The Potential Protective Effects of Misoprostol Against Cardiac Damage induced by the Anticancer Drugs [Paclitaxel as an example]

Background: Cancer is associated with increased mortality. Chemotherapeutic agents had different toxic effects.  Paclitaxel, as a chemotherapeutic agent, is effective against different cancers. However, its cardiac toxicity shortens its use. The research of protective agents is continuing.
Aim of the work:  The study aimed to investigate the potential protective role of misoprostol against Paclitaxel -induced cardiac toxicity, besides the value of this combination for treatment of cancer.
Methods: This study included 20 rats divided equally into 4 groups. The first [the control] group received 1 ml of normal saline by intraperitoneal injection and 1 ml orally for six days. The second was paclitaxel group, received 2mg/kg of paclitaxel by intraperitoneal injection at days 0, 2, 4 and 6. The third was misoprostol and received 0.2 mg/kg, dissolved in 1 ml saline daily by oral gavage for six days. The fourth group was assigned the combination [paclitaxel and misoprostol] and animals treated as in the paclitaxel and misoprostol groups. At the end, there were assessment of cardiac biomarkers [cardiac Troponin-I [cTn-I], lactate dehydrogenase [LDH] and creatine kinase-MB [CK-MB]] Tissue oxidative stress [malondialdehyde [MDA], reduced glutathione [GSH], superoxide dismutase [SOD], catalase [CAT]] biomarkers were evaluated.
Results: Paclitaxel group recorded the highest cTn-I, CK-MB and LDH [1.76±0.26, 878.00±152.87 and 871.40±29.40, respectively]. However, the lower values were recorded for misoprostol [cTn-I], combination group [serum CK-Mb] and control group [serum LDH]. There was significant variance regarding oxidative stress indicators.   The lowest CAT activity was obtained in Paclitaxel, then combination, misoprostol and control groups respectively [0.078±0.013, 0.080±0.018, 0.110±0.023 and 0.116±0.015 respectively]. Reduced glutathione was significantly reduced in Paclitaxel group, then misoprostol, combination and finally control group [0.150±0.015, 0.182±0.025, 0.186±0.024 and 0.203±0.021, respectively].
Conclusion: Misoprostol can protect against Paclitaxel-induced cardiotoxic effects by anti-oxidative stress and direct protective mechanisms. It does not affect the therapeutic value of paclitaxel.