Emblica officinalis Gaertn. Fruits, their Phytochemicals, and Composite Herbal Products as Adjuncts in Preventing Ionizing Radiation Effects: Possible Use in Clinics.

In the management of solid tumors, ionizing radiation is a critical therapeutic modality, particularly when surgical intervention is impractical due to patient-related factors, such as compromised health or elevated mortality risk. However, its non-selective action can cause serious side effects that negate the therapeutic benefits. Efforts have thus been made to identify pharmacological agents that can selectively protect normal tissues from exposure to ionizing radiation. Seven decades of study, however, have shown that the desired success has not been achieved in obtaining an ideal radioprotective agent. Moreover, even at optimal doses, the FDA-approved drug, amifostine (also known as WR-2721 [S-2- (3-aminopropyl-amino) ethyl phosphorothioic acid], exhibits significant toxicity. An ideal radioprotective agent can also be beneficial in environments where individuals are exposed to prolonged, low-dose radiation. Considering this, there is a pressing need to develop methods of shielding cells and patients from the deleterious effects of radiation, and a non-toxic radioprotective drug can be useful in both clinical and occupational contexts. Studies have shown that the fruits of Emblica officinalis and its cardinal phytochemicals, such as gallic acid, ellagic acid, quercetin, geraniin, corilagin, and kaempferol, have been demonstrated to mitigate radiationinduced side effects. Research has also demonstrated that fruits can reduce the severity of radiationinduced mucositis in head and neck cancer patients undergoing curative treatment. Currently, there are no clinically effective non-toxic medications that are beneficial in mitigating radiation-induced ill effects. In lieu of this, for the first time, this review compiles the positive effects of fruits, phytochemicals, and their byproducts, chyawanprash and triphala, on radiation-induced damage, the mechanisms by which these effects occur, and the gaps that must be filled in order for future research to help people and the agricultural and nutraceutical industries.