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Cappetta D, De Angelis A, Sapio L, Prezioso L, Illiano M, Quaini F, Rossi F, Berrino L, Naviglio S, Urbanek K. Oxidative Stress and Cellular Response to Doxorubicin: A Common Factor in the Complex Milieu of Anthracycline Cardiotoxicity. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:1521020. [PMID: 29181122 PMCID: PMC5664340 DOI: 10.1155/2017/1521020] [Citation(s) in RCA: 229] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/18/2017] [Indexed: 12/11/2022]
Abstract
The production of reactive species is a core of the redox cycling profile of anthracyclines. However, these molecular characteristics can be viewed as a double-edged sword acting not only on neoplastic cells but also on multiple cellular targets throughout the body. This phenomenon translates into anthracycline cardiotoxicity that is a serious problem in the growing population of paediatric and adult cancer survivors. Therefore, better understanding of cellular processes that operate within but also go beyond cardiomyocytes is a necessary step to develop more effective tools for the prevention and treatment of progressive and often severe cardiomyopathy experienced by otherwise successfully treated oncologic patients. In this review, we focus on oxidative stress-triggered cellular events such as DNA damage, senescence, and cell death implicated in anthracycline cardiovascular toxicity. The involvement of progenitor cells of cardiac and extracardiac origin as well as different cardiac cell types is discussed, pointing to molecular signals that impact on cell longevity and functional competence.
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Affiliation(s)
- Donato Cappetta
- Department of Experimental Medicine, Section of Pharmacology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonella De Angelis
- Department of Experimental Medicine, Section of Pharmacology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Luigi Sapio
- Department of Biochemistry, Biophysics and General Pathology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Lucia Prezioso
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Michela Illiano
- Department of Biochemistry, Biophysics and General Pathology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Federico Quaini
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesco Rossi
- Department of Experimental Medicine, Section of Pharmacology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Liberato Berrino
- Department of Experimental Medicine, Section of Pharmacology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Silvio Naviglio
- Department of Biochemistry, Biophysics and General Pathology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Konrad Urbanek
- Department of Experimental Medicine, Section of Pharmacology, University of Campania Luigi Vanvitelli, Naples, Italy
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252
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Clark RA, Marin TS, Berry NM, Atherton JJ, Foote JW, Koczwara B. Cardiotoxicity and cardiovascular disease risk assessment for patients receiving breast cancer treatment. CARDIO-ONCOLOGY (LONDON, ENGLAND) 2017; 3:6. [PMID: 32154001 PMCID: PMC7048103 DOI: 10.1186/s40959-017-0025-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 10/05/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cardiotoxicity from anticancer therapy affects heart function and structure. Cardiotoxicity can also lead to accelerated development of chronic diseases, especially in the presence of risk factors. METHODS This study aimed to develop and pilot a combined cardiovascular disease and cardiotoxicity risk assessment questionnaire to quantify the potential extent of risk factors in breast cancer patients prior to treatment. The questionnaire underwent content and face validity evaluation by an expert panel followed by pilot testing in a sample of breast cancer patients (n = 36). Questionnaires were self-administered while attending chemotherapy clinic, in the presence of a research assistant. RESULTS Mean age of participants was 54.8 years (range 36-72 years). Participants reported CVD risk factors including diabetes 2.8%, hypertension 19.8%, hypercholesterolaemia 11% and sleep apnoea 5%. Lifestyle risk factors, included not eating the recommended serves of vegetables (100%) or fruit (78%) per day; smoking (13%) and regularly consuming alcohol (75%). Twenty five percent reported being physically inactive, 61%, overweight or obese, 24%, little or no social support and 30% recorded high to very high psychological distress. Participants were highly (75%) reluctant to undertake lifestyle changes; i.e. changing alcohol consumption; dietary habits; good emotional/mental health strategies; improving physical activity; quitting smoking; learning about heart-health and weight loss. CONCLUSION This study is an important step towards prevention and management of treatment-associated cardiotoxicity after breast cancer diagnosis. We recommend that our questionnaire is providing important data that should be included in cancer registries so that researchers can establish the relationship between CVD risk profile and cardiotoxicity outcomes and that this study revealed important teaching opportunities that could be used to examine the impact on health literacy and help patients better understand the consequences of cancer treatment.
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Affiliation(s)
- Robyn A. Clark
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Tania S. Marin
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Narelle M. Berry
- Norwich Medical School, University of East Anglia, James Watson Road, Norwich Research Park, Norwich, NR4 7UQ UK
| | - John J. Atherton
- Head Cardiology Royal Brisbane and Women’s Hospital, University of Queensland School of Medicine, Butterfield St & Bowen Bridge Rd, Herston, St Lucia, QLD Australia
| | - Jonathon W. Foote
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Bogda Koczwara
- Department of Medical Oncology, Flinders Centre for Innovation in Cancer, Flinders University, Flinders Drive, Bedford Park, SA 5042 Australia
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253
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Agarwal MA, Aggarwal A, Rastogi S, Ventura HO, Lavie CJ. Cardiovascular disease burden in cancer patients from 2003 to 2014. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2017; 4:69-70. [DOI: 10.1093/ehjqcco/qcx033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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254
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Florido R, Smith KL, Cuomo KK, Russell SD. Cardiotoxicity From Human Epidermal Growth Factor Receptor-2 (HER2) Targeted Therapies. J Am Heart Assoc 2017; 6:JAHA.117.006915. [PMID: 28939718 PMCID: PMC5634312 DOI: 10.1161/jaha.117.006915] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Roberta Florido
- Division of Cardiology, Johns Hopkins University, Baltimore, MD
| | - Karen L Smith
- Breast and Ovarian Cancer Program, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
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255
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Lung cancer as a cardiotoxic state: a review. Med Oncol 2017; 34:159. [DOI: 10.1007/s12032-017-1012-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 07/22/2017] [Indexed: 12/30/2022]
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256
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Henning RJ, Harbison RD. Cardio-oncology: cardiovascular complications of cancer therapy. Future Cardiol 2017; 13:379-396. [DOI: 10.2217/fca-2016-0081] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This paper focuses on three classes of commonly used anticancer drugs, which can cause cardiotoxicity: anthracyclines, monoclonal antibodies exemplified by trastuzumab and tyrosine kinase inhibitors. Anthracyclines can induce cardiomyocyte necrosis and fibrosis. Trastuzumab can cause cardiac stunning. The tyrosine kinase inhibitors can increase systemic arterial pressure and impair myocyte contractility. In addition, radiation therapy to the mediastinum or left chest can exacerbate the cardiotoxicity of these anticancer drugs and can also cause accelerated atherosclerosis, myocardial infarction, heart failure and arrhythmias. Left ventricular ejection fraction measurements are most commonly used to assess cardiac function in patients who receive chemo- or radiation-therapy. However, echocardiographic determinations of global longitudinal strain are more sensitive for detection of early left ventricular systolic dysfunction. Information on patient-risk stratification and monitoring is presented and guidelines for the medical treatment of cardiac dysfunction due to cancer therapies are summarized.
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Affiliation(s)
- Robert J Henning
- Department of Environmental & Occupational Health, College of Public Health, University of South Florida, and the James A Haley Hospital, Tampa, FL 33612-3805, USA
| | - Raymond D Harbison
- Department of Environmental & Occupational Health, College of Public Health, University of South Florida, and the James A Haley Hospital, Tampa, FL 33612-3805, USA
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257
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Ghosh AK, Walker JM. Cardio-Oncology - A new subspecialty with collaboration at its heart. Indian Heart J 2017; 69:556-562. [PMID: 28822531 PMCID: PMC5560887 DOI: 10.1016/j.ihj.2017.05.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 05/05/2017] [Indexed: 12/20/2022] Open
Abstract
Cardio-Oncology is the care of cancer patients with cardiovascular disease, overt or occult, already established or acquired during treatment. Cancer patients can present with a variety of cardiovascular problems not all of which are directly related to cancer therapy (medications or radiotherapy). The cardiovascular problems of oncology patients can range from ischaemia to arrhythmias and can also include valve problems and heart failure. As such, within cardiology, teamwork is required with members of different cardiology subspecialties. The way forward will be to adopt a multidisciplinary approach to produce optimal individual care. Close collaboration between cardiology and oncology specialists in a Cardio-Oncology setting can make this happen.
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Affiliation(s)
- Arjun K Ghosh
- Barts Heart Centre, St Bartholomew's Hospital and Hatter Cardiovascular Institute, University College London Hospital, United Kingdom.
| | - J Malcolm Walker
- Hatter Cardiovascular Institute, University College London Hospital, United Kingdom
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258
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Wang HY, Yin BB, Jia DY, Hou YL. Association between obesity and trastuzumab-related cardiac toxicity in elderly patients with breast cancer. Oncotarget 2017; 8:79289-79297. [PMID: 29108307 PMCID: PMC5668040 DOI: 10.18632/oncotarget.17808] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/25/2017] [Indexed: 12/19/2022] Open
Abstract
Purpose Trastuzumab can improve the prognosis for patients with breast cancer, but its related cardiac toxicity is concerning. This study aimed to identify the risk factors associated with trastuzumab-related cardiac toxicity in elderly patients with HER2-positive breast cancer. Patients and methods A total of 133 elderly (≥ 65 years) patients who were diagnosed with breast cancer between June 1, 2007, and January 31, 2016, and received trastuzumab treatment were retrospectively reviewed. Cardiac events were defined as: (1) LVEF reduction of >10% from baseline echocardiography, (2) reduction of LVEF to <50%, and (3) signs and symptoms of heart failure as defined by the Common Terminology Criteria for Adverse Events (CTCAE) accompanied by a decrease in the LVEF. Univariate and multivariate regression analyses were used to determine the contribution of different clinical variables to trastuzumab-related cardiac events. Results The median age of the cohort was 71.0 years (range, 65–81 years). The median follow-up period for measurement of left ventricular ejection fraction was 11.0 months (range, 2–71 months). Fifteen patients (11.2%) experienced cardiac events during the follow-up. Multivariate regression analysis revealed that obesity (odd ratio[OR], 4.706; 95% CI, 1.984-10.147; P = 0.002) was a statistically significant risk factor associated with cardiac events. Conclusion Obesity is an independent risk factor for trastuzumab-related cardiac toxicity in elderly patients with breast cancer, receiving trastuzumab. Further studies are needed to establish the independent predictive value of obesity on cardiotoxicity in these patients.
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Affiliation(s)
- Hai-Yan Wang
- Department of Echocardiography, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong Province, China
| | - Bei-Bei Yin
- Department of Oncology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong Province, China
| | - Dan-Yan Jia
- Jinan Medical Emergency Center, Jinan, Shandong Province, China
| | - Ying-Long Hou
- Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong Province, China
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259
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Berg DD, Vaduganathan M, Davids MS, Alyea EP, Torre M, Padera RF, Nohria A. Immune-related fulminant myocarditis in a patient receiving ipilimumab therapy for relapsed chronic myelomonocytic leukaemia. Eur J Heart Fail 2017; 19:682-685. [DOI: 10.1002/ejhf.806] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 01/07/2017] [Accepted: 02/01/2017] [Indexed: 11/10/2022] Open
Affiliation(s)
- David D. Berg
- Division of Cardiovascular Medicine Brigham and Women's Hospital; Harvard Medical School; 75 Francis Street Boston MA 02115 USA
| | - Muthiah Vaduganathan
- Division of Cardiovascular Medicine Brigham and Women's Hospital; Harvard Medical School; 75 Francis Street Boston MA 02115 USA
| | - Matthew S. Davids
- Department of Medical Oncology Dana-Farber Cancer Institute; Harvard Medical School; Boston MA USA
| | - Edwin P. Alyea
- Department of Medical Oncology Dana-Farber Cancer Institute; Harvard Medical School; Boston MA USA
| | - Matthew Torre
- Department of Pathology; Brigham and Women's Hospital, Harvard Medical School; Boston MA USA
| | - Robert F. Padera
- Department of Pathology; Brigham and Women's Hospital, Harvard Medical School; Boston MA USA
| | - Anju Nohria
- Division of Cardiovascular Medicine Brigham and Women's Hospital; Harvard Medical School; 75 Francis Street Boston MA 02115 USA
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260
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Delgado V, Ajmone Marsan N. Implementing Quality Control of LV Longitudinal Strain Measurement. JACC Cardiovasc Imaging 2017; 10:523-525. [DOI: 10.1016/j.jcmg.2016.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/06/2016] [Accepted: 09/08/2016] [Indexed: 11/26/2022]
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261
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Song FY, Shi J, Guo Y, Zhang CJ, Xu YC, Zhang QL, Shu XH, Cheng LL. Assessment of biventricular systolic strain derived from the two-dimensional and three-dimensional speckle tracking echocardiography in lymphoma patients after anthracycline therapy. Int J Cardiovasc Imaging 2017; 33:857-868. [PMID: 28255826 DOI: 10.1007/s10554-017-1082-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 01/24/2017] [Indexed: 12/25/2022]
Abstract
The aim of this study was to investigate the usefulness of three-dimensional (3D) speckle tracking echocardiography (STE) for assessment of both left and right ventricular systolic function in patients with lymphoma after anthracycline chemotherapy, compared with two-dimensional (2D) STE. Totally eighty-nine patients undergoing anthracycline containing chemotherapy were studied. Echocardiographic assessment included 2D and 3D left ventricular (LV) global longitudinal strain (GLS), global circumferential strain (GCS) and right ventricular (RV) GLS. All the parameters were analyzed at baseline, after the completion of four cycles and at the end of the regimen respectively. The area under the receiver operating characteristic curve was calculated to determine the capability of various echocardiographic parameters to discriminate between before and after chemotherapy. Compared with those at baseline, the 3D GLS and GCS of LV and GLS of RV decreased significantly after four cycles of the therapy (all p < 0.01). At the end of the treatment, 2D GLS and GCS of LV deteriorated markedly (both p < 0.05). The area under the curve for GLS, GCS of LV and GLS of RV derived by 3D were 0.81, 0.66 and 0.78, respectively. The cutoff value with -20.4% of LV GLS by 3D had sensitivity of 81% and specificity of 66% for differentiating patients after therapy from baselines. The cutoff value with -21.9% of RV GLS by 3D had sensitivity of 71% and specificity of 74% fordifferentiating patients after therapy from baselines. The data from this study demonstrated that both 2D and 3D STE can be conducted to evaluate the slight myocardial damage for lymphoma patients after anthracycline chemotherapy. 3D STE could examine subclinical biventricular dysfunction in earlier point than 2D STE.
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MESH Headings
- Adult
- Aged
- Anthracyclines/adverse effects
- Antibiotics, Antineoplastic/adverse effects
- Area Under Curve
- Biomarkers/blood
- Biomechanical Phenomena
- Cardiotoxicity
- Early Diagnosis
- Echocardiography, Doppler, Pulsed
- Echocardiography, Three-Dimensional
- Female
- Heart Diseases/blood
- Heart Diseases/chemically induced
- Heart Diseases/diagnostic imaging
- Heart Diseases/physiopathology
- Humans
- Image Interpretation, Computer-Assisted
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Male
- Middle Aged
- Observer Variation
- Predictive Value of Tests
- Prospective Studies
- ROC Curve
- Reproducibility of Results
- Risk Factors
- Stress, Mechanical
- Systole
- Time Factors
- Ventricular Function, Left/drug effects
- Ventricular Function, Right/drug effects
- Young Adult
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Affiliation(s)
- Fei-Yan Song
- Department of Echocardiography, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Jing Shi
- Department of Echocardiography, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Ye Guo
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai, 200032, China.
| | - Chu-Jie Zhang
- Department of Echocardiography, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Yu-Chen Xu
- Department of Echocardiography, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Qun-Ling Zhang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai, 200032, China
| | - Xian-Hong Shu
- Department of Echocardiography, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
| | - Lei-Lei Cheng
- Department of Echocardiography, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
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262
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Metra M. January 2017 at a glance: oncology, diabetes and antidiabetic treatment, pulmonary hypertension. Eur J Heart Fail 2017; 19:7-8. [DOI: 10.1002/ejhf.741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia Italy
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263
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Dörr R, Maisch B. [Seeking Ariadne's thread in the labyrinth of guidelines]. Herz 2016; 41:653-654. [PMID: 27844138 DOI: 10.1007/s00059-016-4504-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- R Dörr
- Praxisklinik Herz und Gefäße, Heinrich-Cotta-Str. 12, 01324, Dresden, Deutschland.
| | - B Maisch
- Philipps Universität Marburg und Herz- und Gefäßzentrum Marburg, Marburg, Deutschland
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264
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Petermann E, Keil C, Oei SL. Importance of poly(ADP-ribose) polymerases in the regulation of DNA-dependent processes. Cell Mol Life Sci 2005; 62:731-8. [PMID: 15868398 DOI: 10.1007/s00018-004-4504-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Poly(ADP-ribosyl)ation of proteins is involved in the regulation of basal cellular processes and seems to be crucial for genomic integrity and cell survival. Several nuclear poly(ADP-ribose) polymerases (PARPs) are known which interact with various proteins involved in DNA metabolism. These proteins can be targets of poly(ADP-ribosyl)ation, which generally downregulates their activities. Accordingly, PARPs have been implicated in numerous processes involving chromosomal DNA, such as the regulation of chromatin structure, DNA repair, replication and transcription. PARP-1, the major cellular PARP, and PARP-2 are activated by DNA strand breaks. These enzymes have been shown to participate in DNA repair. PARP-1 has also been associated with DNA replication and recombination. Another outstanding feature of PARP-1 is its impact on the activities of transcription factors and on gene expression. Two other nuclear PARP enzymes, tankyrase-1 and tankyrase-2, are important for telomere maintenance.
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Affiliation(s)
- E Petermann
- Institut für Biochemie, Freie Universität Berlin, Thielallee 63, 14195, Berlin, Germany
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