Wang Tian-Hu, Ma Yan, Gao Shan, Zhang Wei-Wei, Han Dong, Cao Feng
National Clinical Research Center for Geriatric Diseases, the Second Medical Center, Chinese PLA General Hospital, 100853 Beijing, China.
Rev Cardiovasc Med. 2023 Nov 27;24(11):336. doi: 10.31083/j.rcm2411336. eCollection 2023 Nov.
Despite recent advances in cancer therapy, anthracycline-based combination therapy remains the standardized first-line strategy and has been found to have effective antitumor actions. Anthracyclines are extremely cardiotoxic, which limits the use of these powerful chemotherapeutic agents. Although numerous studies have been conducted on the cardiotoxicity of anthracyclines, the precise mechanisms by which doxorubicin causes cardiomyocyte death and myocardial dysfunction remain incompletely understood. This review highlights recent updates in mechanisms and therapies involved in doxorubicin-induced cardiomyocyte death, including autophagy, ferroptosis, necroptosis, pyroptosis, and apoptosis, as well as mechanisms of cardiovascular dysfunction resulting in myocardial atrophy, defects in calcium handling, thrombosis, and cell senescence. We sought to uncover potential therapeutic approaches to manage anthracycline cardiotoxicity manipulation of crucial targets involved in doxorubicin-induced cardiomyocyte death and dysfunction.
尽管近年来癌症治疗取得了进展,但基于蒽环类药物的联合治疗仍然是标准化的一线策略,并且已被发现具有有效的抗肿瘤作用。蒽环类药物具有极强的心脏毒性,这限制了这些强大化疗药物的使用。尽管已经对蒽环类药物的心脏毒性进行了大量研究,但多柔比星导致心肌细胞死亡和心肌功能障碍的确切机制仍未完全明确。本综述重点介绍了多柔比星诱导心肌细胞死亡所涉及的机制和治疗方法的最新进展,包括自噬、铁死亡、坏死性凋亡、焦亡和凋亡,以及导致心肌萎缩、钙处理缺陷、血栓形成和细胞衰老的心血管功能障碍机制。我们试图揭示潜在的治疗方法来处理蒽环类药物心脏毒性——操纵多柔比星诱导的心肌细胞死亡和功能障碍中涉及的关键靶点。