The function of PCSK9 in doxorubicin-induced cardiotoxicity and its underlying mechanism

Abstract Doxorubicin (DOX) is an anthracycline class of chemotherapy drug, the application of which is limited due to its cardiotoxic effects. Recombinant Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9), is a serine protease pivotal in lipid metabolism and has a profound correlation with the o...

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Main Authors: Shuai Shi, Zhihui Qin, Chang Liu, Yanru Zhao, Xiaopeng Bai, Chaoyu Sun, Xu Li, Wanting Cong, Xinyue Yuan, Lixiu Sun, Bingchen Liu, Xueqi Li
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-03419-4
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author Shuai Shi
Zhihui Qin
Chang Liu
Yanru Zhao
Xiaopeng Bai
Chaoyu Sun
Xu Li
Wanting Cong
Xinyue Yuan
Lixiu Sun
Bingchen Liu
Xueqi Li
author_facet Shuai Shi
Zhihui Qin
Chang Liu
Yanru Zhao
Xiaopeng Bai
Chaoyu Sun
Xu Li
Wanting Cong
Xinyue Yuan
Lixiu Sun
Bingchen Liu
Xueqi Li
author_sort Shuai Shi
collection DOAJ
description Abstract Doxorubicin (DOX) is an anthracycline class of chemotherapy drug, the application of which is limited due to its cardiotoxic effects. Recombinant Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9), is a serine protease pivotal in lipid metabolism and has a profound correlation with the onset of cardiovascular diseases. This study uncovers a connection between PCSK9 and DOX-induced cardiotoxicity (DIC). This research found that injection of DOX in mice caused cardiac toxicity. DOX treatment up-regulated the expression of PCSK9 protein in myocardial tissue. Evolocumab (PCSK9 inhibitors) improved cardiac function, myocardial injury, and fibrosis in DOX-treated mice, indicating a protective effect against DIC. The mechanism involved modulation of cardiomyocyte apoptosis and regulation of apoptosis-related proteins, including Bax/Bcl-2 ratio and Cleaved Caspase-3/Pro Caspase-3 ratio. DOX exhibited concentration- and time-dependent cytotoxic effects on H9C2 cardiomyocytes, promoting apoptosis. PCSK9 nuclear aggregation occurred in H9C2 cardiomyocytes after DOX treatment, and PCSK9 interacted with the Importin subunit beta-1 (KPNB1) protein. Interference with PCSK9 up-regulated KPNB1 expression, affecting apoptosis-related proteins and improving DOX-induced H9C2 cardiomyocyte apoptosis. In short, the elucidation of this mechanism is helpful involve that PCSK9 inhibitor may be a potential drug for improving DIC.
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spelling doaj-art-1111520d0b7b4d45aa72eedd4f4f52322025-08-20T03:45:24ZengNature PortfolioScientific Reports2045-23222025-07-0115111910.1038/s41598-025-03419-4The function of PCSK9 in doxorubicin-induced cardiotoxicity and its underlying mechanismShuai Shi0Zhihui Qin1Chang Liu2Yanru Zhao3Xiaopeng Bai4Chaoyu Sun5Xu Li6Wanting Cong7Xinyue Yuan8Lixiu Sun9Bingchen Liu10Xueqi Li11Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical UniversityDepartment of Obstetrics, The Fourth Affiliated Hospital of Harbin Medical UniversityCollege of Pharmacy, Beihua UniversityDepartment of Cardiology, The Fourth Affiliated Hospital of Harbin Medical UniversityDepartment of Cardiology, The Fourth Affiliated Hospital of Harbin Medical UniversityDepartment of Cardiology, The Fourth Affiliated Hospital of Harbin Medical UniversityDepartment of Cardiology, The Fourth Affiliated Hospital of Harbin Medical UniversityDepartment of Cardiology, The Fourth Affiliated Hospital of Harbin Medical UniversityBeijing University of Chinese Medicine Dongfang CollegeDepartment of Cardiology, The Fourth Affiliated Hospital of Harbin Medical UniversityDepartment of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang UniversityDepartment of Cardiology, The Fourth Affiliated Hospital of Harbin Medical UniversityAbstract Doxorubicin (DOX) is an anthracycline class of chemotherapy drug, the application of which is limited due to its cardiotoxic effects. Recombinant Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9), is a serine protease pivotal in lipid metabolism and has a profound correlation with the onset of cardiovascular diseases. This study uncovers a connection between PCSK9 and DOX-induced cardiotoxicity (DIC). This research found that injection of DOX in mice caused cardiac toxicity. DOX treatment up-regulated the expression of PCSK9 protein in myocardial tissue. Evolocumab (PCSK9 inhibitors) improved cardiac function, myocardial injury, and fibrosis in DOX-treated mice, indicating a protective effect against DIC. The mechanism involved modulation of cardiomyocyte apoptosis and regulation of apoptosis-related proteins, including Bax/Bcl-2 ratio and Cleaved Caspase-3/Pro Caspase-3 ratio. DOX exhibited concentration- and time-dependent cytotoxic effects on H9C2 cardiomyocytes, promoting apoptosis. PCSK9 nuclear aggregation occurred in H9C2 cardiomyocytes after DOX treatment, and PCSK9 interacted with the Importin subunit beta-1 (KPNB1) protein. Interference with PCSK9 up-regulated KPNB1 expression, affecting apoptosis-related proteins and improving DOX-induced H9C2 cardiomyocyte apoptosis. In short, the elucidation of this mechanism is helpful involve that PCSK9 inhibitor may be a potential drug for improving DIC.https://doi.org/10.1038/s41598-025-03419-4DoxorubicinPCSK9KPNB1ApoptosisCardiotoxicity
spellingShingle Shuai Shi
Zhihui Qin
Chang Liu
Yanru Zhao
Xiaopeng Bai
Chaoyu Sun
Xu Li
Wanting Cong
Xinyue Yuan
Lixiu Sun
Bingchen Liu
Xueqi Li
The function of PCSK9 in doxorubicin-induced cardiotoxicity and its underlying mechanism
Scientific Reports
Doxorubicin
PCSK9
KPNB1
Apoptosis
Cardiotoxicity
title The function of PCSK9 in doxorubicin-induced cardiotoxicity and its underlying mechanism
title_full The function of PCSK9 in doxorubicin-induced cardiotoxicity and its underlying mechanism
title_fullStr The function of PCSK9 in doxorubicin-induced cardiotoxicity and its underlying mechanism
title_full_unstemmed The function of PCSK9 in doxorubicin-induced cardiotoxicity and its underlying mechanism
title_short The function of PCSK9 in doxorubicin-induced cardiotoxicity and its underlying mechanism
title_sort function of pcsk9 in doxorubicin induced cardiotoxicity and its underlying mechanism
topic Doxorubicin
PCSK9
KPNB1
Apoptosis
Cardiotoxicity
url https://doi.org/10.1038/s41598-025-03419-4
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