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Mechanisms of doxorubicin-mediated reproductive toxicity - A review

Uma Priya Mohan1, Tirupathi Pichiah P B2, Syeda Thabassum Akhtar Iqbal3

  • 1Centre for Cardiovascular and Adverse Drug Reactions, Department of Biotechnology, School of Bio and Chemical Engineering, Kalasalingam Academy of Research and Education, Krishnankoil, Tamil Nadu, PIN 626126, India.

Reproductive Toxicology (Elmsford, N.Y.)
|April 20, 2021
PubMed

Insights

Doxorubicin, an anticancer drug, causes significant reproductive toxicity in both males and females by disrupting testicular function, sperm health, and hormone balance. It also impairs female reproductive processes like folliculogenesis and oogenesis.

Area of Science:

  • Reproductive Toxicology
  • Oncology
  • Biochemistry

Background:

  • Doxorubicin is a widely used chemotherapy agent.
  • Reproductive toxicity is a known adverse effect of doxorubicin treatment.
  • Mechanisms underlying doxorubicin-induced reproductive toxicity require comprehensive understanding.

Purpose of the Study:

  • To review and compile the known mechanisms of doxorubicin-induced reproductive toxicity in both male and female reproductive systems.
  • To provide a consolidated overview of the molecular and cellular pathways affected by doxorubicin.

Main Methods:

  • Literature search using Google Scholar, PubMed, Scopus, and Science Direct.
  • Systematic review and synthesis of existing research on doxorubicin's reproductive effects.
  • Analysis of histopathological, biochemical, and hormonal data from relevant studies.

Main Results:

  • Doxorubicin decreases testicular mass, causes sperm abnormalities (oligospermia, morphological defects), and affects Leydig and Sertoli cell function.
  • It disrupts testicular lipid metabolism, steroidogenesis (3β-HSD, 17β-HSD), and antioxidant enzyme activity (SOD, catalase, GPx).
  • In females, doxorubicin impairs folliculogenesis, oogenesis, ovulation, and the uterine cycle, leading to mitochondrial dysfunction and ER stress in oocytes.

Conclusions:

  • Doxorubicin induces male reproductive toxicity through testicular damage, impaired spermatogenesis, hormonal imbalance, and oxidative/ER stress.
  • Female reproductive toxicity involves disruption of ovarian function, oocyte quality, and hormonal regulation.
  • Understanding these mechanisms is crucial for developing strategies to mitigate doxorubicin's reproductive side effects.
Keywords:
AdriamycinDoxorubicinFolliculogenesisLeydig cellsReproductive toxicitySertoli cellsSpermatogenesisTesticular toxicity

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