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Review
. 2021 Jan-Dec:20:15347354211065038.
doi: 10.1177/15347354211065038.

Is 6-Shogaol an Effective Phytochemical for Patients With Lower-risk Myelodysplastic Syndrome? A Narrative Review

Soo Liang Ooi  1 , Ron Campbell  1   2 , Sok Cheon Pak  1 , Terry Golombick  3 , Arumugam Manoharan  4   5 , Raj Ramakrishna  4   5 , Vladimir Badmaev  6 , Janet Schloss  7
Affiliations
Review

Is 6-Shogaol an Effective Phytochemical for Patients With Lower-risk Myelodysplastic Syndrome? A Narrative Review

Soo Liang Ooi et al. Integr Cancer Ther. 2021 Jan-Dec.

Abstract

Myelodysplastic syndrome (MDS) evolves due to genomic instability, dysregulated signaling pathways, and overproduction of inflammatory markers. Reactive oxygen species contribute to the inflammatory response, which causes gene damage, cellular remodeling, and fibrosis. MDS can be a debilitating condition, and management options in patients with MDS aim to improve cytopenias, delay disease progression, and enhance quality of life. High serum ferritin levels, a source of iron for reactive oxygen species production, correlate with a higher risk of progression to acute myeloid leukemia, and iron overload is compounded by blood transfusions given to improve anemia. 6-shogaol is a natural phenolic compound formed when ginger is exposed to heat and/or acidic conditions, and it has been shown to possess anti-tumor activity against leukemia cell lines and antioxidant effects. This narrative review assessed the potential benefits of this phytochemical in lower-risk MDS patients through examining the current evidence on the pharmacological and therapeutic properties of ginger and 6-shogaol.

Keywords: (max 6) Zingiber officinale; 6-Shogaol; 6-gingerol; anemia; hematopoiesis; hepcidin.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Two dimensions structure of 6-gingerol, 6-, 8-, and 10-shogaol. Source: PubChem.
Figure 2.
Figure 2.
A schematic depiction of how dried ginger extract rich in 6-shogaol can potentially benefit lower-risk MDS patients. Chronic inflammation leads to genetic aberrations in these patients, altering the hematopoietic stem cells’ ability to produce erythrocytes. Ineffective erythropoiesis causes iron overload and accumulation of excess iron in the liver, which lowers the liver’s ability to produce hepcidin. Intestinal absorption of iron increases as a result and further exacerbates iron overload. Excess iron is toxic, causing oxidative stress, which worsens inflammation. Dried ginger extract rich in 6-shogaol provides the much-needed antioxidants to scavenge the free radicals and reduce inflammation. It has anti-cancer properties to reduce the spread of malignancies. Ginger also promotes hematopoiesis and protects against liver damage and preserves hepcidin production to reduce iron overload.
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