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Revisiting the Cardiotoxic Effect of Chloroquine

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Abstract

Purpose

Cardiotoxicity is a well-known side effect of chloroquine. Several studies have proposed chloroquine as a potential anti-diabetic treatment but do not address this problem. The current study investigated the effect of ex vivo chloroquine treatment on (1) heart function and glucose uptake, (2) mitochondrial function and (3) in vivo treatment on heart function.

Methods

Control or obese male Wistar rats were used throughout. Dose responses of increasing chloroquine concentrations versus vehicle on cardiac function were measured using isolated, Langendorff-perfused hearts whilst glucose uptake and cell viability were determined in ventricular cardiomyocytes. Mitochondrial function was assessed with a Clark-type oxygraph (Hansatech) after ex vivo perfusion with 30 μM chloroquine versus vehicle. Animals were treated orally with 5 mg/kg/day chloroquine for 6 weeks.

Results

Acute chloroquine treatment of 10 μM was sufficient to significantly decrease heart function (p < 0.05) whilst 30 μM significantly reduced heart rate (p < 0.05). Chloroquine became toxic to isolated cardiomyocytes at high concentrations (100 μM), and had no effect on cardiomyocyte glucose uptake. Ex vivo treatment did not affect mitochondrial function, but chronic low-dose in vivo chloroquine treatment significantly decreased aortic output and total work in hearts (p < 0.005).

Conclusion

Low and intermediate chloroquine doses administered either chronically or acutely are sufficient to result in myocardial dysfunction.

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Funding

We acknowledge funding from the South African National Research Foundation.

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Authors and Affiliations

  1. Division of Medical Physiology, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa

    Marguerite Blignaut, Yolandi Espach, Mignon van Vuuren, Karthik Dhanabalan & Barbara Huisamen

  2. South African Medical Research Council, Biomedical Research and Innovation Platform, Tygerberg, South Africa

    Barbara Huisamen

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  1. Marguerite Blignaut
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  2. Yolandi Espach
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  3. Mignon van Vuuren
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  4. Karthik Dhanabalan
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Corresponding author

Correspondence to Barbara Huisamen.

Ethics declarations

All applicable international, national, and institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving animals were in accordance with the ethical standards of the institution at which the studies were conducted. This study was approved by the Stellenbosch University Research Ethics Committee: Animal Care and Use (Protocol number SU-ACUM12-00040; SU-ACUD16-0079) and complied with the accepted national and international standards for the use of animals in research as stipulated in the South African National Standards 10386: 2008. This article does not contain any studies with human participants performed by any of the authors.

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Blignaut, M., Espach, Y., van Vuuren, M. et al. Revisiting the Cardiotoxic Effect of Chloroquine. Cardiovasc Drugs Ther 33, 1–11 (2019). https://doi.org/10.1007/s10557-018-06847-9

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