Abstract
Background:Chemotherapy as part of colorectal cancer management can cause death to immunologically active tumor cell, but also it has immune suppressive effect. Phyllanthus niruri Linn is known to has immunomodulatory effect. This study was intended to prove P. niruri Linn effect on infiltrating dendritic cells and Neutrophil/lymphocyte ratios (NLRs) in Sprague–Dawley rats with colorectal cancer which were given capecitabine chemotherapy. Methods:The study was randomized post–test only control group design. The samples were 39 Sprague–Dawley male rats, with body weight around 170–220 grams, induced by 1,2-dimetylhydrazine (DMH) 30 mg/kgBW once per week subcutaneously. On 9th,11th and 13th week, there were four induced rats sacrificed each week to detect colorectal cancer (CRC) development. On the 13th week, all of the 4 sacrificed rats developed colon cancer, so the induction had to be stopped. The rest of 27 induced rats were randomly divided into three groups: control-group (K) were left untreated (9 rats), group P1 (9 rats) were given Capecitabine and group P2 (9 rats) were given Capecitabine with combination of P. niruri Linn extract 13.5 mg/kgBW orally. After 17th week, all rats were terminated and tumor lesion of colon were processed to be paraffin blocks and were stained with HE for evaluating the NLRs, and immunohistochemistry (S100) for evaluating infiltrating dendritic cells. Data was analyzed by using Oneway-Anova-test and post-Hoc LSD-test. Considered significant if p was <0.05. Results:The mean±standard deviation of infiltrating dendritic cells showed increasing value in group P2 (62.11±31.35) compared to group P1 (52.78±29.24) though not statistically significant. The mean of NLRs also showed statistically significant elevation of value in group P2 (0.13±0.05) compared to group P1 (0.04±0.01). Conclusion:Extract of Phyllanthus niruri Linn increasing immunologic status through elevation of infiltrating dendritic cells and NLRs in animal model colorectal cancer with Capecitabine chemotherapy.
Highlights
Colorectal cancer today is the third most commonly diagnosed malignancies and the fourth cause of death in the world, global burden is expected to be more than 60% with more than 2.2 million new cases and 1.1 million mortalities at the year of 2030 (Arnold et al, 2017)
This study aims to evaluate the administration of Phyllanthus niruri Linn extract to 1,2 DMH induced Sprague – Dawley rats colon cancer with the usage of capecitabine as the chemotherapy management, using the infiltrating dendritic cells and neutrophil/ lymphocyte ratios (NLRs) as the parameter of immune response
All of rats were terminated at 17th week, after completed single cycle of chemotherapy with capecitabine, twice a day for 2 weeks and one week rest, and administration of immunotherapy with extract of Phyllanthus niruri Linn
Summary
Colorectal cancer today is the third most commonly diagnosed malignancies and the fourth cause of death in the world, global burden is expected to be more than 60% with more than 2.2 million new cases and 1.1 million mortalities at the year of 2030 (Arnold et al, 2017). The incidence is high in countries with medium to high level of human development index such as Czech Republic and Slovakia in Eastern Europe, Japan in Asia, Australia, Western Europe and North America, but on the other hand, the colorectal cancer mortality rates in these countries are low. This is most likely the result of improvement on colorectal cancer screening and therapy management. Conclusion: Extract of Phyllanthus niruri Linn increasing immunologic status through elevation of infiltrating dendritic cells and NLRs in animal model colorectal cancer with Capecitabine chemotherapy
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