title: Efficacy of antioxidants as a Complementary and Alternative Medicine (CAM) in combination with the chemotherapeutic agent doxorubicin.
abstract: BACKGROUND
  Although doxorubicin (Dox)-induced cardiac toxicity and pegylated liposomal doxorubicin (PLD)-induced hand-foot syndrome (HFS) were reported to be correlated with reactive oxygen species (ROS) generation, there is no effective preventive treatment at present. Therefore, the aim of this study was to investigate whether antioxidants-resveratrol (RSVL), tetrahydroxystilbene glucoside (THSG), curcumin, and the ethanolic extract of Antrodia cinnamomea (EEAC)-have the ability to reduce Dox-induced ROS and have a synergistic anticancer effect with Dox that could prevent those side effects and enhance the efficacy of cancer treatment.
  
  
  METHODS
  3T3 normal cells were used as a model to evaluate the effects of these antioxidants in reducing ROS accumulation. Furthermore, the synergistic anticancer effect of antioxidants with Dox on the MCF-7 breast cancer model was also evaluated.
  
  
  RESULTS
  Pretreatment of cells with RSVL, curcumin, and EEAC increased the cell antioxidant ability by improving the activity of superoxide dismutase (SOD), prevented or limited intracellular damage, and ameliorated the harmful effects of ROS. Additionally, RSVL, curcumin, and EEAC had synergistic effects with Dox against MCF-7 breast cancer cells.
  
  
  CONCLUSIONS
  RSVL, curcumin, and EEAC have the potential to be clinically applied to prevent cardiac toxicity and HFS and enhance the anticancer efficiency of Dox.
authors.affiliation: Taipei Medical University, Taipei, Taiwan, ROC.
authors.forename: Ming-Thau
authors.initials: MT
authors.lastname: Sheu
authors.affiliation: Taipei Medical University, Taipei, Taiwan, ROC.
authors.forename: Hua-Jing
authors.initials: HJ
authors.lastname: Jhan
authors.affiliation: Providence University, Taichung City, Taiwan, ROC.
authors.forename: Chien-Ming
authors.initials: CM
authors.lastname: Hsieh
authors.affiliation: Taipei Medical University, Taipei, Taiwan, ROC.
authors.forename: Chien-Ju
authors.initials: CJ
authors.lastname: Wang
authors.affiliation: Taipei Medical University, Taipei, Taiwan, ROC hsiuoho@tmu.edu.tw.
authors.forename: Hsiu-O
authors.initials: HO
authors.lastname: Ho
mesh_terms: D016475:3T3 Cells; D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000494:pharmacology / Q000633:toxicity; D000975:Antioxidants / Q000008:administration & dosage / Q000378:metabolism / Q000494:pharmacology*; D055491:Antrodia / Q000737:chemistry; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000529:Complementary Therapies / Q000379:methods; D003474:Curcumin / Q000008:administration & dosage / Q000494:pharmacology; D004317:Doxorubicin / Q000008:administration & dosage / Q000494:pharmacology* / Q000633:toxicity; D004357:Drug Synergism; D005260:Female; D005960:Glucosides / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D061986:MCF-7 Cells; D051379:Mice; D010936:Plant Extracts / Q000008:administration & dosage / Q000494:pharmacology; D017382:Reactive Oxygen Species / Q000378:metabolism*; D000077185:Resveratrol; D013267:Stilbenes / Q000008:administration & dosage / Q000494:pharmacology; D013482:Superoxide Dismutase / Q000187:drug effects
chemical_list: D000903:Antibiotics, Antineoplastic; D000975:Antioxidants; D005960:Glucosides; D010936:Plant Extracts; D017382:Reactive Oxygen Species; D013267:Stilbenes; C093026:2,3,5,4'-tetrahydroxystilbene 2-O-glucopyranoside; D004317:Doxorubicin; D013482:Superoxide Dismutase; D003474:Curcumin; D000077185:Resveratrol
keywords: Antrodia cinnamomea; curcumin; doxorubicin; reactive oxygen species; resveratrol; tetrahydroxystilbene glucoside