Cardiomyocyte death in doxorubicin-induced cardiotoxicity.

Cardiomyocyte death in doxorubicin-induced cardiotoxicity.
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DOI:
10.1007/s00005-009-0051-8
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发表时间:
2009-11
影响因子:
3.2
通讯作者:
Wei, Lei
Wei, Lei
中科院分区:
医学4区
文献类型:
--
作者:
Zhang, Yi-Wei;Shi, Jianjian;Li, Yuan-Jian;Wei, Lei

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阿霉素(DOX)是应用最广泛和最成功的抗肿瘤药物之一,但其累积性和剂量依赖性心脏毒性一直是肿瘤学家在癌症治疗实践中关注的主要问题。随着癌症幸存者人数的增加,越来越需要针对dox诱导的心脏毒性,特别是晚发性心肌病,制定预防策略和有效治疗方法。虽然对dox诱导的心脏毒性的深入研究已经持续了几十年,但dox诱导心脏毒性的潜在机制尚未完全阐明。越来越多的证据支持心肌细胞凋亡和坏死是dox诱导心肌病的主要机制,其他类型的细胞死亡,如自噬和衰老/衰老,可能参与这一过程。在这篇综述中,我们将重点关注目前对dox诱导心肌细胞死亡的分子机制的理解,包括活性氧(ROS)过量产生的主要机制和其他最近发现的与ROS无关的机制。成人和年轻心肌细胞对dox诱导的细胞死亡信号的不同敏感性也将被讨论。
Doxorubicin (DOX) is one of the most widely used and successful antitumor drugs, but its cumulative and dose-dependent cardiac toxicity has been the major concern of oncologists in cancer therapeutic practice for decades. With the increasing population of cancer survivals, there is a growing need to develop preventive strategies and effective therapies against DOX-induced cardiotoxicity, in particular, the late onset cardiomyopathy. Although intensive investigations on the DOX-induced cardiotoxicity have been continued for decades, the underlying mechanisms responsible for DOX-induced cardiotoxicity have not been completely elucidated. A rapidly expanding body of evidence supports that cardiomyocyte death by apoptosis and necrosis is a primary mechanism of DOX-induced cardiomyopathy and other types of cell death, such as autophagy and senescence/aging, may participate in this process. In this review, we will focus on the current understanding of molecular mechanisms underlying DOX-induced cardiomyocyte death, including the major primary mechanism of excess production of reactive oxygen species (ROS) and other recently discovered ROS-independent mechanisms. Different sensitivity to DOX-induced cell death signals between adult and young cardiomyocytes will also be discussed.
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