Montelukast ameliorates doxorubicin-induced cardiotoxicity via modulation of p-glycoprotein and inhibition of ROS-mediated TNF-α/NF-κB pathways

Doxorubicin (DOX) cardiotoxicity remains an obstacle to clinical use. The current study examined the possible role of montelukast (ML), which is a cysteinyl leukotrienes receptor antagonist against DOX-induced cardiotoxicity. Male Wistar rats were divided into five groups. The control group, ML group, DOX-challenged group, and DOX/ML-treated groups received ML10 and 20 mg/kg/day for 14 days. Cardiac enzymes; lactate dehydrogenase (LDH); and creatine kinase MB (CK-MB) isoenzymes in serum were measured. Cardiac oxidative/antioxidative parameters were also measured. Cardiac samples were examined for histological images and immunohistochemical expression of tumor necrosis factor alpha (TNF-alpha)/survivin. Quantitative real-time-polymerase chain reaction was used to detect levels of interleukin (IL)-1 beta/caspase-3 mRNA. The levels of P-glycoprotein (P-gp), nuclear factor-kappa B , and reactive oxygen species were estimated by enzyme-linked immunosorbent assay. DOX increased serum cardiac enzymes along with oxidative, inflammatory, and apoptotic markers. Both doses of ML significantly ameliorated cardiac enzymes and attenuated all oxidative stress parameters with the enhancement of P-gp activity. It was concluded that ML may be a valuable cardioprotective adjuvant during DOX use.