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2015 ; 309
(9
): H1453-67
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Drug-induced mitochondrial dysfunction and cardiotoxicity
#MMPMID26386112
Varga ZV
; Ferdinandy P
; Liaudet L
; Pacher P
Am J Physiol Heart Circ Physiol
2015[Nov]; 309
(9
): H1453-67
PMID26386112
show ga
Mitochondria has an essential role in myocardial tissue homeostasis; thus
deterioration in mitochondrial function eventually leads to cardiomyocyte and
endothelial cell death and consequent cardiovascular dysfunction. Several
chemical compounds and drugs have been known to directly or indirectly modulate
cardiac mitochondrial function, which can account both for the toxicological and
pharmacological properties of these substances. In many cases, toxicity problems
appear only in the presence of additional cardiovascular disease conditions or
develop months/years following the exposure, making the diagnosis difficult.
Cardiotoxic agents affecting mitochondria include several widely used anticancer
drugs [anthracyclines (Doxorubicin/Adriamycin), cisplatin, trastuzumab
(Herceptin), arsenic trioxide (Trisenox), mitoxantrone (Novantrone), imatinib
(Gleevec), bevacizumab (Avastin), sunitinib (Sutent), and sorafenib (Nevaxar)],
antiviral compound azidothymidine (AZT, Zidovudine) and several oral
antidiabetics [e.g., rosiglitazone (Avandia)]. Illicit drugs such as alcohol,
cocaine, methamphetamine, ecstasy, and synthetic cannabinoids (spice, K2) may
also induce mitochondria-related cardiotoxicity. Mitochondrial toxicity develops
due to various mechanisms involving interference with the mitochondrial
respiratory chain (e.g., uncoupling) or inhibition of the important mitochondrial
enzymes (oxidative phosphorylation, Szent-Györgyi-Krebs cycle, mitochondrial DNA
replication, ADP/ATP translocator). The final phase of mitochondrial dysfunction
induces loss of mitochondrial membrane potential and an increase in mitochondrial
oxidative/nitrative stress, eventually culminating into cell death. This review
aims to discuss the mechanisms of mitochondrion-mediated cardiotoxicity of
commonly used drugs and some potential cardioprotective strategies to prevent
these toxicities.