scholarly journals Application Potential of Plant-Derived Medicines in Prevention and Treatment of Platinum-Induced Peripheral Neurotoxicity

2022 ◽  
Vol 12 ◽  
Author(s):  
Xiaowei Xu ◽  
Liqun Jia ◽  
Xiaoran Ma ◽  
Huayao Li ◽  
Changgang Sun
Keyword(s):  
Clinical Trials ◽  
Plant Secondary Metabolites ◽  
Chemotherapeutic Agents ◽  
Common Adverse Event ◽  
Sufficient Evidence ◽  
Peripheral Neurotoxicity ◽  
Herbal Products ◽  
Prevention And Treatment ◽  
Platinum Agents

As observed with other chemotherapeutic agents, the clinical application of platinum agents is a double-edged sword. Platinum-induced peripheral neuropathy (PIPN) is a common adverse event that negatively affects clinical outcomes and patients’ quality of life. Considering the unavailability of effective established agents for preventing or treating PIPN and the increasing population of cancer survivors, the identification and development of novel, effective interventions are the need of the hour. Plant-derived medicines, recognized as ideal agents, can not only help improve PIPN without affecting chemotherapy efficacy, but may also produce synergy. In this review, we present a brief summary of the mechanisms of platinum agents and PIPN and then focus on exploring the preventive or curative effects and underlying mechanisms of plant-derived medicines, which have been evaluated under platinum-induced neurotoxicity conditions. We identified 11 plant extracts as well as 17 plant secondary metabolites, and four polyherbal preparations. Their effects against PIPN are focused on oxidative stress and mitochondrial dysfunction, glial activation and inflammation response, and ion channel dysfunction. Also, ten clinical trials have assessed the effect of herbal products in patients with PIPN. The understanding of the molecular mechanism is still limited, the quality of clinical trials need to be further improved, and in terms of their efficacy, safety, and cost effectiveness studies have not provided sufficient evidence to establish a standard practice. But plant-derived medicines have been found to be invaluable sources for the development of natural agents with beneficial effects in the prevention and treatment of PIPN.

scholarly journals Emerging Pharmacological and Non-Pharmacological Therapeutics for Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 766
Author(s):  
Yang Li ◽  
Maryam B. Lustberg ◽  
Shuiying Hu
Keyword(s):  
Peripheral Neuropathy ◽  
Chemotherapeutic Agents ◽  
Common Adverse Event ◽  
Platinum Compounds ◽  
First Line ◽  
Effective Strategies ◽  
Effective Interventions ◽  
Prevention And Treatment ◽  
Mechanistic Understanding

Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse event of several first-line chemotherapeutic agents, including platinum compounds, taxanes, vinca alkaloids, thalidomide, and bortezomib, which negatively affects the quality of life and clinical outcome. Given the dearth of effective established agents for preventing or treating CIPN, and the increasing number of cancer survivors, there is an urgent need for the identification and development of new, effective intervention strategies that can prevent or mitigate this debilitating side effect. Prior failures in the development of effective interventions have been due, at least in part, to a lack of mechanistic understanding of CIPN and problems in translating this mechanistic understanding into testable hypotheses in rationally-designed clinical trials. Recent progress has been made, however, in the pathogenesis of CIPN and has provided new targets and pathways for the development of emerging therapeutics that can be explored clinically to improve the management of this debilitating toxicity. This review focuses on the emerging therapeutics for the prevention and treatment of CIPN, including pharmacological and non-pharmacological strategies, and calls for fostering collaboration between basic and clinical researchers to improve the development of effective strategies.

scholarly journals The Effects of Medicinal Plants and Bioactive Natural Compounds on Homocysteine

Molecules ◽  
2021 ◽  
Vol 26 (11) ◽  
pp. 3081
Author(s):  
Mohammad Amin Atazadegan ◽  
Mohammad Bagherniya ◽  
Gholamreza Askari ◽  
Aida Tasbandi ◽  
Amirhossein Sahebkar
Keyword(s):  
Clinical Trials ◽  
Medicinal Plants ◽  
Vascular Endothelium ◽  
Animal Studies ◽  
Natural Compounds ◽  
Herbal Products ◽  
Mortality And Morbidity ◽  
Beneficial Effects ◽  
Serum Homocysteine ◽  
Prevention And Treatment

Background: Among non-communicable diseases, cardiovascular diseases (CVDs) are the leading cause of mortality and morbidity in global communities. By 2030, CVD-related deaths are projected to reach a global rise of 25 million. Obesity, smoking, alcohol, hyperlipidemia, hypertension, and hyperhomocysteinemia are several known risk factors for CVDs. Elevated homocysteine is tightly related to CVDs through multiple mechanisms, including inflammation of the vascular endothelium. The strategies for appropriate management of CVDs are constantly evolving; medicinal plants have received remarkable attention in recent researches, since these natural products have promising effects on the prevention and treatment of various chronic diseases. The effects of nutraceuticals and herbal products on CVD/dyslipidemia have been previously studied. However, to our knowledge, the association between herbal bioactive compounds and homocysteine has not been reviewed in details. Thus, the main objective of this study is to review the efficacy of bioactive natural compounds on homocysteine levels according to clinical trials and animal studies. Results: Based on animal studies, black and green tea, cinnamon, resveratrol, curcumin, garlic extract, ginger, and soy significantly reduced the homocysteine levels. According to the clinical trials, curcumin and resveratrol showed favorable effects on serum homocysteine. In conclusion, this review highlighted the beneficial effects of medicinal plants as natural, inexpensive, and accessible agents on homocysteine levels based on animal studies. Nevertheless, the results of the clinical trials were not uniform, suggesting that more well-designed trials are warranted.

scholarly journals Quality Evaluation of the Clinical Trials for Natural Products Used in Cancer: An Evidence-Based Literature Review

2020 ◽  
Vol 10 (22) ◽  
pp. 7961
Author(s):  
Rizwan Ahmad ◽  
Lina Hussain AlLehaibi ◽  
Abdulrahman K. Alshammari ◽  
Saif M. Alkhaldi
Keyword(s):  
Clinical Trials ◽  
Natural Products ◽  
Critical Evaluation ◽  
Principal Component ◽  
Drop Out ◽  
Cancer Clinical Trials ◽  
Correlation Pattern ◽  
Herbal Products ◽  
Total Variability

The amount of data regarding the use of herbs/herbal products in cancer clinical trials at times creates a great challenge for oncologists to prescribe or counsel patients. It urges critical evaluation of the quality of clinical trials. Herein, for the first time, the clinical trials for herbs used in cancer were critically evaluated on the basis of three widely used scales, i.e., Jadad, Delphi, and Cochrane scales. The literature was collected with the help of online databases, journals, libraries, and books using a number of specific keywords as mentioned in detail in forthcoming sections. A total of 73 clinical trials were extracted, evaluated, and scored for 14 herbs, according to the predefined criteria mentioned below. A major deficiency of “non-blinding of clinical trials” was observed. The principal component analysis revealed four components (PC1–PC4) with a total variability of 68.21%, wherein the highest percentage variability was observed for PC1 loaded with “non-blinding of the clinical trials, no concealment of the treatment allocation, non-blindness of the patient and care provider”, which accounted for 30.81% of the total variability. The next major variability of 14.70% was observed for PC2 loaded with “non-randomization of the studies, non-blinding of the outcome assessors, no proper drop-out procedures, and lack of information regarding baseline characteristics for the groups”. Pearson’s correlation further confirmed a similar correlation pattern for the mentioned deficiencies (p = 0.05). An in-house grading scale was developed, showing a very small portion (16.44%), i.e., 12/73 studies with a good quality, whereas the majority (57.54%) of the studies, i.e., 42/73, were found to be of poor quality. The rules and regulations governing the quality of clinical trials needs to be more stringent and updated for the natural products/herbs used in cancer clinical trials.

scholarly journals Updates in chronic graft-versus-host disease

Hematology ◽  
2021 ◽  
Vol 2021 (1) ◽  
pp. 648-654
Author(s):  
Betty K. Hamilton
Keyword(s):  
Clinical Trials ◽  
Graft Versus Host Disease ◽  
Hematopoietic Cell Transplantation ◽  
Chronic Gvhd ◽  
Host Disease ◽  
Graft Versus Host ◽  
Late Morbidity ◽  
Prevention And Treatment

Abstract Chronic graft-versus-host disease (GVHD) is the leading cause of late morbidity and mortality after allogeneic hematopoietic cell transplantation. Symptoms and manifestations of chronic GVHD are heterogeneous and pleomorphic, and there are no standard treatments beyond corticosteroids. Therapy is typically prolonged, and chronic GVHD and its treatment are associated with adverse effects that have a significant impact on long-term quality of life and functional status. Several advances have been made over the last 2 decades to define the diagnosis of chronic GVHD as well as its severity and response criteria for clinical trials. Further understanding into the biologic mechanisms of the development of chronic GVHD has led to the investigation of several novel immunomodulatory and targeted therapies. Multi-institutional collaboration and pharmaceutical support in the development of therapies based on sound biologic mechanisms and clinical trials with defined end points and responses have led to several promising agents on the horizon of approval for treatment of chronic GVHD. This article reviews advances in our knowledge of chronic GVHD and its biologic framework to improve approaches to prevention and treatment.

scholarly journals Clinical Trials with Herbal Products for the Prevention of Dental Caries and Their Quality: A Scoping Study

2019 ◽  
Author(s):  
Robert Ancuceanu ◽  
Adriana Iuliana Anghel ◽  
Camelia Ionescu ◽  
Marilena Viorica Hovaneț ◽  
Maria Cojocaru-Toma ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Preliminary Evidence ◽  
Caries Prevention ◽  
Public Health Issue ◽  
Quality Of Reporting ◽  
Design Quality ◽  
Herbal Products ◽  
Study Designs ◽  
Positive Results

It is currently recognized that an injudicious strategy in the last decades has been not only focusing of research typically on caries in children, but also the narrow focusing on fluoride, because despite sufficient availability of fluoride in water and oral healthcare products, caries levels escalate steadily as people get older and caries remain a main public health issue to be settled. In the last two decades the scientific community intensified efforts of exploring other products for caries prevention, herbal products being one of these approaches. Because preliminary evidence indicated that clinical trials for caries prevention with herbal products are heterogeneous in design, quality and products evaluated, we performed a scoping review intended to explore the main characteristics of such clinical trials. From an initial collection of 1986 unique papers from different literature databases, 56 articles satisfied the inclusion and exclusion criteria. The species investigated, dosage forms, study designs, duration of intervention, controls, endpoints, quality of reporting and risk of bias are discussed. 85.71% of the trials reviewed here reported positive results but given the methodological flaws and biases affecting them, it is difficult to conclude on the efficacy of those products based on the studies published thus far.

Nutraceuticals for Prevention of Chemotherapy-Induced Peripheral Neuropathy

2022 ◽  
pp. 1222-1244
Author(s):  
Marco Cascella ◽  
Maria Rosaria Muzio ◽  
Sabrina Bimonte ◽  
Arturo Cuomo
Keyword(s):  
Peripheral Neuropathy ◽  
Peripheral Neurotoxicity ◽  
Herbal Products ◽  
Chemotherapy Agent ◽  
Wide Range ◽  
Potential Applications ◽  
Drug Regimens ◽  
Cessation Of Treatment

A wide range of neurologic complications, including central neurotoxicity conditions and peripheral neurotoxicity, are associated with antineoplastic drug regimens. Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and severe cancer treatment-related adverse effect, as well as the most diffuse type of neurotoxicity, because about one third of all patients who undergo chemotherapy may experience this side effect. CIPN can negatively impact the long-term quality of life of cancer survivors, and can lead to dose reduction of the chemotherapy agent, or possible cessation of treatment. Unfortunately, although several agents and protocols have been proposed, no prophylactic strategies have proven useful yet. Therefore, new alternative therapies have been considered for CIPN prevention. In this chapter, the authors analyze the potential applications of nutrients, dietary supplements and herbal products, such as single herbs, the Kampo medicine goshajinkigan and other herbal combinations, for CIPN prevention.

scholarly journals Clinical Trials with Herbal Products for the Prevention of Dental Caries and Their Quality: A Scoping Study

Biomolecules ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. 884 ◽  
Author(s):  
Robert Ancuceanu ◽  
Adriana Iuliana Anghel ◽  
Camelia Ionescu ◽  
Marilena Viorica Hovaneț ◽  
Maria Cojocaru-Toma ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Preliminary Evidence ◽  
Caries Prevention ◽  
Public Health Issue ◽  
Quality Of Reporting ◽  
Design Quality ◽  
Herbal Products ◽  
Study Designs ◽  
Positive Results

It is currently recognized that an injudicious strategy about caries in the last decades has been not only focusing of research mostly in children, but also the narrow focusing on fluoride, because despite sufficient availability of fluoride in water and oral healthcare products, caries levels escalate steadily as people get older and caries remain a main public health issue to be settled. In the last two decades the scientific community intensified efforts of exploring other products for caries prevention, herbal products being one of these approaches. Preliminary evidence indicated that clinical trials for caries prevention with herbal products are heterogeneous in design, quality and products evaluated, we therefore performed a scoping review intended to explore the main characteristics of such clinical trials. From an initial collection of 1986 unique papers from different literature databases, 56 articles satisfied the inclusion and exclusion criteria. The species investigated, dosage forms, study designs, duration of intervention, controls, endpoints, quality of reporting, and risk of bias are discussed. Of the trials reviewed here, 85.71% reported positive results but given the methodological flaws and biases affecting them, it is difficult to conclude on the efficacy of those products based on the studies published thus far.

scholarly journals Efficacy of Contact Needle Therapy for Chemotherapy-Induced Peripheral Neuropathy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Keiko Ogawa ◽  
Masao Ogawa ◽  
Koji Nishijima ◽  
Masaki Tsuda ◽  
Genichi Nishimura
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Peripheral Neuropathy ◽  
Breakthrough Pain ◽  
Chemotherapeutic Agents ◽  
Discontinuation Of Treatment ◽  
Before And After ◽  
The Common ◽  
Adequate Sample Size

Cancer chemotherapy-induced peripheral neuropathy (CIPN) often results in discontinuation of treatment with potentially useful anticancer drugs and may deteriorate the patient’s quality of life. This study investigated the effect of contact needle therapy (CNT) on CIPN caused by responsible chemotherapeutic agents as taxanes and oxaliplatin. Six patients with CIPN were treated with CNT. The severity of CIPN was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) version 4 and FACT/GOG-Ntx before and after CNT. After the treatment, all of the patients showed some improvement. Four patients showed apparent improvement in breakthrough pain. One of the cases had difficulty in walking because of CIPN in lower extremities, but after 2 times of CNT, he could walk without pain and could continue the chemotherapy. Although its putative mechanisms remain elusive, CNT has strong potential as an adjunctive therapy in CIPN. Well-designed clinical trials with adequate sample size and power are necessary to confirm the findings of this study.

A gyermekkori malignus kórképek kemoterápiájának leggyakoribb mellékhatása, az oralis mucositis. Irodalmi áttekintés

2018 ◽  
Vol 159 (13) ◽  
pp. 495-502 ◽  
Author(s):  
Judit Nemes ◽  
Ágnes Jenei ◽  
Ildikó Márton
Keyword(s):  
Oral Mucosa ◽  
Oral Mucositis ◽  
Chemotherapeutic Agents ◽  
Assessment Tools ◽  
Prevention And Treatment ◽  
Dividing Cells ◽  
Oral Complication ◽  
Pharmacologic Agents ◽  
Scoring Tools

Abstract: Mucositis is the most common oral complication of cancer therapy. Oral mucositis in childhood is more frequent and severe compared to adults, especially in children with leukemia. Lesions develop as the chemotherapeutic agents attack the rapidly dividing cells of the oral mucous membrane. Patients may experience trouble in eating, drinking, swallowing or even speaking due to the significant pain caused by the ulceration of the oral mucosa. Oral mucositis has a direct impact on the quality of life and may affect survival. The regular assessment of the oral mucosa is crucial during chemotherapy to evaluate the effectiveness of the oral mucositis prevention and treatment. Several oral mucositis scoring tools have been developed for adults to qualify the symptoms, but there is no universally accepted assessment scale for children. The prevention and treatment of therapy-related mucositis is difficult, though several methods and pharmacologic agents have been tested. Here we discuss the pathogenesis of chemotherapy-induced oral mucositis, the available assessment tools and their applicability to pediatric patients and the available therapeutic and preventive strategies. Orv Hetil. 2018; 159(13): 495–502.

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