Genotoxic Effects of Drugs: Experimental Findings Concerning Some Chemical Families of Therapeutic Relevance

Among the multiple possible interactions of drugs with cellular macromolecules, the one with DNA is of paramount importance, since it may be followed either by cell death or by heritable alterations of the genetic code. Cell death can be the aim of a therapeutic approach, as indeed is the case for antiproliferative agents (antineoplastic and innunosuppressive drugs). Conversely, a drug-induced heritable alteration of DNA must be considered a toxic effect. If this alteration concerns somatic cells (somatic mutation), a possible consequence is cancer induction; aging and atherosclerosis have been also related to DNA damage. When this alteration concerns germinal cells (germinal mutation), birth defects and the gradual accumulation in the human gene pool of subtle but essentially irreversible deleterious mutations are likely to take place.