Thrombo-inflammation linking androgen suppression with cardiovascular risk in patients with prostate cancer

Abstract Androgen deprivation therapy (ADT), a key element of prostate cancer treatment, is associated with increased risk for cardiovascular morbidity and mortality. The underlying mechanisms include adverse metabolic alterations, but further mechanisms are likely. Animal studies suggest increased...

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Main Authors: Antonia Beitzen-Heineke, David R. Wise, Jeffrey S. Berger
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Cardio-Oncology
Subjects:
Online Access:https://doi.org/10.1186/s40959-024-00278-2
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author Antonia Beitzen-Heineke
David R. Wise
Jeffrey S. Berger
author_facet Antonia Beitzen-Heineke
David R. Wise
Jeffrey S. Berger
author_sort Antonia Beitzen-Heineke
collection DOAJ
description Abstract Androgen deprivation therapy (ADT), a key element of prostate cancer treatment, is associated with increased risk for cardiovascular morbidity and mortality. The underlying mechanisms include adverse metabolic alterations, but further mechanisms are likely. Animal studies suggest increased progression of atherosclerosis in androgen deprived conditions. Based on in vitro studies, lack of androgens may modulate immune cells including monocytes, macrophages, and T-cells towards a pro-inflammatory phenotype and pro-atherogenic function. As a novel aspect, this review summarizes existing data on the effect of androgens and androgen deprivation on platelet activity, which play a major role in inflammation and in the initiation and progression of atherosclerotic lesions. Testosterone modulates platelet aggregation responses which are affected by dose level, source of androgen, and age. Data on the effects of ADT on platelet activity and aggregation are limited and conflicting, as both increased and decreased aggregation responses during ADT have been reported. Gaps in knowledge about the mechanisms leading to increased cardiovascular risk during ADT remain and further research is warranted. Improved understanding of pathogenic pathways linking ADT to cardiovascular risk may help identify clinically useful diagnostic and prognostic biomarkers, and accelerate finding novel therapeutic targets, and thus optimize prostate cancer treatment outcomes.
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spelling doaj-art-50ed8816f3ef4d4d87a1d7350eae61332024-12-08T12:47:19ZengBMCCardio-Oncology2057-38042024-12-011011810.1186/s40959-024-00278-2Thrombo-inflammation linking androgen suppression with cardiovascular risk in patients with prostate cancerAntonia Beitzen-Heineke0David R. Wise1Jeffrey S. Berger2Department of Medicine, New York University Grossman School of MedicineDepartment of Medicine, Laura & Isaac Perlmutter Cancer Center, NYU Langone HealthDepartment of Medicine, New York University Grossman School of MedicineAbstract Androgen deprivation therapy (ADT), a key element of prostate cancer treatment, is associated with increased risk for cardiovascular morbidity and mortality. The underlying mechanisms include adverse metabolic alterations, but further mechanisms are likely. Animal studies suggest increased progression of atherosclerosis in androgen deprived conditions. Based on in vitro studies, lack of androgens may modulate immune cells including monocytes, macrophages, and T-cells towards a pro-inflammatory phenotype and pro-atherogenic function. As a novel aspect, this review summarizes existing data on the effect of androgens and androgen deprivation on platelet activity, which play a major role in inflammation and in the initiation and progression of atherosclerotic lesions. Testosterone modulates platelet aggregation responses which are affected by dose level, source of androgen, and age. Data on the effects of ADT on platelet activity and aggregation are limited and conflicting, as both increased and decreased aggregation responses during ADT have been reported. Gaps in knowledge about the mechanisms leading to increased cardiovascular risk during ADT remain and further research is warranted. Improved understanding of pathogenic pathways linking ADT to cardiovascular risk may help identify clinically useful diagnostic and prognostic biomarkers, and accelerate finding novel therapeutic targets, and thus optimize prostate cancer treatment outcomes.https://doi.org/10.1186/s40959-024-00278-2Androgen deprivation therapyProstate cancerCardiooncologyCardiotoxicityCardiovascular toxicityAtherosclerosis
spellingShingle Antonia Beitzen-Heineke
David R. Wise
Jeffrey S. Berger
Thrombo-inflammation linking androgen suppression with cardiovascular risk in patients with prostate cancer
Cardio-Oncology
Androgen deprivation therapy
Prostate cancer
Cardiooncology
Cardiotoxicity
Cardiovascular toxicity
Atherosclerosis
title Thrombo-inflammation linking androgen suppression with cardiovascular risk in patients with prostate cancer
title_full Thrombo-inflammation linking androgen suppression with cardiovascular risk in patients with prostate cancer
title_fullStr Thrombo-inflammation linking androgen suppression with cardiovascular risk in patients with prostate cancer
title_full_unstemmed Thrombo-inflammation linking androgen suppression with cardiovascular risk in patients with prostate cancer
title_short Thrombo-inflammation linking androgen suppression with cardiovascular risk in patients with prostate cancer
title_sort thrombo inflammation linking androgen suppression with cardiovascular risk in patients with prostate cancer
topic Androgen deprivation therapy
Prostate cancer
Cardiooncology
Cardiotoxicity
Cardiovascular toxicity
Atherosclerosis
url https://doi.org/10.1186/s40959-024-00278-2
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