Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec 29;12(1):45.
doi: 10.3390/life12010045.

Endothelial Dysfunction in Childhood Cancer Survivors: A Narrative Review

Marco Crocco  1   2 , Giuseppe d'Annunzio  3 , Alberto La Valle  2 , Gianluca Piccolo  1   2 , Decimo Silvio Chiarenza  2 , Carolina Bigatti  2 , Marta Molteni  2 , Claudia Milanaccio  1 , Maria Luisa Garrè  1 , Natascia Di Iorgi  2   3 , Mohamad Maghnie  2   3
Affiliations
Review

Endothelial Dysfunction in Childhood Cancer Survivors: A Narrative Review

Marco Crocco et al. Life (Basel). .

Abstract

Assessment of endothelial dysfunction in cancer survivors may have a role in the early identification of non-communicable diseases and cardiovascular late effects. Oncological therapies may impair endothelial function. Therefore, in patients such as childhood cancer survivors who could benefit from early cardioprotective pharmacological interventions, it is essential to monitor endothelial function, even if the optimal methodology for investigating the multifaceted aspects of endothelial dysfunction is still under debate. Biochemical markers, as well as invasive and non-invasive tools with and without pharmacological stimuli have been studied. Human clinical studies that have examined lifestyle or cancer treatment protocols have yielded evidence showing the involvement of lipid and lipoprotein levels, glycemic control, blood pressure, adiposity, inflammation, and oxidative stress markers on the state of endothelial health and its role as an early indicator of cardiometabolic risk. However, with regards to pharmacological interventions, cautious interpretation of the result attained whilst monitoring the endothelial function is warranted due to methodological limitations and substantial heterogeneity of the results reported in the published studies. In this narrative review, an overview of evidence from human clinical trials examining the effects of cancer therapies on endothelial disease is provided together with a discussion of endothelial function assessment using the different non-invasive techniques available for researchers and clinicians, in recent years.

Keywords: atherosclerosis; cancer survivors; cardiotoxicity; carotid intima media thickness; endothelial dysfunction; flow mediated dilation; noncommunicable diseases prevention; peripheral artery tonometry; pulse wave velocity; vascular toxicity.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for eligible studies. * letters to editors, book chapters, study protocols, case reports.
Figure 2
Figure 2
Etiopathogenesis of endothelial dysfunction in cancer survivors.
See this image and copyright information in PMC

References

    1. GBD 2015 Risk Factors Collaborators Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1659–1724. doi: 10.1016/S0140-6736(16)31679-8. - DOI - PMC - PubMed
    1. Armenian S.H., Armstrong G.T., Aune G., Chow E.J., Ehrhardt M.J., Ky B., Moslehi J., Mulrooney D.A., Nathan P.C., Ryan T.D., et al. LCM. Cardiovascular Disease in Survivors of Childhood Cancer: Insights into Epidemiology, Pathophysiology, and Prevention. J. Clin. Oncol. 2018;36:2135–2144. doi: 10.1200/JCO.2017.76.3920. - DOI - PMC - PubMed
    1. Haupt R., Jankovic M., Hjorth L., Skinner R. Late effects in childhood cancer survivors and survivorship issues. Epidemiol. Prev. 2013;37:266–273. - PubMed
    1. Meacham L.R., Chow E.J., Ness K.K., Kamdar K.Y., Chen Y., Yasui Y., Oeffinger K.C., Sklar C.A., Robison L.L., Mertens A.C. Cardiovascular risk factors in adult survivors of pediatric cancer—A report from the childhood cancer survivor study. Cancer Epidemiol. Biomark. Prev. 2010;19:170–181. doi: 10.1158/1055-9965.EPI-09-0555. - DOI - PMC - PubMed
    1. Mertens A.C., Liu Q., Neglia J.P., Wasilewski K., Leisenring W., Armstrong G.T., Robison L.L., Yasui Y. Cause-specific late mortality among 5-year survivors of childhood cancer: The Childhood Cancer Survivor Study. J. Natl. Cancer Inst. 2008;100:1368–1379. doi: 10.1093/jnci/djn310. - DOI - PMC - PubMed

LinkOut - more resources