Abstract
Objective This study aimed to review the potential chemoprotective effects of curcumin against the doxorubicin-induced cardiotoxicity. Methods According to the PRISMA guideline, a comprehensive systematic search was performed in different electronic databases (Web of Science, PubMed, and Scopus) up to July 2021. One hundred and sixty-four studies were screened in accordance with a predefined set of inclusion and exclusion criteria. Eighteen eligible articles were finally included in the current systematic review. Results According to the in vitro and in vivo findings, it was found that doxorubicin administration leads to decreased cell survival, increased mortality, decreased bodyweight, heart weight, and heart to the bodyweight ratio compared to the control groups. However, curcumin cotreatment demonstrated an opposite pattern in comparison with the doxorubicin-treated groups alone. Other findings showed that doxorubicin significantly induces biochemical changes in the cardiac cells/tissue. Furthermore, the histological changes on the cardiac tissue were observed following doxorubicin treatment. Nevertheless, for most of the cases, these biochemical and histological changes mediated by doxorubicin were reversed near to control groups following curcumin coadministration. Conclusion It can be mentioned that coadministration of curcumin alleviates the doxorubicin-induced cardiotoxicity. Curcumin exerts these cardioprotective effects through different mechanisms of antioxidant, antiapoptosis, and anti-inflammatory. Since the finding presented in this systematic review are based on in vitro and in vivo studies, suggesting the use of curcumin in cancer patients as a cardioprotector agent against cardiotoxicity mediated by doxorubicin requires further clinical studies.
Highlights
For many years, cardiovascular anomalies are considered as the leading cause of death in the worldwide; cardiotoxicity has become a crucial concern for scientific community [1, 2]
Literature supports that severe cardiotoxicity is commonly evident in antitumor treatments [3–8]; even if these patients survive from malignant tumor, they end up with heart complications in longer run that lead to compromised life style or death [9]
A PICO framework was used to structure the review process [54]. is framework includes participants (P): cardiac cells damaged by doxorubicin and/or patients/ animals with cardiac adverse effects induced by doxorubicin; intervention (I): patients/animals/ cells treatment with doxorubicin chemotherapeutic drug; comparison (C): patients/animals/cells treated with curcumin and doxorubicin; outcomes (O): there were two critical outcomes: changes induced in the cardiac cells/tissue following doxorubicin treatment compared to control/untreated groups and changes resulted in the cardiac cells/tissue following combined treatment of curcumin and doxorubicin in comparison with doxorubicin treatment alone
Summary
Cardiovascular anomalies are considered as the leading cause of death in the worldwide; cardiotoxicity has become a crucial concern for scientific community [1, 2]. Literature supports that severe cardiotoxicity is commonly evident in antitumor treatments [3–8]; even if these patients survive from malignant tumor, they end up with heart complications in longer run that lead to compromised life style or death [9]. In this regard, drug-induced cardiotoxicity has withdrawn much attention in past two decades, as it has led to ban on various classes of drugs (such as rosiglitazone, prenylamine, rofecoxib, and levomethadyl acetate) due to their associated severe cardiotoxicity [10–13]. There are still some cardiotoxic drugs that are applied by clinicians either other safer alternatives are not available or these drugs outweigh the risk of cardiac deformities. Major limitation reported for doxorubicin is the associated toxicity on various body organs, the heart [9]
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