Zare-Zardini Hadi, Hedayati-Goudarzi Mohammad-Taghi, Alizadeh Ameneh, Sadeghian-Nodoushan Fatemeh, Soltaninejad Hossein
Department of Biomedical Engineering, Meybod University, Meybod, Iran.
Department of Cardiology, School of Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran.
Biomed Eng Online. 2024 Dec 21;23(1):128. doi: 10.1186/s12938-024-01322-z.
Chemotherapy-induced cardiotoxicity is a significant concern in cancer treatment, as certain chemotherapeutic agents can have adverse effects on the cardiovascular system. This can lead to a range of cardiac complications, including heart failure, arrhythmias, myocardial dysfunction, pericardial complications, and vascular toxicity. Strategies to mitigate chemotherapy-induced cardiotoxicity may include the use of cardioprotective agents (e.g., dexrazoxane), dose adjustments, alternative treatment regimens, and the implementation of preventive measures, such as lifestyle modifications and the management of cardiovascular risk factors. Ginsenosides, the active compounds found in ginseng (Panax ginseng), have been studied for their potential cardioprotective effects in the context of chemotherapy-induced cardiotoxicity. In this review, we investigate the cardioprotective effect of ginsenosides in chemotherapy-induced cardiotoxicity. Ginsenosides have been shown to possess potent antioxidant properties, which can help mitigate the oxidative stress and inflammation associated with chemotherapy-induced cardiac injury. They can modulate the expression of antioxidant enzymes and reduce the production of reactive oxygen species, thereby protecting cardiomyocytes from damage. Ginsenosides can also inhibit apoptosis (programmed cell death) of cardiomyocytes, which is a key mechanism underlying chemotherapy-induced cardiotoxicity. Modulation of ion channels, improvement of lipid profiles, anti-platelet and anti-thrombotic effects, and promotion of angiogenesis and neovascularization are another important mechanisms behind potential effects of ginsenosides on cardiovascular health. Ginsenosides can improve various parameters of cardiac function, such as ejection fraction, fractional shortening, and cardiac output, in animal models of chemotherapy-induced cardiotoxicity. The cardioprotective effects of ginsenosides have been observed in preclinical studies using various chemotherapeutic agents, including doxorubicin, cisplatin, and 5-fluorouracil. However, more clinical studies are needed to fully elucidate the therapeutic potential of ginsenosides in preventing and managing chemotherapy-induced cardiotoxicity in cancer patients.
化疗引起的心脏毒性是癌症治疗中的一个重大问题，因为某些化疗药物会对心血管系统产生不良影响。这可能导致一系列心脏并发症，包括心力衰竭、心律失常、心肌功能障碍、心包并发症和血管毒性。减轻化疗引起的心脏毒性的策略可能包括使用心脏保护剂（如右丙亚胺）、调整剂量、采用替代治疗方案以及实施预防措施，如改变生活方式和控制心血管危险因素。人参（Panax ginseng）中的活性成分人参皂苷，已在化疗引起的心脏毒性背景下对其潜在的心脏保护作用进行了研究。在这篇综述中，我们研究了人参皂苷在化疗引起的心脏毒性中的心脏保护作用。人参皂苷已被证明具有强大的抗氧化特性，这有助于减轻与化疗引起的心脏损伤相关的氧化应激和炎症。它们可以调节抗氧化酶的表达并减少活性氧的产生，从而保护心肌细胞免受损伤。人参皂苷还可以抑制心肌细胞的凋亡（程序性细胞死亡），这是化疗引起的心脏毒性的关键机制。调节离子通道、改善血脂水平、抗血小板和抗血栓形成作用以及促进血管生成和新血管形成是人参皂苷对心血管健康潜在影响背后的另一个重要机制。在化疗引起的心脏毒性动物模型中，人参皂苷可以改善心脏功能的各种参数，如射血分数、缩短分数和心输出量。在使用各种化疗药物（包括阿霉素、顺铂和5-氟尿嘧啶）的临床前研究中已经观察到人参皂苷的心脏保护作用。然而，需要更多的临床研究来充分阐明人参皂苷在预防和管理癌症患者化疗引起的心脏毒性方面的治疗潜力。
