1. ¹Sackler Faculty of Medicine, Felsenstein Medical Research Center, Tel-Aviv University, Beilinson Campus, Petach-Tikva, 49100, Israel
2. ²Chemistry Department, Bar-Ilan University, Ramat-Gan, 52900, Israel
3. ³Department of Biochemistry, La Trobe University, Victoria 3086, Australia

Correspondence: Dr A Rephaeli, E-mail: adarep@post.tau.ac.il

Revised 4 April 2007; Accepted 12 April 2007; Published online 1 May 2007.

Abstract

Formaldehyde has been previously shown to play a dominant role in promoting synergy between doxorubicin (Dox) and formaldehyde-releasing butyric acid (BA) prodrugs in killing cancer cells. In this work, we report that these prodrugs also protect neonatal rat cardiomyocytes and adult mice against toxicity elicited by Dox. In cardiomyocytes treated with Dox, the formaldehyde releasing prodrugs butyroyloxymethyl diethylphosphate (AN-7) and butyroyloxymethyl butyrate (AN-1), but not the corresponding acetaldehyde-releasing butyroyloxydiethyl phosphate (AN-88) or butyroyloxyethyl butyrate (AN-11), reduced lactate dehydrogenase leakage, prevented loss of mitochondrial membrane potential (m) and attenuated upregulation of the proapoptotic gene Bax. In Dox-treated mice, AN-7 but not AN-88 attenuated weight-loss and mortality, and increase in serum lactate dehydrogenase. These findings show that BA prodrugs that release formaldehyde and augment Dox anticancer activity also protect against Dox cardiotoxicity. Based on these observations, clinical applications of these prodrugs for patients treated with Dox warrant further investigation.