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抗癌药物的心脏毒性:分子机制、临床管理和创新治疗。

Cardiotoxicity of Anticancer Drugs: Molecular Mechanisms, Clinical Management and Innovative Treatment.

机构信息

Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221004, People's Republic of China.

出版信息

Drug Des Devel Ther. 2024 Sep 12;18:4089-4116. doi: 10.2147/DDDT.S469331. eCollection 2024.

Abstract

With the continuous refinement of therapeutic measures, the survival rate of tumor patients has been improving year by year, while cardiovascular complications related to cancer therapy have become increasingly prominent. Exploring the mechanism and prevention strategy of cancer therapy-related cardiovascular toxicity (CTR-CVT) remains one of the research hotspots in the field of Cardio-Oncology in recent years. Cardiotoxicity of anticancer drugs involves heart failure, myocarditis, hypertension, arrhythmias and vascular toxicity, mechanistically related to vascular endothelial dysfunction, ferroptosis, mitochondrial dysfunction and oxidative stress. To address the cardiotoxicity induced by different anticancer drugs, various therapeutic measures have been put in place, such as reducing the accumulation of anticancer drugs, shifting to drugs with less cardiotoxicity, using cardioprotective drugs, and early detection. Due to the very limited treatments available to ameliorate anticancer drugs-induced cardiotoxicity, a few innovations are being shifted from animal studies to human studies. Examples include mitochondrial transplantation. Mitochondrial transplantation has been proven to be effective in in vivo and in vitro experiments. Several recent studies have demonstrated that intercellular mitochondrial transfer can ameliorate doxorubicin(DOX)-induced cardiotoxicity, laying the foundation for innovative therapies in anticancer drugs-induced cardiotoxicity. In this review, we will discuss the current status of anticancer drugs-induced cardiotoxicity in terms of the pathogenesis and treatment, with a focus on mitochondrial transplantation, and we hope that this review will bring some inspiration to you.

摘要

随着治疗措施的不断完善,肿瘤患者的生存率逐年提高,而与癌症治疗相关的心血管并发症也日益突出。探索癌症治疗相关心血管毒性(CTR-CVT)的机制和预防策略仍然是近年来心血管肿瘤学领域的研究热点之一。抗癌药物的心脏毒性涉及心力衰竭、心肌炎、高血压、心律失常和血管毒性,其机制与血管内皮功能障碍、铁死亡、线粒体功能障碍和氧化应激有关。为了解决不同抗癌药物引起的心脏毒性,已经采取了各种治疗措施,例如减少抗癌药物的积累、转向心脏毒性较小的药物、使用心脏保护药物以及早期检测。由于改善抗癌药物引起的心脏毒性的治疗方法非常有限,一些创新方法正在从动物研究转移到人体研究。例如线粒体移植。线粒体移植已被证明在体内和体外实验中都是有效的。最近的几项研究表明,细胞间线粒体转移可以改善阿霉素(DOX)引起的心脏毒性,为抗癌药物引起的心脏毒性的创新治疗奠定了基础。在这篇综述中,我们将讨论抗癌药物引起的心脏毒性的发病机制和治疗现状,重点介绍线粒体移植,希望这篇综述能给您带来一些启发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69fa/11404500/0fcb2c506fbe/DDDT-18-4089-g0001.jpg

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