The dilemma of the strive for apoptosis in oncology: mind the heart.
In recent years, apoptosis has increasingly drawn the attention of both oncologists and cardiologists alike. Anticancer treatment is possible by induction of apoptosis in cancer cells, and targeted anticancer drugs are being developed to promote this. However, since these drugs usually are not selective for malignant cells, side effects on non-cancerous tissue, such as the myocardium must be anticipated. Since apoptosis is a pathophysiological mechanism in cardiac diseases leading to heart failure, cardiologists in contrast to oncologists, aim at preventing apoptosis in the heart. The purpose of this review is to describe new insights in mechanisms of cardiomyocyte apoptosis. In addition to the mitochondrial and death receptor apoptotic pathways, apoptosis through lack or inhibition of growth factor receptor-mediated signalling is discussed. Exploration of the apoptotic pathways in the heart can contribute to the safer use of new anticancer drugs and to the development of new therapies for heart failure.
Perik
Patrick J
PJ
Department of Cardiology, Thorax center, University Hospital Groningen, Groningen, 9700 RB, The Netherlands.
de Vries
Elisabeth G E
EG
Gietema
Jourik A
JA
van der Graaf
Winette T A
WT
Sleijfer
Dirk Th
DT
Suurmeijer
Albert J H
AJ
van Veldhuisen
D J
DJ
D000970:Antineoplastic Agents / Q000009:adverse effects*; D017209:Apoptosis / Q000502:physiology*; D006321:Heart / Q000187:drug effects; D006801:Humans; D032383:Myocytes, Cardiac / Q000187:drug effects*; D009369:Neoplasms / Q000188:drug therapy*; D015398:Signal Transduction / Q000502:physiology*
D000970:Antineoplastic Agents