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Supplementation in suppressing Troponin I and NT-proBNP level in breast cancer patients with 5- fluorouracil, adriamycin, and cyclophosphamide chemotherapy

  • Stefanus Satria Adi Dharma ,
  • Selamat Budiono ,
  • Sefri Noventi Sofia ,


Abstract

Background: Breast cancer is a malignancy originating from breast tissue, where chemotherapy is one of the choice therapy. Doxorubicin, 5-fluorouracil, and cyclophosphamide (FAC) are the most commonly used combination of chemotherapy. One of the side effects of chemotherapy is cardiotoxicity. Multiflora honey prevents cardiotoxic effects through its flavonoids and polyphenols compounds. The aim of this research is to analyze the effectiveness of adding honey in preventing cardiotoxic effects in breast cancer patients receiving FAC chemotherapy.

Methods: An experimental study with double-blind randomized pre and post-test with control group design. Ductal invasive breast cancer patients were divided into 2 groups, the control group, who received FAC chemotherapy (n=18) and the treatment group, who received chemotherapy and 90 ml/day honey consumption for 14 days (n=18). The patient's Troponin I and NT-proBNP enzyme levels before and after 14 days of the study were assessed.

Results: Post-treatment, there was an increase in Troponin I levels from the treatment group (0.22 ± 0.07 vs. 0.24 ± 0.07) vs. control (0.25 ± 0.11 vs. 0.34 ± 0.20) with a significant difference. (p = 0.031). There was a decrease in NT-proBNP levels in the treatment group (461.0 ± 610.4 vs. 215.6 ± 260.3) and an increase in NT-proBNP levels (275.9 ± 392.4 vs. 315.4 ± 293.9) with a significant difference (p = 0.006).

Conclusion: Multiflora honey can prevent cardiotoxic effects in breast cancer patients receiving FAC chemotherapy.

Keywords: breast cancer cardiotoxic induced chemotherapy chemotherapy FAC multiflora honey

References

  1. World Health Organization. Indonesia Source GLOBOCAN 2018 [Internet]. Vol. 256, International Agency for Research on Cancer. 2019. p1-2. (Available from: URL:http://gco.iarc.fr/)
  2. Veronesi P, Davide O, Maria G, Leonardi C. Breast Cancer: Innovations in Research and Management. Springer Nature. 2017.
  3. Lestari AAW, Prabawa IPY, Wiranata S, Supadmanaba IGP. High eosinophilic lymphocyte ratio (ELR) related with subtype of breast cancer in Sanglah General Hospital. Annals of Oncology. 2018;29(suppl_9). DOI: https://doi.org/10.1093/annonc/mdy427.014.
  4. Wihandani D, Adiputra P, Supadmanaba I. Low prevalence of Caveolin-1 oncogenic polymorphism G14713A and T29107A among breast cancer patient in Sanglah General Hospital. Bali Medical Journal. 2017;6(3): S109-S112. DOI:10.15562/bmj.v6i3.743.
  5. Early Breast Cancer Trialists' Collaborative Group (EBCTCG), Peto R, Davies C, et al. Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet. 2012;379(9814):432-444. doi:10.1016/S0140-6736(11)61625-5.
  6. Roezin A. Perkembangan mutakhir terapi tumor ganas payudara. Ilmu Bedah. 2005;24(4):1-9.
  7. Adjuvant Breast Cancer Trials Collaborative Group. Polychemotherapy for early breast cancer: results from the international adjuvant breast cancer chemotherapy randomized trial. J Natl Cancer Inst. 2007;99(7):506-515. doi:10.1093/jnci/djk108.
  8. Florescu M, Cinteza M, Vinereanu D. Chemotherapy-induced Cardiotoxicity. Maedica (Bucur). 2013;8(1):59-67.
  9. Varricchi G, Ameri P, Cadeddu C, et al. Antineoplastic Drug-Induced Cardiotoxicity: A Redox Perspective. Front Physiol. 2018;9:167. Published 2018 Mar 7. doi:10.3389/fphys.2018.00167.
  10. Cardinale D, Colombo A, Sandri MT, et al. Prevention of high-dose chemotherapy-induced cardiotoxicity in high-risk patients by angiotensin-converting enzyme inhibition. Circulation. 2006;114(23):2474-2481. doi:10.1161/CIRCULATIONAHA.106.635144.
  11. Cubbon RM, Lyon AR. Cardio-oncology: Concepts and practice. Indian Heart J. 2016;68 Suppl 1(Suppl 1):S77-S85. doi:10.1016/j.ihj.2016.01.022.
  12. Cardinale D, Biasillo G, Salvatici M, Sandri MT, Cipolla CM. Using biomarkers to predict and to prevent cardiotoxicity of cancer therapy. Expert Rev Mol Diagn. 2017;17(3):245-256. doi:10.1080/14737159.2017.1283219.
  13. Sanz ML, Polemis N, Morales V, et al. In vitro investigation into the potential prebiotic activity of honey oligosaccharides. J Agric Food Chem. 2005;53(8):2914-2921. doi:10.1021/jf0500684.
  14. Malekinejad H, Ahsan S, Delkhosh-Kasmaie F, Cheraghi H, Rezaei-Golmisheh A, Janbaz-Acyabar H. Cardioprotective effect of royal jelly on paclitaxel-induced cardio-toxicity in rats. Iran J Basic Med Sci. 2016;19(2):221-227.
  15. Ahmed S, Othman NH. Honey as a potential natural anticancer agent: a review of its mechanisms. Evid Based Complement Alternat Med. 2013;2013:829070. doi:10.1155/2013/829070.
  16. Fauzi AN, Norazmi MN, Yaacob NS. Tualang honey induces apoptosis and disrupts the mitochondrial membrane potential of human breast and cervical cancer cell lines. Food Chem Toxicol. 2011;49(4):871-878. doi:10.1016/j.fct.2010.12.010.
  17. Jaganathan S. Honey Constituents and their apoptotic effect in colon cancer cells. J Apiproduct Apimedical Sci. 2009;1. p29-36. DOI: 10.3896/IBRA.4.01.2.02
  18. Jaganathan SK, Mandal M. Involvement of non-protein thiols, mitochondrial dysfunction, reactive oxygen species and p53 in honey-induced apoptosis. Invest New Drugs. 2010;28(5):624-633. doi:10.1007/s10637-009-9302-0.
  19. Tomasin R, Gomes-Marcondes MC. Oral administration of Aloe vera and honey reduces Walker tumour growth by decreasing cell proliferation and increasing apoptosis in tumour tissue. Phytother Res. 2011;25(4):619-623. doi:10.1002/ptr.3293.
  20. Moore RJ, Owens DM, Stamp G, et al. Mice deficient in tumor necrosis factor-alpha are resistant to skin carcinogenesis [published correction appears in Nat Med 1999 Sep;5(9):1087]. Nat Med. 1999;5(7):828-831. doi:10.1038/10552.
  21. Munker R, Gasson J, Ogawa M, Koeffler HP. Recombinant human TNF induces production of granulocyte-monocyte colony-stimulating factor. Nature. 1986;323(6083):79-82. doi:10.1038/323079a0.
  22. Viuda-Martos M, Ruiz-Navajas Y, Fernández-López J, Pérez-Alvarez JA. Functional properties of honey, propolis, and royal jelly. J Food Sci. 2008;73(9):R117-R124. doi:10.1111/j.1750-3841.2008.00966.x.
  23. Hussein SZ, Mohd Yusoff K, Makpol S, Mohd Yusof YA. Gelam Honey Inhibits the Production of Proinflammatory, Mediators NO, PGE(2), TNF-α, and IL-6 in Carrageenan-Induced Acute Paw Edema in Rats. Evid Based Complement Alternat Med. 2012;2012:109636. doi:10.1155/2012/109636.
  24. Araújo JR, Gonçalves P, Martel F. Chemopreventive effect of dietary polyphenols in colorectal cancer cell lines. Nutr Res. 2011;31(2):77-87. doi:10.1016/j.nutres.2011.01.006.
  25. Al-Waili NS. Effects of daily consumption of honey solution on hematological indices and blood levels of minerals and enzymes in normal individuals. J Med Food. 2003;6(2):135-140. doi:10.1089/109662003322233549.
  26. Porcza LM, Simms C, Chopra M. Honey and Cancer: Current Status and Future Directions. Diseases. 2016;4(4):30. DOI:10.3390/diseases4040030.
  27. Katsurada K, Ichida M, Sakuragi M, Takehara M, Hozumi Y, Kario K. High-sensitivity troponin T as a marker to predict cardiotoxicity in breast cancer patients with adjuvant trastuzumab therapy. Springerplus. 2014;3:620. Published 2014 Oct 20. doi:10.1186/2193-1801-3-620.
  28. Khalil MI, Tanvir EM, Afroz R, Sulaiman SA, Gan SH. Cardioprotective Effects of Tualang Honey: Amelioration of Cholesterol and Cardiac Enzymes Levels. Biomed Res Int. 2015;2015:286051. doi:10.1155/2015/286051.
  29. Johnston JE, Sepe HA, Miano CL, Brannan RG, Alderton AL. Honey inhibits lipid oxidation in ready-to-eat ground beef patties. Meat Sci. 2005;70(4):627-631. doi:10.1016/j.meatsci.2005.02.011.
  30. Zidan A, Sherief LM, El-sheikh A, et al. NT-proBNP as early marker of subclinical late cardiotoxicity after doxorubicin therapy and mediastinal irradiation in childhood cancer survivors. Dis Markers. 2015;2015:513219. doi:10.1155/2015/513219.
  31. Hossen MS, Ali MY, Jahurul MHA, Abdel-Daim MM, Gan SH, Khalil MI. Beneficial roles of honey polyphenols against some human degenerative diseases: A review. Pharmacol Rep. 2017;69(6):1194-1205. doi:10.1016/j.pharep.2017.07.002.
  32. Lee JH, Zhou HY, Cho SY, Kim YS, Lee YS, Jeong CS. Anti-inflammatory mechanisms of apigenin: inhibition of cyclooxygenase-2 expression, adhesion of monocytes to human umbilical vein endothelial cells, and expression of cellular adhesion molecules. Arch Pharm Res. 2007;30(10):1318-1327. doi:10.1007/BF02980273.

How to Cite

Dharma, S. S. A., Budiono, S., & Sofia, S. N. (2022). Supplementation in suppressing Troponin I and NT-proBNP level in breast cancer patients with 5- fluorouracil, adriamycin, and cyclophosphamide chemotherapy. Bali Medical Journal, 11(3), 1721–1725. https://doi.org/10.15562/bmj.v11i3.3596
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Stefanus Satria Adi Dharma
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Selamat Budiono
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Sefri Noventi Sofia
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