Protective effect of Vernonia amygdalina Delile against doxorubicin-induced cardiotoxicity

Abstract

Doxorubicin has been used as an anticancer drug and has already indicated effective in the treatment of cancer. The incidence of cardiotoxicity due to doxorubicin was approximately 11%, resulting in the limited use of doxorubicin. Cardiac protection during doxorubicin therapy is needed because it can reduce the incidence of heart failure. Vernonia amygdalina (VA) is traditionally used by Indonesians as a traditional medicine and contains many secondary metabolites, including vernolide, vernodalol, vernoamygdalin, vernolepin, luteolin, luteolin 7-O-betaglucoronoside and luteolin 7-O-glucoside. The pharmacological activity of VA has been widely studied, including its antimalarial, antidiabetic, anticancer, hepatoprotective, nephroprotective, and antioxidant activities. This research aimed to determine the antioxidant 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity, total phenol, total flavonoid, and cardioprotective effects of Vernonia Amygdalina.Negative control was only intraperitoneal injection of doxorubicin (20 mg/kgbw) on the eight day while quercetin (85 mg/kgbw) and ethanol extract of Vernonia amygdalina (EEVA) 100, 200, 400 mg/kgbw dose are orally administered for eight consecutive days. Both quercetin and EEVA groups were also injected with doxorubicin (20 mg/kgbw) on the same day. On the following day, rats were injected with ketamine HCL 75 mg/kgbw and were dissected for heart blood collected. The blood collected 3 ml from each rat was analyzed for biochemical parameters. The analyzed biochemical parameters were Aspartate transaminase (AST), Alanine transaminase (ALT), Ureum, Creatinine, Creatinine kinase-MB (CK-MB), Lactate dehydrogenase (LDH), Troponin T, Brain natriuretic peptide (BNP), and antioxidant parameter Superoxide Dismutase (SOD).The result showed that EEVA antioxidant activity was 40.51 AE 4.89 μg/mL, total flavonoid was 3.79 AE 0.61 mg QE/g extract, and total phenol was 281.575 AE 1.069 mg GAE/g extract. Quercetin (85 mg/kgbw) and EEVA (400 mg/kgbw) reduce AST, ALT, Ureum, Creatinine, CK-MB, LDH, Troponin T, BNP significantly and increase rats' SOD level compared with negative control. So that, this study explicates that EEVA potentials as cardioprotective agent against doxorubicin by reducing biochemical parameters.

The Role of Flavonoids as a Cardioprotective Strategy against Doxorubicin-Induced Cardiotoxicity: A Review

“…In an in vivo study, CK-MB, LDH, and some specific cardiac biomarkers including BNP, Troponin T, and CRP were used to assess cardiotoxicity rate [118]. An agreement study by Syahputra showed that rats induced by doxorubicin significantly increased their BNP and Troponin T levels [119]. In some studies, the antioxidant was widely determined by the abundance of ROS production.…”

Mokko Lactone Alleviates Doxorubicin-Induced Cardiotoxicity in Rats via Antioxidant, Anti-Inflammatory, and Antiapoptotic Activities

“…However, its clinical applications are relatively restricted due to its detrimental side effects that include cardiotoxicity [2]. It was reported that the incidence of acute DOX cardiotoxicity is around 11%, which can be characterized on the electrocardiogram by decreased amplitude of QRS complexes and nonspecific ST changes [3,4]. This toxic damage to the cardiomyocytes induced by DOX can lead to the development of tachycardia, arrhythmia, pericarditis, myocarditis, left ventricular function transient depression, late-onset refractory cardiomyopathy, and, eventually, congestive heart failure [5,6].…”

Cardioprotective Effect of Rheum turkestanicum Against Doxorubicin-Induced Toxicity in Rats

“…Patients receiving doxorubicin exhibit left ventricular dysfunction demonstrated by elevated CK-MB and BNP activities ( Pongprot et al, 2012 ). Additionally, animal studies have reported increased CK-MB, LDH, BNP, and cTnT activities following doxorubicin administration ( Arafa et al, 2014 ; Kulkarni and Swamy, 2015 ; Nugraha et al, 2020 ; Syahputra et al, 2021 ). Moreover, previous research has also reported that doxorubicin elevates ALT ( Barakat et al, 2018 ); our findings support these previous ones of doxorubicin-induced clinical enzyme alterations.…”