Frontiers in Pharmacology · 7 authors, 4 centres
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This narrative review synthesizes preclinical and clinical evidence on how endogenous metal ions—iron, copper, zinc, and calcium—and ferroptosis contribute to doxorubicin-induced cardiotoxicity. It evaluates metal chelators, ion regulators, and natural compounds as potential strategies to mitigate cardiac damage.
This narrative review examines the role of endogenous metal ions (iron, copper, zinc, calcium) and ferroptosis in doxorubicin-induced cardiotoxicity (DIC). Alterations in intracellular metal ion levels are described as either facilitating or mitigating DIC, with ferroptosis identified as a key cell death mechanism. Various therapeutic strategies are discussed, including metal chelators, ferroptosis inhibitors, natural compounds, and traditional Chinese medicine formulations. The review concludes that while promising preclinical results exist, translation to clinical application through drug trials remains a future goal.
