This review evaluates hypotheses on the role of oxidative stress in doxorubicin-induced cardiotoxicity, highlighting that the preventive efficacy of antioxidants remains controversial.
What is the role of oxidative stress in anthracycline-induced cardiotoxicity, and can antioxidants prevent these side effects?
This review highlights the multifactorial nature of anthracycline-induced cardiotoxicity and the controversial role of antioxidants in its prevention.
The anthracyclines constitute a group of drugs widely used for the treatment of a variety of human tumors. However, the development of irreversible cardiotoxicity has limited their use. Anthracycline-induced cardiotoxicity can persist for years with no clinical symptoms. However, its prognosis becomes poor after the development of overt heart failure, possibly even worse than ischemic or idiopathic dilated cardiomyopathies. Due to the successful action of anthracyclines as chemotherapic agents, several strategies have been tried to prevent/attenuate their side effects. Although anthracycline-induced injury appears to be multifactorial, a common denominator among most of the proposed mechanisms is cellular damage mediated by reactive oxygen species. However, it remains controversial as to whether antioxidants can prevent such side effects given that different mechanisms may be involved in acute versus chronic toxicity. The present review applies a multisided approach to the critical evaluation of various hypotheses proposed over the last decade on the role of oxidative stress in cardiotoxicity induced by doxorubicin, the most used anthracycline agent. The clinical diagnosis and treatment is also discussed.
Ferreira et al. (2008) conducted a review in Anthracycline-induced cardiotoxicity. Anthracyclines was evaluated. This review evaluates hypotheses on the role of oxidative stress in doxorubicin-induced cardiotoxicity, highlighting that the preventive efficacy of antioxidants remains controversial.