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Doxorubicin-induced cardiotoxicity: An update on the molecular mechanism and novel therapeutic strategies for effective management
Open accessAbstract
homeostasis, autophagy, the release of nitric oxide and inflammatory mediators and altered gene and protein expression that involved apoptosis. Dox also causes downregulation of DNA methyltransferase 1 (DNMT1) enzyme activity which leads to a reduction in the DNA methylation process. This hypomethylation causes dysregulation in the mitochondrial genes like peroxisome proliferator-activated receptor-gamma coactivator (PGC)-1-alpha (PGC-1α), nuclear respiratory factor 1 (NRF-1) and mitochondrial transcription factor A (TFAM) unit in the heart. Apart from DNA methylation, Dox treatment also alters the micro RNAs levels and histone deacetylase (HDAC) activity. Therefore, in the current review, we have provided a detailed update on the current understanding of the pathological mechanisms behind the well-known Dox-induced cardiotoxicity. Further, we have provided some of the most plausible pharmacological strategies which have been tested against Dox-induced cardiotoxicity.
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“The cumulative anthracycline dose is a major risk factor for severe cardiomyopathy development but young age at treatment, female sex, peak drug exposure and additional stress to the heart have also been implicated 161,162,163 .”
From Osteosarcoma (2022) · cites this paper as [163]
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Metadata
- Authors
- Rawat, P. S., Jaiswal, A., Khurana, A., Bhatti, J. S., & Navik, U.
- Affiliations
- Central University of Punjab (IN)
- P.V. Narsimha Rao Telangana Veterinary University (IN)
- Venue
- Biomedicine & Pharmacotherapy
- Publisher
- Elsevier BV
- Published
- 2021-07
- Volume
- 139
- Pages
- 111708
- ISSN
- 0753-3322 (ISSN-L)
- OpenAlex
- W3160992829
- Cited by
- 909
- References
- 198
- Citations by year
- 2026: 171 · 2025: 232 · 2024: 208 · 2023: 193 · 2022: 92 · 2021: 13
- FWCI
- 24.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Biomedicine & Pharmacotherapy (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Royal Society of Medicine
- University of Central Punjab (GP-25)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Chemotherapy-induced cardiotoxicity and mitigation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- doxorubicin, cardiotoxicity, molecular mechanisms, DNA methylation, DNMT1, mitochondrial dysfunction, PGC-1α, NRF1, TFAM, microRNA, histone deacetylase, autophagy, apoptosis, nitric oxide, inflammatory mediators, cardioprotection, anthracycline chemotherapy
- MeSH terms
- Animals, Antibiotics, Antineoplastic, Doxorubicin, Humans, Mitochondria, Heart, Apoptosis, Oxidative Stress, Cardiotoxicity
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