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Integrated Omics Approach to Delineate the Mechanisms of Doxorubicin-Induced Cardiotoxicity.

Pharmaceuticals (Basel, Switzerland) 2026 Vol.19(2)

Dabour MS, Abdelgawad IY, Sadaf B, Daniel MR, Grant MKO, Blaes AH, Jacobson PA, Zordoky BN

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Doxorubicin (DOX) is an effective chemotherapeutic agent whose clinical utility is limited by cardiotoxicity.

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BibTeX ↓ RIS ↓
APA Dabour MS, Abdelgawad IY, et al. (2026). Integrated Omics Approach to Delineate the Mechanisms of Doxorubicin-Induced Cardiotoxicity.. Pharmaceuticals (Basel, Switzerland), 19(2). https://doi.org/10.3390/ph19020234
MLA Dabour MS, et al.. "Integrated Omics Approach to Delineate the Mechanisms of Doxorubicin-Induced Cardiotoxicity.." Pharmaceuticals (Basel, Switzerland), vol. 19, no. 2, 2026.
PMID 41754775
DOI 10.3390/ph19020234

Abstract

Doxorubicin (DOX) is an effective chemotherapeutic agent whose clinical utility is limited by cardiotoxicity. To investigate underlying mechanisms, we employed a multi-omics approach integrating transcriptomics and proteomics, leveraging established mouse models of chronic DOX-induced cardiotoxicity. : Five-week-old male mice received weekly DOX (4 mg/kg) or saline injections for six weeks, with heart tissues harvested 4 days post-treatment. Differentially expressed genes (DEGs) and proteins (DEPs) were identified by bulk RNA-seq and proteomics, validated via qPCR and Western blot, respectively. Key DEPs were validated in plasma samples from DOX-treated breast cancer patients. Additionally, temporal comparison was conducted between DEPs in the mice hearts 4 days and 6 weeks post-DOX. : RNA-seq revealed upregulation of stress-responsive genes (, ) and circadian regulators (), with downregulation of and . Proteomics identified upregulation of serpina3n, thrombospondin-1, and epoxide hydrolase 1. Plasma SERPINA3 concentrations were significantly elevated in breast cancer patients 24 h post-DOX. Gene set enrichment analysis (GSEA) revealed upregulated pathways, including p53 signaling, apoptosis, and unfolded protein response. Integrated omics analysis revealed 2089 gene-protein pairs. GSEA of concordant gene-protein pairs implicated p53 signaling, apoptosis, and epithelial-mesenchymal transition in upregulated pathways, while oxidative phosphorylation and metabolic pathways were downregulated. Temporal comparison with a delayed timepoint (6 weeks post-DOX) uncovered dynamic remodeling of cardiac signaling, with early response dominated by inflammatory and apoptotic responses, and delayed response marked by cell cycle and DNA repair pathway activation. : This integrated omics study reveals key molecular pathways and temporal changes in DOX-induced cardiotoxicity, identifying potential biomarkers for future cardioprotective strategies.