Effect and Mechanism of Herbal Medicines on Cisplatin-Induced Anorexia

Abstract

Cisplatin is a well-known chemotherapeutic agent used to treat various types of cancers; however, it can also induce anorexia, which results in reduced food intake, loss of body weight, and lower quality of life. Although drugs such as megestrol acetate and cyproheptadine are used to decrease this severe feeding disorder, they can also induce side effects, such as diarrhea and somnolence, which limit their widespread use. Various types of herbal medicines have long been used to prevent and treat numerous gastrointestinal tract diseases; however, to date, no study has been conducted to analyze and summarize their effects on cisplatin-induced anorexia. In this paper, we analyze 12 animal studies that used either a single herbal medicine extract or mixtures thereof to decrease cisplatin-induced anorexia. Among the herbal medicines, Ginseng Radix was the most used, as it was included in seven studies, whereas both Glycyrrhizae Radix et Rhizoma and Angelicae Gigantis Radix were used in four studies. As for the mechanisms of action, the roles of serotonin and its receptors, cytokines, white blood cells, ghrelin, and leptin were investigated. Based on these results, we suggest that herbal medicines could be considered a useful treatment method for cisplatin-induced anorexia.

Keywords: anorexia; chemotherapy-induced side effects; cisplatin; herbal medicines.

Figure 1

The pathogenesis mechanism of cisplatin-induced anorexia and the mechanisms of action of herbal extracts. Intraperitoneal administration of cisplatin induces anorexia (red), whereas administration herbal extract increases appetite (blue). The brain, serum, small intestine, stomach, and spleen were affected by both cisplatin and herbal-extract treatments. Abbreviation: GHS-R1a, growth hormone secretagogue receptor type 1a; GSH-PX, glutathione peroxidase; 5-HIAA, 5-Hydroxyindole acetic acid; HMF, 3,3′,4′,5,6,7,8-heptamethoxyflavone; 5-HT, 5-Hydroxytryptamine (serotonin); 5-HTR, 5-HT receptor; IFN-γ, interferon-γ; MAO-A, monoamine oxidase A; MDA, malonaldehyde; SERT, serotonin reuptake transporter; SOD, superoxide dismutase; TNF-α, tumor necrosis factor-α; TPH, tryptophan hydroxylase.

Figure 2

Flow chart of article inclusion protocol. Identification through searches of MEDLINE (PubMed) and Google Scholar yielded 1165 articles, which were screened by abstract and full-text examinations. Finally, a total of 12 articles assessing the effect of herbal extracts in cisplatin-induced anorexia in rodents were included in our review.