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Dexrazoxane induced <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> damage responses, shown by enhanced levels of \u03b3\u2010<jats:styled-content style=\"fixed-case\">H2AX<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">53BP1<\/jats:styled-content> foci, <jats:styled-content style=\"fixed-case\">ATM<\/jats:styled-content> (ataxia telangiectasia mutated), <jats:styled-content style=\"fixed-case\">ATR<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">ATM<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ad3\u2010related), <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>hk1 and <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>hk2 phosphorylation, and by p53 accumulation. Dexrazoxane\u2010induced \u03b3\u2010<jats:styled-content style=\"fixed-case\">H2AX<\/jats:styled-content> accumulation was dependent on <jats:styled-content style=\"fixed-case\">ATM<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">ATF<\/jats:styled-content>3 protein was induced by dexrazoxane in a concentration\u2010 and time\u2010dependent manner, which was abolished in <jats:styled-content style=\"fixed-case\">TOP2A<\/jats:styled-content>\u2010depleted cells and in cells pre\u2010incubated with <jats:styled-content style=\"fixed-case\">ATM<\/jats:styled-content> inhibitor. Knockdown of <jats:styled-content style=\"fixed-case\"><jats:italic>ATF<\/jats:italic><\/jats:styled-content><jats:italic>3<\/jats:italic> gene expression by si<jats:styled-content style=\"fixed-case\">RNA<\/jats:styled-content> triggered apoptosis in control cells and diminished the p53 protein level in both control and dexrazoxane \u2010treated cells. This was accompanied by increased \u03b3\u2010<jats:styled-content style=\"fixed-case\">H2AX<\/jats:styled-content> accumulation. <jats:styled-content style=\"fixed-case\">ATF<\/jats:styled-content>3 knockdown also delayed the repair of dexrazoxane \u2010induced <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> double\u2010strand breaks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Implications<\/jats:title><jats:p>As with other <jats:styled-content style=\"fixed-case\">TOP2A<\/jats:styled-content> poisons, dexrazoxane induced <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> double\u2010strand breaks followed by activation of the <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> damage response. The <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> damage\u2010triggered <jats:styled-content style=\"fixed-case\">ATF<\/jats:styled-content>3 controlled p53 accumulation and generation of double\u2010strand breaks and is proposed to serve as a switch between <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> damage and cell death following dexrazoxane treatment. These findings suggest a mechanistic explanation for the diverse clinical observations associated with dexrazoxane.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bph.13046","type":"journal-article","created":{"date-parts":[[2014,12,19]],"date-time":"2014-12-19T06:47:58Z","timestamp":1418971678000},"page":"2246-2257","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["The catalytic topoisomerase <scp>II<\/scp> inhibitor dexrazoxane induces <scp>DNA<\/scp> breaks, <scp>ATF<\/scp>3 and the <scp>DNA<\/scp> damage response in cancer cells"],"prefix":"10.1111","volume":"172","author":[{"given":"Shiwei","family":"Deng","sequence":"first","affiliation":[{"name":"Institute of Pharmacology Medical Center of the University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiandong","family":"Yan","sequence":"additional","affiliation":[{"name":"Institute of Pharmacology Medical Center of the 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