Protective Effects of Ginsenosides on Drug-induced Cardiotoxicity: A New Therapeutic Approach with Focus on Molecular Mechanisms inCardio-oncology Field

Abstract: Panax ginseng (PG), a staple in traditional medicine in Korea and China, holds a rich history of application for various diseases. Notably, its primary active components, ginsenosides, exhibit diverse therapeutic effects. Chemotherapy-induced side effects pose significant challenges to the treatment outcomes of cancer patients. Current strategies for managing the adverse effects of chemotherapy exhibit limited efficacy and have the potential to induce various detrimental side effects. In the realm of complications, cardiotoxicity poses a serious threat, ranking as the second major contributor to illness and death in individuals suffering cancer. It is linked to various cellular mechanisms such as oxidative stress, inflammation, apoptosis, autophagy, endoplasmic reticulum stress, and aberrant myocardial energy metabolism. Both in vivo and in vitro experiments confirm that ginsenosides undeniably present non-toxic and efficacious alternatives for addressing chemotherapy-induced side effects, including cardiotoxicity, neurotoxicity, nephrotoxicity, hepatotoxicity, immunotoxicity, and hematopoietic inhibition. Hence, there is a need to produce novel and potent drugs sourced from natural, non-toxic compounds to address the side effects induced by chemotherapy. The emphasis should be on the underlying mechanisms targeting mentioned cellular pathways. In this comprehensive review, we consolidate current knowledge and summarization with this aim and shed light on the future research of PG in cardio-oncology.