Vitamin C as a Cardioprotective Agent Against Doxorubicin‐Induced Cardiotoxicity
Doxorubicin is used and highly effective chemotherapeutic agent; however, its clinical utility remains limited by dose‐dependent cardiotoxicity, presenting a significant challenge in cancer management. Growing preclinical research and clinical evidence suggest that the antioxidant vitamin C (ascorbi...
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2025-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.125.042534 |
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| author | Hamdi Nsairat Zainab Lafi Bassam M. Abualsoud Belal O. Al‐Najjar Ali Al‐Samydai Ghaleb Ali Oriquat Walhan Alshaer Abed Alqader Ibrahim Anthony L. Dellinger |
| author_facet | Hamdi Nsairat Zainab Lafi Bassam M. Abualsoud Belal O. Al‐Najjar Ali Al‐Samydai Ghaleb Ali Oriquat Walhan Alshaer Abed Alqader Ibrahim Anthony L. Dellinger |
| author_sort | Hamdi Nsairat |
| collection | DOAJ |
| description | Doxorubicin is used and highly effective chemotherapeutic agent; however, its clinical utility remains limited by dose‐dependent cardiotoxicity, presenting a significant challenge in cancer management. Growing preclinical research and clinical evidence suggest that the antioxidant vitamin C (ascorbic acid) may confer cardioprotective effects against doxorubicin‐induced cardiotoxicity. In this review, both preclinical and clinical research has been synthesized to assess the potential role of vitamin C in mitigating doxorubicin‐induced cardiotoxicity. Preclinical data have routinely indicated that vitamin C can reduce oxidative stress, preserve mitochondrial function, and modulate proinflammatory cytokine levels. Additionally, animal models have demonstrated promising results in maintaining cardiomyocyte structural integrity. In this capacity, vitamin C may be an effective adjunctive therapeutic for attenuating cardiac injury. Conversely, the clinical data remain variable, with emerging evidence supporting the notion that vitamin C can serve as a safe adjunct that preserves cardiac function during anthracycline therapy. Further investigation is warranted to optimize dosing, timing, and delivery routes and better elucidate the exact molecular mechanisms of these protective effects. This review emphasizes key molecular mechanisms, such as oxidative and nitrosative stress, mitochondrial dysfunction, and inflammatory signaling, in the myocardium, and examines the role of vitamin C supplementation, alone or in combination with doxorubicin, on myocardial damage markers and cardiomyocyte viability. |
| format | Article |
| id | doaj-art-09e61a8fda4e422b90c9ed5a1bc2de6f |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-09e61a8fda4e422b90c9ed5a1bc2de6f2025-08-20T07:24:49ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-08-01141610.1161/JAHA.125.042534Vitamin C as a Cardioprotective Agent Against Doxorubicin‐Induced CardiotoxicityHamdi Nsairat0Zainab Lafi1Bassam M. Abualsoud2Belal O. Al‐Najjar3Ali Al‐Samydai4Ghaleb Ali Oriquat5Walhan Alshaer6Abed Alqader Ibrahim7Anthony L. Dellinger8Pharmacological and Diagnostic Research Center, Faculty of Pharmacy Al‐Ahliyya Amman University Amman JordanPharmacological and Diagnostic Research Center, Faculty of Pharmacy Al‐Ahliyya Amman University Amman JordanPharmacological and Diagnostic Research Center, Faculty of Pharmacy Al‐Ahliyya Amman University Amman JordanPharmacological and Diagnostic Research Center, Faculty of Pharmacy Al‐Ahliyya Amman University Amman JordanPharmacological and Diagnostic Research Center, Faculty of Pharmacy Al‐Ahliyya Amman University Amman JordanPharmacological and Diagnostic Research Center, Faculty of Allied Medical Sciences Al‐Ahliyya Amman University Amman JordanCell Therapy Center The University of Jordan Amman JordanDepartment of Nanoscience, Joint School of Nanoscience and Nanoengineering University of North Carolina at Greensboro Greensboro NC USADepartment of Nanoscience, Joint School of Nanoscience and Nanoengineering University of North Carolina at Greensboro Greensboro NC USADoxorubicin is used and highly effective chemotherapeutic agent; however, its clinical utility remains limited by dose‐dependent cardiotoxicity, presenting a significant challenge in cancer management. Growing preclinical research and clinical evidence suggest that the antioxidant vitamin C (ascorbic acid) may confer cardioprotective effects against doxorubicin‐induced cardiotoxicity. In this review, both preclinical and clinical research has been synthesized to assess the potential role of vitamin C in mitigating doxorubicin‐induced cardiotoxicity. Preclinical data have routinely indicated that vitamin C can reduce oxidative stress, preserve mitochondrial function, and modulate proinflammatory cytokine levels. Additionally, animal models have demonstrated promising results in maintaining cardiomyocyte structural integrity. In this capacity, vitamin C may be an effective adjunctive therapeutic for attenuating cardiac injury. Conversely, the clinical data remain variable, with emerging evidence supporting the notion that vitamin C can serve as a safe adjunct that preserves cardiac function during anthracycline therapy. Further investigation is warranted to optimize dosing, timing, and delivery routes and better elucidate the exact molecular mechanisms of these protective effects. This review emphasizes key molecular mechanisms, such as oxidative and nitrosative stress, mitochondrial dysfunction, and inflammatory signaling, in the myocardium, and examines the role of vitamin C supplementation, alone or in combination with doxorubicin, on myocardial damage markers and cardiomyocyte viability.https://www.ahajournals.org/doi/10.1161/JAHA.125.042534cardioprotectiondoxorubicin‐induced cardiotoxicityoxidative stressreactive oxygen speciesvitamin C |
| spellingShingle | Hamdi Nsairat Zainab Lafi Bassam M. Abualsoud Belal O. Al‐Najjar Ali Al‐Samydai Ghaleb Ali Oriquat Walhan Alshaer Abed Alqader Ibrahim Anthony L. Dellinger Vitamin C as a Cardioprotective Agent Against Doxorubicin‐Induced Cardiotoxicity Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardioprotection doxorubicin‐induced cardiotoxicity oxidative stress reactive oxygen species vitamin C |
| title | Vitamin C as a Cardioprotective Agent Against Doxorubicin‐Induced Cardiotoxicity |
| title_full | Vitamin C as a Cardioprotective Agent Against Doxorubicin‐Induced Cardiotoxicity |
| title_fullStr | Vitamin C as a Cardioprotective Agent Against Doxorubicin‐Induced Cardiotoxicity |
| title_full_unstemmed | Vitamin C as a Cardioprotective Agent Against Doxorubicin‐Induced Cardiotoxicity |
| title_short | Vitamin C as a Cardioprotective Agent Against Doxorubicin‐Induced Cardiotoxicity |
| title_sort | vitamin c as a cardioprotective agent against doxorubicin induced cardiotoxicity |
| topic | cardioprotection doxorubicin‐induced cardiotoxicity oxidative stress reactive oxygen species vitamin C |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.125.042534 |
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