Can short-term fasting protect against doxorubicin-induced cardiotoxicity?
Can short-term fasting protect against doxorubicin-induced cardiotoxicity?
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DOI：
10.4331/wjbc.v5.i3.269
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发表时间：
2014-08-26
期刊：
影响因子：
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通讯作者：
Taylor, Heather N
中科院分区：
文献类型：
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作者：
Dirks-Naylor, Amie J;Kouzi, Samir A;Taylor, Heather N
阿霉素(Dox)是目前治疗多种癌症最有效的化疗药物之一。然而，其使用受到心脏毒性的限制。尽管对DOX的毒性机制和预防策略进行了广泛的研究，但Dox引起的心脏毒性仍然是癌症幸存者发病率和死亡率的主要原因。因此，继续研究预防策略是至关重要的。短期禁食已被证明对心脏有保护作用，可以抵御各种侮辱。尽管有这种潜力，但只有少数研究对其预防Dox诱导的心脏毒性的能力进行了研究。然而，所有这些都证明了短期禁食对Dox具有心脏保护作用。禁食影响过多的细胞过程，使得很难辨别禁食到心脏保护的机制(S)，但可能涉及通过刺激的自噬抑制胰岛素和胰岛素样生长因子-1信号。其他机制很可能也起到了作用。重要的是，文献表明禁食可以增强Dox的抗肿瘤活性。因此，禁食是一种值得进一步研究的方案，作为预防Dox诱导的心脏毒性的潜在策略。未来的研究应该着眼于确定最佳的禁食方案，确认该方案不会干扰Dox的抗肿瘤特性，以及发挥心脏保护作用的潜在机制。
Doxorubicin (Dox) is one of the most effective chemotherapeutic agents used in the treatment of several types of cancer. However the use is limited by cardiotoxicity. Despite extensive investigation into the mechanisms of toxicity and preventative strategies, Dox-induced cardiotoxicity still remains a major cause of morbidity and mortality in cancer survivors. Thus, continued research into preventative strategies is vital. Short-term fasting has proven to be cardioprotective against a variety of insults. Despite the potential, only a few studies have been conducted investigating its ability to prevent Dox-induced cardiotoxicity. However, all show proof-of-principle that short-term fasting is cardioprotective against Dox. Fasting affects a plethora of cellular processes making it difficult to discern the mechanism(s) translating fasting to cardioprotection, but may involve suppression of insulin and insulin-like growth factor-1 signaling with stimulated autophagy. It is likely that additional mechanisms also contribute. Importantly, the literature suggests that fasting may enhance the antitumor activity of Dox. Thus, fasting is a regimen that warrants further investigation as a potential strategy to prevent Dox-induced cardiotoxicity. Future research should aim to determine the optimal regimen of fasting, confirmation that this regimen does not interfere with the antitumor properties of Dox, as well as the underlying mechanisms exerting the cardioprotective effects.