Protective Effects of Salidroside on Epirubicin-Induced Early Left Ventricular Regional Systolic Dysfunction in Patients with Breast Cancer

Abstract

Background: Salidroside [2-(4-hydroxyphenyl)ethyl-b-D-glucopyranoside], one of the most potent ingredients extracted from the plant Rhodiola rosea L., has been shown to have a cardiovascular protective effect as an antioxidant, and early treatment of epirubicin-induced cardiotoxicity has been the focus of clinical chemotherapy in patients with breast cancer. However, the cardioprotective effects of salidroside on epirubicin-induced cardiotoxicity, especially early left ventricular regional systolic dysfunction, have to date been sparsely investigated. Objective: The aim of this study was to investigate the protective effects of salidroside in preventing early left ventricular regional systolic dysfunction induced by epirubicin. Methods: Sixty patients with histologically confirmed breast cancer were enrolled. Eligible patients were randomized to receive salidroside (600 mg/day; n = 30) or placebo (n = 30) starting 1 week before chemotherapy. Patients were investigated by means of echocardiography and strain rate (SR) imaging. We also measured plasma concentrations of reactive oxygen species (ROS). All parameters were assessed at baseline and 7 days after each new epirubicin dose of 100 mg/m 2 . Results: A decline of the SR peak was observed at an epirubicin dose of 200 mg/m 2 , with no significant differences between salidroside and placebo (1.35 -0.36 vs 1.42 -0.49/second). At growing cumulative doses of epirubicin, the SR normalized only with salidroside, showing a significant difference in comparison with placebo at epirubicin doses of 300 mg/m 2 (1.67 -0.43 vs 1.32 -0.53/second, p < 0.05) and 400 mg/m 2 (1.68 -0.29 vs 1.40 -0.23/second, p < 0.05). Moreover, a significant increase in plasma concentrations of ROS was found with placebo, but they remained unchanged with salidroside.

Immunmodulatory and Antiproliferative Properties of Rhodiola Species

“…Salidroside (p-hydroxyphenethyl-β-D-glucoside) is a major phenylpropanoid glycoside present in Rhodiola species. Various pharmacological properties, including antiaging, neuroprotective, anti-inflammatory, hepatoprotective, and antioxidant effects have all been reported for this compound [34][35][36][37][38]. In addition, studies have demonstrated the antitumoral effects of salidroside through its inhibition of cell proliferation, arrest of the cell cycle, and induction of apoptosis in human bladder, breast, lung, and liver cancer cells [39,40].…”

Rhodiola rosea L., Rosenwurz

“…Die Studie zeigte eine signifikante Normalisierung der Herzfunktion in der Salidrosidgruppe. Die Autoren der Studie verweisen damit auf eine deutliche kardioprotektive Wirkung von Salidrosid und schlagen die Verwendung dieser Verbindung zur Verhinderung unerwünschter Wirkungen bei Epirubicin-Therapie vor [24].…”

“…Zur Embryotoxizität von Salidrosid gibt es noch keine verlässlichen Daten. Eine Behandlung mit 600 mg Salidrosid pro kg Körpergewicht pro Tag bei 60 Krebspatienten wurde gut toleriert [22], [24]. Bei Dosierungen von 200-600 mg Extrakt treten selten unerwünschte Wirkungen wie Angst, Agitation und Zittern auf.…”

Current Status of Microbial Phenylethanoid Biosynthesis

“…Therefore, they have potential uses in cardiovascular diseases, cancer, and AIDS [17]. Salidroside confers protection from brain cell damage [18] and bone loss [19] and reduces the side effects of chemotherapy [20].…”