Free radical-dependent DNA lesions are involved in the delayed cardiotoxicity induced by adriamycin in the rat

The role of free radicals in the genesis of adriamycin (ADR)-induced delayed cardiotoxicity and the cardioprotective effects of the spin trap N-tert-butyl-alpha-phenylnitrone (PBN) were investigated in an in vivo rat model. As ADR and free radicals are no longer present in the myocardium by the time the delayed effects of the drug become apparent, ADR has been proposed to act by causing early radical-dependent DNA lesions, resulting in impaired synthesis of critical target proteins. DNA lesions were detected 10 days after ADR treatment (3X3 mg/kg i.v.) and were still present at the time of onset of the delayed cardiomyopathy. PBN, administered by a slow-release osmotic pump to maintain constant plasma levels throughout the time of persistence of ADR in the myocardium (approximately 2 weeks), prevented the development of DNA lesions, as well as the late contractile and electrical impairment induced by the anthracycline, thus supporting the hypothesis that free radicals play a causal role in both phenomena.