الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Doxorubicin (DOX) is an anthracycline antibiotic used as an anticancer drug
with a wide range of action in human neoplasms such as breast cancer, acute
lymphoblastic leukemia and testicular carcinoma. However, its use is limited due to
cardiomyopathy and nephropcathy. 1,2
Doxorubicin, also known as Adriamycin (ADR), has well-established, serious,
dose-dependent side effects of development of cardiomyopathy, progressing to
congestive heart failure (CHF). 3 Analysis of heart transplantation patients found
doxorubicin as the underlying cause in 2–3% of all cases. 4
Doxorubicin nephropathy is a well-known animal model, which is similar to
human focal segmental glomerulosclerosis (FSGS), characterized by reduction in
glomerular filtration rate (GFR), proteinuria, glomerulosclerosis related to changes in
the glomerular filtration membrane, and tubulointerstitial fibrosis which is clinically
presented as nephrotic syndrome (NS). 5
The exact mechanism of toxicity remains unclear, but studies indicate critical
role of oxidative stress and inflammation in the pathology of cardiac and renal injury.
Markers of oxidative stress have been recognized and aberrant antioxidant activity
exacerbates the pathology in animal models. 6,7
Some reports have noted that the pathogenesis of renal injury is mediated, at
least in part, by release of toxic reactive radicals. 8,9
Metformin is a well-known insulin sensitizer used for treatment of type 2
diabetes (T2D). It also has been proved to have antioxidant, anti-inflammatory and
anti-apoptotic effect.