Food Supplements to Mitigate Detrimental Effects of Pelvic Radiotherapy

Abstract

Pelvic radiotherapy has been frequently reported to cause acute and late onset gastrointestinal (GI) toxicities associated with significant morbidity and mortality. Although the underlying mechanisms of pelvic radiation-induced GI toxicity are poorly understood, they are known to involve a complex interplay between all cell types comprising the intestinal wall. Furthermore, increasing evidence states that the human gut microbiome plays a role in the development of radiation-induced health damaging effects. Gut microbial dysbiosis leads to diarrhea and fatigue in half of the patients. As a result, reinforcement of the microbiome has become a hot topic in various medical disciplines. To counteract GI radiotoxicities, apart from traditional pharmacological compounds, adjuvant therapies are being developed including food supplements like vitamins, prebiotics, and probiotics. Despite the easy, cheap, safe, and feasible approach to protect patients against acute radiation-induced toxicity, clinical trials have yielded contradictory results. In this review, a detailed overview is given of the various clinical, intestinal manifestations after pelvic irradiation as well as the role of the gut microbiome herein. Furthermore, whilst discussing possible strategies to prevent these symptoms, food supplements are presented as auspicious, prophylactic, and therapeutic options to mitigate acute pelvic radiation-induced GI injury by exploring their molecular mechanisms of action.

Nuclear and Radiological Emergencies: Biological Effects, Countermeasures and Biodosimetry

“…Prebiotics, fecal microbiota transplantation and, especially, probiotics prevent and improve radiation-induced enteritis [ 242 , 243 ]. In preclinical and clinical studies, probiotic interventions with Lactobacilli and/or Bifidobacteria ameliorate micro-intestinal atrophy and diarrheal symptoms [ 244 ], and exert cancer protection [ 245 ].…”

JAC4 Protects from X-ray Radiation-Induced Intestinal Injury by JWA-Mediated Anti-Oxidation/Inflammation Signaling

“…Varying degrees of villi shortening or loss and crypt atrophy may occur after radiation exposure, leading to the disruption of epithelial homeostasis and epithelial integrity [ 19 ]. Intestinal mucosal injury can lead to nutrient deficiencies, weight loss, and even death [ 20 ]. Our results showed that JAC4 treatment slowed weight loss and reduced death in mice, and the intestinal crypt villi structure of mice was preserved after 12 Gy ABI.…”

Effect of Lactobacillus species on apoptosis-related genes BCL2, BAX, and caspase 3 in the testes of gamma-irradiated rats

“…A recently published study reported that probiotics improved the testes' function by neutralizing the toxins, improving sperm quality and testosterone levels, and modulating the immune system 21 . Researchers suggested that probiotics reduced the ROS activation evoked by radiation via the production of antioxidant enzymes such as superoxide dismutase, GSH peroxidase, GSH reductase, and catalase 22,23 . Shokri et al demonstrated that melatonin with its antioxidant property can decrease oxidative damage induced by radiofrequency electromagnetic radiation (RF-EMR) of mobile phones on testis tissue 24 .…”