1
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Frediani JK, Lal AA, Kim E, Leslie SL, Boorman DW, Singh V. The role of diet and non-pharmacologic supplements in the treatment of chronic neuropathic pain: A systematic review. Pain Pract 2024; 24:186-210. [PMID: 37654090 DOI: 10.1111/papr.13291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/01/2023] [Accepted: 08/04/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND/IMPORTANCE Dietary interventions, vitamins, and nutritional supplementation are playing an increasingly important role in the management of neuropathic pain. Current pharmacological treatments are poorly tolerated and ineffective in many cases. OBJECTIVE This systematic review aims to study the efficacy of dietary interventions, vitamins, and nutritional supplementation in the management of chronic neuropathic pain in adults. EVIDENCE REVIEW The review followed PRISMA guidelines and was registered with PROSPERO (#CRD42022300312). Ten databases and gray literature, including Embase.com, MEDLINE and Web of Science, were systematically searched using a combination of keywords and controlled vocabulary related to chronic neuropathic pain and oral non-pharmacological supplements. Studies on adult humans published between 2000 and 2021 were considered for inclusion. The Cochrane Handbook was used to assess risk of bias, and Grading of Recommendations Assessment, Development, and Evaluation was used to determine overall quality of evidence. FINDINGS Forty studies were included in the final review, and results were categorized according to pain type including pain related to chemotherapy-induced peripheral neuropathy (CIPN, 22 studies, including 3 prospective cohorts), diabetic peripheral neuropathy (DPN, 13 studies, including 2 prospective), complex regional pain syndrome (CRPS-I, 3 studies, including 1 prospective), and other (2 studies, both RCT). The CIPN studies used various interventions including goshajinkigan (4 studies), vitamin E (5), vitamin B12 (3), glutamine (3), N-acetyl-cysteine (2), acetyl-l-carnitine (2), guilongtonluofang (1), ninjin'yoeito (1), alpha-lipoic acid (1), l-carnosine (1), magnesium and calcium (1), crocin (1), and antioxidants (1), with some studies involving multiple interventions. All CIPN studies involved varying cancers and/or chemotherapies, advising caution for generalizability of results. Interventions for DPN included alpha-lipoic acid (5 studies), vitamin B12 (3), acetyl-l-carnitine (3), vitamin E (1), vitamin D (2), and a low-fat plant-based diet (1). Vitamin C was studied to treat CRPS-I (3 studies, including 1 prospective). Magnesium (1) and St. John's wort (1) were studied for other or mixed neuropathologies. CONCLUSIONS Based on the review, we cannot recommend any supplement use for the management of CIPN, although further research into N-acetyl-cysteine, l-carnosine, crocin, and magnesium is warranted. Acetyl-l-carnitine was found to be likely ineffective or harmful. Alpha-lipoic acid was not found effective. Studies with goshajinkigan, vitamin B12, vitamin E, and glutamine had conflicting results regarding efficacy, with one goshajinkigan study finding it harmful. Guilongtonluofang, ninjin'yoeito, and antioxidants showed various degrees of potential effectiveness. Regarding DPN, our review supports the use of alpha-lipoic acid, acetyl-l-carnitine, and vitamin D. The early use of vitamin C prophylaxis for the development of CRPS-I also seems promising. Further research is warranted to confirm these findings.
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Affiliation(s)
- Jennifer K Frediani
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Asim A Lal
- Department of Anesthesiology, Emory School of Medicine, Atlanta, Georgia, USA
| | - Esther Kim
- Philadelphia College of Osteopathic Medicine, Suwanee, Georgia, USA
| | - Sharon L Leslie
- Woodruff Health Sciences Center Library, Emory University, Atlanta, Georgia, USA
| | - David W Boorman
- Department of Anesthesiology, Emory School of Medicine, Atlanta, Georgia, USA
| | - Vinita Singh
- Department of Anesthesiology, Emory School of Medicine, Atlanta, Georgia, USA
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2
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Okem A, Henstra C, Lambert M, Hayeshi R. A review of the pharmacodynamic effect of chemo-herbal drug combinations therapy for cancer treatment. MEDICINE IN DRUG DISCOVERY 2022. [DOI: 10.1016/j.medidd.2022.100147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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3
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Chung G, Kim SK. Therapeutics for Chemotherapy-Induced Peripheral Neuropathy: Approaches with Natural Compounds from Traditional Eastern Medicine. Pharmaceutics 2022; 14:pharmaceutics14071407. [PMID: 35890302 PMCID: PMC9319448 DOI: 10.3390/pharmaceutics14071407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) often develops in patients with cancer treated with commonly used anti-cancer drugs. The symptoms of CIPN can occur acutely during chemotherapy or emerge after cessation, and often accompany long-lasting intractable pain. This adverse side effect not only affects the quality of life but also limits the use of chemotherapy, leading to a reduction in the survival rate of patients with cancer. Currently, effective treatments for CIPN are limited, and various interventions are being applied by clinicians and patients because of the unmet clinical need. Potential approaches to ameliorate CIPN include traditional Eastern medicine-based methods. Medicinal substances from traditional Eastern medicine have well-established analgesic effects and are generally safe. Furthermore, many substances can also improve other comorbid symptoms in patients. This article aims to provide information regarding traditional Eastern medicine-based plant extracts and natural compounds for CIPN. In this regard, we briefly summarized the development, mechanisms, and changes in the nervous system related to CIPN, and reviewed the substances of traditional Eastern medicine that have been exploited to treat CIPN in preclinical and clinical settings.
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Affiliation(s)
- Geehoon Chung
- Department of Physiology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea;
| | - Sun Kwang Kim
- Department of Physiology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea;
- Department of Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea
- Correspondence:
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4
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Xu X, Jia L, Ma X, Li H, Sun C. Application Potential of Plant-Derived Medicines in Prevention and Treatment of Platinum-Induced Peripheral Neurotoxicity. Front Pharmacol 2022; 12:792331. [PMID: 35095502 PMCID: PMC8793340 DOI: 10.3389/fphar.2021.792331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 12/23/2021] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Xiaowei Xu
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Liqun Jia
- Oncology Department of Integrative Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Xiaoran Ma
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Huayao Li
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Changgang Sun
- Department of Oncology, Weifang Traditional Chinese Hospital, Weifang, China.,Qingdao Academy of Chinese Medical Sciences, Shandong University of Traditional Chinese Medicine, Qingdao, China.,College of Traditional Chinese Medicine, Weifang Medical University, Weifang, China
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5
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Uchida M, Ushio S, Niimura T, Takechi K, Kawazoe H, Hidaka N, Tanaka A, Araki H, Zamami Y, Ishizawa K, Kitamura Y, Sendou T, Kawasaki H, Namba H, Shibata K, Tanaka M, Takatori S. Renin-angiotensin-aldosterone system inhibitors prevent the onset of oxaliplatin-induced peripheral neuropathy: A retrospective multicenter study and in vitro evaluation. Biol Pharm Bull 2021; 45:226-234. [PMID: 34803077 DOI: 10.1248/bpb.b21-00852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Oxaliplatin (OXA) is used in chemotherapy for various cancer types and is associated with acute and chronic neurotoxicity. However, a preventive strategy for OXA-induced peripheral neuropathy (OIPN) and its underlying mechanism remain unclear. We examined the effects of renin-angiotensin-aldosterone system inhibitors (RAASIs) on OIPN by performing a retrospective multicenter study and an in vitro assay. We retrospectively evaluated electronic medical records of 976 patients who underwent one or more courses of OXA-containing regimens at Ehime, Okayama, and Tokushima University Hospitals. The primary endpoint was the incidence of OIPN during or after OXA administration. The effects of RAASIs and OXA on the neurite length in PC12 cells were determined. The combined administration of an OXA-containing regimen and RAASI significantly inhibited the cumulative incidence grade-2 or higher OIPN (log-rank test; P=0.0001). RAASIs markedly suppressed the development of both acute and chronic OIPN (multivariate analysis; P=0.017 and P=0.011). In an in vitro assay, 10 µM OXA suppressed the neurite length; treatment with 1 μM aliskiren, spironolactone, 10 μM candesartan, and enalapril significantly restored neurite length to the control level. Moreover, 1 μM SCH772984 (a selective inhibitor of extracellular signal-regulated kinase, ERK1/2) and 500 μM SQ22536 (a cell-permeable adenylate cyclase [AC] inhibitor) markedly abolished neuroprotective effects of candesartan and enalapril. These results indicate that RAASIs possess preventive or therapeutic effects in acute and chronic OIPN, candesartan and enalapril may directly increase in the activity of ERK1/2 and AC in PC12 cells.
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Affiliation(s)
- Mami Uchida
- Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University
| | | | - Takahiro Niimura
- Department of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical Sciences.,Department of Pharmacy, Tokushima University Hospital
| | - Kenshi Takechi
- Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University
| | - Hitoshi Kawazoe
- Division of Pharmaceutical Care Sciences, Center for Social Pharmacy and Pharmaceutical Care Sciences, Keio University Faculty of Pharmacy
| | | | | | | | - Yoshito Zamami
- Department of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical Sciences.,Division of Pharmacy, Ehime University Hospital
| | - Keisuke Ishizawa
- Department of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical Sciences.,Division of Pharmacy, Ehime University Hospital
| | | | | | - Hiromu Kawasaki
- Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University
| | - Hiroyuki Namba
- Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University
| | - Kazuhiko Shibata
- Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University
| | - Mamoru Tanaka
- Division of Pharmaceutical Care Sciences, Center for Social Pharmacy and Pharmaceutical Care Sciences, Keio University Faculty of Pharmacy
| | - Shingo Takatori
- Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University
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6
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Jhang JS, Livneh H, Yang SY, Huang HJ, Chan MWY, Lu MC, Yeh CC, Tsai TY. Decreased risk of colorectal cancer among patients with type 2 diabetes receiving Chinese herbal medicine: a population-based cohort study. BMJ Open Diabetes Res Care 2020; 8:8/1/e000732. [PMID: 32169932 PMCID: PMC7069272 DOI: 10.1136/bmjdrc-2019-000732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 12/11/2019] [Accepted: 01/04/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Patients with type 2 diabetes have a higher risk of colorectal cancer (CRC), but whether Chinese herbal medicines (CHMs) can reduce this risk is unknown. This study investigated the effect that CHMs have on CRC risk in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS This cohort study used the Taiwanese National Health Insurance Research Database to identify 54 744 patients, newly diagnosed with type 2 diabetes, aged 20-70 years, who were receiving treatment between 1998 and 2007. From this sample, we randomly selected 14 940 CHMs users and 14 940 non-CHMs users, using propensity scores matching. All were followed through 2012 to record CRC incidence. Cox proportional hazards regression was used to compute the hazard ratio (HR) of CRC by CHMs use. RESULTS During follow-up, 235 CHMs users and 375 non-CHMs users developed CRC, incidence rates of 1.73% and 2.47% per 1000 person-years, respectively. CHM users had a significantly reduced risk of CRC compared with non-CHM users (adjusted HR=0.71; 95% CI 0.60 to 0.84). The greatest effect was in those receiving CHMs for more than 1 year. Huang-Qin, Xue-Fu-Zhu-Yu-Tang, Shu-Jing-Huo-Xue-Tang, Liu-Wei-Di-Huang-Wan, Ji-Sheng-Shen-Qi-Wan, Gan-Lu-Yin, Shao-Yao-Gan-Cao-Tang and Ban-Xia-Xie-Xin-Tang were significantly associated with lower risk of CRC. CONCLUSION Integrating CHMs into the clinical management of patients with type 2 diabetes may be beneficial in reducing the risk of CRC.
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Affiliation(s)
- Jing-Siang Jhang
- Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- Department of Biomedical Sciences, National Chung Cheng University, Chiayi, Taiwan
| | - Hanoch Livneh
- Rehabilitation Counseling Program, Portland State University, Portland, Oregon, USA
| | - Shu-Yi Yang
- Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- Department of Biomedical Sciences, National Chung Cheng University, Chiayi, Taiwan
| | - Hui-Ju Huang
- Department of Nursing, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
| | - Michael W Y Chan
- Department of Biomedical Sciences, National Chung Cheng University, Chiayi, Taiwan
- Epigenomics and Human Diseases Research Center, National Chung Cheng University, Chiayi, Taiwan
| | - Ming-Chi Lu
- Division of Allergy, Immunology and Rheumatology, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chia-Chou Yeh
- Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Tzung-Yi Tsai
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
- Department of Medical Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
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7
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Oveissi V, Ram M, Bahramsoltani R, Ebrahimi F, Rahimi R, Naseri R, Belwal T, Devkota HP, Abbasabadi Z, Farzaei MH. Medicinal plants and their isolated phytochemicals for the management of chemotherapy-induced neuropathy: therapeutic targets and clinical perspective. ACTA ACUST UNITED AC 2019; 27:389-406. [PMID: 30852764 DOI: 10.1007/s40199-019-00255-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/26/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Chemotherapy, as one of the main approaches of cancer treatment, is accompanied with several adverse effects, including chemotherapy-induced peripheral neuropathy (CIPN). Since current methods to control the condition are not completely effective, new treatment options should be introduced. Medicinal plants can be suitable candidates to be assessed regarding their effects in CIPN. Current paper reviews the available preclinical and clinical studies on the efficacy of herbal medicines in CIPN. METHODS Electronic databases including PubMed, Scopus, and Cochrane library were searched with the keywords "neuropathy" in the title/abstract and "plant", "extract", or "herb" in the whole text. Data were collected from inception until April 2018. RESULTS Plants such as chamomile (Matricaria chamomilla L.), sage (Salvia officinalis L.), cinnamon (Cinnamomum cassia (L.) D. Don), and sweet flag (Acorus calamus L.) as well as phytochemicals like matrine, curcumin, and thioctic acid have demonstrated beneficial effects in animal models of CIPN via prevention of axonal degeneration, decrease in total calcium level, improvement of endogenous antioxidant defense mechanisms such as superoxide dismutase and reduced glutathione, and regulation of neural cell apoptosis, nuclear factor-ĸB, cyclooxygenase-2, and nitric oxide signaling. Also, five clinical trials have evaluated the effect of herbal products in patients with CIPN. CONCLUSIONS There are currently limited clinical evidence on medicinal plants for CIPN which shows the necessity of future mechanistic studies, as well as well-designed clinical trial for further confirmation of the safety and efficacy of herbal medicines in CIPN. Graphical abstract Schematic mechanisms of medicinal plants to prevent chemotherapy-induced neuropathy: NO: nitric oxide, TNF: tumor necrosis factor, PG: prostaglandin, NF-ĸB: nuclear factor kappa B, LPO: lipid peroxidation, ROS: reactive oxygen species, COX: cyclooxygenase, IL: interleukin, ERK: extracellular signal-related kinase, X: inhibition, ↓: induction.
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Affiliation(s)
- Vahideh Oveissi
- Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,PhytoPharmacology Interest Group (PPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mahboobe Ram
- Student Research Committee, Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roodabeh Bahramsoltani
- Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Ebrahimi
- Pharmacy Students' Research Committee, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roja Rahimi
- Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Rozita Naseri
- Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Tarun Belwal
- G. B. Pant National Institute of Himalayan Environment and Sustainable Development, Kosi-Katarmal, Almora, Uttarakhand, 263643, India
| | - Hari Prasad Devkota
- School of Pharmacy, Kumamoto University, 5-1 Oe-honmachi, Chuo ku, Kumamoto, 862-0973, Japan.,Program for Leading Graduate Schools, Health life science: Interdisciplinary and Glocal Oriented (HIGO) Program, Kumamoto University, 5-1 Oe-honmachi, Chuo ku, Kumamoto, 862-0973, Japan
| | - Zahra Abbasabadi
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hosein Farzaei
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran. .,Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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8
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Plant-derived medicines for neuropathies: a comprehensive review of clinical evidence. Rev Neurosci 2019; 30:671-684. [DOI: 10.1515/revneuro-2018-0097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/05/2018] [Indexed: 12/13/2022]
Abstract
Abstract
Neuropathy is defined as the damage to the peripheral or central nervous system accompanied by pain, numbness, or muscle weakness, which can be due to congenital diseases or environmental factors such as diabetes, trauma, or viral infections. As current treatments are not sufficiently able to control the disease, studies focusing on the identification and discovery of new therapeutic agents are necessary. Natural products have been used for a long time for the management of different neurological problems including neuropathies. The aim of the present study is to review the current clinical data on the beneficial effects of medicinal plants in neuropathy. Electronic databases including PubMed, Scopus, and Cochrane Library were searched with the keywords ‘neuropathy’ in the title/abstract and ‘plant’ or ‘extract’ or ‘herb’ in the whole text from inception until August 2017. From a total of 3679 papers, 22 studies were finally included. Medicinal plants were evaluated clinically in several types of neuropathy, including diabetic neuropathy, chemotherapy-induced peripheral neuropathy, carpal tunnel syndrome, and HIV-associated neuropathy. Some studies reported the improvement in pain, nerve function, nerve conduction velocity, and quality of life. Cannabis sativa (hemp), Linum usitatissimum (linseed oil), capsaicin, and a polyherbal Japanese formulation called Goshajinkigan had the most evidence regarding their clinical efficacy. Other investigated herbal medicines in neuropathy, such as Matricaria chamomilla (chamomile), Curcuma longa (turmeric), and Citrullus colocynthis (colocynth), had only one clinical trial. Thus, future studies are necessary to confirm the safety and efficacy of such natural medicines as a complementary or alternative treatment for neuropathy.
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9
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Liu Y, May BH, Zhang AL, Guo X, Lu C, Xue CC, Zhang H. Integrative Herbal Medicine for Chemotherapy-Induced Peripheral Neuropathy and Hand-Foot Syndrome in Colorectal Cancer: A Systematic Review and Meta-Analysis. Integr Cancer Ther 2018; 18:1534735418817833. [PMID: 30526124 PMCID: PMC7240882 DOI: 10.1177/1534735418817833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objectives: To assess the clinical evidence for integrative herbal
medicine therapy in the management of chemotherapy-induced peripheral neuropathy
(CIPN) and hand-foot syndrome (HFS) resulting from treatments for colorectal
cancer (CRC). Design: Randomized controlled trials (RCTs) were
identified from major English and Chinese databases. Participants had been
diagnosed with CRC by pathology and had received or were undergoing
chemotherapy. Interventions included herbal medicines administered orally or
topically. Controls were placebo, supportive care or conventional chemotherapy
for CRC. Methods followed the Cochrane handbook. Meta-analyses were grouped by
study design, outcome measure, severity, and chemotherapy. Random-effects models
with 95% confidence intervals were used. Heterogeneity was assessed as
I2. Results: Sixty-three RCTs (4286
participants) were included. Five used a placebo in the control groups.
Fifty-eight studies tested oral herbal medicine, and 5 tested topical herbal
medicine. Data were available for CIPN (60 studies) and HFS (12 studies).
Fifty-seven studies combined orally administered herbal medicine with
chemotherapy compared with the same chemotherapy. For CIPN, 33 studies used
World Health Organization (WHO) criteria, 7 used Levi’s criteria, and 10 used
the National Cancer Institute Common Terminology Criteria for Adverse Events
(NCI-CTCAE). These were analyzed separately. For grades III + IV CIPN, there was
a significant reduction in the integrative groups for WHO (relative risk [RR]
0.42 [0.23, 0.77], I2 = 0%) and Levi’s (RR 0.28
[0.11, 0.69], I2 = 0%) but not NCI-CTCAE (RR 0.65
[0.37, 1.13], I2 = 26.4%). Hand and foot baths
showed no differences for Levi’s grades III + IV CIPN but a significant
reduction in all grades (RR 0.69 [0.50, 0.95], I2 =
68.8%). For HFS (all grades) there was a significant reduction in the
integrative groups for WHO (RR 0.62 [0.41, 0.96], I2
= 22%) but not for NCI-CTCAE (RR 0.93 [0.55, 1.55],
I2 = 75.7%). Sensitivity analyses explored
sources of heterogeneity. Conclusions: Integrative herbal therapy
appeared to reduce CIPN and HFS in people receiving chemotherapy for CRC.
However, the strength of the evidence was limited by lack of blinding in most
studies, potential for bias, and relatively short study durations.
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Affiliation(s)
- Yihong Liu
- 1 Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Brian H May
- 2 China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Anthony Lin Zhang
- 2 China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Xinfeng Guo
- 1 Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chuanjian Lu
- 1 Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Charlie Changli Xue
- 1 Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,2 China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Haibo Zhang
- 1 Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
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10
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Qu N, Kuramasu M, Hirayanagi Y, Nagahori K, Hayashi S, Ogawa Y, Terayama H, Suyama K, Naito M, Sakabe K, Itoh M. Gosha-Jinki-Gan Recovers Spermatogenesis in Mice with Busulfan-Induced Aspermatogenesis. Int J Mol Sci 2018; 19:ijms19092606. [PMID: 30177609 PMCID: PMC6165450 DOI: 10.3390/ijms19092606] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 08/31/2018] [Accepted: 08/31/2018] [Indexed: 11/29/2022] Open
Abstract
Busulfan is an anti-cancer chemotherapeutic drug and is often used as conditioning regimens prior to bone marrow transplant for treatment of chronic myelogenous leukemia. Male infertility, including spermatogenesis disturbance, is known to be one of the side effects of anticancer drugs. While hormone preparations and vitamin preparations are used for spermatogenesis disturbance, their therapeutic effects are low. Some traditional herbal medicines have been administered to improve spermatogenesis. In the present study, we administered Gosha-jinki-gan (TJ107; Tsumura Co., Ltd., Tokyo, Japan) to mice suffering from severe aspermatogenesis after busulfan treatment to determine whether TJ107 can recover spermatogenesis. Male 4-week-old C57BL/6J mice were administered a single intraperitoneal injection of busulfan, and they were then fed a normal diet for 60 days and then a TJ107 diet or TJ107-free normal diet for another 60 days. After busulfan treatment, the weight of the testes and the epididymal sperm count progressively decreased in the normal diet group. On the other hand, in the TJ107 group, these variables dramatically recovered at 120 days. These results suggest that busulfan-induced aspermatogenesis is irreversible if appropriate treatment is not administered. Supplementation of TJ107 can completely recover the injured seminiferous epithelium via normalization of the macrophage migration and reduction of the expressions of Tool-like receptor (TLR) 2 and TLR4, suggesting that TJ107 has a therapeutic effect on busulfan-induced aspermatogenesis.
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Affiliation(s)
- Ning Qu
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, Kanagawa 259-1193, Japan.
- Department of Anatomy, Tokyo Medical University, Tokyo 160-8402, Japan.
| | - Miyuki Kuramasu
- Department of Anatomy, Tokyo Medical University, Tokyo 160-8402, Japan.
| | - Yoshie Hirayanagi
- Department of Anatomy, Tokyo Medical University, Tokyo 160-8402, Japan.
| | - Kenta Nagahori
- Department of Anatomy, Tokyo Medical University, Tokyo 160-8402, Japan.
| | - Shogo Hayashi
- Department of Anatomy, Tokyo Medical University, Tokyo 160-8402, Japan.
| | - Yuki Ogawa
- Department of Anatomy, Tokyo Medical University, Tokyo 160-8402, Japan.
| | - Hayato Terayama
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, Kanagawa 259-1193, Japan.
| | - Kaori Suyama
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, Kanagawa 259-1193, Japan.
| | - Munekazu Naito
- Department of Anatomy, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Kou Sakabe
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, Kanagawa 259-1193, Japan.
| | - Masahiro Itoh
- Department of Anatomy, Tokyo Medical University, Tokyo 160-8402, Japan.
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11
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Uchida M, Kawazoe H, Takatori S, Namba H, Uozumi R, Tanaka A, Kawasaki H, Araki H. Preventive Effects of Renin-angiotensin System Inhibitors on Oxaliplatin-induced Peripheral Neuropathy: A Retrospective Observational Study. Clin Ther 2018; 40:1214-1222.e1. [PMID: 29983264 DOI: 10.1016/j.clinthera.2018.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE Oxaliplatin-induced peripheral neuropathy has remained an unresolved issue in clinical practice. Our previous study hypothesized that inhibition of the renin-angiotensin system (RAS) may produce a preventive effect on oxaliplatin-induced neuropathy. The aim of this study was to clarify whether RAS inhibitors prevent oxaliplatin-induced peripheral neuropathy. METHODS This study retrospectively analyzed data from cancer patients who had received chemotherapy including oxaliplatin and were treated with or without RAS inhibitors. This retrospective observational study was conducted at Ehime University Hospital using electronic medical records from May 2009 to December 2016. The primary end point was the incidence of severe peripheral neuropathy during or after oxaliplatin treatment, according to the Common Terminology Criteria for Adverse Events, version 4.0. A multivariate Cox proportional hazards model analysis was used to identify risk factors. FINDINGS A total of 150 patients were included in the study. The estimated incidence of peripheral neuropathy was 36.9% and 91.7% in the RAS inhibitor group and the non-RAS inhibitor group, respectively. The multivariate analysis using a Cox proportional hazards model showed that the RAS inhibitor group was slightly associated with a decreased risk of neurotoxicity (adjusted hazard ratio, 0.42 [95% CI, 0.18-0.99]; P = 0.048). IMPLICATIONS The present findings suggest that RAS inhibitors have the ability to prevent oxaliplatin-induced peripheral neuropathy.
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Affiliation(s)
- Mami Uchida
- Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University, 4-2 Bunkyo-cho, Matsuyama, Ehime, Japan
| | - Hitoshi Kawazoe
- Division of Pharmacy, Ehime University Hospital, Shitsukawa, Toon, Ehime, Japan; Division of Pharmaceutical Care Sciences, Keio University Graduate School of Pharmaceutical Sciences, 1-5-30 Shibakoen, Minato-ku, Tokyo, Japan
| | - Shingo Takatori
- Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University, 4-2 Bunkyo-cho, Matsuyama, Ehime, Japan.
| | - Hiroyuki Namba
- Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University, 4-2 Bunkyo-cho, Matsuyama, Ehime, Japan
| | - Ryuji Uozumi
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Japan
| | - Akihiro Tanaka
- Division of Pharmacy, Ehime University Hospital, Shitsukawa, Toon, Ehime, Japan
| | - Hiromu Kawasaki
- Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University, 4-2 Bunkyo-cho, Matsuyama, Ehime, Japan
| | - Hiroaki Araki
- Division of Pharmacy, Ehime University Hospital, Shitsukawa, Toon, Ehime, Japan; Faculty of Pharmaceutical Sciences, Shujitsu University, 1-6-1 Nishigawara, Naka-ku, Okayama, Japan
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12
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Liu Jun Zi Tang-A Potential, Multi-Herbal Complementary Therapy for Chemotherapy-Induced Neurotoxicity. Int J Mol Sci 2018; 19:ijms19041258. [PMID: 29690597 PMCID: PMC5979528 DOI: 10.3390/ijms19041258] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 04/10/2018] [Accepted: 04/18/2018] [Indexed: 12/25/2022] Open
Abstract
Liu Jun Zi Tang (LJZT) has been used to treat functional dyspepsia and depression, suggesting its effects on gastrointestinal and neurological functions. LJZT is currently used as a complementary therapy to attenuate cisplatin-induced side effects, such as dyspepsia. However, its effect on chemotherapy-induced neuropathic pain or neurotoxicity has rarely been studied. Thus, we explored potential mechanisms underlying LJZT protection against cisplatin-induced neurotoxicity. We observed that LJZT attenuated cisplatin-induced thermal hyperalgesia in mice and apoptosis in human neuroblastoma SH-SY5Y cells. Furthermore, it also attenuated cisplatin-induced cytosolic and mitochondrial free radical formation, reversed the cisplatin-induced decrease in mitochondrial membrane potential, and increased the release of mitochondrial pro-apoptotic factors. LJZT not only activated the peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) promoter region, but also attenuated the cisplatin-induced reduction of PGC-1α expression. Silencing of the PGC-1α gene counteracted the protection of LJZT. Taken together, LJZT mediated, through anti-oxidative effect and mitochondrial function regulation, to prevent cisplatin-induced neurotoxicity.
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13
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Kuriyama A, Endo K. Goshajinkigan for prevention of chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis. Support Care Cancer 2017; 26:1051-1059. [PMID: 29280005 DOI: 10.1007/s00520-017-4028-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 12/18/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE Chemotherapy-induced peripheral neuropathy (CIPN) limits the dose of chemotherapy and reduces patients' quality of life. Goshajinkigan is a Japanese herbal medicine used to alleviate neuropathy and general pain. A clinical guideline for prevention and management of CIPN stated that the prophylactic efficacy of goshajinkigan against CIPN was inconclusive. We conducted a systematic review to examine whether goshajinkigan prevents CIPN in patients receiving neurotoxic chemotherapy. METHODS We searched PubMed, EMBASE, Ichushi, and the Cochrane Central Register of Controlled Trials for eligible trials. Randomized controlled trials that examined the efficacy and safety of goshajinkigan for prevention of CIPN were included. Our primary outcomes were incidence of CIPN, response to chemotherapy, and adverse effects. We pooled data using a random effects model. RESULTS We analyzed five trials involving a total of 397 patients. When evaluated with Neurotoxicity Criteria of Debiopharm, goshajinkigan was associated with reduced incidence of CIPN of grade ≥ 1 (risk ratio [RR] 0.43; 95% CI, 0.27 to 0.66) and grade 3 (RR 0.42; 95% CI, 0.25 to 0.71), but this beneficial association was not found for grade ≥ 2 of CIPN. Goshajinkigan was not associated with reduced incidence of CIPN when assessed with the National Cancer Institute Common Terminology Criteria for Adverse Events, or improved response to chemotherapy. Goshajinkigan was well tolerated based on one trial. CONCLUSIONS Goshajinkigan is unlikely to prevent CIPN in patients undergoing neurotoxic chemotherapy. Given the low quality and insufficient amount of the evidence, use of goshajinkigan as standard of care is not currently recommended.
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Affiliation(s)
- Akira Kuriyama
- Department of General Medicine, Emergency and Critical Care Center, Kurashiki Central Hospital, 1-1-1 Miwa Kurashiki, Okayama, 710-8602, Japan.
| | - Koji Endo
- Department of General Internal Medicine, Tottori Prefectural Central Hospital, 730 Ezu Tottori, Tottori, 680-0901, Japan
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Mizuno K, Shibata K, Komatsu R, Omiya Y, Kase Y, Koizumi S. An effective therapeutic approach for oxaliplatin-induced peripheral neuropathy using a combination therapy with goshajinkigan and bushi. Cancer Biol Ther 2017; 17:1206-1212. [PMID: 27416484 PMCID: PMC5137495 DOI: 10.1080/15384047.2016.1210742] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Oxaliplatin-induced peripheral neuropathy (OIPN) occurs at extraordinarily high frequency, but no effective treatment for this disorder has been established. Goshajinkigan (GJG), a traditional Japanese medicine known as Kampo, is known to reduce OIPN in both basic and clinical studies. However, its molecular mechanisms remain largely unknown. Here, we elucidate the mechanisms underlying the therapeutic effects of GJG against OIPN and the therapeutic benefits of combining GJG with bushi, a herbal medicine derived from the processed Aconiti tuber. Oxaliplatin (4 mg/kg) was injected into mice twice a week for up to 4 and 3 weeks, respectively. OIPN was assessed using pain behavioral tests, such as those testing cold hypersensitivity, thermal hyperalgesia, and mechanical allodynia, as well as a reduction of the current perception threshold (CPT). GJG (0.3 or 1 g/kg) and bushi (0.1 or 0.3 g/kg) were orally administered 5 times a week for 4 weeks. Behavioral analysis was performed 24 h after the final dose. Oxaliplatin induced cold hypersensitivity and mechanical allodynia but not thermal hyperalgesia and reduced CPT of Aδ- and Aβ-fibers but not C-fibers. All these effects were counteracted by GJG. Bushi, an ingredient of GJG that shows analgesic effect, reduced oxaliplatin-induced cold hypersensitivity but had no effect on oxaliplatin-induced mechanical allodynia. However, bushi significantly accentuated the effects of GJG when co-administered with GJG. GJG reduces OIPN by counteracting the sensitization of Aδ- and Aβ-fibers and shows analgesic effects against cold hypersensitivity and mechanical allodynia. These effects are potentiated by bushi. The combination of GJG with bushi has high potential for preventing OIPN.
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Affiliation(s)
- Keita Mizuno
- a Tsumura Research Laboratories , Kampo Scientific Strategies Division, Tsumura & Co., Yoshiwara, Ami-machi , Inashiki-gun, Ibaraki , Japan
| | - Keisuke Shibata
- b Department of Neuropharmacology , Interdisciplinary Graduate School of Medicine, University of Yamanashi , Shimokato, Chuo, Yamanashi , Japan
| | - Ryohei Komatsu
- b Department of Neuropharmacology , Interdisciplinary Graduate School of Medicine, University of Yamanashi , Shimokato, Chuo, Yamanashi , Japan
| | - Yuji Omiya
- a Tsumura Research Laboratories , Kampo Scientific Strategies Division, Tsumura & Co., Yoshiwara, Ami-machi , Inashiki-gun, Ibaraki , Japan
| | - Yoshio Kase
- a Tsumura Research Laboratories , Kampo Scientific Strategies Division, Tsumura & Co., Yoshiwara, Ami-machi , Inashiki-gun, Ibaraki , Japan
| | - Schuichi Koizumi
- b Department of Neuropharmacology , Interdisciplinary Graduate School of Medicine, University of Yamanashi , Shimokato, Chuo, Yamanashi , Japan
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Wing C, Komatsu M, Delaney SM, Krause M, Wheeler HE, Dolan ME. Application of stem cell derived neuronal cells to evaluate neurotoxic chemotherapy. Stem Cell Res 2017. [PMID: 28645005 DOI: 10.1016/j.scr.2017.06.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The generation of induced pluripotent stem cells (iPSCs) and differentiation to cells composing major organs has opened up the possibility for a new model system to study adverse toxicities associated with chemotherapy. Therefore, we used human iPSC-derived neurons to study peripheral neuropathy, one of the most common adverse effects of chemotherapy and cause for dose reduction. To determine the utility of these neurons in investigating the effects of neurotoxic chemotherapy, we measured morphological differences in neurite outgrowth, cell viability as determined by ATP levels and apoptosis through measures of caspase 3/7 activation following treatment with clinically relevant concentrations of platinating agents (cisplatin, oxaliplatin and carboplatin), taxanes (paclitaxel, docetaxel and nab-paclitaxel), a targeted proteasome inhibitor (bortezomib), an antiangiogenic compound (thalidomide), and 5-fluorouracil, a chemotherapeutic that does not cause neuropathy. We demonstrate differential sensitivity of neurons to mechanistically distinct classes of chemotherapeutics. We also show a dose-dependent reduction of electrical activity as measured by mean firing rate of the neurons following treatment with paclitaxel. We compared neurite outgrowth and cell viability of iPSC-derived cortical (iCell® Neurons) and peripheral (Peri.4U) neurons to cisplatin, paclitaxel and vincristine. Goshajinkigan, a Japanese herbal neuroprotectant medicine, was protective against paclitaxel-induced neurotoxicity but not oxaliplatin as measured by morphological phenotypes. Thus, we have demonstrated the utility of human iPSC-derived neurons as a useful model to distinguish drug class differences and for studies of a potential neuroprotectant for the prevention of chemotherapy-induced peripheral neuropathy.
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Affiliation(s)
- Claudia Wing
- Section of Hematology/Oncology, Department of Medicine, Chicago, IL, USA
| | - Masaaki Komatsu
- Section of Hematology/Oncology, Department of Medicine, Chicago, IL, USA
| | - Shannon M Delaney
- Section of Hematology/Oncology, Department of Medicine, Chicago, IL, USA
| | - Matthew Krause
- Committee of Molecular Pathogenesis and Molecular Medicine, The University of Chicago, Chicago, IL, USA
| | - Heather E Wheeler
- Section of Hematology/Oncology, Department of Medicine, Chicago, IL, USA
| | - M Eileen Dolan
- Section of Hematology/Oncology, Department of Medicine, Chicago, IL, USA.
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16
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Lifestyle-Related Factors in the Self-Management of Chemotherapy-Induced Peripheral Neuropathy in Colorectal Cancer: A Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:7916031. [PMID: 28400846 PMCID: PMC5376448 DOI: 10.1155/2017/7916031] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/24/2017] [Accepted: 03/01/2017] [Indexed: 02/07/2023]
Abstract
Background. Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of chemotherapy treatment in colorectal cancer (CRC), negatively affecting the daily functioning and quality of life of CRC patients. Currently, there are no established treatments to prevent or reduce CIPN. The purpose of this systematic review was to identify lifestyle-related factors that can aid in preventing or reducing CIPN, as such factors may promote self-management options for CRC patients suffering from CIPN. Methods. A literature search was conducted through PubMed, Embase, and Google Scholar. Original research articles investigating oxaliplatin-related CIPN in CRC were eligible for inclusion. Results. In total, 22 articles were included, which suggested that dietary supplements, such as antioxidants and herbal extracts, as well as physical exercise and complementary therapies, such as acupuncture, may have beneficial effects on preventing or reducing CIPN symptoms. However, many of the reviewed articles presented various limitations, including small sample sizes and heterogeneity in study design and measurements of CIPN. Conclusions. No strong conclusions can be drawn regarding the role of lifestyle-related factors in the management of CIPN in CRC patients. Certain dietary supplements and physical exercise may be beneficial for the management of CIPN, but further research is warranted.
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17
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Cascella M, Muzio MR. Potential application of the Kampo medicine goshajinkigan for prevention of chemotherapy-induced peripheral neuropathy. JOURNAL OF INTEGRATIVE MEDICINE 2017; 15:77-87. [PMID: 28285612 DOI: 10.1016/s2095-4964(17)60313-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and severe adverse effects related to cancer treatment. Unfortunately, although several agents and protocols have been proposed, no prophylactic strategies have yet to be proven useful. Therefore, new alternative therapies have been considered for CIPN prevention. Herbal medicine in Japan, called Kampo medicine, is derived from traditional Chinese medicine. Goshajinkigan (GJG) is a Kampo medicine, that is comprised of ten herbs. The aim of this work is to analyse the results of pre-clinical and clinical studies on the potential applications of GJG in CIPN prevention.
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Affiliation(s)
- Marco Cascella
- Division of Anesthesia, Department of Anesthesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale"-IRCCS, via Mariano Semmola, Naples 80131, Italy
| | - Maria Rosaria Muzio
- Division of Infantile Neuropsychiatry, UOMI-Maternal and Infant Health, Asl NA 3 SUD, Torre del Greco, via Marconi, Naples 80059, Italy
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18
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Lee G, Kim SK. Therapeutic Effects of Phytochemicals and Medicinal Herbs on Chemotherapy-Induced Peripheral Neuropathy. Molecules 2016; 21:molecules21091252. [PMID: 27657026 PMCID: PMC6273821 DOI: 10.3390/molecules21091252] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/11/2016] [Accepted: 09/12/2016] [Indexed: 12/18/2022] Open
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent adverse effect of neurotoxic anticancer medicines. It leads to autonomic and somatic system dysfunction and decreases the patient’s quality of life. This side effect eventually causes chemotherapy non-compliance. Patients are prompted to seek alternative treatment options since there is no conventional remedy for CIPN. A range of medicinal herbs have multifarious effects, and they have shown some evidence of efficacy in various neurological and immunological diseases. While CIPN has multiple mechanisms of neurotoxicity, these phytomedicines might offer neuronal protection or regeneration with the multiple targets in CIPN. Thus far, researchers have investigated the therapeutic benefits of several herbs, herbal formulas, and phytochemicals in preventing the onset and progress of CIPN in animals and humans. Here, we summarize current knowledge regarding the role of phytochemicals, herb extracts, and herbal formulas in alleviating CIPN.
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Affiliation(s)
- Gihyun Lee
- Department of Physiology, College of Korean Medicine, Kyung Hee University, 26 Kyunghee-daero, Dongdaemoon-gu, Seoul 02447, Korea.
- Department of Research and Development, National Development Institute of Korean Medicine, 94 Hwarang-ro, Gyeongsan-si, Gyeongsangbuk-do 38540, Korea.
| | - Sun Kwang Kim
- Department of Physiology, College of Korean Medicine, Kyung Hee University, 26 Kyunghee-daero, Dongdaemoon-gu, Seoul 02447, Korea.
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19
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Nakanishi M, Nakae A, Kishida Y, Baba K, Sakashita N, Shibata M, Yoshikawa H, Hagihara K. Go-sha-jinki-Gan (GJG) ameliorates allodynia in chronic constriction injury-model mice via suppression of TNF-α expression in the spinal cord. Mol Pain 2016; 12:12/0/1744806916656382. [PMID: 27296622 PMCID: PMC4956397 DOI: 10.1177/1744806916656382] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background Alternative medicine is noted for its clinical effect and minimal invasiveness in the treatment of neuropathic pain. Go-sha-jinki-Gan, a traditional Japanese herbal medicine, has been used for meralgia and numbness in elderly patients. However, the exact mechanism of GJG is unclear. This study aimed to investigate the molecular mechanism of the analgesic effect of GJG in a chronic constriction injury model. Results GJG significantly reduced allodynia and hyperalgesia from the early phase (von Frey test, p < 0.0001; cold-plate test, p < 0.0001; hot-plate test p = 0.011; two-way repeated measures ANOVA). Immunohistochemistry and Western blot analysis revealed that GJG decreased the expression of Iba1 and tumor necrosis factor-α in the spinal cord. Double staining immunohistochemistry showed that most of the tumor necrosis factor-α was co-expressed in Iba1-positive cells at day 3 post-operation. GJG decreased the phosphorylation of p38 in the ipsilateral dorsal horn. Moreover, intrathecal injection of tumor necrosis factor-α opposed the anti-allodynic effect of GJG in the cold-plate test. Conclusions Our data suggest that GJG ameliorates allodynia in chronic constriction injury model mice via suppression of tumor necrosis factor-α expression derived from activated microglia. GJG is a promising drug for the treatment of neuropathic pain induced by neuro-inflammation.
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Affiliation(s)
| | - Aya Nakae
- Osaka University Graduate School of medicineOsaka University Graduate School of medicineOsaka University Graduate School of medicineOsaka University Graduate School of medicine Osaka University Graduate School of Medicine Osaka University Graduate School of Medicine
| | | | | | | | | | | | - Keisuke Hagihara
- Osaka University Graduate School of medicineOsaka University Graduate School of medicineOsaka University Graduate School of medicineOsaka University Graduate School of medicine Osaka University Graduate School of Medicine Osaka University Graduate School of Medicine
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20
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Quick, non-invasive and quantitative assessment of small fiber neuropathy in patients receiving chemotherapy. J Neurooncol 2016; 127:373-80. [PMID: 26749101 DOI: 10.1007/s11060-015-2049-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 12/26/2015] [Indexed: 12/15/2022]
Abstract
Chemotherapy-induced peripheral neurotoxicity (CIPN) is a common, potentially severe and dose-limiting adverse effect; however, it is poorly investigated at an early stage due to the lack of a simple assessment tool. As sweat glands are innervated by small autonomic C-fibers, sudomotor function testing has been suggested for early screening of peripheral neuropathy. This study aimed to evaluate Sudoscan, a non-invasive and quantitative method to assess sudomotor function, in the detection and follow-up of CIPN. Eighty-eight patients receiving at least two infusions of Oxaliplatin only (45.4%), Paclitaxel only (14.8%), another drug only (28.4%) or two drugs (11.4%) were enrolled in the study. At each chemotherapy infusion the accumulated dose of chemotherapy was calculated and the Total Neuropathy Score clinical version (TNSc) was carried out. Small fiber neuropathy was assessed using Sudoscan (a 3-min test). The device measures the Electrochemical Skin Conductance (ESC) of the hands and feet expressed in microSiemens (µS). For patients receiving Oxaliplatin mean hands ESC changed from 73 ± 2 to 63 ± 2 and feet ESC from 77 ± 2 to 66 ± 3 µS (p < 0.001) while TNSc changed from 2.9 ± 0.5 to 4.3 ± 0.4. Similar results were observed in patients receiving Paclitaxel or another neurotoxic chemotherapy. During the follow-up, ESC values of both hands and feet with a corresponding TNSc < 2 were 70 ± 2 and 73 ± 2 µS respectively while they were 59 ± 1.4 and 64 ± 1.5 µS with a corresponding TNSc ≥ 6 (p < 0.0001 and p = 0.0003 respectively). This preliminary study suggests that small fiber neuropathy could be screened and followed using Sudoscan in patients receiving chemotherapy.
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21
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Ohnishi S, Takeda H. Herbal medicines for the treatment of cancer chemotherapy-induced side effects. Front Pharmacol 2015; 6:14. [PMID: 25713534 PMCID: PMC4322614 DOI: 10.3389/fphar.2015.00014] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 01/14/2015] [Indexed: 01/24/2023] Open
Abstract
Accumulating evidence suggests that Japanese herbal medicines, called Kampo, have beneficial effects on cancer chemotherapy-induced side effects. Rikkunshito ameliorates cisplatin-induced anorexia through an antagonistic effect on the 5-HT receptors and by increasing the serum ghrelin levels. Hangeshashinto improves irinotecan-induced diarrhea and chemotherapy-induced mucositis by inhibiting the activity of β-glucuronidase as well as the synthesis of prostaglandin E2. Goshajinkigan prevents oxaliplatin-induced neurotoxicity, possibly through suppressing functional alterations of the transient receptor potential channels. In this review, we will summarize the currently available literature regarding the clinical efficacy and potential mechanisms of Kampo medicines in the treatment of cancer chemotherapy-induced side effects.
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Affiliation(s)
- Shunsuke Ohnishi
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine , Sapporo, Japan
| | - Hiroshi Takeda
- Pathophysiology and Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University , Sapporo, Japan
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22
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Kaspersen SJ, Han J, Nørsett KG, Rydså L, Kjøbli E, Bugge S, Bjørkøy G, Sundby E, Hoff BH. Identification of new 4-N-substituted 6-aryl-7H-pyrrolo[2,3-d]pyrimidine-4-amines as highly potent EGFR-TK inhibitors with Src-family activity. Eur J Pharm Sci 2014; 59:69-82. [DOI: 10.1016/j.ejps.2014.04.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 04/11/2014] [Accepted: 04/16/2014] [Indexed: 11/27/2022]
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Searle EJ, Illidge TM, Stratford IJ. Emerging opportunities for the combination of molecularly targeted drugs with radiotherapy. Clin Oncol (R Coll Radiol) 2014; 26:266-76. [PMID: 24602563 DOI: 10.1016/j.clon.2014.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 01/29/2014] [Accepted: 02/11/2014] [Indexed: 02/08/2023]
Abstract
Recent drug discovery developments in the field of small molecule targeted agents have led to much interest in combining these with radiotherapy. There are good preclinical data to suggest this approach worthy of investigation and in this review we discuss how this has translated into recent clinical trials. The outcome of clinical trials investigating radiotherapy/targeted drug combinations published in the last 5 years is discussed, as are trials in progress. The perceived future opportunities and challenges in the development of this exciting area are considered.
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Affiliation(s)
- E J Searle
- Manchester Pharmacy School, University of Manchester, Manchester, UK; Targeted Therapy Group, Institute of Cancer Sciences, University of Manchester, Manchester, UK.
| | - T M Illidge
- Targeted Therapy Group, Institute of Cancer Sciences, University of Manchester, Manchester, UK
| | - I J Stratford
- Manchester Pharmacy School, University of Manchester, Manchester, UK
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24
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Tsukada R, Yamaguchi T, Hang L, Iseki M, Kobayashi H, Inada E. Effects of a Traditional Japanese Medicine Goshajinkigan, Tokishigyakukagoshuyushokyoto on the Warm and Cold Sense Threshold and Peripheral Blood Flow. Health (London) 2014. [DOI: 10.4236/health.2014.68097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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