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TP53-mediated therapy-related clonal hematopoiesis contributes to doxorubicin-induced cardiomyopathy by augmenting a neutrophil-mediated cytotoxic response
Soichi Sano, Ying Wang, Hayato Ogawa, Keita Horitani, Miho Sano, Ariel H. Polizio, Anupreet Kour, Yoshimitsu Yura, Heather Doviak, Kenneth Walsh
Soichi Sano, Ying Wang, Hayato Ogawa, Keita Horitani, Miho Sano, Ariel H. Polizio, Anupreet Kour, Yoshimitsu Yura, Heather Doviak, Kenneth Walsh
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Research Article Cardiology

TP53-mediated therapy-related clonal hematopoiesis contributes to doxorubicin-induced cardiomyopathy by augmenting a neutrophil-mediated cytotoxic response

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Abstract

Therapy-related clonal hematopoiesis (t-CH) is often observed in cancer survivors. This form of clonal hematopoiesis typically involves somatic mutations in driver genes that encode components of the DNA damage response and confer hematopoietic stem and progenitor cells (HSPCs) with resistance to the genotoxic stress of the cancer therapy. Here, we established a model of TP53-mediated t-CH through the transfer of Trp53 mutant HSPCs to mice, followed by treatment with a course of the chemotherapeutic agent doxorubicin. These studies revealed that neutrophil infiltration in the heart significantly contributes to doxorubicin-induced cardiac toxicity and that this condition is amplified in the model of Trp53-mediated t-CH. These data suggest that t-CH could contribute to the elevated heart failure risk that occurs in cancer survivors who have been treated with genotoxic agents.

Authors

Soichi Sano, Ying Wang, Hayato Ogawa, Keita Horitani, Miho Sano, Ariel H. Polizio, Anupreet Kour, Yoshimitsu Yura, Heather Doviak, Kenneth Walsh

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Figure 4

Neutrophil overactivation contributes to the cardiac toxicity induced by Trp53-mediated clonal hematopoiesis.

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Neutrophil overactivation contributes to the cardiac toxicity induced by...
(A) Schematic of the study in B–D. Lethally irradiated mice underwent a competitive BMT with 30% Trp53 heterozygous–deficient (Trp53+/–) cells. After a 6-week recovery from BMT, mice received an intraperitoneal administration of anti-Ly6G (clone 1A8, neutrophil depletion) or isotype control (clone 2A3) antibody (antibody, 500 μg/injection/mouse, 1 injection/3 days for 4 weeks) from 1 day before Dox administration (15 μg/g, split into 3 injections over 10 days) until the end of this study. (B) Left ventricular posterior wall thickness diameter (LVPWTd; mm), fractional shortening (FS; %), left ventricular end-systolic diameter (LVDs; mm), left ventricular end-diastolic diameter (LVDd; mm), and left ventricular mass (LV mass; mg) at the end of study. (C) Heart weight (HW) adjusted to tibia length (TL). (D) Relative immunofluorescence values of 3-nitrotyrosine staining in heart sections of mice. All mice were treated with sterile saline, Dox + isotype control, or Dox + anti-Ly6G. Statistical analysis was performed with 2-way ANOVA with Tukey’s multiple-comparison tests. For B–D, n = 5–8 per group. *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001.

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