Prebiotic Intervention in Chemotherapy Induced Adverse Effects A Systematic Review- Muscle Wasting and Gut Health as Major Thrust
Main Article Content
Abstract
Background: Cancer is the world's leading cause of death and considered as life threatening disease. Its treatment usually includes chemotherapy, radiotherapy, surgery, or combination of the therapies. However, most preferred is chemotherapy which can be applied at the early stage as well as late stages of the disease. The development of adverse effects from chemotherapy impedes therapeutic utilization and significantly impacts cancer patients' quality of life. Muscle wasting, gastro intestinal inflammation, cardiotoxicity neurotoxicity and nephrotoxicity to name a few.
Objective: To lessen the discomfort brought on by chemotherapy, traditional medications including antiemetic, multivitamins, diuretics, and antidiarrheal are recommended. However, these are known for secondary adverse effects as insomnia, hallucinations, intestinal cramping, etc. Natural drugs complementary and alternative therapies are employed to counteract these; however they lack scientific support and vary depending on the patient's personality. Certain contemporary approaches, such the use of probiotics and prebiotics, have been demonstrated to be effective in overcoming these disorders. Evidently, skeletal muscular atrophy and weakness are the tell-tale signs of cachexia brought on by chemotherapy, which reduces treatment tolerance, impairs daily functioning, and worsens survival in cancer patients. These conditions are referred to as sarcopenia and cancer cachexia. These therapies can also cause mucositis, a disorder marked by gastro-intestinal inflammation and disruption of the gut flora.
Methods: Findings of different researcher in this thrust are analyzed and outcomes are summarized. This review focuses to examine the known mechanisms of prebiotic action and explores their potential to reduce the severity of chemotherapy-induced with primary focus on muscle wasting and gastro intestinal inflammation.
Result and conclusion: The prebiotics are found to be effective in combating this chemotherapy induced adverse effects evidently focusing on the muscle wasting and GI inflammation. With a detailed literature survey, we conclude that this review will surely provide firm and better insights to the researchers to develop relevant option of prebiotics and establishing the possible mode of action.
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References
Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, et al. Global Cancer Observatory: Cancer Today. Lyon: International Agency for Research on Cancer; 2020 (https://gco.iarc.fr/today, accessed February 2021).
Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023; 73(1):17-48. doi:10.3322/caac.21763
Sathishkumar, Krishnan; Chaturvedi, Meesha; Das, Priyanka; Stephen, S.; Mathur, Prashant. Cancer incidence estimates for 2022 & projection for 2025: Result from National Cancer Registry Programme, India. Indian Journal of Medical Research 156(4&5): p 598-607, Oct–Nov 2022. | DOI: 10.4103/ijmr.ijmr_1821_22
Hosseinzadeh, Elham & Banaee, Nooshin & Nedaie, Hassan. (2017). Cancer and Treatment Modalities. Current Cancer Therapy Reviews. 13. 10.2174/1573394713666170531081818.
Brown AP, Chen J, Hitchcock YJ, et al. The risk of second primary malignancies up to three decades after the treatment of differentiated thyroid cancer. J Clin Endocrinol Metab. 2008; 93(2):504-515.
Balachandran P, Govindarajan R. Cancer—an ayurvedic perspective. Pharmacological research. 2005; 51(1):19-30.
Malvika S, Satyapal S, Lal JM, Mita K. An Ayurveda approach to combat toxicity of chemo-radiotherapy in cancer patients. International Journal of Research in Ayurveda and Pharmacy. 2016; 7(Suppl 2):124-129.
Aslam, Muhammad & Naveed, Sidra & Ahmad, Aftab & Abbas, Zaigham & Gull, Iram & Athar, Muhammad. (2014). Side Effects of Chemotherapy in Cancer Patients and Evaluation of Patients Opinion about Starvation Based Differential Chemotherapy. Journal of Cancer Therapy. 5. 817-822. 10.4236/jct.2014.58089.
Gegechkori N, Haines L, Lin JJ. Long-term and latent side effects of specific cancer types. Medical Clinics. 2017; 101(6):1053-1073.
Michalczyk K, Pawlik J, Czekawy I, Kozłowski M, Cymbaluk-Płoska A. Complementary Methods in Cancer Treatment—Cure or Curse? International Journal of Environmental Research and Public Health. 2021; 18(1):356.
Buckner C, Lafrenie R, Dénommée J, Caswell J, Want D. Complementary and alternative medicine use in patients before and after a cancer diagnosis. Current Oncology. 2018; 25(4):275-281.
Molassiotis A, Fernadez-Ortega P, Pud D, et al. Use of complementary and alternative medicine in cancer patients: a European survey. Annals of oncology. 2005; 16(4):655- 663.
Xiang Y, Guo Z, Zhu P, Chen J, Huang Y. Traditional Chinese medicine as a cancer treatment: modern perspectives of ancient but advanced science. Cancer medicine. 2019; 8(5):1958-1975.
Myers SP, Cheras PA. The other side of the coin: safety of complementary and alternative medicine. Med J Aust. 2004; 181(4):222-225.
Cassani E, Privitera G, Pezzoli G, et al. Use of probiotics for the treatment of constipation in Parkinson's disease patients. Minerva gastroenterologica e dietologica. 2011; 57(2):117-121.
Górska A, Przystupski D, Niemczura MJ, Kulbacka J. Probiotic bacteria: a promising tool in cancer prevention and therapy. Current microbiology. 2019; 76(8):939-949.
Lili Z, Junyan W, Hongfei Z, Baoqing Z, Bolin Z. Detoxification of cancerogenic compounds by lactic acid bacteria strains. Critical reviews in food science and nutrition. 2018; 58(16):2727-2742.
Reuter G. Probiotics--possibilities and limitations of their application in food, animal feed, and in pharmaceutical preparations for men and animals. Berliner und Munchener Tierarztliche Wochenschrift. 2001; 114(11-12):410-419.
Gibson GR, Rastall RA. Prebiotics: development & application. Wiley Online Library; 2006.
Davani-Davari D, Negahdaripour M, Karimzadeh I, et al. Prebiotics: definition, types, sources, mechanisms, and clinical applications. Foods. 2019; 8(3):92.
Roberfroid M. Prebiotics: the concept revisited. The Journal of nutrition. 2007; 137(3):830S-837S.
Bindels LB, Delzenne NM, Cani PD, Walter J. Towards a more comprehensive concept for prebiotics. Nature reviews Gastroenterology & hepatology. 2015; 12(5):303-310.
Sonis, S. T. (2009). Mucositis: the Impact, Biology and Therapeutic Opportunities of Oral Mucositis. Oral Oncol. 45, 1015–1020. doi:10.1016/j.oraloncology.2009. 08.006
Lalla, R. V., Choquette, L. E., Curley, K. F., Dowsett, R. J., Feinn, R. S., Hegde, U.P., et al. (2014). Randomized Double-Blind Placebo-Controlled Trial of Celecoxib for Oral Mucositis in Patients Receiving Radiation Therapy for Head and Neck Cancer. Oral Oncol. 50, 1098–1103. doi:10.1016/j.oraloncology.2014.08.001
Sonis, S. T., O’donnell, K. E., Popat, R., Bragdon, C., Phelan, S., Cocks, D., et al.(2004). The Relationship between Mucosal Cyclooxygenase-2 (COX-2) Expression and Experimental Radiation-Induced Mucositis. Oral Oncol. 40, 170–176. doi:10.1016/s1368-8375(03)00148-9.
Stringer, A. M., Gibson, R. J., Bowen, J. M., Logan, R. M., Yeoh, A. S., and Keefe, D. M. (2009). Chemotherapy-induced Mucositis: The Role of Gastrointestina Microflora and Mucins in the Luminal Environment. J Support Oncol. 5(6), 259–67.
Sonis, S., Elting, L., Elting, L., Keefe, D., Nguyen, H., Grunberg, S., et al. (2015).Unanticipated Frequency and Consequences of Regimen-Related Diarrhea in Patients Being Treated with Radiation or Chemoradiation Regimens for Cancers of the Head and Neck or Lung. Support Care Cancer 23, 433–439. doi:10.1007/s00520-014- 2395-96.
Ijiri, K., and Potten, C. S. (1983). Response of Intestinal Cells of Differing Topographical and Hierarchical Status to Ten Cytotoxic Drugs and Five Sources of Radiation. Br. J. Cancer 47, 175–185. doi:10.1038/bjc.1983.25
Ribeiro, R. A., Wanderley, C. W. S., Wong, D. V. T., Mota, J. M. S. C., Leite, C. A. V. G., Souza, M. H. L. P., et al. (2016). Irinotecan- and 5-Fluorouracil-Induced Intestinal Mucositis: Insights into Pathogenesis and Therapeutic Perspectives. Cancer Chemother. Pharmacol. 78, 881–893. doi:10.1007/s00280-016-3139.
Bowen, J. M., Gibson, R. J., Keefe, D. M., and Cummins, A. G. (2005). Cytotoxic Chemotherapy Upregulates Pro-poptotic Bax and Bak in the Small Intestine of Rats and Humans. Pathology 37, 56–62. doi:10.1080/00313020400023461.
Gori, A., Rizzardini, G., Van't Land, B., Amor, K.B., van Schaik, J., Torti, C., Quirino, T., Tincati, C., Bandera, A., Knol, J., Benlhassan-Chahour, K., Trabattoni, D., Bray, D., Vriesema, A., Welling, G., Garssen, J., and Clerici, M. (2011). Specific prebiotics modulate gut microbiota and immune activation in HAART-naive HIV-infected adults: results of the "COPA" pilot randomized trial. Mucosal Immunol. 4: 554-563.
Eiwegger, T., Stahl, B., Haidl, P., Schmitt, J., Boehm, G., Dehlink, E., Urbanek, R., and Szepfalusi, Z. (2010). Prebiotic oligosaccharides: in vitro evidence for gastrointestinal epithelial transfer and immunomodulatory properties. Pediatr Allergy Immunol. 21: 1179- 1188.
Specian, R.D., and Oliver, M.G. (1991). Functional biology of intestinal goblet cells. Am J Physiol. 260: C183-193.
Abdelouhab, K., Rafa, H., Toumi, R., Bouaziz, S., Medjeber, O., and Touil-Boukoffa, C. (2012). Mucosal intestinal alteration in experimental colitis correlates with nitric oxide production by peritoneal macrophages: Effect of probiotics and prebiotics. Immunopharmacol Immunotoxicol. 34: 590-597.
Liu, P., Piao, X.S., Kim, S.W., Wang, L., Shen, Y.B., Lee, H.S., and Li, S.Y. (2008). Effects of chito-oligosaccharide supplementation on the growth performance, nutrientdigestibility, intestinal morphology, and fecal shedding of Escherichia coli and Lactobacillus in weaning pigs. J Anim Sci. 86: 2609-2618.
Sheth KA, Iyer CC, Wier CG, Crum AE, Bratasz A, Kolb SJ, Clark BC, Burghes AHM and Arnold WD. Muscle strength and size are associated with motor unit connectivity in agmice. Neurobiol Aging 2018; 67: 128-136.
Herman EH, Ferrans VJ, Myers CE, and Van Vleet JF. Comparison of the effectiveness of ( + /-)-1,2-bis(3,5-dioxopiperazinyl-1-yl)propane (ICRF-187) and N-acetylcysteine in preventing chronic doxorubicin cardiotoxicity in beagles. Cancer Res 45: 276–281, 1985.
Daou N, Hassani M, Matos E, De Castro GS, Costa RGF, Seelaender M, Moresi V, Rocchi M, Adamo S, Li Z, Agbulut O and Coletti D. Displaced myonuclei in cancer cachexia suggest altered innervation. Int J Mol Sci 2020; 21: 1092.
Cole, C.L.; Kleckner, I.R.; Jatoi, A.; Schwarz, E.M.; Dunne, R.F. The role of systemic inflammation in cancer-associated muscle wasting and rationale for exercise as a therapeutic intervention. JCSM Clin. Rep. 2018, 3, e00065.
Al-Sheraji SH, Ismail A, Manap MY, Mustafa S, Yusof RM, Hassan FA. Prebiotics as functional foods: A review. Journal of functional foods. 2013; 5(4):1542-1553.
Hasona N, Morsi A. Grape seed extract alleviates dexamethasone-induced hyperlipidemia, lipid peroxidation, and hematological alteration in rats. Indian Journal of Clinical Biochemistry. 2019; 34(2):213-218.
Ruwiyatul Aliyah , Suryani As'ad, Prebiotics for Chemotherapy-Induced Lower Intestinal Mucositis (CIM) With Moderate Protein Energy Malnutrition: A Case Report, Current Developments in Nutrition, Volume 6, Issue Supplement_1, June 2022, Page 734.
Deleemans JM, Gajtani Z, Baydoun M, Reimer RA, Piedalue K-A, Carlson LE. The Use of Prebiotic and Probiotic Interventions for Treating Gastrointestinal and Psychosocial Health Symptoms in Cancer Patients and Survivors: A Systematic Review. Integrative Cancer Therapies. 2021;20. doi:10.1177/15347354211061733.
Österlund, P., Ruotsalainen, T., Korpela, R. et al. Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study. Br J Cancer 97, 1028–1034 (2007).
Nicolette J. Wierdsma, Adriaan A. van Bodegraven, Bernhard M. J. Uitdehaag, Willy Arjaans, Paul H. M. Savelkoul, Hinke M. Kruizenga & Marian A. E. van Bokhorst-de van der Schueren (2009) Fructo-oligosaccharides and fibre in enteral nutrition has a beneficial influence on microbiota and gastrointestinal quality of life, Scandinavian Journal of Gastroenterology, 44:7, 804-812.
Sarah Andersen, Merrilyn Banks, Judy Bauer. (2020) Nutrition Support and the Gastrointestinal Microbiota: A Systematic Review. Journal of the Academy of Nutrition and Dietetics 120:9, pages 1498-1516.
Agustina, Rina & Lukito, Widjaja & Firmansyah, Agus & Suhardjo, Hartati & Murniati, Dewi & Bindels, Jacques. (2007). The effect of early nutritional supplementation with a mixture of probiotic, prebiotic, fiber and micronutrients in infants with acute diarrhea in Indonesia. Asia Pacific journal of clinical nutrition. 16. 435-42.
Krumbeck JA, Maldonado-Gomez MX, Ramer-Tait AE, Hutkins RW. Prebiotics and synbiotics: dietary strategies for improving gut health. Curr Opin Gastroenterol. 2016 Mar;32(2):110-9. doi: 10.1097/MOG.0000000000000249. PMID: 26825589.
Eur J Nutr. 2002 Nov;41 Suppl 1:I11-6. doi: 10.1007/s00394-002-1102-7.
Cassie L. Smith, Mark S. Geier, Roger Yazbeck, Diana M. Torres, Ross N. Butler & Gordon S. Howarth (2008) Lactobacillus fermentum BR11 and FructoOligosaccharide Partially Reduce Jejunal Inflammation in a Model of Intestinal Mucositis in Rats, Nutrition and Cancer, 60:6, 757-767
Flávia Mendes Peradeles Galdino, Maria Emília Rabelo Andrade, Patrícia Aparecida Vieira de Barros, Simone de Vasconcelos Generoso, Jacqueline Isaura Alvarez-Leite, Camila Megale de Almeida-Leite, Maria do Carmo Gouveia Peluzio, Simone Odília Antunes Fernandes, Valbert Nascimento Cardoso, Pretreatment and treatment with fructo-oligosaccharides attenuate intestinal mucositis induced by 5-FU in mice, Journal of Functional Foods, Volume 49,2018,Pages 485-492.
Luca D. Prisciandaro, Mark S. Geier, Ross N. Butler, Adrian G. Cummins & Gordon S. Howarth (2011) Probiotic factors partially improve parameters of 5-fluorouracilinduced intestinal mucositis in rats, Cancer Biology & Therapy, 11:7, 671- 677, DOI: 10.4161/cbt.11.7.14896
Ferreira, T. M., Leonel, A. J., Melo, M. A., Santos, R. R. G., Cara, D. C., Cardoso, V. N., et al. (2012). Oral supplementation of butyrate reduces mucositis and intestinal permeability associated with 5-fluorouracil administration. Lipids 47, 669–678.
N.S. Oh and others, Mulberry leaf extract fermented with Lactobacillus acidophilus A4 ameliorates 5‐fluorouracil‐induced intestinal mucositis in rats, Letters in Applied Microbiology, Volume 64, Issue 6, 1 June 2017, Pages 459–468.
Inglis JE, Lin PJ, Kerns SL, et al. Nutritional Interventions for Treating Cancer-Related Fatigue: Qualitative Review. Nutr Cancer. 2019; 71(1):21-40. doi:10.1080/01635581.2018.1513046.
Bindels, L., Neyrinck, A., Claus, S. et al. Synbiotic approach restores intestinal homeostasis and prolongs survival in leukaemic mice with cachexia. ISME J 10, 1456–1470 (2016).
Herremans KM, Riner AN, Cameron ME, Trevino JG. The Microbiota and Cancer Cachexia. Int J Mol Sci. 2019;20(24):6267.
Huang, G., Khan, I., Li, X. et al. Ginsenosides Rb3 and Rd reduce polyps formation while reinstate the dysbiotic gut microbiota and the intestinal microenvironment in ApcMin/+ mice. Sci Rep 7, 12552 (2017).
Obermüller B, Singer G, Kienesberger B, Klymiuk I, Sperl D, Stadlbauer V, Horvath A, Miekisch W, Gierschner P, Grabherr R, Gruber H-J, Semeraro MD, Till H, Castellani C. The Effects of Prebiotic Supplementation with OMNi-LOGiC® FIBRE on Fecal Microbiome, Fecal Volatile Organic Compounds, and Gut Permeability in Murine Neuroblastoma-Induced Tumor-Associated Cachexia. Nutrients. 2020; 12(7):2029.
N.E.P Deutz ,Evans W.J. Morley J.E. Argiles J. Bales C. Baracos V. Guttridge D.Cachexia: a new definition.Clin Nutr. 2008; 27: 793-799.
Aversa Z, Costelli P, Muscaritoli M. Cancer-induced muscle wasting: latest findings in prevention and treatment. Therapeutic Advances in Medical Oncology. 2017;9(5):369-382.
Buigues C., Gernandez-Garrido J., Pruimboom L., Hoogland A.J., Navarro-Martinez R., Martinez-Martinez M., Verdejo Y., Mascaros M.C., Peris C., Cauli O. Effect of a prebiotic formulation on frailty syndrome: A randomized, double-blind clinical trial. Int. J. Mol. Sci. 2016; 17:932.
63.Al-Sheraji SH, Ismail A, Manap MY, Mustafa S, Yusof RM, Hassan FA. Prebiotics as functional foods: A review. Journal of functional foods. 2013; 5(4):1542-1553.
Hasona N, Morsi A. Grape seed extract alleviates dexamethasone-induced hyperlipidemia, lipid peroxidation, and hematological alteration in rats. Indian Journal of Clinical Biochemistry. 2019; 34(2):213-218
Seyyedi S-A, Sanatkhani M, Pakfetrat A, Olyaee P. The therapeutic effects of chamomilla tincture mouthwash on oral aphthae: a randomized clinical trial. Journal of Clinical and Experimental Dentistry. 2014; 6(5):e535.
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