Abstract

Purpose Changrui enema, a traditional Chinese medicine prescription, is used as a supplementary treatment for acute radiation proctitis (ARP). Herein we explored the inhibition effects of Changrui enema on NF-κB and VEGF in ARP mice.Methods A total of 120 C57BL/6 mice were divided randomly into normal mice group, ARP mice group, western medicine enema group (dexamethasone combined with gentamicin), and Changrui enema group. ARP mice were established by pelvic local irradiation. The expression of IL-1β, NF-κB, VEGF, AQP1, AQP3, p-ERK1/2 and p-JNK was determined by immunohistochemistry or western blot.Results The study firstly found that Changrui enema alleviated ARP mice. The expression of IL-1β, NF-κB, VEGF, AQP1 and p-ERK1/2 was increased in ARP mice, and was reserved by Changrui enema. However, the expression of AQP3 and p-JNK was decreased in ARP mice, and was up-regulated by Changrui enema.Conclusions Changrui enema is an effective treatment with fewer side effects for ARP. The mechanism of Changrui enema may be related to the inhibition of inflammation-induced angiogenesis. Changrui enema inhibits IL-1β and NF-κB expression as well as VEGF expression. Interestingly, AQP1 promotes angiogenesis, while AQP3 inhibits inflammation. Changrui enema probably inhibits AQP1 expression by down-regulating p-ERK1/2, and improves AQP3 expression by up-regulating p-JNK.

Highlights

  • Radiation proctitis is the most common radiotherapy side effect[1] of abdominal and pelvic malignant tumors, such as colorectal cancer, ovarian cancer, prostate cancer and bladder cancer etc

  • Changrui enema and western medicine enema group were all effective in the treatment of acute radiation proctitis (ARP), and the highdose Changrui enema was more effective than western medicine enema in the treatment of the general signs score of ARP mice (Fig. 1 A-B)

  • The body weight of ARP mice was decreased; it was significantly restored by Changrui enema treatment and increased by western medicine enema treatment (Fig. 1C)

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Summary

Introduction

Radiation proctitis is the most common radiotherapy side effect[1] of abdominal and pelvic malignant tumors, such as colorectal cancer, ovarian cancer, prostate cancer and bladder cancer etc. Patients with radiation proctitis mainly suffered from abdominal pain, diarrhea, excretion of mucus or blood and so on. Radiation proctitis results in poor quality of life, radiotherapy failure, and unfavorable prognosis of the patients. Traditional Chinese medicine (TCM) has been used to treat radiation proctitis. Enema with traditional Chinese medicine offers a safe, efficacious and low-toxicity treatment for ulcerative colitis[3] and radiation proctitis[4]. A traditional Chinese medicine compound prescription patent (Chinese patent ZL200810054678.2), is used as a supplementary treatment for ARP and is undergoing phase II clinical trials in China. Changrui enema contains 7 herbs (Table 1), including 30g Sanguisorba officinalis L., 15g

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