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      Anticancer drugs and cardiotoxicity: the role of cardiomyocyte and non-cardiomyocyte cells

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          Abstract

          Cardiotoxicity can be defined as “chemically induced heart disease”, which can occur with many different drug classes treating a range of diseases. It is the primary cause of drug attrition during pre-clinical development and withdrawal from the market. Drug induced cardiovascular toxicity can result from both functional effects with alteration of the contractile and electrical regulation in the heart and structural changes with morphological changes to cardiomyocytes and other cardiac cells. These adverse effects result in conditions such as arrhythmia or a more serious reduction in left ventricular ejection fraction (LVEF), which can lead to heart failure and death. Anticancer drugs can adversely affect cardiomyocyte function as well as cardiac fibroblasts and cardiac endothelial cells, interfering in autocrine and paracrine signalling between these cell types and ultimately altering cardiac cellular homeostasis. This review aims to highlight potential toxicity mechanisms involving cardiomyocytes and non-cardiomyocyte cells by first introducing the physiological roles of these cells within the myocardium and secondly, identifying the physiological pathways perturbed by anticancer drugs in these cells.

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          Most cited references141

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          Apoptosis: a review of programmed cell death.

          The process of programmed cell death, or apoptosis, is generally characterized by distinct morphological characteristics and energy-dependent biochemical mechanisms. Apoptosis is considered a vital component of various processes including normal cell turnover, proper development and functioning of the immune system, hormone-dependent atrophy, embryonic development and chemical-induced cell death. Inappropriate apoptosis (either too little or too much) is a factor in many human conditions including neurodegenerative diseases, ischemic damage, autoimmune disorders and many types of cancer. The ability to modulate the life or death of a cell is recognized for its immense therapeutic potential. Therefore, research continues to focus on the elucidation and analysis of the cell cycle machinery and signaling pathways that control cell cycle arrest and apoptosis. To that end, the field of apoptosis research has been moving forward at an alarmingly rapid rate. Although many of the key apoptotic proteins have been identified, the molecular mechanisms of action or inaction of these proteins remain to be elucidated. The goal of this review is to provide a general overview of current knowledge on the process of apoptosis including morphology, biochemistry, the role of apoptosis in health and disease, detection methods, as well as a discussion of potential alternative forms of apoptosis.
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            Fulminant Myocarditis with Combination Immune Checkpoint Blockade.

            Immune checkpoint inhibitors have improved clinical outcomes associated with numerous cancers, but high-grade, immune-related adverse events can occur, particularly with combination immunotherapy. We report the cases of two patients with melanoma in whom fatal myocarditis developed after treatment with ipilimumab and nivolumab. In both patients, there was development of myositis with rhabdomyolysis, early progressive and refractory cardiac electrical instability, and myocarditis with a robust presence of T-cell and macrophage infiltrates. Selective clonal T-cell populations infiltrating the myocardium were identical to those present in tumors and skeletal muscle. Pharmacovigilance studies show that myocarditis occurred in 0.27% of patients treated with a combination of ipilimumab and nivolumab, which suggests that our patients were having a rare, potentially fatal, T-cell-driven drug reaction. (Funded by Vanderbilt-Ingram Cancer Center Ambassadors and others.).
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              Pericytes: developmental, physiological, and pathological perspectives, problems, and promises.

              Pericytes, the mural cells of blood microvessels, have recently come into focus as regulators of vascular morphogenesis and function during development, cardiovascular homeostasis, and disease. Pericytes are implicated in the development of diabetic retinopathy and tissue fibrosis, and they are potential stromal targets for cancer therapy. Some pericytes are probably mesenchymal stem or progenitor cells, which give rise to adipocytes, cartilage, bone, and muscle. However, there is still confusion about the identity, ontogeny, and progeny of pericytes. Here, we review the history of these investigations, indicate emerging concepts, and point out problems and promise in the field of pericyte biology. Copyright © 2011 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/2565386/overviewRole: Role: Role: Role:
                Role: Role: Role:
                URI : https://loop.frontiersin.org/people/2697218/overviewRole: Role: Role:
                URI : https://loop.frontiersin.org/people/1784920/overviewRole: Role: Role:
                URI : https://loop.frontiersin.org/people/2681851/overviewRole: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/861464/overviewRole: Role: Role: Role: Role:
                Journal
                Front Cardiovasc Med
                Front Cardiovasc Med
                Front. Cardiovasc. Med.
                Frontiers in Cardiovascular Medicine
                Frontiers Media S.A.
                2297-055X
                11 July 2024
                2024
                : 11
                : 1372817
                Affiliations
                [ 1 ]Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool , Liverpool, United Kingdom
                [ 2 ]Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University , Manchester, United Kingdom
                [ 3 ]Safety Sciences, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca , Cambridge, United Kingdom
                [ 4 ]Medicines Discovery Catapult , Macclesfield, United Kingdom
                [ 5 ]Liverpool Centre for Cardiovascular Science , Liverpool, United Kingdom
                Author notes

                Edited by: Goo Taeg Oh, Ewha Womans University, Republic of Korea

                Reviewed by: Jiahe Wu, Wuhan University, China

                Carmen Miano, National Institute of Biostructures and Biosystems (INBB), Italy

                [* ] Correspondence: Michael J. Cross m.j.cross@ 123456liv.ac.uk
                Article
                10.3389/fcvm.2024.1372817
                11287221
                39081368
                efbf7dd4-d91f-42cf-b4da-4e9c4c767c25
                © 2024 Koukorava, Ahmed, Almaghrabi, Pointon, Haddrick and Cross.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 18 January 2024
                : 31 May 2024
                Page count
                Figures: 3, Tables: 1, Equations: 0, References: 141, Pages: 13, Words: 0
                Funding
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article.
                This work was supported by University of Liverpool and Medicines Discovery Catapult (MDC) Ph.D. studentship (CK, MH and MC), an MRC DiMeN Ph.D. studentship (KA and MC), College of Pharmacy, Taibah University, Madinah, Saudi Arabia (SA).
                Categories
                Cardiovascular Medicine
                Review
                Custom metadata
                Cardio-Oncology

                cardiotoxicity,cardio-oncology,cardiomyocytes,endothelial,fibroblast

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