Review of the therapeutic effect of alpha-tocopherol, ascorbic acid, and folic acid against ovarian toxicity induced by drugs and heavy metals

Introduction and aim. The ovaries are almond-shaped organs that produce the female gametes and reproductive hormones. They also play a critical role of ovulation under well-coordinated hormonal regulation. However, chemotherapy involving the application of drugs to combat chronic diseases (like cancer) results in toxicity to tissues like ovaries. Similarly, exposure to heavy metals has a toxic effect on the ovaries. Hence, potential therapeutic agents including vitamin antioxidants have been explored to combat ovarian toxicity caused by drugs or heavy metals. Material and methods. This review was based on previous articles archived on Web of Science, PubMed, Scopus and Google Scholar databases. After initial assessment, the relevant articles were selected for further critical assessment. Analysis of the literature. Induction of oxidative stress and activation of inflammo-apoptotic signaling were indicated as the major mechanisms of ovarian toxicity due to exposure to drugs and heavy metals. Moreover, vitamins such as alpha-tocopherol, ascorbic acid and folic acid demonstrated therapeutic effects against drug and heavy metal-induced ovarian toxicity based on their modulatory effect on the downstream mechanisms of the toxicity. Conclusion. Vitamins exert a therapeutic effect against ovarian toxicity caused by drugs or heavy metal exposure due to their antioxidant, anti-inflammatory and anti-apoptotic properties.