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Review
. 2022 Feb 9:12:790784.
doi: 10.3389/fphar.2021.790784. eCollection 2021.

Research Progress on the Antiemetic Effect of Traditional Chinese Medicine Against Chemotherapy-Induced Nausea and Vomiting: A Review

Yao-Zhong Zhao  1 , Yong-Zhao Dai  1 , Ke Nie  1
Affiliations
Review

Research Progress on the Antiemetic Effect of Traditional Chinese Medicine Against Chemotherapy-Induced Nausea and Vomiting: A Review

Yao-Zhong Zhao et al. Front Pharmacol. .

Abstract

Chemotherapy-induced nausea and vomiting (CINV), a common side effect in antineoplastic treatment, dramatically decreases the quality of life as well as the compliance of cancer patients. Although numerous antiemetic agents have been used for CINV treatment, its adverse reactions as well as its inadequate control toward delayed emesis still limit its clinical usage. Traditional Chinese medicine (TCM), with more than 3,000 years of practical history in Asia, has been successfully applied to mitigate chemotherapy-induced side effects. Growing attention is drawn to the antiemetic effect of TCM against CINV due to its promising therapeutic property and higher safety recently. In this review, we summarize the classic antiemetic TCM-based treatment and its mechanisms, so as to provide a theoretical basis for further investigations of TCM against CINV in the future.

Keywords: chemotherapy; nausea; review; traditional Chinese medicine; vomiting.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
The mechanism of CINV. In the peripheral nervous system, chemotherapy drugs stimulate enterochromaffin cells to release 5-HT, which activates 5-HT3R and then stimulates the vomiting center via the vagal afferent, eventually inducing emesis. In the central nervous system, the increased levels of SP, DA, and GDF-15 induce vomiting via activating their respective receptors. Also, chemotherapy drugs induce gastrointestinal mucositis and delayed gastric emptying, which may be the other potential mechanism that leads to nausea and vomiting.
FIGURE 2
FIGURE 2
The antiemetic mechanism of XBXD against CINV. In the central nervous system, XBXD markedly reduces levels of 5-HT, SP, and DA and blocks 5-HT3R, NK-1R, and D2R. In the peripheral nervous system, XBXD inhibits the biosynthesis of 5-HT, SP, and DA and blocks their respective receptors. Also, XBXD significantly mitigates chemotherapy-drug-induced gastrointestinal mucositis and delayed gastric emptying.
FIGURE 3
FIGURE 3
The antiemetic mechanism of LJZD against CINV. LJZD markedly increases the food intake and circling ghrelin level via blocking 5-HT2BR and 5-HT2CR, Besides, LJZD improves the cisplatin-induced delayed gastric emptying via blocking the 5-HT3R pathway.
FIGURE 4
FIGURE 4
The antiemetic mechanism of ginger against CINV. In the central nervous system, ginger markedly reduces levels of 5-HT, SP, and DA and blocks 5-HT3R, NK-1R, and D2R. In the peripheral nervous system, ginger inhibits the biosynthesis of 5-HT, SP, and DA, blocking their respective receptors. Also, ginger ameliorated microbiota disorders and delayed gastric emptying induced by chemotherapeutic agents.
FIGURE 5
FIGURE 5
The antiemetic mechanism of Forsythiae Fructus against CINV. In the peripheral nervous system, Forsythiae Fructus markedly reduces levels of 5-HT and blocks 5-HT3R. Besides, Forsythiae Fructus significantly mitigates chemotherapy-drug-induced gastrointestinal mucositis and delayed gastric emptying.
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