Doxorubicin-Induced Platelet Activation and Clearance Relieved by Salvianolic Acid Compound: Novel Mechanism and Potential Therapy for Chemotherapy-Associated Thrombosis and Thrombocytopenia.
Wenjing MaZackary RousseauSladjana SlavkovicChuanbin ShenGeorge M YousefHeyu NiPublished in: Pharmaceuticals (Basel, Switzerland) (2022)
Doxorubicin (Dox) is a widely utilized chemotherapeutic; however, it carries side effects, including drug-induced immune thrombocytopenia (DITP) and increased risk of venous thromboembolism (VTE). Currently, the mechanisms for Dox-associated DITP and VTE are poorly understood, and an effective inhibitor to relieve these complications remains to be developed. In this study, we found that Dox significantly induced platelet activation and enhanced platelet phagocytosis by macrophages and accelerated platelet clearance. Importantly, we determined that salvianolic acid C (SAC), a water-soluble compound derived from Danshen root traditionally used to treat cardiovascular diseases, inhibited Dox-induced platelet activation more effectively than current standard-of-care anti-platelet drugs aspirin and ticagrelor. Mechanism studies with tyrosine kinase inhibitors indicate contributions of phospholipase C, spleen tyrosine kinase, and protein kinase C signaling pathways in Dox-induced platelet activation. We further demonstrated that Dox enhanced platelet-cancer cell interaction, which was ameliorated by SAC. Taken together, these findings suggest SAC may be a promising therapy to reduce the risk of Dox-induced DITP, VTE, and the repercussions of amplified platelet-cancer interaction in the tumor microenvironment.
Keyphrases
- drug induced
- venous thromboembolism
- liver injury
- high glucose
- tyrosine kinase
- diabetic rats
- low dose
- cardiovascular disease
- healthcare
- stem cells
- squamous cell carcinoma
- drug delivery
- acute coronary syndrome
- epidermal growth factor receptor
- water soluble
- endothelial cells
- risk factors
- quality improvement
- chronic pain
- cancer therapy
- pain management
- cell proliferation
- st elevation myocardial infarction
- papillary thyroid
- rectal cancer