Effectiveness of crocin of saffron (Crocus sativus L.) against chemotherapy-induced peripheral neuropathy: A randomized, double-blind, placebo-controlled clinical trial

Bozorgi, Hooman; Ghahremanfard, Farahnaz; Motaghi, Ehsan; Zamaemifard, Maryam; Zamani, Melika; Izadi, Amin

doi:10.1016/j.jep.2021.114511

Cited by 17 publications

(21 citation statements)

References 37 publications

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“…With a limitation of extremely low yield and labor extensive handling, saffron production usually comes with high costs. However, it continuously attracts numerous studies for various health-related diseases in human subjects, such as inflammatory status of elderly hypertensive men ( Mojtahedi et al, 2022 ), obese men with type 2 diabetes mellitus ( Hooshmand Moghadam et al, 2022 ), chemotherapy-induced peripheral neuropathy ( Bozorgi et al, 2021 ), and it has been shown to increase happiness as it reduces depression ( Moghadam et al, 2021 ). In Iran, the dried, red stigmas of the C. sativus are thought to be a stimulant with anti-spasmodic action and are also a favorite coloring spice in food ( Parsa, 1959b ).…”

Section: Resultsmentioning

confidence: 99%

The current status of old traditional medicine introduced from Persia to China

Shi

Yang²,

Zhou³

et al. 2022

Front. Pharmacol.

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Traditional Chinese medicine (TCM) includes over ten thousand herbal medicines, some of which were introduced from outside countries and territories. The Silk Road enabled the exchange of merchandise such as teas, silks, carpets, and medicines between the East and West of the Eurasia continent. During this time, the ‘Compendium of Materia Medica’ (CMM) was composed by a traditional medicine practitioner, Shizhen Li (1,518–1,593) of the Ming Dynasty. This epoch-making masterpiece collected knowledge of traditional medical materials and treatments in China from the 16th century and before in utmost detail, including the origin where a material was obtained. Of 1892 medical materials from the CMM, 46 came from Persia (now Iran). In this study, the basic information of these 46 materials, including the time of introduction, the medicinal value in TCM theory, together with the current status of these medicines in China and Iran, are summarized. It is found that 20 herbs and four stones out of the 46 materials are registered as medicinal materials in the latest China Pharmacopoeia. Now most of these herbs and stones are distributed in China or replacements are available but saffron, ferula, myrrh, and olibanum are still highly dependent on imports. This study may contribute to the further development, exchange, and internationalization of traditional medicine of various backgrounds in the world, given the barriers of transportation and language are largely eased in nowadays.

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Section: Resultsmentioning

confidence: 99%

The current status of old traditional medicine introduced from Persia to China

Shi

Yang²,

Zhou³

et al. 2022

Front. Pharmacol.

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“…As shown above, crocin has been demonstrated to attenuate neuropathic pain in animal models ( Table 1 ). In the only randomized, double-blind, placebo-controlled trial conducted so far by Bozorgi et al [ 32 ], its statistically significant effectiveness for relieving symptoms of chemotherapy-induced peripheral neuropathy was confirmed. In that study, cancer patients were randomly treated with 15 mg crocin twice daily by oral route versus placebo for 8 weeks (details of this study are presented in Table 2 ).…”

Section: Carotenoids As An Adjuvant Treatment Of Neuropathic Painmentioning

confidence: 95%

“…During the study it was also observed that crocin had no serious adverse effects, except nausea (grade 2). The incidence of other adverse effects did not differ statistically significantly between the study and the control groups, and included increased appetite, sedation, headache, hypomania, stomachache, vomiting, and swelling of the feet [ 32 ].…”

Section: Carotenoids As An Adjuvant Treatment Of Neuropathic Painmentioning

confidence: 99%

“…As was shown above, crocetin/crocin, xanthophylls (astaxanthin, beta-cryptoxanthin, and fucoxanthin), as well as bixin and lycopene have been demonstrated to attenuate neuropathic pain in animal models. However, the authors identified only one RCT [ 32 ] that positively evaluated the effectiveness of crocin in chemotherapy-induced peripheral neuropathy, and two interventional studies that confirmed beneficial effects of lycopene in the adjuvant treatment of cancer-related pain in patients with metastatic prostate cancer [ 48 , 49 ]. Unfortunately, the results of the abovementioned studies, due to their small number and the lack of detailed data allowing for a thorough assessment of the analgesic properties of lycopene, do not allow for the presentation of recommendations regarding the effectiveness of crocetin and lycopene in relieving neuropathic pain.…”

Section: Carotenoid Supplementation In Palliative Care Patients—is It...mentioning

confidence: 99%

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Carotenoids in Palliative Care—Is There Any Benefit from Carotenoid Supplementation in the Adjuvant Treatment of Cancer-Related Symptoms?

2022

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Carotenoids are organic, liposoluble pigments found in nature, which are responsible for the characteristic colors of ripe tomatoes, carrots, peppers, and crustaceans, among others. Palliative care provided to patients with an incurable disease is aimed at improving the patient’s quality of life through appropriate treatment of symptoms accompanying the disease. Palliative care patients with burdensome symptoms related to advanced-stage cancers are especially interested in the use of natural dietary supplements and herbal remedies to reduce symptoms’ intensity and ameliorate the quality of life. Carotenoids seem to be a group of natural compounds with particularly promising properties in relieving symptoms, mainly due to their strong antioxidant, anti-inflammatory, and neuroprotective properties. Moreover, carotenoids have been used in folk medicine to treat various diseases and alleviate the accompanying symptoms. In this narrative review, the authors decided to determine whether there is any scientific evidence supporting the rationale for carotenoid supplementation in advanced-stage cancer patients, with particular emphasis on the adjuvant treatment of cancer-related symptoms, such as neuropathic pain and cancer-related cachexia.

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“…Crocin was investigated in an 18-week open-labeled, randomized, controlled, crossover study specific to the curative effect of CIPN through the scores of pain, quality of life, ENS, and sensory neuropathy (Bozorgi et al, 2021). The total sample size was 177.…”

Section: Crocinmentioning

confidence: 99%

Treatment for chemotherapy-induced peripheral neuropathy: A systematic review of randomized control trials

2022

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Purpose: Treatment of chemotherapy-induced peripheral neuropathy (CIPN) is challenging for clinicians, and many clinical trials and meta-analyses on CIPN are controversial. There are also few comparisons of the efficacy among drugs used to treat CIPN. Therefore, this systematic review aimed to study the efficacy of drugs in treating CIPN using existing randomized controlled trials.Methods: Electronic databases were searched for randomized controlled trials (RCTs) involving any pharmaceutical intervention and/or combination therapy of treating CIPN.Results: Seventeen RCTs investigating 16 drug categories, duloxetine, pregabalin, crocin, tetrodotoxin, venlafaxine, monosialotetrahexosyl ganglioside (GM1), lamotrigine, KA (ketamine and amitriptyline) cream, nortriptyline, amitriptyline, topical Citrullus colocynthis (bitter apple) oil, BAK (baclofen, amitriptyline hydrochloride, and ketamine) pluronic lecithin organogel, gabapentin, and acetyl l-carnitine (ALC), in the treatment of CIPN were retrieved. Many of the included RCTs consisted of small sample sizes and short follow-up periods. It was difficult to quantify due to the highly variable nature of outcome indicators.Conclusion: Duloxetine, venlafaxine, pregabalin, crocin, tetrodotoxin, and monosialotetrahexosyl ganglioside exhibited some beneficial effects in treating CIPN. Duloxetine, GM1, and crocin showed moderate benefits based on the evidence review, while lamotrigine, KA cream, nortriptyline, amitriptyline, and topical Citrullus colocynthis (bitter apple) oil were not beneficial. Further studies were necessary to confirm the efficacy of gabapentin in the treatment of CIPN because of the controversy of efficacy of gabapentin. Furthermore, BAK topicalcompound analgesic gel only had a tendency to improve the CIPN symptoms, but the difference was not statistically significant. ALC might result in worsening CIPN. Most studies were not of good quality because of small sample sizes. Therefore, standardized randomized controlled trials with large samples were needed to critically assess the effectiveness of these drugs in treating CIPN in the future.

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Effectiveness of crocin of saffron (Crocus sativus L.) against chemotherapy-induced peripheral neuropathy: A randomized, double-blind, placebo-controlled clinical trial

Cited by 17 publications

References 37 publications

The current status of old traditional medicine introduced from Persia to China

The current status of old traditional medicine introduced from Persia to China

Carotenoids in Palliative Care—Is There Any Benefit from Carotenoid Supplementation in the Adjuvant Treatment of Cancer-Related Symptoms?

Treatment for chemotherapy-induced peripheral neuropathy: A systematic review of randomized control trials

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