title: Anthracycline-dependent cardiotoxicity and extracellular matrix remodeling.
abstract: The mechanisms of anthracycline-dependent cardiotoxicity have been studied widely, with the suggested principal mechanism of anthracycline damage being the generation of reactive oxygen species by iron-anthracycline complexes, leading to lipid peroxidation and membrane damage. An increasing number of researchers studying cardiovascular events associated with anthracycline-based chemotherapy are addressing cardiac extracellular matrix (ECM) remodeling. The heart is an efficient muscular pump, with the cardiomyocytes and intramural coronary vasculature of the heart tethered in an ECM consisting of a network of fibrillar, structural proteins, mostly collagens. Increasing evidence suggests that the ECM plays a complex and diverse role in the processes initiated by anthracycline-class drugs that lead to cardiac damage. This review discusses adverse myocardial remodeling induced by anthracyclines and focuses on their mechanisms of action.
authors.affiliation: Department of Anatomy-Histology-Embryology, School of Medicine, University of Crete, Heraklion, Greece. Electronic address: dnikitovic@med.uoc.gr.
authors.forename: Dragana
authors.initials: D
authors.lastname: Nikitovic
authors.affiliation: Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Bratislava, Slovakia.
authors.forename: Ivo
authors.initials: I
authors.lastname: Juranek
authors.affiliation: Swiss Centre for Applied Human Toxicology, University of Basel, Basel, Switzerland.
authors.forename: Martin F
authors.initials: MF
authors.lastname: Wilks
authors.affiliation: Department of Pathology, School of Medicine, University of Crete, Heraklion, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Tzardi
authors.affiliation: Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, Heraklion, Greece.
authors.forename: Aristidis
authors.initials: A
authors.lastname: Tsatsakis
authors.affiliation: Department of Anatomy-Histology-Embryology, School of Medicine, University of Crete, Heraklion, Greece.
authors.forename: George N
authors.initials: GN
authors.lastname: Tzanakakis
mesh_terms: D018943:Anthracyclines / Q000009:adverse effects*; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D066126:Cardiotoxicity / Q000503:physiopathology*; D005109:Extracellular Matrix / Q000473:pathology*; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic