The human gut microbiota contributes to host metabolic processes. Diverse microbial metabolic enzymes can affect therapeutic agents, resulting in chemical modifications that alter drug efficacy and toxicology. These interactions may result in ineffective treatments and dose-limiting side effects, as shown by bacterial modifications of the cardiac drug digoxin and chemotherapy drug irinotecan, respectively. Yet, few drug-microbiome interactions have been characterized. Here, a platform is developed to screen for drug-microbiome interactions, validated by the isolation of a gut bacterium capable of inactivating the antineoplastic drug doxorubicin. Two hundred gut strains isolated from a healthy patient fecal sample were cultured in the presence of antibiotic and antineoplastic drugs to enrich for resistance and possible inactivation. Raoultella planticola was identified for its ability to inactivate doxorubicin anaerobically through whole cell and crude lysate assays. This activity was also observed in other Enterobacteriaceae and resulted in doxorubicin inactivation by the removal of its daunosamine sugar, likely mediated by a molybdopterin-dependent enzyme. Other potential drug-microbiome interactions were identified in this screen and can be analyzed further. This platform enables the identification of drug-microbiome interactions that can be used to study drug pharmacology, improve the efficacy of therapeutic treatments, and advance personalized medicine. / Thesis / Bachelor of Science (BSc) / The collection of microbes in the human intestinal tract, referred to as the gut microbiome, can modify therapeutic agents and change the efficacy of drug treatments. Identifying these interactions between drugs and the microbiome will help the study of drug metabolism, provide explanations for treatment failure, and enable more personalized health care. For this project, a platform was developed to isolate gut bacteria from human fecal samples and characterize bacteria that are capable of inactivating various antibiotics and anticancer drugs. Through this platform, the gut bacterium Raoultella planticola was found to inactivate doxorubicin, a commonly used anticancer drug. These results suggest that doxorubicin may be inactivated in the gut and demonstrates how this platform can be used to identify drug-microbiome interactions.

[ES] La presente tesis doctoral titulada "La terapia senolítica como nuevo enfoque terapéutico para la prevención de la cardiotoxicidad inducida por la doxorrubicina" se centra en explorar la eliminación de células senescentes (senolisis) in vitro e in vivo mediante la administración del fármaco senolítico, navitoclax, como opción terapéutica para prevenir la cardiotoxicidad asociada al tratamiento antitumoral con doxorrubicina. La exposición a doxorrubicina afecta gravemente a la población de células cardíacas tanto en ratones como en corazones humanos al inducir senescencia prematura y navitoclax es uno de los senolíticos más potentes y ampliamente conocido en el campo de la senescencia celular pero su administración está asociada a la aparición de efectos adversos, principalmente trombocitopenia. Con el objetivo de mejorar el perfil terapéutico del fármaco, se han desarrollado dos estrategias específicamente dirigidas a células senescentes que incluyen la encapsulación y el desarrollo de un profármaco basado en navitoclax. En la primera sección experimental, abordamos la inducción de senescencia en un modelo in vitro de cardiomiocitos y evaluamos la terapia senolítica como estrategia terapéutica. Desarrollamos y caracterizamos, así mismo, las nanopartículas y la prodroga basada en navitoclax. Este nanodispositivo senolítico se basa en MSNs cargadas con navitoclax y funcionalizadas con un hexa-galacto-oligosacárido (galactán). Por su parte, la prodroga se obtiene tras la conjugación del navitoclax a una molécula de galactosa acetilada. En ambos casos, el mecanismo de la terapia dirigida radica en la presencia de la enzima lisosomal ß-galactosidasa, la cual presenta mayor expresión en las células senescentes. Al entrar en el lisosoma de células senescentes, los enlaces glicosídicos se hidrolizan por acción de la enzima, liberando el fármaco para su función. Los resultados muestran un aumento del efecto terapéutico del fármaco libre. A continuación, ponemos a punto un modelo murino de cardiotoxicidad donde demostramos que la administración sistémica de doxorrubicina induce la expresión de marcadores de cardiotoxicidad y senescencia en el corazón de ratones tratados y contribuye al deterioro de la función cardíaca de los animales seguido por ecografía. En este modelo preclínico, el tratamiento combinado de doxorrubicina con el senolítico navitoclax, en las diferentes formulaciones descritas, conduce a la disminución significativa de los marcadores de senescencia y cardiotoxicidad junto con el restablecimiento de la función cardíaca y, se observa, de manera similar con las tres estrategias mencionadas: fármaco libre, fármaco encapsulado y fármaco en formulación de prodroga. Los resultados científicos presentados en esta tesis resaltan el papel de la senescencia en la progresión de cardiotoxicidad por la administración de doxorrubicina y se concluye que los sistemas senolíticos aquí evaluados podrían ser una herramienta importante para el desarrollo de nuevas estrategias terapéuticas en el campo de la prevención de efectos secundarios asociados a terapia. / [CA] La present tesi doctoral titulada "La teràpia senolítica com a nou enfocament terapèutic per a la prevenció de la cardiotoxicitat induïda per la doxorrubicina" se centra en explorar l'eliminació de cèl·lules senescents (senolisis) in vitro i in vivo mitjançant l'administració del fàrmac senolític, navitoclax, com a opció terapèutica per a previndre la cardiotoxicitat associada al tractament antitumoral amb doxorrubicina. L'exposició a doxorrubicina afecta greument a la població de cèl·lules cardíaques tant en ratolins com en cors humans en induir senescència prematura y navitoclax és un dels senolítics més potents i àmpliament conegut en el camp de la senescència cel·lular però la seua administració està associada a l'aparició d'efectes adversos, principalment trombocitopenia. Amb l'objectiu de millorar el perfil terapèutic del fàrmac, s'han desenvolupat dues estratègies específicament dirigides a cèl·lules senescents que inclouen l'encapsulació i el desenvolupament d'un profàrmac basat en navitoclax. En la primera secció experimental, abordem la inducció de senescència en un model in vitro de cardiomiòcits i avaluem la teràpia senolítica com a estratègia terapèutica. Desenvolupem i caracteritzem, així mateix, les nanopartícules i la prodroga basada en navitoclax. Aquest nanodispositiu senolític es basa en MSNs carregades amb navitoclax i modificades amb un hexa-galacto-oligosacàrid (galactán). Per part seua, la prodroga s'obté després de la conjugació del navitoclax a una molècula de galactosa acetilada. En tots dos casos, el mecanisme de la teràpia dirigida radica en la presència de l'enzim lisosòmic ß-galactosidasa, la qual presenta major expressió en les cèl·lules senescents. En entrar en el lisosoma de cèl·lules senescents, els enllaços glicosídics s'hidrolitzen per acció de l'enzim, alliberant el fàrmac per a la seua funció. Els resultats mostren un augment de l'efecte terapèutic del fàrmac lliure. A continuació, posem a punt un model de ratolí on vam demostrar que l'administració sistèmica de doxorrubicina indueix l'expressió de marcadors de cardiotoxicitat i senescència en el cor de ratolins tractats i contribueix a la deterioració de la funció cardíaca dels animals seguit per ecografia. En aquest model preclínic, el tractament combinat de doxorrubicina amb el senolític navitoclax, en les diferents formulacions descrites, condueix a la disminució significativa dels marcadors de senescència i cardiotoxicitat juntament amb el restabliment de la funció cardíaca i, s'observa, de manera similar amb les tres estratègies esmentades: fàrmac lliure, fàrmac encapsulat i fàrmac en formulació de prodroga. Els resultats científics presentats en aquesta tesi ressalten el paper de la senescència en la progressió de cardiotoxicitat per l'administració de doxorrubicina i es conclou que els sistemes senolítics ací avaluats podrien ser una eina important per al desenvolupament de noves estratègies terapèutiques en el camp de la prevenció d'efectes secundaris associats a teràpia. / [EN] The present PhD thesis entitled " Pharmacological senolysis as a new therapeutic approach for the prevention of doxorubicin-induced cardiotoxicity" focuses on exploring the elimination of senescent cells (senolysis) in vitro and in vivo by administration of the senolytic drug, navitoclax, as a therapeutic option to prevent cardiotoxicity associated with antitumor treatment with doxorubicin. Doxorubicin exposure severely affects the cardiac cell population in both mouse and human hearts by inducing premature senescence and navitoclax is one of the most potent and widely known senolytics in the field of cellular senescence, but its administration is associated with the occurrence of adverse effects, mainly thrombocytopenia. In the first experimental section, we addressed the induction of senescence in an in vitro cardiomyocyte model and evaluated senolytic therapy as a therapeutic strategy. We also developed and characterized the nanoparticles targeting senescent cells and the navitoclax-based prodrug. The senolytic nanodevice is based on MSNs loaded with navitoclax and functionalized with a hexa-galacto-oligosaccharide (galactan). The prodrug is obtained after conjugation of navitoclax to an acetylated galactose molecule. In both cases, the mechanism of targeted therapy lies in the presence of the lysosomal enzyme ß-galactosidase, which is highly expressed in senescent cells. Upon entering the lysosome of senescent cells, the glycosidic bonds are hydrolyzed by the action of the enzyme, releasing the drug. The results show an increase in the therapeutic effect of the free drug. Next, we developed a murine model of cardiotoxicity in which we demonstrated that systemic administration of doxorubicin induces the expression of markers of cardiotoxicity and senescence in the heart of treated mice and contributes to the deterioration of the cardiac function of the animals followed by echocardiography. In this preclinical model, the combined treatment of doxorubicin with the senolytic navitoclax, in the different formulations described above, leads to significant decrease in senescence and cardiotoxicity markers along with restoration of cardiac function. Similar results were observed with the three strategies mentioned: free drug, encapsulated drug, and prodrug formulation. The scientific results presented in this thesis highlight the role of senescence in the progression of cardiotoxicity by doxorubicin administration and it is concluded that the senolytic systems evaluated here could be an important tool for the development of new therapeutic strategies in the field of prevention of therapy-associated side effects and represent an alternative to the limitations of current treatments. / Lérida Viso, A. (2023). Pharmacological Senolysis as a New Therapeutic Approach for the Prevention of Doxorubicin-Induced Cardiotoxicity [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/194709

Doxorubicin (DOX) is an incessantly used chemotherapeutic drug that can cause detrimental dose-dependent effects such as cardiotoxicity and congestive heart failure. Studies have focused on therapeutic strategies such as exosomes derived from embryonic stem cell (ES-Exos) and antioxidants for example resveratrol; however, the function of mesenchymal stem cell-derived exosomes (MSC-Exos) have never been examined in DOX-induced pyroptosis. MSC-Exos maintains the therapeutic potential of exosome therapy without the ethical concerns. Hence, the current study focuses on determining whether MSC-Exos has the potential to ameliorate inflammation-induced cell death pyroptosis in our established in vitro DOX-induced cardiotoxicity (DIC) model. Rat embryonic cardiomyocytes (H9c2) were first exposed to DOX to stimulate pyroptosis, followed by subsequent treatment with MSC-Exos, with further analysis performed through immunocytochemistry, western blotting, and RT-PCR. We evaluated the therapeutic potential of MSC-Exos by investigating the pyroptotic initiator HMGB1 which binds to TLR4 resulting in the formation of the NLRP3 inflammasome that initiates pyroptosis by activating the pyroptotic markers, caspase-1, IL-1β and IL-18, and the pyroptotic executioner GSDMD. Our data depicted that treatment with MSC-Exos significantly (p

20 svenska barn diagnostiseras årligen med barntumören neuroblastom (NB). Läkemedelsresistens och intratumoral heterogenitet försvårar behandlingen och 50-60% av hög-risk NB-patienter drabbas av återfall. Subpopulationer av resistenta celler har identifierats i hög-risk NB-cellinjer, vilket belyser behovet av nya behandlingsalternativ. Dessa celler har visats vara känsliga mot antimetaboliter, som är S-fas specifika läkemedel. Syftet med detta projekt är att utvärdera antimetaboliter som singelbehan-dling eller i kombination med kemoterapi som en ny behandlingsmetod i resistenta NB-celler. Cellvia-bilitiet, cellåterväxt efter långtidsbehandling och cellcykelarrest samt cellcykelns förlopp analyserades på en panel bestående av de fem TP53-muterade ultra-högrisk NB-cellinjerna Kelly, SK-N-DZ, SK-N-AS, BE(2)-C och SK-N-FI. Läkemedlena som utvärderades var kemoterapierna doxorubicin (doxo) och cisplatin samt antimetaboliterna cytarabine (Ara-C), gemcitabine, 5-fluorouracil (5-FU) och hy-droxyurea (HU). Resultaten indikerar att Kelly och SK-N-FI var de cellinjer som var mest känsliga mot kombinationer av doxo tillsammans med antimetaboliter. Detta styrktes ytterligare av analysen av cellcykelarrest som visade att dessa cellinjer föredrar att arrestera i S-fas. Cellinjerna SK-N-DZ, SK-N-AS och BE(2)-C var mindre känsliga mot kombinationsbehandlingarna och visade preferens för att arrestera i andra faser av cellcykeln. Eftersom cellinjerna visade variationer i cellcykelarrest så föreslår vi en utvärdering av trippelkombinationer med läkemedel som är G2/M-fas specifika för att ytterligare eliminera resistenta subpopulationer. / Every year, 20 Swedish children are diagnosed with the pediatric tumor neuroblastoma (NB). Therapy resistance and intratumor heterogeneities complicate treatment of NB and ultimately, 50-60% of high- risk NB patients relapse. Subpopulations of resistant cells have been identified in high-risk NB cell lines, which elucidates the need for novel treatment options. These cells have been suggested to be sensitive to the S-phase specific drugs antimetabolites. The objective of this project is to evaluate antimetabolites as monotherapy and in combination with chemotherapy as a novel treatment option in high-risk NB. Analyses of cell viability, cell regrowth following long-term treatment, and cell cycle progression and mitotic arrest were performed in a panel of five TP53 mutated ultra-high risk NB cell lines, Kelly, SK- N-DZ, SK-N-AS, BE(2)-C, and SK-N-FI. The evaluated drugs were the chemotherapies doxorubicin (doxo) and cisplatin, and the antimetabolites cytarabine (Ara-C), gemcitabine, 5-fluorouracil (5-FU), and hydroxyurea (HU). Obtained results indicated that out of the tested cell lines, Kelly and SK-N-FI are the most sensitive to combinations of doxo with antimetabolites. This was further corroborated via analysis of cell cycle progression and mitotic arrest which demonstrated that Kelly and SK-N-FI have a preference for S-phase arrest. Cell lines SK-N-DZ, SK-N-AS, and BE(2)-C were less sensitive to combination treatments and showed preference for arrest in other phases of the cell cycle. Since resistant cell lines show variations in mitotic arrest, we suggest evaluating triple combinations with targeted treatments for G2/M-phase, in order to further eliminate resistant subpopulations.

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No / Objective: To investigate the use of the National Cancer Institute's hollow fiber assay (HFA) to evaluate and prioritize novel treatment strategies for clinical trials in the Ewing's sarcoma family of tumors (ESFT). Study design: The growth and morphology of ESFT cell lines in hollow fibers (HFs) was characterized in vitro and in vivo. Reliability and reproducibility were evaluated using doxorubicin. Results: The numbers of viable cells in all 6 ESFT cell lines increased with time in vitro (0 to 96 hours). The SKES-1 and A673 cell lines grew exponentially after implantation of HFs in nude mice at subcutaneous and intraperitoneal sites. ESFT cells formed highly organized distinctive morphology within the HFs in vitro and in vivo. The number of viable ESFT cells within the HFs decreased in a time-dependent (24 to 96 hours) and dose-dependent (1 to 10 mg/kg) manner after treatment with doxorubicin in vivo. Conclusions: The HFA is a versatile short-term in vivo model that may be exploited to predict efficacy of potential anticancer agents in ESFT cells. Tumor markers and pharmacodynamic endpoints may be quantified in the pure population of ESFT cells from within the HFs.

No / Inadequate drug delivery to tumours is now recognised as a key factor that limits the efficacy of anticancer drugs. Extravasation and penetration of therapeutic agents through avascular tissue are critically important processes if sufficient drug is to be delivered to be therapeutic. The purpose of this study is to develop an in silico model that will simulate the transport of the clinically used cytotoxic drug doxorubicin across multicell layers (MCLs) in vitro. Three cell lines were employed: DLD1 (human colon carcinoma), MCF7 (human breast carcinoma) and NCI/ADR-Res (doxorubicin resistant and P-glycoprotein [Pgp] overexpressing ovarian cell line). Cells were cultured on transwell culture inserts to various thicknesses and doxorubicin at various concentrations (100 or 50 microM) was added to the top chamber. The concentration of drug appearing in the bottom chamber was determined as a function of time by HPLC-MS/MS. The rate of drug penetration was inversely proportional to the thickness of the MCL. The rate and extent of doxorubicin penetration was no different in the presence of NCI/ADR-Res cells expressing Pgp compared to MCF7 cells. A mathematical model based upon the premise that the transport of doxorubicin across cell membrane bilayers occurs by a passive "flip-flop" mechanism of the drug between two membrane leaflets was constructed. The mathematical model treats the transwell apparatus as a series of compartments and the MCL is treated as a series of cell layers, separated by small intercellular spaces. This model demonstrates good agreement between predicted and actual drug penetration in vitro and may be applied to the prediction of drug transport in vivo, potentially becoming a useful tool in the study of optimal chemotherapy regimes.

Yes / Anthracyclines such as doxorubicin (Dox), widely used to treat various types of tumours, may result in induced testicular toxicity and oxidative stress. The present investigation was designed to determine whether exposure of isolated and purified mouse germ cells to Dox induces DNA damage in the form of strand breaks (presumably) resulting in apoptosis and to investigate the relative sensitivity of specific cell types. DNA damage was assessed using the Comet assay and the presence of apoptosis was determined by TUNEL assay. Isolated mouse germ cells were treated with different concentrations (0.05, 0.5 and 1 mM, respectively) of Dox, and fixed 1 h after treatment. The incidences of both DNA damage shown by single cell gel-electrophoresis and of apoptosis increased significantly in each specific cell type in a concentration-dependent manner. The DNA damage and apoptosis incidences gradually increased with concentration from 0.05 to 1 mM with Dox. Our results indicate that apoptosis plays a vital role in the induction of germ cell phase-specific toxicity caused by Dox with pre-meiotically and meiotically dividing spermatogonia and spermatocytes respectively as highly susceptible target cells. / Higher Education Funding Council for England (HEFCE)