Sesame oil and sesamol as protective and therapeutic agents against drug-induced sinusoidal obstruction syndrome

Sinusoidal obstruction syndrome (SOS), previously known as venoocclusive disease (VOD), occurs in patients undergoing hematopoietic cell transplantation and chemotherapy. SOS is historically called Gulran disease in Afghanistan and senecio disease in South Africa; it dates back to 1920. Pyrrolizidine alkaloids (PAs) in herbal preparations such as tea and Chinese medicine induce SOS. PAs in grasses and animal feed cause acute and chronic poisoning in cattle. The chemotherapeutic drugs oxaliplatin and cyclophosphamide also cause SOS. The search for a novel and effective therapy for chemotherapeutic-drug-induced-SOS continues. Sesame oil is a nutrient-rich antioxidant popular in alternative medicine and traditional health foods in Asian countries. Sesame oil and its lignan sesamol have been proved effective for treating various drug-induced and chemically induced liver injuries. Sesame oil and sesamol maintain glutathione and reduce myeloperoxidase activity, nitrate content, lipid peroxidation (LPO), and the recruitment of inflammatory cells in SOS. In addition, they downregulate matrix metalloproteinase (MMP)-9 expression and upregulate tissue inhibitor of metalloproteinases (TIMP)- 1, laminin, and collagen in SOS. We hypothesize that sesame oil and sesamol would be useful for treating PA-mimicking chemotherapeutic drug-associated SOS.