Assessment of herb-drug synergy to combat doxorubicin induced cardiotoxicity

Aim Doxorubicin (Dox) is one of the most cardiotoxic anti-cancerous drug that is widely used for broad-range of cancers. There is an urgent need for developing cardio-oncological therapeutic interventions. Natural products having both anti-cancerous potential as well as cardioprotective effects may hold a great potential in this regard. Curcuma longa (an Indian herb) polyphenols including curcumin, and well known for its anti-oxidative and anti-cancerous potential was used in the present study for its synergistic effect on cancer cells and cardiomyocytes. Preliminary dose dependent analysis for cell viability was conducted by MTT and trypan blue assays where the effects of curcumin and Dox on cancer cell progression and cardiotoxicity were studied. Microscopic studies were done to analyse the morphological alterations of cells followed by intracellular ROS production studies by NBT and DCFH-DA assays. Apoptotic cellular death was studied by caspase activity and Annexin/PI FACS analysis. TUNEL assay was done followed by expression analysis of different cellular death biomarkers by quantitative real-time PCR. We observed that dose dependent cardiotoxicity of Dox can be significantly minimized by supplementing it with curcumin. Curcumin supplementation exaggerates oxidative stress and apoptosis leading to cancer cell death by modulating pro- and anti-apoptotic biomarkers. The combination treatment with curcumin results in achieving the desired anti-cancerous effect of Dox without compromising its activity and hence, reduces the possibility of its dose mediated cardiotoxic effects. Hence, curcumin holds a great potential for cardio-oncological therapeutic interventions.