Journal of Forensic Medicine ›› 2025, Vol. 41 ›› Issue (2): 120-126.DOI: 10.12116/j.issn.1004-5619.2024.440404

• Topic on Forensic Identification of Poisoning • Previous Articles     Next Articles

Research on Doxorubicin-Induced Cardiotoxicity Mechanism and Its Forensic Application

Shuai ZHANG(), Hong-fei XU, Zhi-xiang ZHANG, Ying WANG, Shao-hua ZHU()   

  1. Department of Forensic Medicine, School of Basic Medical Sciences, Soochow University, Suzhou 215123, Jiang-su Province, China
  • Received:2024-04-12 Online:2025-08-11 Published:2025-04-25
  • Contact: Shao-hua ZHU

Abstract:

Doxorubicin is a commonly used antitumor drug for the treatment of various cancers. However, its clinical application is greatly restricted by its severe cardiotoxicity. At present, doxorubicin-induced cardiotoxicity is categorized into acute and chronic forms, depending on the dosage and duration of exposure, which may eventually lead to the occurrence of heart failure. The pathogenesis of doxorubicin cardiotoxicity is associated with oxidative stress, mitochondrial damage, calcium overload, dysregulation of autophagy, and apoptosis. In forensic medical practice, cases of poisoning or even cardiac death caused by doxorubicin showed no obvious changes in cardiac morphology through routine forensic pathological examinations. The paper aims to summarize the research on the mechanisms of action of doxorubicin-induced cardiotoxicity in recent years, analyze and discuss the possible pathways of cardiomyocyte injury caused by doxorubicin, and provide references for research on the mechanisms of doxorubicin-induced cardiotoxicity and forensic application.

Key words: forensic pathology, forensic toxicology, doxorubicin, cardiotoxicity, mechanism of drug action, review

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