Doxorubicin induces an increase of nitric oxide synthesis in rat cardiac cells that is inhibited by iron supplementation

Doxorubicin is an anthracycline antibiotic generally used in the treatment of solid tumors, but its use is limited by a severe cardiotoxicity, which has been related to the generation of oxygen- and nitrogen-derived free radicals. We have demonstrated that doxorubicin induces nitric oxide (NO) synthesis in the rat cardiac cells H9c2: the drug, after a 24-h incubation, evoked a dose-dependent increase of both NO synthase (NOS) activity in the cells and nitrite levels in the culture supernatant; the accumulation of nitrite (a stable derivative of NO) was prevented by different NOS inhibitors. The increase of NO production was associated with an increased expression of the inducible NOS isoform gene. These effects were significantly inhibited by the coincubation of doxorubicin with iron nitrilotriacetate, a compound that releases iron into the cells. Our results suggest that doxorubicin could induce NO generation in cardiac cells by modifying the iron homeostasis.