Abstract
Chemotherapy-induced nausea and vomiting (CINV) is a common and painful side effect that occurs in cancer patients receiving chemotherapeutic drugs. Although an abundance of agents are applied to prevent CINV, there is still lack of effective control in delayed nausea and vomiting. Ginger (Zingiber officinale Rosc.), a traditional antiemetic herb, draws attention due to its therapeutic effect in treating acute and delayed CINV. Its main bioactive pungent constituents, gingerols, contribute to the antiemetic effect against CINV primarily. A growing number of reports have made progress in investigating the mechanisms of gingerols and their single ingredients against CINV. In this review, we searched for relevant studies in PubMed database to summarize the mechanism of gingerols in the prevention of CINV and provided a preliminary prediction on the potential targets and signaling pathways using network pharmacology, laying a foundation for further researches.
Highlights
Chemotherapy-induced nausea and vomiting (CINV) is a side effect that occurs in antineoplastic chemotherapies and severely affects the compliance as well as life quality of cancer patients [1]. e underlying mechanisms of CINV have not been fully clarified yet. e major mechanism of CINV is concerned with the alteration of neurotransmitters in central and peripheral, such as 5-hydroxytryptamine (5HT), substance P (SP), and dopamine (DA) [2]. rough binding with 5-HT type 3 receptor (5-HT3R) and neurokinin-1 receptor (NK-1R), 5-HT and SP are closely related to the onset of acute phase and delayed phase of CINV, respectively. e 5-HT type receptor (5-HT3R) antagonist like ondansetron and NK-1R antagonist like aprepitant are the basic clinical prophylaxis to treat CINV [3, 4]
5-HT3R antagonist alone is less effective in relieving delayed CINV, while combining with the NK-1R antagonist is effective in treating delayed emesis, it calls for large medical cost to patients [2]. erefore, CINV remains as a great restriction for the usage of chemotherapy agents in clinical cancer treatments. ere is an urgent need for further investigating the mechanism of CINV, as well as exploring novel medicines with less side effects and promising antiemetic property in controlling delayed nausea and vomiting
Gingerols are the major pungent ingredients in ginger, and studies have proven the effect of gingerols in treating CINV. e single ingredients contained in gingerols include 6, 8, 10-gingerol, 6, 8, 10shogaol, and others, with 6-gingerol and 6-shogaol being the most abundant
Summary
Chemotherapy-induced nausea and vomiting (CINV) is a side effect that occurs in antineoplastic chemotherapies and severely affects the compliance as well as life quality of cancer patients [1]. e underlying mechanisms of CINV have not been fully clarified yet. e major mechanism of CINV is concerned with the alteration of neurotransmitters in central and peripheral, such as 5-hydroxytryptamine (5HT), substance P (SP), and dopamine (DA) [2]. rough binding with 5-HT type 3 receptor (5-HT3R) and neurokinin-1 receptor (NK-1R), 5-HT and SP are closely related to the onset of acute phase and delayed phase of CINV, respectively. e 5-HT3R antagonist like ondansetron and NK-1R antagonist like aprepitant are the basic clinical prophylaxis to treat CINV [3, 4]. Ere is an urgent need for further investigating the mechanism of CINV, as well as exploring novel medicines with less side effects and promising antiemetic property in controlling delayed nausea and vomiting. Clinical trial had proven the antiemetic effect of ginger against acute and delayed phases of CINV. Only 5 manuscripts are searched out when using the terms “gingerols or 6-gingerol” and “CINV” in PubMed. Up to date, only 5 manuscripts are searched out when using the terms “gingerols or 6-gingerol” and “CINV” in PubMed Among these studies, there are one review on the mechanisms of ginger against CINV, one clinical trial on the effect of 6-gingerol against chemotherapy-induced emesis in cancer patients, one mechanism study of gingerols on cisplatin-induced emesis, and two in silico studies. We summarized the mechanism studies of gingerols in treating CINV and used network pharmacology to predict potential targets and pathways, providing new prospects on the basic of previous investigations
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