Panax ginseng and its ginsenosides: potential candidates for the prevention and treatment of chemotherapy-induced side effects

Abstract

Chemotherapy-induced side effects affect the quality of life and efficacy of treatment of cancer patients. Current approaches for treating the side effects of chemotherapy are poorly effective and may cause numerous harmful side effects. Therefore, developing new and effective drugs derived from natural non-toxic compounds for the treatment of chemotherapy-induced side effects is necessary. Experiments in vivo and in vitro indicate that Panax ginseng ( PG ) and its ginsenosides are undoubtedly non-toxic and effective options for the treatment of chemotherapy-induced side effects, such as nephrotoxicity, hepatotoxicity, cardiotoxicity, immunotoxicity, and hematopoietic inhibition. The mechanism focus on anti-oxidation, anti-inflammation, and anti-apoptosis, as well as the modulation of signaling pathways, such as nuclear factor erythroid-2 related factor 2 (Nrf2)/heme oxygenase-1 (HO-1), P62/keap1/Nrf2, c-jun N-terminal kinase (JNK)/P53/caspase 3, mitogen-activated protein kinase (MEK)/extracellular signal-regulated kinases (ERK), AMP-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR), mitogen-activated protein kinase kinase 4 (MKK4)/JNK, and phosphatidylinositol 3-kinase (PI3K)/AKT. Since a systemic review of the effect and mechanism of PG and its ginsenosides on chemotherapy-induced side effects has not yet been published, we provide a comprehensive summarization with this aim and shed light on the future research of PG.

Combination of Panax ginseng C. A. Mey and Febuxostat Boasted Cardioprotective Effects Against Doxorubicin-Induced Acute Cardiotoxicity in Rats

“…An experimental study demonstrated that P. ginseng mitigated the electrocardiographic and histopathological changes induced by DOX and restored the antioxidant capacity ( Chen et al, 2021 ). Another study reported that P. ginseng constituents might be a novel candidate for improving DOX-induced cardiotoxicity ( Wan et al, 2021 ).…”

“…Febuxostat is a xanthine oxidase inhibitor indicated in patients with gout suffering from hyperuricemia, and it is used chiefly in the management of chronic gout (Zhang et al, 2021). With minimal adverse effects, Febuxostat is more effective than allopurinol at its standard doses ( Wang et al, 2021 ).…”

Ginsenoside Rc Promotes Bone Formation in Ovariectomy-Induced Osteoporosis In Vivo and Osteogenic Differentiation In Vitro

“…Ginsenosides are the main active components of ginseng [ 7 ], which is a rare and precious Chinese medicine produced in Northeast China. Traditional Chinese medicine is famous for its multiple pharmacological effects and mild side effects [ 8 , 9 ].…”

β-Caryophyllene Ameliorates Cyclophosphamide Induced Cardiac Injury: The Association of TLR4/NFκB and Nrf2/HO1/NQO1 Pathways

“…CYC is associated with cardiomyocyte apoptosis, inflammation, endothelial dysfunction, calcium dysregulation, endoplasmic reticulum damage, and mitochondrial damage [ 24 ]. Several molecular mechanisms were proposed discussing CYC induced cardiotoxicity, e.g., through Nrf2/HO-1 [ 25 , 26 ], PI3K/Akt/mTOR [ 25 , 26 ], SIRT1/FoxO1 [ 27 ], Akt/GSK-3β/NFAT/calcineurin [ 22 ], p53/p38MAPK [ 26 ], and TLR4/NFκB [ 19 , 28 ], among other signaling pathways. CYC undergoes hepatic metabolism to produce of aldophosphamide, which further decomposes into phosphoramide mustard, the active neoplastic metabolite, and acrolein, the detrimental metabolite [ 29 ].…”