Ginger augmented chemotherapy: A novel multitarget nontoxic approach for cancer management

Effectivity of oral ginger supplementation for chemotherapy induced nausea and vomiting (CINV) in children: A systematic review of clinical trials

Chemotherapy-induced nausea and vomiting (CINV) affects over 50% of pediatric patients undergoing chemotherapy, a higher proportion than in adults. CINV often occurs despite adequate antiemetic prophylaxis, hampering patients' willingness to continue the chemotherapy regimen. As an ayurvedic medicine, ginger (Zingiber officinale) has an antiemetic effect by inhibiting serotonin in gastrointestinal nerves and as an NK1 antagonist. Therefore, we aimed to review oral ginger supplementation in children with CINV systematically. Systematic searching was performed in June 2023 from Pubmed, Embase, CINAHL, Cochrane, and hand searching. The search consisted of PICO "children chemotherapy", "ginger", and "CINV incidence". We limited the search to only human studies. Studies that meet inclusion and exclusion criteria were included for analysis. Out of 116 studies found with our selection criteria, four were compatible with inclusion and exclusion criteria. Two studies had a small Risk of Bias (RoB), while the others had a high RoB. All studies statistically significantly reduced acute and delayed CINV with the number needed to treat (NNT) 2-4. No adverse effects were reported. However, these studies still had high heterogeneity based on cancer treatment, chemotherapy regimen, ginger dosing, and ginger processing. Ginger has the potential to reduce both the acute and delayed phases of CINV in children. Additional research employing standardized methodologies is recommended to validate this effect.

Preparation and Evaluation of 6-Gingerol Derivatives as Novel Antioxidants and Antiplatelet Agents

Ginger (Zingiber officinale) is widely used as a spice and a traditional medicine. Many bioactivities have been reported for its extracts and the isolated compounds, including cardiovascular protective effects. Different pathways were suggested to contribute to these effects, like the inhibition of platelet aggregation. In this study, we synthesised fourteen 6-gingerol derivatives, including eight new compounds, and studied their antiplatelet, COX-1 inhibitor, and antioxidant activities. In silico docking of selected compounds to h-COX-1 enzyme revealed favourable interactions. The investigated 6-gingerol derivatives were also characterised by in silico and experimental physicochemical and blood-brain barrier-related parameters for lead and preclinical candidate selection. 6-Shogaol (2) was identified as the best overall antiplatelet lead, along with compounds 3 and 11 and the new compound 17, which require formulation to optimize their water solubility. Compound 5 was identified as the most potent antioxidant that is also promising for use in the central nervous system (CNS).

Effects of ginger extract and its major component 6-gingerol on anti-tumor property through mitochondrial biogenesis in CD8+ T cells

Ginger extract (GE) and its major component 6-gingerol (6G) have been reported to exert anti-tumor effects in various cancers. The underlying mechanism, however, has not been well demonstrated. Here, we have focused on the relationship between promotion of mitochondrial biogenesis in tumor infiltrating CD8+ T cells induced by GE and 6G and their cytotoxic effect. The results showed that GE induced 56% inhibition of tumor growth in Lewis lung carcinoma (LLC) xenograft mouse model and 6G induced 33% (25 mg/kg) and 37% (50 mg/kg) inhibition. GE increased mitochondrial mass of CD8+ T cells in tumor and draining lymph nodes (DLNs) significantly, while 6G had no significant effect. GE and 6G both had no significant influence on histopathological changes of liver and kidney in mice. In the co-culture system of CTLL-2 cells and LLC cells, GE enhanced the cytotoxicity of CTLL-2 cells against LLC cells by 14% and 19% at concentrations of 2.5 and 5 mg/ml, respectively. 6G did not promote cytotoxicity of CTLL-2 cells. GE increased mitochondrial mass at 5 and 10 mg/ml and mtDNA copy number and ATP production at 2.5, 5, 10 mg/ml in CTLL-2 cells. 6G promoted mtDNA copy number at 50, 100, 150 µM and mitochondrial mass and ATP production at 25, 50, 100, 150 µM in CTLL-2 cells. These results suggest that promotion of mitochondrial biogenesis and function in tumor infiltrating CD8+ T cells may play an essential role in GE-induced inhibition of tumor growth. The current results perfect the mechanism of anti-tumor effect of ginger, which is beneficial for further application in cancer management. PRACTICAL APPLICATION: Ginger, as a worldwide food seasoning and herbal medicine in traditional Chinese medicine, has been reported to possess anti-tumor efficacy. To our knowledge, it is the first time to focus on ginger's ability of promoting mitochondrial biogenesis in tumor infiltrating CD8+ T cells to explore the mechanism of its anti-tumor effect. Our observations demonstrate that ginger inhibits tumor growth via promoting mitochondrial biogenesis and function of T cells. The present study links food to anti-tumor immunity and provides impetus to investigate and design dietary supplements for cancer management.

Development of Optimized Novel Liposome Loaded with 6-gingerol and Assessment of its Therapeutic Activity Against NSCLC In vitro and In vivo Experimental Models

6-Gingerol (Gn) is an active compound derived from ginger which possesses various biological activities. The therapeutic applications of Gn are limited due to its hydrophobic nature. To ease its administration, one of the nano-emulsion methods, liposome was selected to encapsulate Gn. Response Surface Methodology (RSM) was used to optimize liposome ratio. 97.2% entrapment efficiency was achieved at the ratio of 1:20:2 (Drug: Lipid: Cholesterol). The optimized liposome attained size below 200 d nm, spherical shape, negative surface charge and showed sustain release upon physical characterization methods such as FESEM, DLS, Zeta potential, Drug release. The signature FTIR peaks of both free Gn and free liposome (FL) were also observed in Lipo-Gn peak. Lipo-Gn showed significant cytotoxic effect on A549 cells (IC50 160.5 ± 0.74µM/ml) as well as inhibits the cell migration. DAPI staining showed higher apoptotic nuclear morphological change in the cells treated with Lipo-Gn, and also Lipo-Gn increased the apoptotic percentage in A549 as 39.89 and 70.32 for 12 and 24h respectively which were significantly more than free Gn. Moreover, the formulation of Lipo-Gn showed significant cell cycle arrest at the G2/M phase compared with free Gn (28.9 and 34.9% in Free Gn vs. 42.7 and 50.1% in Lipo -Gn for 12 and 24hours respectively). Lipo-Gn have been assessed in NSCLC induced BALB/c mice and showed significantly improved pharmacological properties compared to those of free Gn. Thus, Lipo-Gn may be considered for its widening applications against lung cancer.

6-Shogaol improves behavior and memory in Wistar rats prenatally exposed to lipopolysaccharide

OBJECTIVE

6-Shogaol, bioactive compound of Zingiber officinale Roscoe, has anti-inflammatory, antioxidant, and neuroprotective properties. The objective of the present study was to verify the effect of 6-shogaol on behavioral parameters in a preclinical model based on a maternal immune activation (MIA) by lipopolysaccharide (LPS).

METHODOLOGY

Twelve pregnant Wistar rats received 100-μg/kg LPS or saline solution on gestational day (GD) 9.5. Male offspring participated in the study and in the postnatal day (PND) 30 and 55 were supplemented with 6-shogaol or saline solution, by gavage at a dose of 10 mg/kg/day, orally for 5 days. In the PND 35 and 60 was performed the behavioral tests: grooming, crossing, and rearing that evaluated repetitive movements, anxiety, and interest in the new, respectively, and the inhibitory avoidance test that evaluated short-term (STM) and long-term memory (LTM).

RESULT

Prenatal exposure to LPS increased the grooming and crossing episodes at different ages and reduced rearing episodes in PND 37. Treatment with 6-shogaol reversed these parameters. In the inhibitory avoidance test, an improvement of memory was identified with 6-shogaol in the STM and LTM at both ages comparing training and test session of treated groups and between groups.

CONCLUSION

Administration of 6-shogaol reverses the stereotypy, exploratory behavior, and memory impairment in prenatal LPS-exposed offspring, acting as a promising therapeutic component against brain disorders associated with the process of MIA.

The Study of Ginger-Derived Extracellular Vesicles as a Natural Nanoscale Drug Carrier and Their Intestinal Absorption in Rats

Extracellular vesicles have been widely used in drug delivery systems and clinical studies as a new natural nanoscale drug carrier. Most of these studies focused on the extracellular vesicles from animals, but few involved in the extracellular vesicles from edible plants. This study was the first to explore the potential and value of ginger-derived extracellular vesicles (GDEVs) as drug carrier by using the content ratio method and to further study their intestinal absorption in rats. In this experiment, GDEVs were extracted and purified by ultrahigh-speed centrifugation. GDEVs were saucer-like with a particle size of 70.09±19.24 nm and a zeta potential of -27.70±12.20 mV. In this experiment, high-performance liquid chromatography was used to explore the difference in gingerol content between GDEVs and ginger slices. Under the same mass, the contents of 6-gingerol (6G), 8-gingerol (8G), and 10-gingerol (10G) in GDEVs were 10.21-fold, 22.69-fold, and 32.36-fold of those in ginger slices, respectively. In this experiment, the absorption kinetics and absorption site of GDEVs were investigated using in situ single-pass intestinal perfusion method in rats. GDEVs could be absorbed by the small intestine in the concentration range of 15-60 mg/mL, and the absorption trend of different intestinal segments was duodenum > jejunum > ileum. These results indicated that GDEVs had good loading capacity and significant prospects as a carrier of the drug delivery system. At the same time, combining the oil-water partition coefficient (6G < 8G < 10G) of three gingerol compounds, we speculated that the loading capacity of GDEVs increased with the increase of the lipid solubility of the compounds. This study fully demonstrated the potential and value of ginger-derived extracellular vesicles as natural nanocarrier and provided an important reference for the further application of plant-derived extracellular vesicles in the drug delivery system.

Assessing the Effects of Ginger Extract on Polyphenol Profiles and the Subsequent Impact on the Fecal Microbiota by Simulating Digestion and Fermentation In Vitro

The beneficial effects of ginger polyphenols have been extensively reported. However, their metabolic characteristics and health effects on gut microbiota are poor understood. The purpose of this study was to investigate the digestion stability of ginger polyphenols and their prebiotic effects on gut microbiota by simulating digestion and fermentation in vitro. Following simulated digestion in vitro, 85% of the polyphenols were still detectable, and the main polyphenol constituents identified in ginger extract are 6-, 8-, and 10-gingerols and 6-shogaol in the digestive fluids. After batch fermentation, the changes in microbial populations were measured by 16S rRNA gene Illumina MiSeq sequencing. In mixed-culture fermentation with fecal inoculate, digested ginger extract (GE) significantly modulated the fecal microbiota structure and promoted the growth of some beneficial bacterial populations, such as Bifidobacterium and Enterococcus. Furthermore, incubation with GE could elevate the levels of short-chain fatty acids (SCFAs) accompanied by a decrease in the pH value. Additionally, the quantitative PCR results showed that 6-gingerol (6G), as the main polyphenol in GE, increased the abundance of Bifidobacterium significantly. Therefore, 6G is expected to be a potential prebiotic that improves human health by promoting gut health.

Ginger extract has anti-leukemia and anti-drug resistant effects on malignant cells

PURPOSE

Based on the poor prognosis of drug resistance in pediatric acute lymphoblastic leukemia (ALL) and adverse effects of chemotherapy, this study was aimed to evaluate the effect of several herbal extracts on leukemic cells.

METHODS

Two subtypes of T- and B-ALL cell lines, followed by ALL primary cells were treated with cinnamon, ginger, and green tea extracts, alone or in combination with methotrexate (MTX). Possible apoptosis was investigated using Annexin-V/PI double staining. Real-time PCR was applied to evaluate the expression levels of related ABC transporters upon combination therapy.

RESULTS

The IC50s for cinnamon, ginger and green tea extracts on ALL cell lines were 300 μg/ml, 167 μg/ml and 70 μg/ml, respectively. Surprisingly, the methotrexate (MTX)-resistant sub-line showed more sensitivity to ginger. Combined treatment with ginger and MTX showed synergistic effects on CCRF-CEM, Nalm-6 and ALL primary cells. It was shown that ginger does not impair the high expression levels of ABCA2 or ABCA3 transporter genes in the ALL malignant cells, suggesting other molecular pathways involved in its anticancer potential.

CONCLUSION

To the best of our knowledge, this is the first study that reveals the antileukemic effect of ginger extract on both, pediatric ALL cell lines and primary cells.

Occurrence, biological activity and metabolism of 6-shogaol

As one of the main bioactive compounds of dried ginger, 6-shogaol has been widely used to alleviate many ailments. It is also a major pungent flavor component, and its precursor prior to dehydration is 6-gingerol, which is reported to be responsible for the pungent flavor and biological activity of fresh ginger. Structurally, gingerols including 6-gingerol have a β-hydroxyl ketone moiety and is liable to dehydrate to generate an α,β-unsaturated ketone under heat and/or acidic conditions. The conjugation of the α,β-unsaturated ketone skeleton in the chemical structure of 6-shogaol explicates its higher potency and efficacy than 6-gingerol in terms of antioxidant, anti-inflammatory, anticancer, antiemetic and other bioactivities. Research on the health benefits of 6-shogaol has been conducted and results have been reported recently; however, scientific data are scattered due to a lack of systematic collection. In addition, action mechanisms of the preventive and/or therapeutic actions of 6-shogaol remain obscurely non-collective. Herein, we review the preparations, biological activity and mechanisms, and metabolism of 6-shogaol as well as the properties of 6-shogaol metabolites.