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DOX mainly targets the heart, causing cardiotoxicity

For example, glucose is converted into sorbitol by the action of enzyme aldose reductase ( via hexokinase pathway to generate pyruvate

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Fibroblasts rush in and lay down collagen to close the gap, which can leave a patch that feels thick, tight, or ropey instead of smooth and flexible

Over-expressing anti-apoptotic Bcl2 factors has been shown to reduce HC death due to ototoxins (Cunningham et al., Purinergic Pathways Adenosine is an endogenous nucleoside present in all cells of the body that exerts its pharmacologic effects by activation of purine adenosine receptors, also present in the HCs, supporting Deiters cells and SGNs (Vlajkovic et al., 2007, 2009)