Mitoxantrone, pixantrone, and mitoxantrone (2-hydroxyethyl)piperazine are toll-like receptor 4 antagonists, inhibit NF-κB activation, and decrease TNF-alpha secretion in primary microglia

Maiju Rinne, Kert Mätlik, Tiina Ahonen, Fabio Vedovi, Giovanni Zappia, Vania Moreira, Jari Yli-Kauhaluoma, Sakari Leino, Outi Salminen, Eija Kalso, Mikko Airavaara, Henri Xhaard

Research output: Contribution to journalArticlepeer-review


Toll-like receptor 4 (TLR4) recognizes various endogenous and microbial ligands and is an essential part in the innate immune system. TLR4 signaling initiates transcription factor NF-κB and production of proinflammatory cytokines. TLR4 contributes to the development or progression of various diseases including stroke, neuropathic pain, multiple sclerosis, rheumatoid arthritis and cancer, and better therapeutics are currently sought for these conditions. In this study, a library of 140 000 compounds was virtually screened and a resulting hit-list of 1000 compounds was tested using a cellular reporter system. The topoisomerase II inhibitor mitoxantrone and its analogues pixantrone and mitoxantrone (2-hydroxyethyl)piperazine were identified as inhibitors of TLR4 and NF-κB activation. Mitoxantrone was shown to bind directly to the TLR4, and pixantrone and mitoxantrone (2-hydroxyethyl)piperazine were shown to inhibit the production of proinflammatory cytokines such as tumor necrosis factor alpha (TNFα) in primary microglia. The inhibitory effect on NF-κB activation or on TNFα production was not mediated through cytotoxity at ≤ 1 µM concentration for pixantrone and mitoxantrone (2-hydroxyethyl)piperazine treated cells, as assessed by ATP counts. This study thus identifies a new mechanism of action for mitoxantrone, pixantrone, and mitoxantrone (2-hydroxyethyl)piperazine through the TLR4.

Original languageEnglish
Article number105493
JournalEuropean Journal of Pharmaceutical Sciences
Early online date27 Jul 2020
Publication statusPublished - 1 Nov 2020


  • Mitoxantrone
  • Mitoxantrone (2-hydroxyethyl)piperazine
  • NF-κB
  • Pixantrone
  • Toll-like receptor 4
  • Virtual screening

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