, supporting the therapeutic efficacy of EVs, with decreased side effects, are still scarce. The main objective of this study was to evaluate the role of the gap junction protein connexin43 (Cx43) in mediating the release of EV content into tumor cells. Moreover, we aimed to investigate whether Cx43 improves the efficiency of dox-based anti-tumor treatment, with a concomitant decrease of cardiotoxicity. In the present report, we demonstrate that the presence of Cx43 in EVs increases the release of luciferin from EVs into tumor cells in vitro and in vivo. Additionally, using cell-based approaches and a subcutaneous mouse tumor model, we show that the anti-tumor effect of dox incorporated into EVs is similar to the administration of the free drug, regardless the presence of Cx43. Strikingly, we demonstrate that the presence of Cx43 in dox-loaded EVs reduces the cardiotoxicity of the drug. Altogether, these results bring new insights into the concrete potential of EVs as therapeutic vehicles and open new avenues towards the development of new strategies that help to reduce unwanted side effects.

Journal of Extracellular Vesicles