Cardiotoxicity induced by antineoplastic drug Daunorubicin and its amelioration: A review of literature

Abstract

Daunorubicin (DNR) belongs to anthracycline class of drugs that has been reported with a significant role in treating leukemia. But use of DNR is restricted due to associated cardiotoxicity. In this review, we present the cardiotoxic effects associated with DNR along with some ameliorative agents. DNR induced sub chronic cardiomyopathy, down regulation of cytokines and stem cell markers which may reflect impaired chemotaxis, migration and homing of stem cells; and tissue repair in the heart. DNR may affect the heart by forming hydrophobic interactions and hydrogen bonds with cardiac myosin. DNR cardiotoxicity may change with age of patient as systematic clearance of drug decreases with age. Cardiotoxicity effects may include inhibition of cardioprotective epoxyeicosatrienoic acid. Adenosine, sodium ferulate and pomegranate have been reported as promising cardio-protectants against DNR induced cardiotoxicity. GnRH conjugates containing DNR also showed no associated cytotoxic effects on cardiomyocytes. Future research on amelioration of DNR associated toxicity is highly recommended.