Liu Cun, Ma Xiaoran, Zhuang Jing, Liu Lijuan, Sun Changgang
College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, 250014, Shandong, China.
Department of Oncology, Weifang Traditional Chinese Hospital, Weifang, 261041, Shandong Province, China.
Pharmacol Res. 2020 Oct;160:105062. doi: 10.1016/j.phrs.2020.105062. Epub 2020 Jul 8.
Doxorubicin (DOX) continues to attract the interest of preclinical and clinical investigations despite its longer-than-50-year record of longevity. The clinical application of DOX can be regarded as a sort of double-edged sword. On one hand, anthracyclines play an indisputable key role in the treatment of tumors; on the other hand, their chronic administration leads to cardiomyopathy and congestive heart failure, which is usually refractory to common medications. Finding the ideal cardioprotective agents has always been the focus of oncologists and cardiologists. Researchers put a lot of energy into phytochemicals because they are often in line with the expected standards, that is, to improve DOX-induced cardiotoxicity without compromising the clinical efficacy or to even produce synergy. We summarized the previous efforts, briefly outlined the mechanism of DOX cardiotoxicity, and focused on exploring the protective effects and potential mechanisms of all phytochemical types that have been investigated under DOX-induced cardiotoxicity. Phytochemicals have been found to be potential cardioprotective agents with universal safety and effectiveness. As a resource repository of pharmacophores, phytochemicals deserve to be utilized as drug templates for further development and research in combating DOX-induced cardiotoxicity.
尽管阿霉素（DOX）已有50多年的使用历史，但它仍然吸引着临床前和临床研究的关注。DOX的临床应用可谓是一把双刃剑。一方面，蒽环类药物在肿瘤治疗中发挥着无可争议的关键作用；另一方面，长期使用它们会导致心肌病和充血性心力衰竭，而这通常对常用药物具有耐药性。寻找理想的心脏保护剂一直是肿瘤学家和心脏病学家关注的焦点。研究人员将大量精力投入到植物化学物质上，因为它们往往符合预期标准，即在不影响临床疗效甚至产生协同作用的情况下，改善DOX诱导的心脏毒性。我们总结了以往的研究成果，简要概述了DOX心脏毒性的机制，并重点探讨了在DOX诱导的心脏毒性下已被研究的所有植物化学物质类型的保护作用和潜在机制。已发现植物化学物质是具有普遍安全性和有效性的潜在心脏保护剂。作为药效团的资源库，植物化学物质值得用作药物模板，以进一步开发和研究对抗DOX诱导的心脏毒性。
