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Georgiadis N, Tsarouhas K, Rezaee R, Nepka H, Kass GEN, Dorne JLCM, Stagkos D, Toutouzas K, Spandidos DA, Kouretas D, Tsitsimpikou C. What is considered cardiotoxicity of anthracyclines in animal studies. Oncol Rep 2020; 44:798-818. [PMID: 32705236 PMCID: PMC7388356 DOI: 10.3892/or.2020.7688] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/14/2020] [Indexed: 12/22/2022] Open
Abstract
Anthracyclines are commonly used anticancer drugs with well-known and extensively studied cardiotoxic effects in humans. In the clinical setting guidelines for assessing cardiotoxicity are well-established with important therapeutic implications. Cardiotoxicity in terms of impairment of cardiac function is largely diagnosed by echocardiography and based on objective metrics of cardiac function. Until this day, cardiotoxicity is not an endpoint in the current general toxicology and safety pharmacology preclinical studies, although other classes of drugs apart from anthracyclines, along with everyday chemicals have been shown to manifest cardiotoxic properties. Also, in the relevant literature there are not well-established objective criteria or reference values in order to uniformly characterize cardiotoxic adverse effects in animal models. This in depth review focuses on the evaluation of two important echocardiographic indices, namely ejection fraction and fractional shortening, in the literature concerning anthracycline administration to rats as the reference laboratory animal model. The analysis of the gathered data gives promising results and solid prospects for both, defining anthracycline cardiotoxicity objective values and delineating the guidelines for assessing cardiotoxicity as a separate hazard class in animal preclinical studies for regulatory purposes.
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Affiliation(s)
| | | | - Ramin Rezaee
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, 9177948564 Mashhad, Iran
| | - Haritini Nepka
- Department of Pathology, University Hospital of Larissa, 41334 Larissa, Greece
| | | | | | - Dimitrios Stagkos
- Department of Biochemistry and Biotechnology, University of Thessaly, 41500 Larissa, Greece
| | - Konstantinos Toutouzas
- First Department of Cardiology, Hippokration Hospital, Medical School, University of Athens, 11527 Athens, Greece
| | - Demetrios A Spandidos
- Laboratory of Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Dimitrios Kouretas
- Department of Biochemistry and Biotechnology, University of Thessaly, 41500 Larissa, Greece
| | - Christina Tsitsimpikou
- Department of Biochemistry and Biotechnology, University of Thessaly, 41500 Larissa, Greece
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