REVIEW article
Front. Cardiovasc. Med.
Sec. Cardio-Oncology
NO/NOS System Dysregulation as a Key Molecular Mechanism in Chemotherapy-Induced Cardiotoxicity: A Review
Provisionally accepted
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Cardiotoxicity, as a side effect of chemotherapeutic treatments, represents a major limiting factor during anti-tumour therapies. This is usually evident by decreased cardiac function, and the cardiovascular diseases linked to chemotherapeutic agents can range from mild arrhythmias and hypertension to myocardial injuries and heart failure. One of the most important regulators of cardiovascular function is nitric oxide (NO), a small signalling molecule associated with multiple cardioprotective properties. The activity of NO producing enzymes, the nitric oxide synthases (NOSs), is tightly regulated by pathways responsible for maintaining the cardiovascular NO homeostasis. Thus, the dysregulation of the NO/NOS system could lead to severe pathologic changes in cardiomyocytes and endothelial cells. This narrative review examines the evidence on how chemotherapeutic agents affect cardiac NOS activity and NO signalling, and explores whether NO/NOS dysregulation may be considered as a relevant mechanism in the development of chemotherapy-induced cardiotoxicity.
Keywords: cardiotoxicity, Cardiovascular System, chemotherapy, Nitric Oxide Synthase, NOsignaling
Received: 08 Aug 2025; Accepted: 28 Oct 2025.
Copyright: © 2025 Nagy, Virág, Kiss, Börzsei, Varga and Szabó. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Renáta Szabó, szrenata@bio.u-szeged.hu
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.