A comprehensive systematic review of the therapeutic effects and mechanisms of action of quercetin in sepsis

Karimi, Arash; Naeini, Fatemeh; Azar, Vahid Asghari; Hasanzadeh, Malihe; Ostadrahimi, Alireza; Niazkar, Hamid Reza; Mobasseri, Majid; Tutunchi, Helda

doi:10.1016/j.phymed.2021.153567

Cited by 44 publications

(26 citation statements)

References 89 publications

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“…The protective effect of QUR on hematological parameters was previously reported in furan- and cadmium-intoxicated rats [ 42 , 43 ]. This may be attributed to the antioxidant and genoprotective effects of QUR [ 20 ]. The protective effect of QUR on various blood cells is in line with the recorded enhancement of antioxidant status as well as the alleviation of the inflammatory and apoptotic responses in the spleen of DOX-treated rats.…”

Section: Discussionmentioning

confidence: 99%

“…It has been established that combination therapy with phytochemicals that have antioxidant and anti-inflammatory activities is beneficial in providing protection against chemotherapy-induced oxidative damage and immunomodulation [ 19 ]. Quercetin (QUR) is a plant flavonoid widely distributed in many vegetables, fruits, and seeds such as apples, cherries, grapes, onions, broccoli, peanuts, soybeans, as well as beverages of plant origin such as tea and wine [ 20 ]. It possesses antioxidant properties that may improve general health and physical/mental performance.…”

Section: Introductionmentioning

confidence: 99%

“…It possesses antioxidant properties that may improve general health and physical/mental performance. In addition, it has antimicrobial, anti-allergic, antineoplastic, antihypertensive, and hypolipidemic properties [ 20 , 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Quercetin Alleviates the Immunotoxic Impact Mediated by Oxidative Stress and Inflammation Induced by Doxorubicin Exposure in Rats

et al. 2021

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Doxorubicin (DOX) is a chemotherapeutic agent against hematogenous and solid tumors with undesirable side effects including immunosuppression. Quercetin (QUR), a natural flavonoid abundant in fruits and vegetables, has a potent antioxidant activity. The aim of the current study was to assess the impact of QUR on DOX-induced hematological and immunological dysfunctions in a rodent model. Randomly grouped rats were treated as follows: control, QUR alone (50 mg/kg for 15 days per os), DOX alone (2.5 mg/kg I/P, three times a week, for two weeks), and co-treated rats with QUR for 15 days prior to and concomitantly with DOX (for two weeks), at the doses intended for groups two and three. DOX alone significantly disrupted the erythrogram and leukogram variables. Serum immunoglobulin (IgG, IgM, and IgE) levels and the activities of catalase (CAT) and superoxide dismutase (SOD) in spleen were declined. The DNA damage traits in spleen were elevated with an upregulation of the expression of the apoptotic markers (p53 and Caspase-3 genes) and the proinflammatory cytokines (IL-6 and TNF-α genes), while the expression of CAT gene was downregulated. These biochemical changes were accompanied by morphological changes in the spleen of DOX-treated rats. Co-treatment with QUR abated most of the DOX-mediated alterations in hematological variables, serum immunoglobulins, and spleen antioxidant status, pro-inflammatory and apoptotic responses, and histopathological alterations. In essence, these data suggest that QUR alleviated DOX-induced toxicities on the bone marrow, spleen, and antibody-producing cells. Supplementation of chemotherapy patients with QUR could circumvent the DOX-induced inflammation and immunotoxicity, and thus prevent chemotherapy failure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quercetin Alleviates the Immunotoxic Impact Mediated by Oxidative Stress and Inflammation Induced by Doxorubicin Exposure in Rats

et al. 2021

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“…The results indicate that treatment with quercetin decreases the levels of COX-2, MDA, and nitrates but increases the expression of the anti-oxidants glutathione, glutathione peroxidase, superoxide dismutase, and catalase, accompanied by downregulation of NF-κB activation and expression of the pro-inflammatory molecules TNF-α, IL-1β, IL-6, and high-mobility group box 1 protein. 102 A combination of quercetin and vitamin C also has been advocated to ameliorate respiratory infections, such as COVID-19, due to their synergistic antioxidant role. 103 Clinical trials have revealed that quercetin has successfully reduced oxidative stress, IL-8, and TNF-α levels in sarcoidosis patients.…”

Section: Piperinementioning

confidence: 99%

Plant-based Immunomodulators and Their Potential Therapeutic Actions

Pathak¹,

Fialho²,

Nandi³

2022

J Explor Res Pharmacol

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Immunomodulation is a diverse process by which immunomodulators enhance or suppress immune responses to control disease progression. Immunomodulators are a broad class of drugs that include immunosuppressants and immunostimulants. These agents have been used to fight against the dysregulated immune responses observed during tissue/organ transplantation and disorders, such as rheumatoid arthritis, ulcerative colitis, and cancers. Immunomodulators obtained from a myriad of plant sources are a major class of compounds that are known to have medicinal properties and are used for the treatment of various diseases. However, the mechanisms underlying the action of plant-derived compounds are poorly understood. Here, we discuss the major classes of plantbased immunomodulators with examples and their effects on the major signaling pathways, such as the nuclear factor kappa light chain enhancer of activated B cells (NF-κB), mitogen-activated protein kinase (MAPK), and mammalian target of rapamycin pathways. Importantly, we discuss the preclinical and clinical research to date to understand the importance of these immunomodulators. Overall, this review highlights the significance of plantbased immunomodulators as an alternative therapeutic strategy for combating various diseases.

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“…Sepsis is a major infectious disease that prolongs the length of stay in hospital and intensive care units (ICU) in critically ill patients, which can lead to increased mortality and costs of health services (Arash Karimi et al, 2021; Kempker & Martin, 2018). According to the definitions of sepsis, which were offered by the society of critical care medicine and the European society of intensive care medicine, sepsis refers to an organ dysfunction caused by an infection (Singer et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Does nano‐curcumin supplementation improve hematological indices in critically ill patients with sepsis? A randomized controlled clinical trial

Naeini

Tutunchi

Razmi

et al. 2022

Journal of Food Biochemistry

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Sepsis is the final common pathway to death for severe infectious diseases worldwide. The present trial aimed to investigate the effects of nano‐curcumin supplementation on hematological indices in critically ill patients with sepsis. Fourteen ICU‐admitted patients were randomly allocated into either nano‐curcumin or placebo group for 10 days. The blood indices, serum levels of inflammatory biomarker and presepsin as well as nutrition status, and clinical outcomes were assessed before the intervention and on days 5 and 10. White blood cells, neutrophils, platelets, erythrocyte sedimentation rate (ESR), and the levels of interleukin‐8 significantly decreased in the nano‐curcumin group compared to the placebo after 10 days of intervention (p = .024, p = .045, p = .017, p = .041, and p = .004, respectively). There was also a marginal meaningful decrease in serum presepsin levels in the intervention group compared to the placebo at the end of the study (p = .054). However, total lymphocyte count showed a significant increase in the nano‐curcumin group compared to the placebo at the end‐point (p = .04). No significant differences were found in the level of lymphocyte and the ratios of neutrophil/lymphocyte and platelet/lymphocyte between the study groups. Moreover, no significant between‐group differences were observed for other study outcomes, post‐intervention. Collectively, nano‐curcumin may be a useful adjuvant therapy in critically ill patients with sepsis. However, further trials are suggested to examine the effects of nano‐curcumin in the management of sepsis and its complications. Practical applications Curcumin (1,7‐bis[4‐hydroxy‐3‐methoxyphenyl]‐1,6‐heptadiene‐3,5‐ dione) or diferuloylmethane is widely used in medicine due to its several biological properties. Recent evidence has shown that curcumin possesses multiple pharmacological activities including immune‐modulatory, antioxidant, anti‐inflammatory, anti‐cancer, and anti‐microbial effects. In this study, it was observed that nano‐curcumin at a dose of 160 mg for 10 days, without side effects, reduced some inflammatory factors and regulated the immune responses in sepsis patients. For the first time, this trial was conducted to determine the effect of nano‐curcumin on hematological indices and the serum levels of presepsin and IL‐8.

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A comprehensive systematic review of the therapeutic effects and mechanisms of action of quercetin in sepsis

Cited by 44 publications

References 89 publications

Quercetin Alleviates the Immunotoxic Impact Mediated by Oxidative Stress and Inflammation Induced by Doxorubicin Exposure in Rats

Quercetin Alleviates the Immunotoxic Impact Mediated by Oxidative Stress and Inflammation Induced by Doxorubicin Exposure in Rats

Plant-based Immunomodulators and Their Potential Therapeutic Actions

Does nano‐curcumin supplementation improve hematological indices in critically ill patients with sepsis? A randomized controlled clinical trial

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