Exosomal transfer of pro-pyroptotic miR-216a-5p exacerbates anthracycline cardiotoxicity through breast cancer-heart pathological crosstalk

Abstract Doxorubicin (DOX) is the most effective chemotherapeutic for breast cancer, but it is usually associated with severe cardiotoxicity. Further investigation to alleviate its side effects is essential. The present study investigated the mechanism of the cross-organ communication between tumors...

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Main Authors: Yan Ma, Yongjun Wang, Renzheng Chen, Yabin Wang, Yan Fang, Cheng Qin, Tianhu Wang, Xiaoying Shen, Tingwen Zhou, Lei Tian, Ting Sun, Li Fan, Xiaoning Wang, Dong Han, Feng Cao
Format: Article
Language:English
Published: Nature Publishing Group 2025-05-01
Series:Signal Transduction and Targeted Therapy
Online Access:https://doi.org/10.1038/s41392-025-02245-4
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author Yan Ma
Yongjun Wang
Renzheng Chen
Yabin Wang
Yan Fang
Cheng Qin
Tianhu Wang
Xiaoying Shen
Tingwen Zhou
Lei Tian
Ting Sun
Li Fan
Xiaoning Wang
Dong Han
Feng Cao
author_facet Yan Ma
Yongjun Wang
Renzheng Chen
Yabin Wang
Yan Fang
Cheng Qin
Tianhu Wang
Xiaoying Shen
Tingwen Zhou
Lei Tian
Ting Sun
Li Fan
Xiaoning Wang
Dong Han
Feng Cao
author_sort Yan Ma
collection DOAJ
description Abstract Doxorubicin (DOX) is the most effective chemotherapeutic for breast cancer, but it is usually associated with severe cardiotoxicity. Further investigation to alleviate its side effects is essential. The present study investigated the mechanism of the cross-organ communication between tumors and the heart and potential intervention targets. Morphological bubble-like protrusions were observed in both adult murine ventricular cardiomyocytes (AMVCs) and human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) cocultured with breast cancer cells (BCCs), along with elevated expression of pyroptosis-related proteins. Exosomes (EXOs) from DOX-treated BCCs aggravated DOX-induced cardiotoxicity (DOXIC) in an orthotopic mouse model of breast cancer. Blocking miRNAs by knocking down Rab27a or inhibiting the release of EXOs in cancer tissue by Dicer enzyme knockout attenuated this additional injury effect. Exosomal miRNA sequencing revealed that miR-216a-5p is especially upregulated in EXOs from DOX-induced BCCs. Mechanistically, miR-216a-5p was upregulated by enhanced transcription mediated by DOX-induced AMP-dependent transcription factor 3 (ATF3) and packaged into EXOs by splicing factor 3b subunit 4 (SF3B4) in BCCs. Itchy E3 ubiquitin-protein ligase (ITCH) was identified as a novel downstream target mRNA of miR-216a-5p. ITCH negatively mediated thioredoxin-interacting protein (TXNIP) ubiquitination to activate the NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome pathway, ultimately leading to cardiomyocyte pyroptosis. Our findings revealed novel cross-organ pathogenic communication between breast cancer and the heart through the exosomal miR-216a-5p-mediated ITCH/TXNIP/NLRP3 pathway, which drives cardiomyocyte pyroptosis. These findings suggest that targeting myocardial miR-216a-5p or blocking harmful EXOs from breast cancer is a potential therapeutic strategy for alleviating DOXIC.
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series Signal Transduction and Targeted Therapy
spelling doaj-art-ce2060bd8d1e4b5b91f84c86c2dbfab92025-08-20T03:53:57ZengNature Publishing GroupSignal Transduction and Targeted Therapy2059-36352025-05-0110112610.1038/s41392-025-02245-4Exosomal transfer of pro-pyroptotic miR-216a-5p exacerbates anthracycline cardiotoxicity through breast cancer-heart pathological crosstalkYan Ma0Yongjun Wang1Renzheng Chen2Yabin Wang3Yan Fang4Cheng Qin5Tianhu Wang6Xiaoying Shen7Tingwen Zhou8Lei Tian9Ting Sun10Li Fan11Xiaoning Wang12Dong Han13Feng Cao14Chinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalDepartment of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyChinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalChinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalChinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalChinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalChinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalChinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalDepartment of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyChinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalChinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalChinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalChinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalChinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalChinese Military Medical School, National Clinical Research Center for Geriatric Diseases, The Second Medical Center, Chinese PLA General HospitalAbstract Doxorubicin (DOX) is the most effective chemotherapeutic for breast cancer, but it is usually associated with severe cardiotoxicity. Further investigation to alleviate its side effects is essential. The present study investigated the mechanism of the cross-organ communication between tumors and the heart and potential intervention targets. Morphological bubble-like protrusions were observed in both adult murine ventricular cardiomyocytes (AMVCs) and human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) cocultured with breast cancer cells (BCCs), along with elevated expression of pyroptosis-related proteins. Exosomes (EXOs) from DOX-treated BCCs aggravated DOX-induced cardiotoxicity (DOXIC) in an orthotopic mouse model of breast cancer. Blocking miRNAs by knocking down Rab27a or inhibiting the release of EXOs in cancer tissue by Dicer enzyme knockout attenuated this additional injury effect. Exosomal miRNA sequencing revealed that miR-216a-5p is especially upregulated in EXOs from DOX-induced BCCs. Mechanistically, miR-216a-5p was upregulated by enhanced transcription mediated by DOX-induced AMP-dependent transcription factor 3 (ATF3) and packaged into EXOs by splicing factor 3b subunit 4 (SF3B4) in BCCs. Itchy E3 ubiquitin-protein ligase (ITCH) was identified as a novel downstream target mRNA of miR-216a-5p. ITCH negatively mediated thioredoxin-interacting protein (TXNIP) ubiquitination to activate the NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome pathway, ultimately leading to cardiomyocyte pyroptosis. Our findings revealed novel cross-organ pathogenic communication between breast cancer and the heart through the exosomal miR-216a-5p-mediated ITCH/TXNIP/NLRP3 pathway, which drives cardiomyocyte pyroptosis. These findings suggest that targeting myocardial miR-216a-5p or blocking harmful EXOs from breast cancer is a potential therapeutic strategy for alleviating DOXIC.https://doi.org/10.1038/s41392-025-02245-4
spellingShingle Yan Ma
Yongjun Wang
Renzheng Chen
Yabin Wang
Yan Fang
Cheng Qin
Tianhu Wang
Xiaoying Shen
Tingwen Zhou
Lei Tian
Ting Sun
Li Fan
Xiaoning Wang
Dong Han
Feng Cao
Exosomal transfer of pro-pyroptotic miR-216a-5p exacerbates anthracycline cardiotoxicity through breast cancer-heart pathological crosstalk
Signal Transduction and Targeted Therapy
title Exosomal transfer of pro-pyroptotic miR-216a-5p exacerbates anthracycline cardiotoxicity through breast cancer-heart pathological crosstalk
title_full Exosomal transfer of pro-pyroptotic miR-216a-5p exacerbates anthracycline cardiotoxicity through breast cancer-heart pathological crosstalk
title_fullStr Exosomal transfer of pro-pyroptotic miR-216a-5p exacerbates anthracycline cardiotoxicity through breast cancer-heart pathological crosstalk
title_full_unstemmed Exosomal transfer of pro-pyroptotic miR-216a-5p exacerbates anthracycline cardiotoxicity through breast cancer-heart pathological crosstalk
title_short Exosomal transfer of pro-pyroptotic miR-216a-5p exacerbates anthracycline cardiotoxicity through breast cancer-heart pathological crosstalk
title_sort exosomal transfer of pro pyroptotic mir 216a 5p exacerbates anthracycline cardiotoxicity through breast cancer heart pathological crosstalk
url https://doi.org/10.1038/s41392-025-02245-4
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