Doxorubicin (Dox) is a cytotoxic drug widely incorporated in various chemotherapy protocols. Severe side effects such as cardiotoxicity, however, limit Dox application. Mechanisms by which Dox promotes cardiac damage and cardiomyocyte cell death have been investigated extensively, but a definitive picture has yet to emerge. Autophagy, regarded generally as a protective mechanism that maintains cell viability by recycling unwanted and damaged cellular constituents, is nevertheless subject to dysregulation having detrimental effects for the cell. Autophagic cell death has been described, and has been proposed to contribute to Dox-cardiotoxicity. Additionally, mitophagy, autophagic removal of damaged mitochondria, is affected by Dox in a manner contributing to toxicity. Here we will review Dox-induced cardiotoxicity and cell death in the broad context of the autophagy and mitophagy processes.

In fibrosing hearts, myofibroblasts are associated with cardiac extracellular matrix remodeling. Expression of key genes in the transition of cardiac fibroblast to myofibroblast phenotype in post‐myocardial infarction heart and in vitro has not been well addressed. Contractile, focal adhesion‐associated, receptor proteins, fibroblast growth factor‐2 (FGF‐2) expression, and motility were compared to assess phenotype in adult and neonatal rat cardiac fibroblasts and myofibroblasts. Neonatal and adult fibroblasts undergo phenotypic transition to myofibroblastic cells, marked by increased α‐smooth muscle actin (αSMA), smooth muscle myosin heavy chain (SMemb), extra domain‐A (ED‐A) fibronectin, paxillin, tensin, FGF‐2, and TβRII receptor. Elevated ED‐A fibronectin confirmed fibroblast to supermature myofibroblastic phenotype transition. Presence of myofibroblasts in vivo was noted in sections of healed infarct scar after myocardial infarction, and their expression is similar to that in culture. Thus, cultured neonatal and adult cardiac fibroblasts transition to myofibroblasts in vitro and share expression profiles of cardiac myofibroblasts in vivo. Reduced motility with in vitro passage reflects enhanced production of focal adhesions. Developmental Dynamics 239:1573–1584, 2010.

Extracts from atrial and ventricular heart tissue of several species (chicken, rat, sheep, and cow) are strongly mitogenic for chicken skeletal myoblasts, with the highest apparent concentration of biological activity in the atrial extracts. Using several approaches (biological activity assay and biochemical and immunological analyses), we have established that (a) all cardiac extracts contain an 18,000-D peptide which is identified as basic fibroblast growth factor (bFGF) since it elutes from heparin-Sepharose columns at salt concentrations greater than 1.4 M and is recognized by bFGF-specific affinity-purified antibodies; (b) bFGF is more abundant in the atrial extracts in all species so examined; (c) avian cardiac tissue extracts contain the highest concentration of immunoreactive bFGF; and (d) avian ventricles contain a higher relative molecular mass (23,000-D) bFGF-like peptide which is absent from atrial extracts. Examination of frozen bovine cardiac tissue sections by indirect immunofluorescence using anti-bFGF antibodies shows bFGF-like reactivity associated with nuclei and intercalated discs of muscle fibers. There is substantial accumulation of bFGF around atrial but not ventricular myofibers, resulting most likely from more extensive endomysium in the atria. Blood vessels and single, nonmuscle, connective tissue cells react strongly with the anti-bFGF antibodies. Higher bFGF content and pericellular distribution in atrial muscles suggest a correlation with increased regenerative potential in this tissue. Distribution within the myofibers is intriguing, raising the possibility for an intimate and continuous involvement of bFGF-like components with normal myocardial function.

—Gap junctions (GJs), composed of connexins, are intercellular channels ensuring electric and metabolic coupling between cardiomyocytes. We have shown previously that an endogenous mitogenic and cardioprotective protein, fibroblast growth factor-2 (FGF-2), decreases cardiomyocyte GJ permeability by stimulating phosphorylation of connexin-43 (Cx43). Identifying the kinase(s) phosphorylating cardiac Cx43 may thus provide a way of modulating cardiac intercellular communication. Because FGF-2 activates receptors linked to protein kinase C (PKC) and mitogen-activated protein kinase, we first investigated participation of these enzymatic systems in Cx43 phosphorylation. The inhibitor PD98059 blocked activation of mitogen-activated protein kinase, but it did not prevent the FGF-2 effects on GJs. In contrast, the PKC inhibitor chelerythrine blocked the effects of FGF-2 on Cx43 phosphorylation and permeability. Because the ε-isoform of PKC localizes to plasma membrane sites, we examined whether it is directly involved in the FGF-2–induced Cx43 phosphorylation. In nonstimulated myocytes, PKCε displayed a discontinuous pattern of localization at intercellular contact sites and partial colocalization with Cx43. Treatment with FGF-2 or phorbol 12-myristate 13-acetate induced a more continuous pattern of PKCε distribution, whereas the anti-Cx43 staining appeared to overlap extensively with that of PKCε. In immunoprecipitation experiments using specific anti-Cx43 antibodies, PKCε but not PKCα coprecipitated with Cx43. FGF-2 increased levels of coprecipitated PKCε, suggesting increased association between PKCε and Cx43 on stimulation. Transient gene transfer and overexpression of cDNAs coding for truncated or mutated dominant-negative forms of PKCε decreased cardiomyocyte Cx43 phosphorylation significantly. We conclude that PKC mediates the FGF-2–induced effects on cardiac GJs and that PKCε likely interacts with and phosphorylates cardiac Cx43 at sites of intercellular contact.