Effect of Melissa officinalis on Chemotherapy-Induced Peripheral Neuropathy in Cancer Patients: A Randomized Trial
-
Zohreh Ehsani
,
Ebrahim Salehifar
,
Emran Habibi
,
Reza Alizadeh-Navaei
,
Mahmoud Moosazadeh
,
Nasim Tabrizi
,
Ehsan Zaboli
,
Versa Omrani-Nava
,
Ramin Shekarriz
Abstract
Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a significant cancer treatment side effect that can influence both quality of life and treatment course. Melissa Officinalis (MO), due to its high content of flavonoids, has antioxidant, anti-inflammatory, and neuroprotective properties.
Materials and Methods: The cancer patients diagnosed with CIPN attended a referral center in Sari (Iran). The hydroalcoholic extract of MO leaves was extracted by the maceration method. The control group received a placebo along with gabapentin as the standard treatment, and the intervention group received 500 mg Melissa officinalis 2 times daily for 3 months plus gabapentin. Patients were evaluated at the baseline and 3 months later, according to Common Terminology Criteria for Adverse Effects (CTCAE) and EORTC QLQ-C30 (Integrated System for Quality of Life Assessment).
Results: A total of 40 patients were considered as group D (intervention group), and 35 patients completed the study. Out of 40 subjects in the placebo group (P), 3 patients could not tolerate the drug due to gastrointestinal disturbances. The final values of CTCAE showed a statistically significant difference (p=0.010). Indicators related to the quality of life in both groups showed a significant improvement. In the intervention group, the pain perception and diarrhea experience were significantly reduced.
Conclusion: Quality of life indicators were improved by prescribing gabapentin with and without Melissa officinalis. The addition of Melissa officinalis to the chemotherapy regimen may improve diarrhea and pain perception.
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2. Liu YQ, Wang XL, He DH, et al. Protection against chemotherapy- and radiotherapy-induced side effects: A review based on the mechanisms and therapeutic opportunities of phytochemicals. Phytomedicine. 2021; 80: 153402.
3. Pearce A, Haas M, Viney R, et al. Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study. PLOS One. 2017; 12(10): e0184360.
4. Grisold W, Cavaletti G, Windebank AJ. Peripheral neuropathies from chemotherapeutics and targeted agents: diagnosis, treatment, and prevention. Neuro Oncol. 2012; 14 Suppl 4 (Suppl 4): iv45-54.
5. Ibrahim EY, Ehrlich BE. Prevention of chemotherapy-induced peripheral neuropathy: a review of recent findings. Crit Rev in Oncol Hematol. 2020; 145: 102831.
6. Seretny M, Currie GL, Sena ES, et al. Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: A systematic review and meta-analysis. Pain. 2014; 155(12): 2461-70.
7. Chaudhry V, Cornblath DR, Polydefkis M, et al. Characteristics of bortezomib- and thalidomide-induced peripheral neuropathy. J Peripher Nerv Syst. 2008; 13(4): 275-82.
8. Scagliotti G, Novello S, Pawel Jv, et al. Phase III Study of Carboplatin and Paclitaxel Alone or With Sorafenib in Advanced Non–Small-Cell Lung Cancer. J Clin Oncol. 2010; 28(11): 1835-42.
9. Yoon SY, Oh J. Neuropathic cancer pain: prevalence, pathophysiology, and management. Korean J Intern Med. 2018; 33(6): 1058-69.
10. Desforges AD, Hebert CM, Spence AL, et al. Treatment and diagnosis of chemotherapy-induced peripheral neuropathy: An update. Biomed Pharmacother. 2022; 147: 112671.
11. Maleki-Saghooni N, Karimi FZ, Behboodi Moghadam Z, et al. The effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome: A systematic review. Avicenna J Phytomed. 2018; 8(2): 96-113.
12. Shakeri A, Sahebkar A, Javadi B. Melissa officinalis L. – A review of its traditional uses, phytochemistry and pharmacology. J Ethnopharmacol. 2016; 188: 204-28.
13. Miraj S, Rafieian K, Kiani S. Melissa officinalis L: A Review Study With an Antioxidant Prospective. J Evid Based Complementary Altern Med. 2017; 22(3): 385-94.
14. Acklin S, Xia F. The Role of Nucleotide Excision Repair in Cisplatin-Induced Peripheral Neuropathy: Mechanism, Prevention, and Treatment. Int J Mol Sci. 2021; 22(4): 1975.
15. Salehifar E, Janbabaei G, Hendouei N, et al. Comparison of the Efficacy and Safety of Pregabalin and Duloxetine in Taxane-Induced Sensory Neuropathy: A Randomized Controlled Trial. Clin Drug Investig. 2020; 40(3): 249-57.
16. Zhang S, Liang F, Tannock I. Use and misuse of common terminology criteria for adverse events in cancer clinical trials. BMC Cancer. 2016; 16: 392.
17. Montazeri A, Harirchi I, Vahdani M, et al. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): translation and validation study of the Iranian version. Support Care Cancer. 1999; 7(6): 400-6.
18. Colvin LA. Chemotherapy-induced peripheral neuropathy: where are we now? Pain. 2019; 160 Suppl 1 (Suppl 1):S1-S10.
19. Naderi Dastjerdi M, Darooneh T, Nasiri M, et al. Investigating the Effect of Melissa Officinalis on After-Pains: A Randomized Single-Blind Clinical Trial. J Caring Sci. 2019; 8(3): 129-138.
20. Khodsook S, Moshtaghian J. Effect extract of melissa officinal is onblood lipids and lipoproteins and the prevention of diabetes in rats. IJDM. 2015; 14(5): 315-24.
21. Fumagalli G, Monza L, Cavaletti G, et al. Neuroinflammatory Process Involved in Different Preclinical Models of Chemotherapy-Induced Peripheral Neuropathy. Front Immunol. 2021; 11:626687.
22. König F, Custodio CM. Chapter 22 - Peripheral Nervous System Involvement in Breast and Gynecologic Cancers. In: Cristian A, ed., Breast Cancer and Gynecologic Cancer Rehablitation. St. Louis: Elsevier, 2021.
23. Draginic N, Andjic M, Jeremic J, et al. Anti-inflammatory and Antioxidant Effects of Melissa officinalis Extracts: A Comparative Study. Iran J Pharm Res. 2022; 21(1): e126561.
24. Guginski G, Luiz AP, Silva MD, et al. Mechanisms involved in the antinociception caused by ethanolic extract obtained from the leaves of Melissa officinalis (lemon balm) in mice. Pharmacol Biochem Behav. 2009; 9391): 10-16.
25. Hasanein P, Riahi H. Antinociceptive and Antihyperglycemic Effects of Melissa officinalis Essential Oil in an Experimental Model of Diabetes. Med Princ Pract. 2015;24(1):47-52.
26. Borgonetti V, Pressi G, Bertaiola O, et al. Attenuation of neuroinflammation in microglia cells by extracts with high content of rosmarinic acid from in vitro cultured Melissa officinalis L. cells. J Pharm Biomed Anal. 2022; 220: 114969.
27. Mirabi P, Namdari M, Alamolhoda S, et al. The effect of Melissa officinalis extract on the severity of primary dysmenorrha. Iran J pharm Res. 2017; 16: (Suppl):171-177.
28. McQuade RM, Stojanovska V, Abalo R, et al. Chemotherapy-Induced Constipation and Diarrhea: Pathophysiology, Current and Emerging Treatments. Front Pharmacol. 2016; 7: 414.
29. Emami H, Nikoobin F, Roayaei M, et al. Double-blinded, randomized, placebo-controlled study to evaluate the effectiveness of green tea in preventing acute gastrointestinal complications due to radiotherapy. J Res Med Sci. 2014; 19(5): 445-50.
30. Dolatabadi F, Abdolghaffari AH, Farzaei MH, et al. The Protective Effect of Melissa officinalis L. in Visceral Hypersensitivity in Rat Using 2 Models of Acid-induced Colitis and Stress-induced Irritable Bowel Syndrome: A Possible Role of Nitric Oxide Pathway. J Neurogastroenterol Motil. 2018; 24(3): 490-501.
2. Liu YQ, Wang XL, He DH, et al. Protection against chemotherapy- and radiotherapy-induced side effects: A review based on the mechanisms and therapeutic opportunities of phytochemicals. Phytomedicine. 2021; 80: 153402.
3. Pearce A, Haas M, Viney R, et al. Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study. PLOS One. 2017; 12(10): e0184360.
4. Grisold W, Cavaletti G, Windebank AJ. Peripheral neuropathies from chemotherapeutics and targeted agents: diagnosis, treatment, and prevention. Neuro Oncol. 2012; 14 Suppl 4 (Suppl 4): iv45-54.
5. Ibrahim EY, Ehrlich BE. Prevention of chemotherapy-induced peripheral neuropathy: a review of recent findings. Crit Rev in Oncol Hematol. 2020; 145: 102831.
6. Seretny M, Currie GL, Sena ES, et al. Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: A systematic review and meta-analysis. Pain. 2014; 155(12): 2461-70.
7. Chaudhry V, Cornblath DR, Polydefkis M, et al. Characteristics of bortezomib- and thalidomide-induced peripheral neuropathy. J Peripher Nerv Syst. 2008; 13(4): 275-82.
8. Scagliotti G, Novello S, Pawel Jv, et al. Phase III Study of Carboplatin and Paclitaxel Alone or With Sorafenib in Advanced Non–Small-Cell Lung Cancer. J Clin Oncol. 2010; 28(11): 1835-42.
9. Yoon SY, Oh J. Neuropathic cancer pain: prevalence, pathophysiology, and management. Korean J Intern Med. 2018; 33(6): 1058-69.
10. Desforges AD, Hebert CM, Spence AL, et al. Treatment and diagnosis of chemotherapy-induced peripheral neuropathy: An update. Biomed Pharmacother. 2022; 147: 112671.
11. Maleki-Saghooni N, Karimi FZ, Behboodi Moghadam Z, et al. The effectiveness and safety of Iranian herbal medicines for treatment of premenstrual syndrome: A systematic review. Avicenna J Phytomed. 2018; 8(2): 96-113.
12. Shakeri A, Sahebkar A, Javadi B. Melissa officinalis L. – A review of its traditional uses, phytochemistry and pharmacology. J Ethnopharmacol. 2016; 188: 204-28.
13. Miraj S, Rafieian K, Kiani S. Melissa officinalis L: A Review Study With an Antioxidant Prospective. J Evid Based Complementary Altern Med. 2017; 22(3): 385-94.
14. Acklin S, Xia F. The Role of Nucleotide Excision Repair in Cisplatin-Induced Peripheral Neuropathy: Mechanism, Prevention, and Treatment. Int J Mol Sci. 2021; 22(4): 1975.
15. Salehifar E, Janbabaei G, Hendouei N, et al. Comparison of the Efficacy and Safety of Pregabalin and Duloxetine in Taxane-Induced Sensory Neuropathy: A Randomized Controlled Trial. Clin Drug Investig. 2020; 40(3): 249-57.
16. Zhang S, Liang F, Tannock I. Use and misuse of common terminology criteria for adverse events in cancer clinical trials. BMC Cancer. 2016; 16: 392.
17. Montazeri A, Harirchi I, Vahdani M, et al. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): translation and validation study of the Iranian version. Support Care Cancer. 1999; 7(6): 400-6.
18. Colvin LA. Chemotherapy-induced peripheral neuropathy: where are we now? Pain. 2019; 160 Suppl 1 (Suppl 1):S1-S10.
19. Naderi Dastjerdi M, Darooneh T, Nasiri M, et al. Investigating the Effect of Melissa Officinalis on After-Pains: A Randomized Single-Blind Clinical Trial. J Caring Sci. 2019; 8(3): 129-138.
20. Khodsook S, Moshtaghian J. Effect extract of melissa officinal is onblood lipids and lipoproteins and the prevention of diabetes in rats. IJDM. 2015; 14(5): 315-24.
21. Fumagalli G, Monza L, Cavaletti G, et al. Neuroinflammatory Process Involved in Different Preclinical Models of Chemotherapy-Induced Peripheral Neuropathy. Front Immunol. 2021; 11:626687.
22. König F, Custodio CM. Chapter 22 - Peripheral Nervous System Involvement in Breast and Gynecologic Cancers. In: Cristian A, ed., Breast Cancer and Gynecologic Cancer Rehablitation. St. Louis: Elsevier, 2021.
23. Draginic N, Andjic M, Jeremic J, et al. Anti-inflammatory and Antioxidant Effects of Melissa officinalis Extracts: A Comparative Study. Iran J Pharm Res. 2022; 21(1): e126561.
24. Guginski G, Luiz AP, Silva MD, et al. Mechanisms involved in the antinociception caused by ethanolic extract obtained from the leaves of Melissa officinalis (lemon balm) in mice. Pharmacol Biochem Behav. 2009; 9391): 10-16.
25. Hasanein P, Riahi H. Antinociceptive and Antihyperglycemic Effects of Melissa officinalis Essential Oil in an Experimental Model of Diabetes. Med Princ Pract. 2015;24(1):47-52.
26. Borgonetti V, Pressi G, Bertaiola O, et al. Attenuation of neuroinflammation in microglia cells by extracts with high content of rosmarinic acid from in vitro cultured Melissa officinalis L. cells. J Pharm Biomed Anal. 2022; 220: 114969.
27. Mirabi P, Namdari M, Alamolhoda S, et al. The effect of Melissa officinalis extract on the severity of primary dysmenorrha. Iran J pharm Res. 2017; 16: (Suppl):171-177.
28. McQuade RM, Stojanovska V, Abalo R, et al. Chemotherapy-Induced Constipation and Diarrhea: Pathophysiology, Current and Emerging Treatments. Front Pharmacol. 2016; 7: 414.
29. Emami H, Nikoobin F, Roayaei M, et al. Double-blinded, randomized, placebo-controlled study to evaluate the effectiveness of green tea in preventing acute gastrointestinal complications due to radiotherapy. J Res Med Sci. 2014; 19(5): 445-50.
30. Dolatabadi F, Abdolghaffari AH, Farzaei MH, et al. The Protective Effect of Melissa officinalis L. in Visceral Hypersensitivity in Rat Using 2 Models of Acid-induced Colitis and Stress-induced Irritable Bowel Syndrome: A Possible Role of Nitric Oxide Pathway. J Neurogastroenterol Motil. 2018; 24(3): 490-501.
| Files | ||
| Issue | Vol 18 No 2 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijhoscr.v18i2.15372 | |
| Keywords | ||
| Cancer Chemotherapy Neuropathy Lemon balm Melissa officinalis | ||
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How to Cite
1.
Ehsani Z, Salehifar E, Habibi E, Alizadeh-Navaei R, Moosazadeh M, Tabrizi N, Zaboli E, Omrani-Nava V, Shekarriz R. Effect of Melissa officinalis on Chemotherapy-Induced Peripheral Neuropathy in Cancer Patients: A Randomized Trial. Int J Hematol Oncol Stem Cell Res. 2024;18(2):165-173.
