FREE RADICALS

Although free radical generation leading to direct oxidative damage to cellular components
remains a common postulated mechanism of AIC, there are alternative proposed mechanisms
that probably contribute to cardiac dysfunction. Anthracycline compounds have a planar
structure, which intercalates into the DNA through noncovalent interaction, preventing further
DNA and RNA synthesis and likely contributing to the death of myocytes and mitochondrial
mutations. Anthracyclines disrupt DNA by poisoning topoisomerase, a critical enzyme for
unwinding of the DNA for replication and synthesis, thereby causing growth arrest and
programmed cell death.