Adriamycin cardiotoxicity

The application of antibodies in cardiovascular targeting in vivo originated with the experimental demonstration of the feasibility of using radiolabeled antimyosin antibody for diagnosis of acute myocardial infarction in 1976. Since then, the use of antibodies in the cardiovascular system has encompassed imaging of myocarditis,heart transplant rejection, dilated cardiomyopathy, alcohol induced cardiomyopathy,adriamycin cardiotoxicity, various other cardiomyopathies, vascular clots, atherosclerotic lesions,and even certain cancers such as soft tissue sarcomas.f Yet the best characterized and studied antibody for cardiovascular diagnostic targeting is monoclonal antimyosin Fab for its exquisite specificity... 

Nakamura K, Miyake T, Kawamura T, Maekawa I. [Prospective monitoring of adriamycin cardiotoxicity with systolic time intervals.] Nippon Gan Chiryo Gakkai Shi 1988 23(8) 1633-7. 

Cortes, E.P., Gupta, M., Chou, C., Amin, V.C., and Folkers, K., Adriamycin cardiotoxicity early detection by systohc time interval and possible prevention by coenzyme QIO, Cancer Treat Rep., 61, 887,1978. 

Cumulative organ toxicity also presents a significant obstacle for effective chemotherapy. In many cases, the severity of the toxicity impedes the broader use of an agent. Other specific toxicities are associated with specific agents, for example cardiotoxicity with adriamycin (32), renal toxicity with i7j -platinum (28), and neurotoxicity with vincristine (49). 

Adriamycin is an antibiotic of the family of anthracyclines with a wide spectrum of chemotherapeutic applications and anti-neoplasic action but it causes cardiotoxicity ranging from delayed and insidious cardiomyopathy to irreversible heart failure [48-52],... 

Doxorubicin (Adriamycin) 60 mg/m2 daily IV for 3 days, or 30-60 mg/m2 IV weekly Nausea, red urine (not hematuria) Cardiotoxicity (see text), alopecia, bone marrow depression, stomatitis... 

In isolated rat nuclei, SOD inhibits bleomycin-induced membrane peroxidation, but has no effect on bleomycin-catalysed DNA scission [57]. Thus, it may be possible to use iron chelators to reduce the toxic extracellular side effects of these drugs, whilst leaving the intracellular therapeutic mode of action unaltered. In fact, it has been demonstrated that the cardiotoxicity of adriamycin can be inhibited by the chelating agent ICRF-187 [60],... 

The ability of bismuth subnitrate to reduce specifically the toxicity of cisplatin and adriamycin was ascribed to the fact that bismuth induces metallothionein by Naganuma and coworkers and Boogaard and coworkers . Naganuma and coworkers also found that preinduction of metallothionein by oral administration of bismuth subnitrate significantly decreased the lethal toxicity, cardiotoxicity and bone-marrow toxicity observed with a single subcutaneous injection of adriamycin. 

AR is a 48-year-old woman who was treated for Hodgkin s disease 15 years ago with ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine). She now presents with breast cancer and her oncologist feels that chemotherapy with FAC (fluorouracil, doxorubicin [Adriamycin], and cyclophosphamide) is the most appropriate regimen. Her previous chemotherapy included a total of 300 mg/m doxorubicin exposure. Which of the following agents may be utilized to reduce risk of cardiotoxicity associated with the anthracycline therapy she is about to receive ... 

Neutral synthetic sugar derivatives, for example SM-5887 (39), display good antitumor activity with reduction in local tissue toxicity and cardiotoxicity compared to, for example, adriamycin (35) [51],... 

Patients with cardiotoxic lesions resulting from an excess treatment with Adriamycin (doxorubicin) showed a diffuse accumulation of " Tc-PYP in the heart, which otherwise is known only as localized uptake in focal lesions of myocardial infarction. Similar images have been observed in patients after defibrillation and reanimation treatment (Chacko et al. 1977). 

Berthiaume, J. M., Wallace, K. B. (2007 Jan). Adriamycin-induced oxidative mitochondrial cardiotoxicity. Cell Biology and Toxicology, 23 ), 15-25. 

Epirubicin is a cell-cycle-phase, nonspecific anthracycline. It forms a complex with DNA by intercalation of its planar rings between nucleotide base pairs, with consequent inhibition of nucleic acid (DNA and RNA) and protein synthesis. It is indicated in breast cancer with axillary node. Epirubicin is a new anthracycline that has activity similar to doxorubicin (Adriamycin) in a variety of solid neoplasms and hematologic malignancies. Importantly, epirubicin causes less cardiotoxicity than doxorabidn (see also Figure 15). 

Cardiotoxicity is one of the major problems associated with administration of many chemotherapentic agents. Venkatesan " examined the protective effect of curcumin on acute adriamycin (ADR) myocardial toxicity in rats. ADR toxicity, induced by a single intraperitoneal injection (30mg/kg), was revealed by elevated serum creatine kinase (CK) and LDH. The level of the hpid peroxidation prodncts, conjugated dienes, and malondialdehyde were markedly elevated by ADR. ADR also caused a decrease in myocardial glutathione content and glntathione peroxidase achvity and an increase in... 

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