Cardiotoxicity linked to anticancer agents and cardioprotective strategy

Khairnar, Shraddha; Kulkarni, Yogesh A.; Singh, Kavita

doi:10.1007/s12272-022-01411-4

Cited by 5 publications

(3 citation statements)

References 177 publications

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“…Other review studies also show that the mechanism of cardiotoxicity caused by other drugs is still unclear. However, various reasons such as oxidative stress, apoptosis, and inflammation can aggravate this condition (31)(32)(33)(34).…”

Section: Discussionmentioning

confidence: 99%

Berberine efficacy against Doxorubicin-induced cardiotoxicity: A systematic review

Khaledifar

Khosravifarsani

Raeisi

2023

J Herbmed Pharmacol

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Cardiotoxicity is one of the main complications of chemotherapy that increases morbidity and mortality in cancerous patients. The present systematic review aimed to investigate the protective effects of berberine (Ber) on doxorubicin (Dox)-induced cardiotoxicity. The study protocol was developed following the PRISMA statement. An extensive search was performed in multiple databases, including Embase, PubMed, Cochrane library, Web of Science, and Scopus. After defining the inclusion/exclusion criteria of the study, 12 records were included. The desired data of the retrieved articles were extracted from the studies and imported into an Excel form and ultimately, the effects, probable outcomes and mechanisms were surveyed. By activating sirtuin 1 (SIRT1), Ber caused reduced oxidative damage and loss of mitochondria integrity in cardiomyocytes. It also regulated autophagy and apoptosis via down-regulating AMP-activated protein kinase (AMPK), nucleotide-binding oligomerization domain, leucine rich repeat, and pyrin domain containing protein (NLRP) activation. Moreover, Ber increased superoxide dismutase (SOD), catalase (CAT), and plasma glutathione peroxidase (GSH-Px) activities, reduced the levels of malondialdehyde (MDA), up-regulated SIRT3, and subsequently reduced oxidative stress in cardiomyocytes and loss of mitochondria integrity, leading to developed apoptosis and regulating the histopathological and electrocardiogram changes in the myocardium. It also ameliorated the DOX-induced calcium ions (Ca2+) and iron overload. Ber reduced oxidant and inflammatory activity, and regulated apoptosis of cardiomyocytes, thus protecting the cells against DOX-induced cardiotoxicity.

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Section: Discussionmentioning

confidence: 99%

Berberine efficacy against Doxorubicin-induced cardiotoxicity: A systematic review

Khaledifar

Khosravifarsani

Raeisi

2023

J Herbmed Pharmacol

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“…A characteristic example of metabolic effects is the chelator prodrug dexrazoxane, which is widely used in cancer patients for cardioprotection against doxorubicin and other anthracycline-induced cardiotoxicity, where iron is thought to be implicated in the toxicity [261][262][263][264][265][266][267]. Dexrazoxane is hydrolyzed in vivo to an EDTA-like active chelating compound ADR-925, which binds and removes the toxic form of iron involved in the cardiotoxicity [268][269][270].…”

Section: Drug Interactions and Metabolic Changes Affecting The Safety...mentioning

confidence: 99%

Drug Selection and Posology, Optimal Therapies and Risk/Benefit Assessment in Medicine: The Paradigm of Iron-Chelating Drugs

Kontoghiorghes

2023

IJMS

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The design of clinical protocols and the selection of drugs with appropriate posology are critical parameters for therapeutic outcomes. Optimal therapeutic protocols could ideally be designed in all diseases including for millions of patients affected by excess iron deposition (EID) toxicity based on personalised medicine parameters, as well as many variations and limitations. EID is an adverse prognostic factor for all diseases and especially for millions of chronically red-blood-cell-transfused patients. Differences in iron chelation therapy posology cause disappointing results in neurodegenerative diseases at low doses, but lifesaving outcomes in thalassemia major (TM) when using higher doses. In particular, the transformation of TM from a fatal to a chronic disease has been achieved using effective doses of oral deferiprone (L1), which improved compliance and cleared excess toxic iron from the heart associated with increased mortality in TM. Furthermore, effective L1 and L1/deferoxamine combination posology resulted in the complete elimination of EID and the maintenance of normal iron store levels in TM. The selection of effective chelation protocols has been monitored by MRI T2* diagnosis for EID levels in different organs. Millions of other iron-loaded patients with sickle cell anemia, myelodysplasia and haemopoietic stem cell transplantation, or non-iron-loaded categories with EID in different organs could also benefit from such chelation therapy advances. Drawbacks of chelation therapy include drug toxicity in some patients and also the wide use of suboptimal chelation protocols, resulting in ineffective therapies. Drug metabolic effects, and interactions with other metals, drugs and dietary molecules also affected iron chelation therapy. Drug selection and the identification of effective or optimal dose protocols are essential for positive therapeutic outcomes in the use of chelating drugs in TM and other iron-loaded and non-iron-loaded conditions, as well as general iron toxicity.

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“…In particular, cardioprotective agents may be used in combination with cytotoxic drugs to treat the symptoms of developing heart failure and to prevent such painful conditions [6]. However, the range of the former is extremely limited, and only dexrazoxane is currently in widespread use [7]. Another approach to solving the problem of the adverse effects of anthracycline antibiotics may be related to reducing the toxic effect of the antiproliferative agent itself.…”

Section: Introductionmentioning

confidence: 99%

Design of anthracyclines with extremely high cytotoxic properties

Moiseeva,

Artyushin,

Anikina

et al. 2024

Preprint

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Chemotherapy with anthracycline antibiotics is a common treatment of tumours of various etiologies. Creation of highly effective cytostatics based on daunorubicin is possible by applying the method of reductive amination using polyalkoxybenzaldehydes. The obtained derivatives of anthracycline structure are up to 500 times more potent compared with daunorubicin due to the increased affinity to DNA, which is confirmed by the data of extensive biological assays and the results of molecular modeling.

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Cardiotoxicity linked to anticancer agents and cardioprotective strategy

Cited by 5 publications

References 177 publications

Berberine efficacy against Doxorubicin-induced cardiotoxicity: A systematic review

Berberine efficacy against Doxorubicin-induced cardiotoxicity: A systematic review

Drug Selection and Posology, Optimal Therapies and Risk/Benefit Assessment in Medicine: The Paradigm of Iron-Chelating Drugs

Design of anthracyclines with extremely high cytotoxic properties

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