Effects of plant extracts and bioactive compounds on attenuation of bleomycin-induced pulmonary fibrosis

Introduction: Bleomycin (BLM) is a chemotherapeutic agent that is used in the management of some human cancers such as lymphomas and squamous cell carcinomas. The major limitation of BLM therapy is pulmonary toxicity. Combining medicinal herbs and chemotherapy drugs are proposed to attenuate this side effect of BLM. Methods: We conducted a search of some databases such as PubMed for articles and reviews published between 1998 and 2018, with different keywords including bleomycin, pulmonary fibrosis, plant extract, bioactive compound, herbal preparation. Results: Studies revealed that these natural products have several mechanisms of action to ameliorate pulmonary fibrosis such as inhibitory effects against the elevation of inflammatory markers such as NF-kappa B and preventing an increase in fibrotic markers like MMP-9 and HYP. Among the plant extracts that were evaluated, Chrysanthemum indicum enhanced the anti-cancer activity of BLM and showed a synergistic effect with BLM besides, substantial potential in improving BLM induced pulmonary fibrosis. Conclusion: In conclusion, the present review demonstrates that the herbs and their active ingredients are a promising source of compounds that can play pivotal roles in the alternative adjuvant chemotherapy in reducing the pulmonary fibrosis of BLM.