Abstract
Abstract: In the treatment of cancer, the use of ionizing radiation is an important modality. However, on the downside, radiation, when used for curative purposes, causes acute dermatitis or radiodermatitis at the site of radiation in most individuals. From a clinical viewpoint, severe dermatitis causes a burning and itching sensation is very painful and severely affects the quality of life of the individual undergoing treatment. In worse situations, acute radiation dermatitis can cause gaps or breaks in the planned treatment and this can adversely affect the treatment objective and outcome.
Background: In various traditional and folk systems of medicine, plants and plant products have been used since time immemorial for treating various skin ailments. Further, many cosmeceutical creams formulated based on knowledge from ethnomedicinal use are marketed and used to treat various ailments. In the current review, an attempt is made at summarizing the beneficial effects of some plants and plant products in mitigating acute radiation dermatitis in humans undergoing curative radiotherapy. Additionally, emphasis is also placed on the mechanisms responsible for the beneficial effects.
Objective: The objective of this review is to summarize the clinical observations on the prevention of radiodermatitis by plant products. In this review, the protective effects of Adlay (Coix lachryma-jobi L.) bran extract, Aloe vera, Calendula officinalis, Cucumis sativus, green tea constituent the epigallocatechin-3-gallate, honey, Achillea millefolium, Matricaria chamomilla, olive oil, and some polyherbal creams are addressed by also focusing on the mechanism of action for the beneficial effects.
Methods: Two authors’ data mined for information in Google Scholar, PubMed, Embase, and the Cochrane Library for publications in the field from 1901 up to July 2020. The focus was on acute radiation dermatitis, ionizing radiation, curative radiotherapy, human cancer. The articles were collected and analyzed.
Results: For the first time, this review addresses the usefulness of natural products like adlay bran, Aloe vera, Calendula officinalis, Cucumis sativus, green tea constituent the epigallocatechin-3-gallate, honey, Achillea millefolium, Matricaria chamomilla, olive oil, and some experimentally constituted and commercially available polyherbal creams as skincare agents against the deleterious effects of ionizing radiation on the skin. The protective effects are possibly due to the free radical scavenging, antioxidant, anti-inflammatory, wound healing and skin protective effects.
Conclusion: The authors suggest that these plants have been used since antiquity as medicinal agents and require in-depth investigation with both clinical and preclinical validated models of study. The results of these studies will be extremely useful to cancer patients requiring curative radiotherapy, the dermatology fraternity, agro-based and pharmaceutical sectors at large.
Keywords: Ionizing radiation, dermatitis, radiation protection, Coix lachryma-jobi L., Aloe vera, Calendula officinalis, Cucumis sativus, green tea constituent the epigallocatechin-3-gallate, honey, Achillea millefolium, Matricaria chamomilla, Olive oil, Vicco turmeric, polyherbal creams.
[PMID: 12095893]
[http://dx.doi.org/10.1007/s40257-016-0186-4] [PMID: 27021652]
[http://dx.doi.org/10.4103/ijd.IJD_607_18] [PMID: 32831368]
[http://dx.doi.org/10.1055/s-0030-1255330] [PMID: 22550433]
[PMID: 29345152]
[http://dx.doi.org/10.1177/1534735418803766] [PMID: 30289008]
[PMID: 11966833]
[http://dx.doi.org/10.12788/j.suponc.0009] [PMID: 24645338]
[http://dx.doi.org/10.1016/j.jvs.2010.06.175] [PMID: 20843630]
[http://dx.doi.org/10.1038/jid.2011.411] [PMID: 22217743]
[http://dx.doi.org/10.1021/acs.jafc.6b04313] [PMID: 27796089]
[http://dx.doi.org/10.1080/09553002.2018.1440092] [PMID: 29504497]
[http://dx.doi.org/10.2174/092986709787002790] [PMID: 19149566]
[http://dx.doi.org/10.1667/RR1948.1] [PMID: 20518654]
[http://dx.doi.org/10.1007/s10059-011-0276-3] [PMID: 22207195]
[http://dx.doi.org/10.1016/j.lfs.2003.10.042] [PMID: 15172174]
[http://dx.doi.org/10.1248/bpb.30.1102] [PMID: 17541161]
[PMID: 10646872]
[http://dx.doi.org/10.1038/sj.onc.1206701] [PMID: 12947395]
[http://dx.doi.org/10.1038/nrd3403] [PMID: 21629295]
[http://dx.doi.org/10.1038/cmi.2014.89] [PMID: 25263488]
[http://dx.doi.org/10.1667/RR3097.1] [PMID: 22856653]
[http://dx.doi.org/10.1038/nrc1950] [PMID: 16929324]
[http://dx.doi.org/10.1016/j.bbadis.2009.06.004] [PMID: 19539753]
[http://dx.doi.org/10.2174/1874467211666180219102520] [PMID: 29468988]
[http://dx.doi.org/10.15190/d.2015.27] [PMID: 32309561]
[http://dx.doi.org/10.1016/j.cell.2008.01.020] [PMID: 18267068]
[http://dx.doi.org/10.1016/S0092-8674(02)00703-1] [PMID: 11983155]
[http://dx.doi.org/10.1101/gad.909001] [PMID: 11562344]
[http://dx.doi.org/10.1080/09553000601132642] [PMID: 17378522]
[http://dx.doi.org/10.1016/j.bcp.2006.07.015] [PMID: 16965765]
[PMID: 20198301]
[http://dx.doi.org/10.1016/0360-3016(95)00060-C] [PMID: 7713792]
[http://dx.doi.org/10.1097/01.coc.0000138965.97476.0f] [PMID: 15577442]
[http://dx.doi.org/10.12968/bjon.1999.8.18.6490] [PMID: 10897708]
[http://dx.doi.org/10.12968/bjon.1999.8.19.1305] [PMID: 10887808]
[http://dx.doi.org/10.1016/j.radmp.2020.02.004]
[http://dx.doi.org/10.1016/j.breast.2015.01.008] [PMID: 25777626]
[http://dx.doi.org/10.1007/s00520-013-1896-2] [PMID: 23942595]
[http://dx.doi.org/10.1007/s12282-020-01082-3] [PMID: 32363524]
[http://dx.doi.org/10.1188/11.CJON.481-492] [PMID: 21951735]
[http://dx.doi.org/10.1188/20.ONF.101-111] [PMID: 31845919]
[http://dx.doi.org/10.3747/co.v17i4.493] [PMID: 20697521]
[http://dx.doi.org/10.4252/wjsc.v5.i3.68] [PMID: 23951388]
[PMID: 18046995]
[http://dx.doi.org/10.5152/eajm.2011.34] [PMID: 25610188]
[http://dx.doi.org/10.1097/01.COC.0000071418.12121.C2] [PMID: 15289728]
[http://dx.doi.org/10.1016/j.adengl.2017.02.005] [PMID: 28010872]
[http://dx.doi.org/10.1093/annonc/mdr139] [PMID: 21606209]
[http://dx.doi.org/10.1016/S0167-8140(96)01882-8] [PMID: 9106924]
[PMID: 28982842]
[http://dx.doi.org/10.2146/ajhp120467] [PMID: 23719879]
[http://dx.doi.org/10.1007/s12325-021-01640-x] [PMID: 33570737]
[http://dx.doi.org/10.1016/j.jep.2012.01.039] [PMID: 22326378]
[http://dx.doi.org/10.3389/fphar.2013.00177] [PMID: 24454289]
[http://dx.doi.org/10.3389/fpls.2018.00847] [PMID: 29997637]
[http://dx.doi.org/10.1016/j.phymed.2017.11.005] [PMID: 30166104]
[http://dx.doi.org/10.4155/fsoa-2017-0061] [PMID: 29134131]
[http://dx.doi.org/10.1007/s00232-013-9588-x] [PMID: 23959026]
[http://dx.doi.org/10.1002/ptr.5840] [PMID: 28618131]
[PMID: 22615655]
[http://dx.doi.org/10.2174/138161208786404281] [PMID: 19075697]
[http://dx.doi.org/10.1016/j.jpag.2014.12.008] [PMID: 26238568]
[http://dx.doi.org/10.1142/S0192415X2050055X] [PMID: 32668966]
[http://dx.doi.org/10.1016/j.jep.2017.02.002] [PMID: 28163113]
[http://dx.doi.org/10.1016/j.jep.2017.06.006] [PMID: 28602757]
[http://dx.doi.org/10.1177/1091581816677717] [PMID: 27913788]
[http://dx.doi.org/10.1016/S2225-4110(16)30112-2] [PMID: 24716141]
[http://dx.doi.org/10.1016/j.lwt.2005.08.003]
[http://dx.doi.org/10.1021/jf990473t] [PMID: 10725158]
[http://dx.doi.org/10.1021/jf021142a] [PMID: 12769541]
[http://dx.doi.org/10.1016/j.fct.2004.03.011] [PMID: 15207385]
[http://dx.doi.org/10.1126/science.299.5604.188] [PMID: 12522228]
[http://dx.doi.org/10.1080/10408398.2018.1496320]
[http://dx.doi.org/10.1007/s11130-019-00747-5] [PMID: 31209704]
[http://dx.doi.org/10.3390/molecules13081599] [PMID: 18794775]
[http://dx.doi.org/10.1007/978-1-62703-167-7_13]
[http://dx.doi.org/10.1159/000114871] [PMID: 18253066]
[http://dx.doi.org/10.1111/1523-1747.ep12371762] [PMID: 7906286]
[PMID: 7561562]
[http://dx.doi.org/10.1177/1534735407309079] [PMID: 18048889]
[http://dx.doi.org/10.1615/JEnvironPatholToxicolOncol.v29.i2.60] [PMID: 20932247]
[http://dx.doi.org/10.1111/j.1468-3083.2004.01186.x] [PMID: 15857459]
[http://dx.doi.org/10.5021/ad.2009.21.1.6] [PMID: 20548848]
[http://dx.doi.org/10.1615/JEnvironPatholToxicolOncol.v28.i1.60] [PMID: 19392655]
[http://dx.doi.org/10.1248/yakushi1947.109.2_113] [PMID: 2746469]
[http://dx.doi.org/10.1248/yakushi1947.115.1_24] [PMID: 7699579]
[http://dx.doi.org/10.1016/0360-3016(94)00467-Y] [PMID: 7607925]
[http://dx.doi.org/10.1016/j.amjsurg.2010.06.017] [PMID: 21396624]
[http://dx.doi.org/10.1016/j.ctcp.2019.01.013] [PMID: 31003648]
[http://dx.doi.org/10.1001/jama.1936.02770160021006]
[http://dx.doi.org/10.1002/jps.3030290806]
[http://dx.doi.org/10.1038/jid.1949.43] [PMID: 18129646]
[http://dx.doi.org/10.1097/00002820-200212000-00007] [PMID: 12464836]
[http://dx.doi.org/10.1080/02841860701243087] [PMID: 17917821]
[http://dx.doi.org/10.1016/S0360-3016(96)00320-3] [PMID: 8892458]
[http://dx.doi.org/10.3390/foods6090077] [PMID: 28878156]
[http://dx.doi.org/10.3747/co.20.1356] [PMID: 23904773]
[http://dx.doi.org/10.1248/cpb.49.863] [PMID: 11456093]
[PMID: 17415852]
[http://dx.doi.org/10.1007/978-0-387-70638-2]
[http://dx.doi.org/10.2147/IJGM.S16709] [PMID: 21556350]
[http://dx.doi.org/10.1001/archpedi.155.7.796] [PMID: 11434846]
[http://dx.doi.org/10.1542/peds.111.5.e574] [PMID: 12728112]
[PMID: 2432691]
[http://dx.doi.org/10.4103/0973-7847.120520] [PMID: 24347926]
[http://dx.doi.org/10.3164/jcbn.2008043] [PMID: 18818737]
[PMID: 16372475]
[http://dx.doi.org/10.1200/JCO.2004.07.063] [PMID: 15084618]
[http://dx.doi.org/10.1016/j.ejon.2012.11.003] [PMID: 23245940]
[http://dx.doi.org/10.1177/1091581810384883] [PMID: 21164072]
[PMID: 21928714]
[http://dx.doi.org/10.1186/1748-717X-8-57] [PMID: 23497676]
[http://dx.doi.org/10.1179/135100002125000325] [PMID: 12189055]
[PMID: 8720810]
[http://dx.doi.org/10.3389/fphys.2017.00440]
[http://dx.doi.org/10.1159/000217583] [PMID: 19420983]
[http://dx.doi.org/10.1002/ptr.5236] [PMID: 25266574]
[PMID: 19374166]
[http://dx.doi.org/10.3390/antiox4020293] [PMID: 26783706]
[http://dx.doi.org/10.1016/j.fitote.2012.10.003] [PMID: 23098877]
[http://dx.doi.org/10.1073/pnas.1005338107] [PMID: 20656934]
[http://dx.doi.org/10.1007/s00403-010-1103-y] [PMID: 21153830]
[http://dx.doi.org/10.1039/b418841c] [PMID: 16010347]
[http://dx.doi.org/10.1021/jf030131u] [PMID: 14664542]
[http://dx.doi.org/10.1111/j.1745-4514.2009.00296.x]
[http://dx.doi.org/10.1016/S0190-9622(84)80466-1] [PMID: 6096420]
[PMID: 2523288]
[http://dx.doi.org/10.1016/S0733-8635(18)30082-2] [PMID: 7600706]
[PMID: 3514154]
[http://dx.doi.org/10.1177/1534735420920714] [PMID: 32406284]
[http://dx.doi.org/10.1080/07352689709701956]
[http://dx.doi.org/10.1039/B505311K] [PMID: 16465310]
[http://dx.doi.org/10.1259/bjr.20150665] [PMID: 26607642]
[http://dx.doi.org/10.18632/oncotarget.9495] [PMID: 27224910]
[http://dx.doi.org/10.1186/1741-7015-4-28] [PMID: 17140430]
[http://dx.doi.org/10.3390/molecules170910355] [PMID: 22932216]
[http://dx.doi.org/10.1016/j.mrgentox.2012.04.002] [PMID: 22521723]
[http://dx.doi.org/10.1074/jbc.M004209200] [PMID: 11278274]
[http://dx.doi.org/10.1016/j.bcp.2011.07.093] [PMID: 21827739]
[http://dx.doi.org/10.1016/S0006-2952(99)00335-4] [PMID: 10644043]
[PMID: 11502884]
[PMID: 23997898]
[PMID: 18650599]
[http://dx.doi.org/10.1080/00218839.2017.1411182]
[http://dx.doi.org/10.1155/2017/5904361] [PMID: 28479926]
[http://dx.doi.org/10.1155/2018/8367846] [PMID: 29492183]
[http://dx.doi.org/10.1186/1472-6882-6-6] [PMID: 16533410]
[http://dx.doi.org/10.1016/S0308-8146(03)00089-X]
[http://dx.doi.org/10.1186/1743-7075-9-61] [PMID: 22716101]
[http://dx.doi.org/10.1080/02841860600781799] [PMID: 16864180]
[http://dx.doi.org/10.1111/j.1524-475X.2012.00825.x] [PMID: 22882448]
[PMID: 12024746]
[http://dx.doi.org/10.2174/092986713804999358] [PMID: 23298140]
[http://dx.doi.org/10.1016/j.fct.2012.05.046] [PMID: 22683488]
[http://dx.doi.org/10.1021/jf0114637] [PMID: 11982440]
[http://dx.doi.org/10.1080/14786419.2014.940945] [PMID: 25105348]
[http://dx.doi.org/10.1111/j.1751-1097.2012.01100.x] [PMID: 22276569]
[http://dx.doi.org/10.1007/s11130-017-0634-1] [PMID: 28929426]
[http://dx.doi.org/10.1155/2015/987385] [PMID: 26508989]
[http://dx.doi.org/10.1002/ptr.2049] [PMID: 17160970]
[http://dx.doi.org/10.1177/0960327113482693] [PMID: 23584354]
[http://dx.doi.org/10.1007/s11011-013-9458-3] [PMID: 24318481]
[http://dx.doi.org/10.12968/jowc.2008.17.4.28839] [PMID: 18494436]
[http://dx.doi.org/10.1021/jf302468h] [PMID: 23176387]
[http://dx.doi.org/10.1089/1096620041224139] [PMID: 15298770]
[http://dx.doi.org/10.4103/0973-7847.79103] [PMID: 22096322]
[http://dx.doi.org/10.1248/yakushi1947.115.2_130]
[http://dx.doi.org/10.1016/j.fitote.2019.104267] [PMID: 31319107]
[http://dx.doi.org/10.1002/ptr.3245] [PMID: 20641055]
[http://dx.doi.org/10.1111/j.1365-4632.2011.05235.x] [PMID: 22715822]
[PMID: 21617262]
[http://dx.doi.org/10.1590/S0104-11692011000100002] [PMID: 21412623]
[http://dx.doi.org/10.1007/BF00316465] [PMID: 8513841]
[http://dx.doi.org/10.1177/1534735420962174] [PMID: 32985288]
[http://dx.doi.org/10.1093/aob/mcy002] [PMID: 29390111]
[http://dx.doi.org/10.3390/ijms13033291] [PMID: 22489153]
[http://dx.doi.org/10.1016/S1470-2045(00)00015-2] [PMID: 11905662]
[PMID: 18069902]
[http://dx.doi.org/10.3390/ijms19030686] [PMID: 29495598]
[http://dx.doi.org/10.3390/medicines5010013] [PMID: 29360770]
[http://dx.doi.org/10.3390/molecules22071082] [PMID: 28661446]
[http://dx.doi.org/10.3945/jn.109.104992] [PMID: 19776181]
[http://dx.doi.org/10.1016/j.phymed.2009.06.003] [PMID: 19577913]
[http://dx.doi.org/10.1016/S0923-1811(00)00083-9] [PMID: 10764992]
[http://dx.doi.org/10.4081/ejh.2017.2784] [PMID: 29046052]
[http://dx.doi.org/10.1002/jcp.27584] [PMID: 30367495]
[http://dx.doi.org/10.1080/09553007714550561] [PMID: 301513]
[PMID: 26379896]
[http://dx.doi.org/10.1159/000496062] [PMID: 31933586]
[http://dx.doi.org/10.1201/b10787]
[http://dx.doi.org/10.22270/jddt.v9i1-s.2339]
[http://dx.doi.org/10.3923/ajava.2011.867.883]
[http://dx.doi.org/10.4103/0975-9476.65081] [PMID: 21836797]
[http://dx.doi.org/10.4103/0973-7847.134229] [PMID: 25125878]
[http://dx.doi.org/10.1259/bjr.20130490] [PMID: 24694358]
[http://dx.doi.org/10.3390/medicines4030043] [PMID: 28930259]
[http://dx.doi.org/10.1016/S0142-9612(03)00625-2] [PMID: 14738855]
[http://dx.doi.org/10.1177/1534734605281674] [PMID: 16286372]
[http://dx.doi.org/10.1046/j.1524-475X.1998.60211.x] [PMID: 9776860]
[http://dx.doi.org/10.1097/BCR.0b013e318203337b] [PMID: 21088615]
[http://dx.doi.org/10.1111/j.2042-7158.1973.tb09131.x] [PMID: 4146582]
[http://dx.doi.org/10.1016/S0006-2952(98)00237-8] [PMID: 9973181]
[http://dx.doi.org/10.1002/biof.5520160104] [PMID: 12515914]
[http://dx.doi.org/10.1089/pho.2011.3004] [PMID: 21819258]
[http://dx.doi.org/10.1007/s10735-012-9452-9] [PMID: 23054142]
[http://dx.doi.org/10.1002/mnfr.201000221] [PMID: 20938987]
[http://dx.doi.org/10.1097/00005373-200111000-00017] [PMID: 11706342]
[http://dx.doi.org/10.1046/j.1365-2133.2000.03767.x] [PMID: 11069500]
[http://dx.doi.org/10.1290/1543-706X(2003)039<0036:COAEOE>2.0.CO;2] [PMID: 12892525]
[http://dx.doi.org/10.3390/molecules16053908] [PMID: 21555979]
[http://dx.doi.org/10.1089/rej.2009.0906] [PMID: 20426620]
[http://dx.doi.org/10.1093/carcin/14.2.293] [PMID: 8435870]
[http://dx.doi.org/10.1089/pho.2009.2637] [PMID: 20961233]
[http://dx.doi.org/10.1038/emm.2005.25] [PMID: 16000872]
[http://dx.doi.org/10.1080/01635589209514174] [PMID: 1574446]
[http://dx.doi.org/10.1016/S0304-3835(97)00187-0] [PMID: 9215864]
[http://dx.doi.org/10.1207/S15327914NC441_9] [PMID: 12672643]
[http://dx.doi.org/10.1002/(SICI)1097-4644(1997)27+<26:AID-JCB7>3.0.CO;2-3] [PMID: 9591190]
[PMID: 3139287]
[http://dx.doi.org/10.1186/1471-2407-1-1] [PMID: 11231886]
[http://dx.doi.org/10.1177/030089168707300105] [PMID: 2435036]
[PMID: 17695502]
[http://dx.doi.org/10.1097/01.cej.0000178075.20124.2a] [PMID: 16175052]
[http://dx.doi.org/10.1093/carcin/bgl058] [PMID: 16679309]
[http://dx.doi.org/10.1111/php.12070] [PMID: 23480292]
[http://dx.doi.org/10.1016/j.jtcme.2016.08.002] [PMID: 28725630]
[http://dx.doi.org/10.4103/ijdvl.IJDVL_1143_16] [PMID: 29243674]
[PMID: 19594223]
[http://dx.doi.org/10.3390/nu11092169] [PMID: 31509968]
[http://dx.doi.org/10.1111/j.1365-2230.1994.tb01167.x] [PMID: 8033378]
[http://dx.doi.org/10.1016/j.burns.2018.03.004] [PMID: 31126777]
[http://dx.doi.org/10.3390/ijms19092842] [PMID: 30235888]
[http://dx.doi.org/10.3390/molecules25030556] [PMID: 32012913]
[http://dx.doi.org/10.4103/0973-7847.91114] [PMID: 22279374]
[http://dx.doi.org/10.1159/000357477] [PMID: 24993834]
[http://dx.doi.org/10.1016/j.ejpb.2012.03.002] [PMID: 22430217]
[http://dx.doi.org/10.1089/acm.2009.0317] [PMID: 20064022]
[PMID: 24214835]
[http://dx.doi.org/10.1016/S2221-1691(13)60105-7] [PMID: 23835719]
[PMID: 20509719]
[http://dx.doi.org/10.2174/1568011053174828] [PMID: 15777222]
[http://dx.doi.org/10.1186/s13014-014-0297-0] [PMID: 25544371]
[http://dx.doi.org/10.1007/s12032-017-0886-5] [PMID: 28101834]
[http://dx.doi.org/10.1177/0300060519882176] [PMID: 31875751]
[http://dx.doi.org/10.1136/bcr-2012-007299]
[http://dx.doi.org/10.1074/jbc.M112.341321] [PMID: 22645149]
[http://dx.doi.org/10.1111/idh.12191] [PMID: 26876277]
[http://dx.doi.org/10.3389/fphar.2011.00007] [PMID: 21687502]
[http://dx.doi.org/10.1111/dth.13186] [PMID: 31830356]
[http://dx.doi.org/10.1155/2016/7382506] [PMID: 27034694]
[http://dx.doi.org/10.1016/j.phymed.2017.07.001] [PMID: 28899496]
[http://dx.doi.org/10.1159/000329214] [PMID: 21709432]
[PMID: 30179391]
[http://dx.doi.org/10.4161/cbt.12.6.16850] [PMID: 21743298]
[http://dx.doi.org/10.1017/S1477200005001842]
[http://dx.doi.org/10.1007/s002130000625] [PMID: 11243487]
[http://dx.doi.org/10.1211/0022357011775910] [PMID: 11370698]