Zhang Shuai, Xu Hong-Fei, Zhang Zhi-Xiang, Wang Ying, Zhu Shao-Hua
Department of Forensic Medicine, School of Basic Medical Sciences, Soochow University, Suzhou 215123, Jiang-su Province, China.
Fa Yi Xue Za Zhi. 2025 Apr 25;41(2):120-126. doi: 10.12116/j.issn.1004-5619.2024.440404.
Doxorubicin is a commonly used antitumor drug for the treatment of various cancers. However, its clinical application is greatly restricted by its severe cardiotoxicity. At present, doxorubicin-induced cardiotoxicity is categorized into acute and chronic forms, depending on the dosage and duration of exposure, which may eventually lead to the occurrence of heart failure. The pathogenesis of doxorubicin cardiotoxicity is associated with oxidative stress, mitochondrial damage, calcium overload, dysregulation of autophagy, and apoptosis. In forensic medical practice, cases of poisoning or even cardiac death caused by doxorubicin showed no obvious changes in cardiac morphology through routine forensic pathological examinations. The paper aims to summarize the research on the mechanisms of action of doxorubicin-induced cardiotoxicity in recent years, analyze and discuss the possible pathways of cardiomyocyte injury caused by doxorubicin, and provide references for research on the mechanisms of doxorubicin-induced cardiotoxicity and forensic application.
阿霉素是一种常用于治疗各种癌症的抗肿瘤药物。然而,其严重的心脏毒性极大地限制了其临床应用。目前,根据接触剂量和持续时间,阿霉素诱导的心脏毒性可分为急性和慢性两种形式,最终可能导致心力衰竭的发生。阿霉素心脏毒性的发病机制与氧化应激、线粒体损伤、钙超载、自噬失调和细胞凋亡有关。在法医实践中,由阿霉素引起的中毒甚至心脏死亡病例,通过常规法医病理检查,心脏形态无明显变化。本文旨在总结近年来阿霉素诱导心脏毒性作用机制的研究,分析和探讨阿霉素导致心肌细胞损伤的可能途径,为阿霉素诱导心脏毒性机制的研究及法医应用提供参考。