Carbon monoxide and
nitric oxide are two of the most important vasoprotective mediators. Their downregulation observed during vascular dysfunction, which is associated with
cancer progression, leads to uncontrolled platelet activation. Therefore, the aim of our studies was to improve vasoprotection and to decrease platelet activation during progression of mouse mammary gland
cancer by concurrent use of CO and NO donors (CORM-A1 and
DETA/NO, respectively). Methods: Mice injected intravenously with 4T1-luc2-tdTomato or orthotopically with 4T1 mouse mammary gland
cancer cells were treated with
CORM-A1 and
DETA/NO. Ex vivo aggregation and activation of platelets were assessed in the blood of healthy donors and
breast cancer patients. Moreover, we analyzed the compounds' direct effect on 4T1 mouse and MDA-MB-231 human
breast cancer cells proliferation, adhesion and migration in vitro. Results: We have observed antimetastatic effect of combination
therapy, which was only transient in orthotopic model. During early stages of
tumor progression concurrent use of
CORM-A1 and
DETA/NO demonstrated vasoprotective ability (decreased
endothelin-1, sICAM and sE-
selectin plasma level) and downregulated platelets activation (decreased bound of
fibrinogen and vWf to platelets) as well as inhibited EMT process. Combined treatment with CO and NO donors diminished adhesion and migration of
breast cancer cells in vitro and inhibited aggregation as well as TGF-β release from
breast cancer patients' platelets ex vivo. However, antimetastatic effect was not observed at a later stage of
tumor progression which was accompanied by increased platelets activation and endothelial dysfunction related to a decrease of VASP level. Conclusion: The
therapy was shown to have antimetastatic action and resulted in normalization of endothelial metabolism, diminution of platelet activation and inhibition of EMT process. The effect was more prominent during early stages of
tumor dissemination. Such treatment could be applied to inhibit
metastasis during the first stages of this process.