Medicinal plants and their isolated phytochemicals for the management of chemotherapy-induced neuropathy: therapeutic targets and clinical perspective

  • Vahideh Oveissi
  • Mahboobe Ram
  • Roodabeh Bahramsoltani
  • Farnaz Ebrahimi
  • Roja Rahimi
  • Rozita Naseri
  • Tarun Belwal
  • Hari Prasad Devkota
  • Zahra Abbasabadi
  • Mohammad Hosein FarzaeiEmail author
Review Article



Chemotherapy, as one of the main approaches of cancer treatment, is accompanied with several adverse effects, including chemotherapy-induced peripheral neuropathy (CIPN). Since current methods to control the condition are not completely effective, new treatment options should be introduced. Medicinal plants can be suitable candidates to be assessed regarding their effects in CIPN. Current paper reviews the available preclinical and clinical studies on the efficacy of herbal medicines in CIPN.


Electronic databases including PubMed, Scopus, and Cochrane library were searched with the keywords “neuropathy” in the title/abstract and “plant”, “extract”, or “herb” in the whole text. Data were collected from inception until April 2018.


Plants such as chamomile (Matricaria chamomilla L.), sage (Salvia officinalis L.), cinnamon (Cinnamomum cassia (L.) D. Don), and sweet flag (Acorus calamus L.) as well as phytochemicals like matrine, curcumin, and thioctic acid have demonstrated beneficial effects in animal models of CIPN via prevention of axonal degeneration, decrease in total calcium level, improvement of endogenous antioxidant defense mechanisms such as superoxide dismutase and reduced glutathione, and regulation of neural cell apoptosis, nuclear factor-ĸB, cyclooxygenase-2, and nitric oxide signaling. Also, five clinical trials have evaluated the effect of herbal products in patients with CIPN.


There are currently limited clinical evidence on medicinal plants for CIPN which shows the necessity of future mechanistic studies, as well as well-designed clinical trial for further confirmation of the safety and efficacy of herbal medicines in CIPN.

Graphical abstract

Schematic mechanisms of medicinal plants to prevent chemotherapy-induced neuropathy: NO: nitric oxide, TNF: tumor necrosis factor, PG: prostaglandin, NF-ĸB: nuclear factor kappa B, LPO: lipid peroxidation, ROS: reactive oxygen species, COX: cyclooxygenase, IL: interleukin, ERK: extracellular signal-related kinase, X: inhibition, ↓: induction.


Pain Neuropathy Phytotherapy Chemotherapeutic agents Inflammation Phytochemicals Medicinal plants Clinical studies 


Compliance with ethical standards

Conflict of interest

Authors declare that they have no conflicts of interest.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Vahideh Oveissi
    • 1
    • 2
  • Mahboobe Ram
    • 3
  • Roodabeh Bahramsoltani
    • 4
  • Farnaz Ebrahimi
    • 5
  • Roja Rahimi
    • 4
  • Rozita Naseri
    • 6
  • Tarun Belwal
    • 7
  • Hari Prasad Devkota
    • 8
    • 9
  • Zahra Abbasabadi
    • 10
  • Mohammad Hosein Farzaei
    • 10
    • 11
    Email author
  1. 1.Faculty of PharmacyTehran University of Medical SciencesTehranIran
  2. 2.PhytoPharmacology Interest Group (PPIG)Universal Scientific Education and Research Network (USERN)TehranIran
  3. 3.Student Research Committee, Faculty of PharmacyMashhad University of Medical SciencesMashhadIran
  4. 4.Department of Traditional Pharmacy, School of Persian MedicineTehran University of Medical SciencesTehranIran
  5. 5.Pharmacy Students’ Research Committee, School of PharmacyIsfahan University of Medical SciencesIsfahanIran
  6. 6.Faculty of MedicineKermanshah University of Medical SciencesKermanshahIran
  7. 7.G. B. Pant National Institute of Himalayan Environment and Sustainable DevelopmentAlmoraIndia
  8. 8.School of PharmacyKumamoto UniversityKumamotoJapan
  9. 9.Program for Leading Graduate Schools, Health life science: Interdisciplinary and Glocal Oriented (HIGO) ProgramKumamoto UniversityKumamotoJapan
  10. 10.Pharmaceutical Sciences Research Center, Health InstituteKermanshah University of Medical SciencesKermanshahIran
  11. 11.Medical Biology Research CenterKermanshah University of Medical SciencesKermanshahIran

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