Abstract
Cardiotoxicity is a frequent undesirable phenomenon observed during oncological treatment that limits the therapeutic dose of antitumor drugs and thus may decrease the effectiveness of cancer eradication. Almost all antitumor drugs exhibit toxic properties towards cardiac muscle. One of the underlying causes of cardiotoxicity is the stimulation of oxidative stress by chemotherapy. This suggests that an appropriately designed diet or dietary supplements based on edible plants rich in antioxidants could decrease the toxicity of antitumor drugs and diminish the risk of cardiac failure. This comprehensive review compares the cardioprotective efficacy of edible plant extracts and foodborne phytochemicals whose beneficial activity was demonstrated in various models in vivo and in vitro. The studies selected for this review concentrated on a therapy frequently applied in cancer, anthracycline antibiotic—doxorubicin—as the oxidative stress- and cardiotoxicity-inducing agent.
Highlights
Cancer remains one of the leading health issues worldwide
The results showed that pretreatment with grape seed extract (GSE) for 14 consecutive days caused the amelioration of all biochemical parameters altered by DOX, and such findings suggest a possible use of GSE in the prevention of DOX-induced cardiomiopathy
Most likely owing to these properties, it was demonstrated that i.p. administration of CAPE at a dose of 10 μmoles/kg/day resulted in a reduction in cardiotoxicity in rats treated with a toxic dose of DOX (20 mg/kg)
Summary
Cancer remains one of the leading health issues worldwide. According to GLOBOCAN, in 2020, there were 19.3 million new cancer cases diagnosed and almost 9.9 million cancer deaths occurred [1]. Significant cardiotoxicity has been observed during chemotherapy with most anti-tumor drugs: mitoxantrone (cardiomyopathy), fluorouracil (cardiac infarction), cyclophosphamide and vinca alkaloids (necrosis of heart cells) [10] This side effect is dangerous in the case of anthracyclines therapy, especially with doxorubicin (DOX). Biomarkers (Table 1) that correlate to the level of heart damage are monitored during treatment to control the safe dose of administered cytostatics This approach makes it possible to evaluate the cardiac damage during chemotherapy, and may be exploited to assess the cardioprotective impact of different substances, including compounds of natural origin (Table 2). One strategy that holds great promise for reducing cardiotoxicity is the use of cardioprotectants or preparations derived from edible plants Since phytochemicals are both well tolerated and often exhibit high antioxidant activity, they can potentially protect cardiac muscle from the negative effects of oxidative stress. It is easy to assess to what extent DOX treatment impairs the redox homeostasis of cardiomyocytes and how successfully it is restored by treatment with evaluated cardioprotectants
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