What does this research mean for the field?

Traditional Chinese medicine-derived natural compounds exert multitarget protective effects against doxorubicin-induced cardiotoxicity by modulating six core pathways, with Nrf2, Sirt1, mTOR, and AMPK acting as central hub nodes. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to explore how natural compounds from traditional Chinese medicine protect against doxorubicin-induced heart damage.

March 26, 2026

Natural Compounds From Traditional Chinese Medicine Against Doxorubicin‐Induced Cardiotoxicity: Biological Mechanisms and Therapeutic Potential

Q: What is the clinical evidence from this study?

Study design: Systematic Review. Population: Doxorubicin-induced cardiotoxicity (n=104). Intervention: Traditional Chinese medicine-derived natural compounds (TCM-NCs). Primary outcome: Cardioprotective effects and mechanisms.

Key Result

Traditional Chinese medicine-derived natural compounds (65 identified across 104 preclinical studies) exert multitarget protective effects against doxorubicin-induced cardiotoxicity.

Key Points

This study aims to explore how natural compounds from traditional Chinese medicine protect against doxorubicin-induced heart damage.
Systematic analysis of 104 preclinical studies on TCM-NCs.
Evaluation of in vivo and in vitro models for cardioprotective effects.
Identification of six core pathways affected by TCM-NCs.
Target validation of central hub nodes like Nrf2 and Sirt1.
TCM-NCs show multitarget protective effects against cardiotoxicity.
Modulation of oxidative stress, apoptosis, and inflammation was noted.
Nrf2, Sirt1, mTOR, and AMPK identified as key protective mechanisms.
Findings support TCM-NCs as potential candidates for preventing chemotherapy-related cardiac injury.

Study Design

Type

Systematic Review (n=104)

Structured PICO

Do traditional Chinese medicine-derived natural compounds prevent doxorubicin-induced cardiotoxicity in preclinical models?

Population

Preclinical models (in vivo and in vitro) of doxorubicin-induced cardiotoxicity

Intervention

Traditional Chinese medicine-derived natural compounds (TCM-NCs)

Outcome

Cardioprotective effects and mechanisms against doxorubicin-induced cardiotoxicitysurrogate

A systematic analysis of preclinical studies identifies 65 traditional Chinese medicine-derived natural compounds that show mechanistic promise in preventing doxorubicin-induced cardiotoxicity.

Abstract

ABSTRACT The clinical application of doxorubicin (DOX) is severely restricted by its dose‐dependent cardiotoxicity. This study aimed to investigate the protective mechanisms of traditional Chinese medicine–derived natural compounds (TCM‐NCs) against DOX‐induced cardiotoxicity. A systematic analysis was performed on 104 preclinical studies (encompassing in vivo and in vitro models) retrieved from PubMed, Web of Science and Embase, summarising the cardioprotective effects and mechanisms of 65 TCM‐NCs. These compounds exert multitarget protective effects by modulating six core pathways: oxidative stress/ferroptosis, apoptosis, inflammation/pyroptosis, mitochondrial homeostasis, autophagy and endoplasmic reticulum stress. Target validation further identified Nrf2, Sirt1, mTOR and AMPK as potential central hub nodes underlying their protective actions. These findings offer a theoretical foundation and promising drug candidates for the prevention of chemotherapy‐related cardiac injury, with future research directions focusing on clinical translation and druggability optimisation.

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