Table 2.

Natural products in reducing chemotherapy and radiotherapy-induced gastrointestinal toxicity.

Name	Effect/Mechanism	Experimental setting/Model	Ingredients/Source	References
B. monnieri	Prevention of increases in dopamine in the brainstem and increases in 5-HT in the intestine	Cisplatin-induced emesis in Suncus murinus	Bacoside II, bacoside A3, bacosaponin C, and isomer of bacosaponin C	Ullah et al., 2017
Red Ginseng	Anti-inflammation	Patients	Ginsenosides	Kim H. S. et al., 2017
6-Gingerol	Anti-emetic activity by inhibiting neurokinin-1, serotonin, and dopamine receptors	Patients	A major component of ginger	Konmun et al., 2017
Persumac	Unknown	Patients	R. Coriaria and B. Persicum	Nazari et al., 2017
Huang-Qin decoction	Regulation of glycine, serine, and threonine pathway as well as bile acid metabolism homeostasis	Irinotecan-induced gastrointestinal toxicity and diarrhea in rats	Made from Glycyrrhiza uralensis, Paeonia lactiflora, Scutelleria baicalensis, and Ziziphus jujuba Main chemical constituents: baicalin, wogonoside, oroxylin-A-glucoside, baicalein, wogonin, orxylin-A, paeoniflorin, glycyrrhizic acid, glycyrrhetinic acid, liquiritin, isoliquirition, liquiritigenin, isoliquiritigenin, and ononin	Cui et al., 2017; Wang X. et al., 2017
Wei-Chang-An pill	Anti-inflammation and gastrointestinal regulation	5-fluorouracil-induced intestinal mucositis in mice	Made from the extracts of Radix aucklandiae, Moschus, Lignum santali, Lignum aquilariae resinatum, Cinnabaris, Cortex magnoliae officinalis, Fructus aurantii, Radix et rhizoma rhei, Pulvis crotonis tiglium, Rhizoma chuanxiong, and Fructus jujubae Main chemical constituents: costunolide, dehydrodehydrocostus lactone, naringin, hesperidin, neohesperidin, magnolol, honokiol, aloe-emodin, rhein, emodin, chrysophanol, and physcion	Chen Y. et al., 2016
Bu-Zhong-Yi-Qi decoction	Reducion of apoptosis and necrosis in intestinal mucosal epithelia via the suppression of inflammatory cytokine upregulation	5-fluorouracil-induced intestinal mucositis in mice	Made fromRadix Astragalus membranaeus, Radix Panax ginseng, Radix Angelica sinensis, Glycyrrhiza uralensis, Cimicifuga foetida Herba Bupleurumchinense, Citrus sinensis Osbeck, and Atractylodes macrocephala Main chemical constituents: astragalosides, acylsucrose derives, dihydroxyflavone-glucopyranoside, liquiritin, liquiritin apioside, neolicuroside, hesperidin, trihydrohyflavone-diglucopyranoside and cimicifugic acid F	Gou et al., 2016
Saireito (TJ-114)	Inhibition of cytokine-mediated apoptosis in intestinal crypt cells	5-fluorouracil-induced intestinal mucositis in mice	A combined formulation of shosaikoto and goreisan containing saikosaponin, ginsenoside, glycyrrhizin, gingerol, and shogaol	Kato et al., 2015
R. glutinosa	Inhibition of oxidative stress and inflammation	Methotrexate-induced gut mucositis in rats	Iridoid glycosides, phenethylalcohol glycosides and furfural derivatives	Shi et al., 2016
18β-Glycyrrhetinic acid	Inhibition of nuclear NF-κB and caspases	Cisplatin-induced oxidative intestinal damage in rats	A pentacyclic triterpenoid derivative obtained from the herb liquorice	Rashid et al., 2017
Rutin	Anti-oxidation and anti-inflammation	Methotrexate-induced intestinal lesion damage in rats	A flavone glycoside extensively found in black tea, apple skin peel and buckwheat	Gautam et al., 2016
N. sativa oil	Anti-oxidation	Cisplatin-induced intestinal damage in rats	Rich in polyunsaturated fatty acids, such as omega-3 and omega-6 fatty acids, phytosterols and several other substances including thymoquinone (up to 25% in volatile oil), carvacrol, t-anethole, sesquiterpenelongifolene, and 4 terpinol	Shahid et al., 2017b
Thymoquinone	Anti-oxidation	Cisplatin-induced intestinal injury in rats	A major principle active ingredient derived from N. sativa oil	Shahid et al., 2017a
Zhu-Ye-Shi-Gao granule	Inhibition of the release of inflammatory cytokines such as IL-1β, IL-8, and tumor necrosis factor-α	Patients with lung, esophagus or mediastinal cancer	Made from Bamboo leaves, Gypsum fibrosuum, Ginseng, Ophiopogon japonicas, Pinellia ternate, Glycyrrhiza uralensis, and Oryza Main chemical constituents: sativa Ginsenoside, ruscogenin, succinic acid, and glycyrrhizic acid	Wang L. J. et al., 2017
A. vera	Anti-inflammation	Patients	Acetylated mannans, polymannans, anthraquinone C-glycosides, anthrones, emodin, and various lectins	Sahebnasagh et al., 2017
Oroxylin	Induction of G2/M phase and activation of cell apoptosis	TE13 and ECA109 cells	A natural flavonoid isolated from S. baicalensis	Tan et al., 2017
Proanthocyanidin	Repair of damaged DNA-dependent activation of immune sensitivity; amelioration of mitochondrial dysfunction	Irradiation-treated HFL1 cells	A class of polyphenols	Katiyar et al., 2017; Yang et al., 2017
Green tea	Anti-oxidation, anti-bacterial, anti-inflammation, and anti-intestinal motility	Patients with abdomen and pelvic malignancy	Catechins	Emami et al., 2014
Silibinin	Inhibition of DNA repair signaling and improvement of the response to radiotherapy	Irradiation-treated Human prostate carcinoma DU145, PC-3, and 22RV1 cells, mouse keratinocyte JB6 cells, human lung cancer A549 cells, murine non-invasive MB49 and MB49-I cells	A major active constituent of silymarin, a complex of flavonolignans extracted from milk thistle	Nambiar et al., 2015; Prack Mc Cormick et al., 2018
Geraniin	Suppression of DNA damage	Irinotecan treated rats	A hydrolysable polyphenol from N. lappaceum	Bing et al., 2013
C. infortunatum	Suppression of Bax/Bcl-2 ratio and COX-2 gene, upregulation of DNA repair gene ATM	Mice exposed to whole-body gamma radiation	Flavonoids and saponins	Chacko et al., 2017
Fucoidan	Upregulation of the abundance of SCFA producer Coprococcus, Rikenella, and Butyricicoccus species within the intestinal mucosa	Cyclophosphamide-treated mice	Fucose-containing sulfated polysaccharides	Shi et al., 2017
PHY906	Anti-inflammation and anti-cancer	CPT-11 treated tumor-bearing mice	Glycyrrhiza uralensis, Paeonia lactiflora, Scutelleria baicalensis, and Ziziphus jujuba	Lam et al., 2014
Baicalin	Down-regulation of OATP2B1	CPT-11 treated mice	A main constituent in PHY906	Fujita et al., 2016
Sheng-Jiang-Xie-Xin decoction	Alteration of the activity of CES2 and jejunal UGT1A1	Irinotecan treated rats	Made from Pinellia ternata, Glycyrrhiza uralensis, Coptis chinensis, Ziziphus jujuba, Zingiber officinale, Scutellaria baicalensis, Codonopsis pilosula, and Zingiber recens Main chemical constituents: 6-gingerol, baicalin, baicalein, wogonin, epiberberine, trigonelline, liquiritin, lobetyolin, rutin, oleanolic acid, betulinic acid, ursolic acid, berberine, and palmatine	Guan et al., 2017