Antioxidant Micronutrient Status during Oncological Treatment in Children with Cancer

Malvy, Denis; Arnaud, Josiane; Burtschy, Bernard; Sommelet, D.; Leverger, Guy; Dostálová, L.; Amédée-Manesme, O

doi:10.1007/978-1-4899-0167-5_66

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“…1, A-C). Cancer-associated nutritional disturbances (59) and deficiencies in ␣-tocopherol, selenium and other antioxidant factors (60,61) probably contribute to the maintenance of one such condition of systemic lipid peroxidation. In our study, CD and LOOH have also been measured, for the first time, in blood plasma samples collected from the coronary sinus of cancer patients before and after intravenous treatments with DOX, a chemotherapeutic agent that is thought to stimulate cardiac lipid peroxidation by overwhelming the local defences against oxygen free radicals.…”

Section: Discussionmentioning

confidence: 99%

Paradoxical inhibition of cardiac lipid peroxidation in cancer patients treated with doxorubicin. Pharmacologic and molecular reappraisal of anthracycline cardiotoxicity.

et al. 1996

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Anticancer therapy with doxorubicin (DOX) and other quinone anthracyclines is limited by severe cardiotoxicity, reportedly because semiquinone metabolites delocalize Fe(II) from ferritin and generate hydrogen peroxide, thereby promoting hydroxyl radical formation and lipid peroxidation. Cardioprotective interventions with antioxidants or chelators have nevertheless produced conflicting results. To investigate the role and mechanism(s) of cardiac lipid peroxidation in a clinical setting, we measured lipid conjugated dienes (CD) and hydroperoxides in blood plasma samples from the coronary sinus and femoral artery of nine cancer patients undergoing intravenous treatments with DOX. Before treatment, CD were unexpectedly higher in coronary sinus than in femoral artery (342 Ϯ 131 vs 112 Ϯ 44 nmol/ml, mean Ϯ SD; P Ͻ 0.01), showing that cardiac tissues were spontaneously involved in lipid peroxidation. This was not observed in ten patients undergoing cardiac catheterization for the diagnosis of arrhythmias or valvular dysfunctions, indicating that myocardial lipid peroxidation was specifically increased by the presence of cancer. The infusion of a standard dose of 60 mg DOX/m 2 rapidly ( ‫ف‬ 5 min) abolished the difference in CD levels between coronary sinus and femoral artery (134 Ϯ 95 vs 112 Ϯ 37 nmol/ml); moreover, dose fractionation studies showed that cardiac release of CD and hydroperoxides decreased by ‫ف‬ 80% in response to the infusion of as little as 13 mg DOX/m 2 . Thus, DOX appeared to inhibit cardiac lipid peroxidation in a rather potent manner. Corollary in vitro experiments were performed using myocardial biopsies from patients undergoing aortocoronary bypass grafting. These experiments suggested that the spontaneous exacerbation of lipid peroxidation probably involved preexisting Fe(II) complexes, which could not be sequestered adequately by cardiac isoferritins and became redox inactive when hydrogen peroxide was included to simulate DOX metabolism and hydroxyl radical formation.

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Section: Discussionmentioning

confidence: 99%