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2016 ; 371
(ä): 58-66
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An integrative view of cisplatin-induced renal and cardiac toxicities: Molecular
mechanisms, current treatment challenges and potential protective measures
#MMPMID27717837
Dugbartey GJ
; Peppone LJ
; de Graaf IA
Toxicology
2016[Sep]; 371
(ä): 58-66
PMID27717837
show ga
Cisplatin is currently one of the most widely-used chemotherapeutic agents
against various malignancies. Its clinical application is limited, however, by
inherent renal and cardiac toxicities and other side effects, of which the
underlying mechanisms are only partly understood. Experimental studies show
cisplatin generates reactive oxygen species, which impair the cell's antioxidant
defense system, causing oxidative stress and potentiating injury, thereby
culminating in kidney and heart failure. Understanding the molecular mechanisms
of cisplatin-induced renal and cardiac toxicities may allow clinicians to prevent
or treat this problem better and may also provide a model for investigating
drug-induced organ toxicity in general. This review discusses some of the major
molecular mechanisms of cisplatin-induced renal and cardiac toxicities including
disruption of ionic homeostasis and energy status of the cell leading to cell
injury and cell death. We highlight clinical manifestations of both toxicities as
well as (novel)biomarkers such as kidney injury molecule-1 (KIM-1), tissue
inhibitor of metalloproteinase-1 (TIMP-1) and N-terminal pro-B-type natriuretic
peptide (NT-proBNP). We also present some current treatment challenges and
propose potential protective strategies including combination therapy with novel
pharmacological compounds that might mitigate or prevent these toxicities, which
include the use of hydrogen sulfide.
|Animals
[MESH]
|Antineoplastic Agents/*toxicity
[MESH]
|Cardiotoxicity/*pathology/*prevention & control
[MESH]
|Cisplatin/*toxicity
[MESH]
|DNA Damage/drug effects
[MESH]
|Heart Diseases/*chemically induced/metabolism/pathology/prevention & control
[MESH]