Mitochondrial-Targeted Therapy for Doxorubicin-Induced Cardiotoxicity

Abstract

Anthracyclines, such as doxorubicin, are effective chemotherapeutic agents for the treatment of cancer, but their clinical use is associated with severe and potentially life-threatening cardiotoxicity. Despite decades of research, treatment options remain limited. The mitochondria is commonly considered to be the main target of doxorubicin and mitochondrial dysfunction is the hallmark of doxorubicin-induced cardiotoxicity. Here, we review the pathogenic mechanisms of doxorubicin-induced cardiotoxicity and present an update on cardioprotective strategies for this disorder. Specifically, we focus on strategies that can protect the mitochondria and cover different therapeutic modalities encompassing small molecules, post-transcriptional regulators, and mitochondrial transfer. We also discuss the shortcomings of existing models of doxorubicin-induced cardiotoxicity and explore advances in the use of human pluripotent stem cell derived cardiomyocytes as a platform to facilitate the identification of novel treatments against this disorder.

Cardioprotective Effect of Rheum turkestanicum Against Doxorubicin-Induced Toxicity in Rats

“…Several mechanisms may be responsible for doxorubicin-induced cardiotoxicity. These mechanisms include mitochondrial injury, ROS generation, intracellular Ca+2 dysregulation, inflammatory cytokine production, and myocyte damage ( Rawat et al, 2021 ; Sheibani et al, 2022 ; Wu et al, 2022 ).…”

Terminalia muelleri Attenuates the Accumulation of Excess Iron, Inhibition of Topoisomerase 2ß and Oxidative Cardiac Damage in Doxorubicin-Induced Cardiotoxicity in Rats

“…DOX treatment in patients shows both effects like therapeutic and toxic effects. It has been reported that the cardiomyopathy initiated by doxorubicin is a progressive and multifactorial process (Wu et al, 2022), including oxidative stress, iron accumulation with the alteration of gene and protein expression and DNA breakage via inhibition of topoisomerase II (Kong et al, 2022).…”

Targeting Energy Protection as a Novel Strategy to Disclose Di’ao Xinxuekang against the Cardiotoxicity Caused by Doxorubicin

“…As there are both hydrophobic and hydrophilic domains in the molecular structure, DOX is characteristic of a phospholipid-loving molecule, which is, therefore, the most susceptible target organ. Studies have pointed out that DOX can not only disturb the normal transmission of the respiratory chain and the structure and function of creatine kinase in mitochondria but also that the concentration of DOX in mitochondria is 100 times that in plasma; induced bioenergy disorder is one of the markers of cardiotoxicity caused by DOX [ 12 , 13 ]. As we all know, normal energy supply is a necessary condition to ensure the normal physiological and biochemical process of myocardial cells and the material basis to maintain the stability of the internal environment of the heart and the diastolic and contractile functions of the heart [ 14 , 15 ].…”