Evaluating the Acute Toxicity and In vivo Protective Effect of Standardized Andrographis paniculata Extract against Doxorubicin-induced Cardiotoxicity in Sprague-dawley Rats

Abstract

It is well-known and efficacious in treating several cancer types including ovarian, breast, thyroid, lung, gastric cancers, and pediatric cancers. 6 However, the consequence of its use is mainly cardiotoxicity. The frequency of DOX-induced cardiotoxicity, which varies with the dose and length of therapy along with the patient's age, sex, and preexisting cardiovascular problems, has been described in investigations. 7 DOX-induced cardiotoxicity remains a challenge in the field of oncology because of the increased risk of mortality in patients. 4,7 Researchers in the field of oncology have dedicated years of relentless effort to the pursuit of a ground breaking treatment for DOX-induced cardiotoxicity. The introduction of conventional drugs, including dexrazoxane, beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB), and statins, represented an initial advancement in managing DOX-induced cardiotoxicity. However, these drugs exhibited limitations and failed to substantially improve the life expectancy of affected patients. [8][9][10][11][12] The limitations of current treatment options necessitate an ongoing search for alternative approaches to effectively manage DOX-induced cardiotoxicity. Herbal plants have shown promising potential and are being extensively investigated. 13 Andrographis paniculata (AP) is an herbal plant and a member of the Acanthaceae family, locally referred to as "sambiloto" in Indonesia. 14 It has been used extensively as an herbal medicine in many parts of Asia including China, the Philippines,