Efficacy of ginger for chemotherapy-induced nausea and vomiting (CINV) prophylaxis in breast cancer patients receiving adriamycin – cyclophosphamide (AC) regimen: Randomized double-blind placebo-control crossover study.

Thamlikitkul, Lucksamon; Soparattanapaisarn, Nopadol

doi:10.1200/jco.2016.34.15_suppl.e21621

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“…In this study, we observed that cisplatin injection indeed resulted in an alteration of the gut microbiome in rats with lowered alpha diversity, elevated abundance of Bacteroidetes at the phylum level and further enriched Escherichia-Shigella, and Enterococcus at the genus level (Figures 2A, B). Numerous studies have shown the efficacy of TCM in treating CINV (Han et al, 2016;Thamlikitkul and Soparattanapaisarn, 2016), and the application of ginger has been recommended as an alternative way to manage CINV according to certain guidelines (Razvi et al, 2019). Mechanisms including decreasing bowel movement and downregulating 5-HT levels in the intestine and medulla oblongata have been shown to participate in the anti-CINV efficacy of TCM (Marx et al, 2017;Yi et al, 2019).…”

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confidence: 99%

Liujunanwei decoction attenuates cisplatin-induced nausea and vomiting in a Rat-Pica model partially mediated by modulating the gut micsrobiome

Chen

Guo

Yang

2022

Front. Cell. Infect. Microbiol.

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Studies show that traditional Chinese medicine (TCM), such as Liujunanwei (LJAW) decoction, can play important roles in alleviating side effects of chemotherapy. The purpose of this study was to understand how LJAW can counter chemotherapy-induced emesis via alteration of gut microbiota. We evaluated the effect of LJAW on cisplatin (DDP)-induced nausea and vomiting using a rat-pica model. Rats react to emetic-producing stimuli with increased kaolin consumption, a phenomenon called pica. The rats were injected with cisplatin and then randomly assigned to the control (DDP), Ondansetron or LJAW. The intake of kaolin and chow diet as well as body weights were recorded every 24 hours. Fecal samples were collected prior to, after three and seven days of treatment. The expression of proteins was measured by western blot. The concentration of cytokines and serotonin was evaluated using ELISA assay kits. Kaolin consumption in rats induced by cisplatin was reduced by 16.5%, 22.5%, and 30.1% in the LJAW group compared to the DDP group at 24 hours, 48 hours and 72 hours, respectively (p>0.05). LJAW significantly increased the food intake of the rats (13.94 ± 4.73 g) during the first 24 hours as opposed to the DDP (9.23 ± 3.77 g) (p<0.05). 16S rRNA gene sequencing showed the abundance of Bacteroidetes increased in cisplatin treated rats. In addition, cisplatin injection caused an enrichment of Escherichia-Shigella and Enterococcus at the genus level. While, enrichment of Blautia and Lactobacillus was presented in LJAW treated rats. Serotonin decreased in LJAW treated intestine and medulla oblongata tissues. Further, the protein expression of tryptophan hydroxylase 1 (TPH1) a rate limiting enzyme of serotonin was inhibited in LJAW treated rat’s jejunum compared with cisplatin only treated rats. In addition, LJAW downregulated chemotherapy induced elevated inflammation. The results of this study indicated that LJAW is capable of decreasing cisplatin-induced kaolin intake in rat-nausea model (pica), which might be mediated through gut microbiome-induced anti-inflammation and anti-serotonin synthesis functions.

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