Synergistic curative effect of chicory extract and cisplatin against thioacetamide-induced hepatocellular carcinoma

Abstract

Aim: Hepatocellular carcinoma (HCC) is the dominant form of primary liver cancer and is histologically and etiologically distinct from other forms of primary liver cancer. The objective of this study was to elucidate the synergistic effect and the role of chicory extract [inulin (IN)] as a chemo-sensitizer for cisplatin (CIS) treatment of HCC. Methods: Five groups of rats were treated for 4 months. These groups consisted of the control group, a group receiving thioacetamide (TAA) (200 mg/kg b.w) in drinking water, a group injected intraperitoneally with a single dose of CIS (7.5 mg/kg b.w) in addition to TAA for 4 months, a group receiving oral doses of IN (10 mg/kg b.w) in addition to TAA for 4 months, and a group injected intraperitoneally with a single dose of CIS (7.5 mg/kg b.w) and IN (10 mg/kg b.w) plus TAA for 4 months. Results: The current data exhibited increment of serum and liver enzyme (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, creatine kinase, and lactate dehydrogenase) activity, serum lipid profile levels (total lipids, total cholesterol, triglycerides, low-density lipoprotein, and very low-density lipoprotein), and a significant increase in β-fetoprotein and bilirubin, accompanied with reduced total serum protein and albumin levels in a HCC rat model. Histopathologically, numerous alterations were detected in hepatic tissues of HCC rats, such as lymphocytic cell infiltration, damage of hepatocytes, dilated congested central vein with degenerated endothelial cells, and congested blood sinusoids in addition to Masson's trichrome staining blue collagen fibers in hepatocytes and central vein indicating hepatic fibrosis. Treatment of HCC rats with CIS or IN improved such deleterious effects, where IN is more effective than CIS, and the best effect can be observed in rats that received both CIS and IN. Conclusion: It could be concluded that IN in chicory extract acts as a chemo-sensitizer to CIS for treatment in an HCC rat model.