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Genotoxic damage and apoptosis in rat glioma (F98) cell line following exposure to bromuconazole. Neurotoxicology 2023; 94:108-116. [PMID: 36370923 DOI: 10.1016/j.neuro.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 08/02/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022]
Abstract
Bromuconazole, a fungicide from the triazole family, is widely used to protect the crop from various fungal contaminations to increase product quality and productivity. Although the massive use of bromuconazole poses a serious risk to human health, the exact mechanism of bromuconazole toxicity, especially on brain support cells, called glia cells, remains unclear so far. This study aimed to determine the mechanism of cytotoxicity and genotoxicity of bromuconazole via inspection of apoptotic death in rat glioma (F98) cells. We observed that bromuconazole treatment caused concentration-dependent cell death with an IC50 of 60 µM, and disruption of the cytoskeleton was observed via immunocytochemical analysis. Further, bromuconazole inhibits cell proliferation, it arrests the cell cycle in the G0/G1 phase and so inhibits DNA synthesis. Genotoxic analysis showed that bromuconazole exposition causes DNA fragmentation (comet assay) and nuclear condensation (DAPI staining). Apoptotic cell death was confirmed through: positive Annexin-V/FITC-PI dyes, p53 and Bax overexpression, Bcl2 repression, an increase in Bax/BCL-2 ratios of the mRNA, mitochondrial membrane depolarization, and an increase of caspase-3 activity. All these results demonstrate that bromuconazole exerts its cytotoxic and genotoxic effects through apoptotic cell death, which could implicate mitochondria.
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Rjiba-Touati K, Ayed-Boussema I, Hamdi H, Azzebi A, Abid S. Bromuconazole fungicide induces cell cycle arrest and apoptotic cell death in cultured human colon carcinoma cells (HCT116) via oxidative stress process. Biomarkers 2022; 27:659-670. [PMID: 35968645 DOI: 10.1080/1354750x.2022.2098378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Bromuconazole, a fungicide belonging to the triazole family, is a plant protection product used to control, repel or destroy fungi that may develop on crops. We investigated the pro-apoptotic effect of bromuconazole and the role of oxidative stress in the death mechanism induced by this fungicide in this study. METHODS The human colon HCT116 cell line was treated with Bromuconazole (IC50/4, IC50/2, and IC50) for 24 h. Cells were collected and analysed for biomarkers of apoptotic cell death and oxidative stress as well as for the assessment of genotoxic damage. RESULTS Our study showed that bromuconazole caused a concentration-dependent increase in cell mortality with an IC50 of 180 µM. Bromuconazole induced cell cycle arrest in the G0/G1 phase and DNA synthesis inhibition. The Comet assay showed that bromuconazole caused DNA damage in a concentration-dependent manner. Bromuconazole-induced apoptosis was observed by, Annexin-V/FITC-PI and BET/AO staining, by mitochondrial membrane depolarisation, and by increased caspase-3 activity. In addition, bromuconazole induced a significant increase in ROS and lipid peroxidation levels and a disruption in SOD and CAT activities. N-acetylcysteine (NAC) strongly prevents cytotoxic and genotoxic damage caused by bromuconazole. CONCLUSION Bromuconazole toxicity was through the oxidative stress process, which causes DNA damage and mitochondrial dysfunction, leading to cell cycle arrest and apoptotic death of HCT116 cells.
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Affiliation(s)
- Karima Rjiba-Touati
- Faculty of Dentistry, Laboratory of Research on Biologically Compatible Compounds, Monastir, Tunisia.,Faculty of Sciences of Gafsa, University Campus, Gafsa, Tunisia
| | - Imen Ayed-Boussema
- Faculty of Dentistry, Laboratory of Research on Biologically Compatible Compounds, Monastir, Tunisia.,Faculty of Sciences of Gafsa, University Campus, Gafsa, Tunisia
| | - Hiba Hamdi
- Faculty of Dentistry, Laboratory of Research on Biologically Compatible Compounds, Monastir, Tunisia
| | - Awatef Azzebi
- Department of Nephrology, Dialysis, and Transplant, University Hospital of Sahloul, Sousse, Tunisia
| | - Salwa Abid
- Faculty of Dentistry, Laboratory of Research on Biologically Compatible Compounds, Monastir, Tunisia
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Epoxiconazole caused oxidative stress related DNA damage and apoptosis in PC12 rat Pheochromocytoma. Neurotoxicology 2022; 89:184-190. [DOI: 10.1016/j.neuro.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 01/31/2022] [Accepted: 02/10/2022] [Indexed: 11/22/2022]
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Lucas AM, Bento AF, Vargas RMF, Scheffel TB, Rockenbach L, Diz FM, Capellari AR, Morrone FB, Cassel E. Use of supercritical CO2 to obtain Baccharis uncinella extracts with antioxidant and antitumor activity. J CO2 UTIL 2021. [DOI: 10.1016/j.jcou.2021.101563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Hamdi H, Abid-Essefi S, Eyer J. Neuroprotective effects of Myricetin on Epoxiconazole-induced toxicity in F98 cells. Free Radic Biol Med 2021; 164:154-163. [PMID: 33429020 DOI: 10.1016/j.freeradbiomed.2020.12.451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/26/2020] [Accepted: 12/29/2020] [Indexed: 01/08/2023]
Abstract
Epoxiconazole is one of the most commonly used fungicides in the world. The exposition of humans to pesticides is mainly attributed to its residue in food or occupational exposure in agricultural production. Because of its lipophilic character, Epoxiconazole can accumulate in the brain Heusinkveld et al. (2013) [1]. Consequently, it is urgent to explore efficient strategies to prevent or treat Epoxiconazole-related brain damages. The use of natural molecules commonly found in our diet represents a promising avenue. Flavonoids belong to a major sub-group compounds possessing powerful antioxidant activities based on their different structural and sterical properties [2]. We choose to evaluate Myricetin, a flavonoid with a wide spectrum of pharmacological effects, for its possible protective functions against Epoxiconazole-induced toxicities. The cytotoxicity induced by this fungicide was evaluated by the cell viability, cell cycle arrest, ROS generation, antioxidant enzyme activities, and Malondialdehyde production, as previously described in Hamdi et al., 2019 [3]. The apoptosis was assessed through the evaluation of the mitochondrial transmembrane potential (ΔΨm), caspases activation, DNA fragmentation, cytoskeleton disruption, nuclear condensation, appearance of sub-G0/G1 peak (fragmentation of the nucleus) and externalization of Phosphatidylserine. This study indicates that pre-treatment of F98 cells with Myricetin during 2 h before Epoxiconazole exposure significantly increased the survival of cells, restored DNA synthesis of the S phase, abrogated the ROS generation, regulated the activities of Catalase (CAT) and Superoxide Dismutase (SOD), and reduced the MDA level. The loss of mitochondrial membrane potential, DNA fragmentation, cytoskeleton disruption, chromatin condensation, Phosphatidylserine externalization, and Caspases activation were also reduced by Myricetin. Together, these findings indicate that Myricetin is a powerful natural product able to protect cells from Epoxiconazole-induced cytotoxicity and apoptosis.
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Affiliation(s)
- Hiba Hamdi
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, University of Monastir, Avicenne Street, 5019, Monastir, Tunisia; Higher Institute of Biotechnology, University of Monastir, Tunisia
| | - Salwa Abid-Essefi
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, University of Monastir, Avicenne Street, 5019, Monastir, Tunisia
| | - Joel Eyer
- Laboratoire Micro et NanomédecinesTranslationnelles (MINT), Inserm 1066, CNRS 6021, Institut de Biologie de La Santé, Centre Hospitalier Universitaire, 49033, Angers, France.
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Zheng Y, Deng Z, Tang M, Cai P. Erythropoietin promoter polymorphism is associated with treatment efficacy and severe hematologic toxicity for platinum-based chemotherapy. Expert Opin Drug Metab Toxicol 2021; 17:495-502. [PMID: 33461346 DOI: 10.1080/17425255.2021.1879048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Erythropoietin (EPO) plays a substantial role in cancer development and probably affects clinical outcomes. A functional polymorphism (rs1617640, G > T) in the promoter region of the EPO increases protein expression. This study investigated the association of EPO rs1617640 with treatment efficacy and severe toxicity in non-small cell lung cancer (NSCLC) patients undergoing platinum-based regimens.Methods: 437 Chinese NSCLC patients treated with platinum-based chemotherapy were recruited. Association between EPO rs1617640 and clinical outcomes was calculated by multivariable logistic regression.Results: The TT genotype of EPO rs1617640 was significantly correlated with a higher response rate to platinum-based treatment than the other genotypes (OR, 0.507; 95% CI: 0.305-0.842; P = 0.009), particularly in elderly patients (>55 years), male gender, smokers, IV stage, cisplatin-based chemotherapies, and platinum-gemcitabine regimen subgroups. As for toxicity, EPO rs1617640 TT genotype demonstrated poorer tolerance to grade 3-4 hematologic toxicity (OR, 1.783; 95% CI: 1.098-2.898; P = 0.019), particularly in subgroups of elderly patients (>55 years), male gender, smokers, IIIA+IIIB stage, and cisplatin-based chemotherapies.Conclusion: Our results demonstrated the role of EPO rs1617640 as a possible predictive marker of treatment efficacy and severe toxicity for platinum-based chemotherapy.
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Affiliation(s)
- Yi Zheng
- Department of Pharmacy, Hunan Provincial Maternal and Child Health Care Hospital, Changsha People's Republic of China
| | - Zheng Deng
- General Department, Hunan Institute for Tuberculosis Control Changsha, People's Republic of China.,General Department, Hunan Chest Hospital, Changsha, People's Republic of China
| | - Mimi Tang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Pei Cai
- Department of Pharmacy, Hunan Provincial Maternal and Child Health Care Hospital, Changsha People's Republic of China
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Role of recombinant human erythropoietin loading chitosan-tripolyphosphate nanoparticles in busulfan-induced genotoxicity: Analysis of DNA fragmentation via comet assay in cultured HepG2 cells. Toxicol In Vitro 2016; 36:46-52. [DOI: 10.1016/j.tiv.2016.07.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 05/25/2016] [Accepted: 07/05/2016] [Indexed: 02/07/2023]
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Ben Salem I, Boussabbeh M, Kantaoui H, Bacha H, Abid-Essefi S. Crocin, the main active saffron constituent, mitigates dichlorvos-induced oxidative stress and apoptosis in HCT-116 cells. Biomed Pharmacother 2016; 82:65-71. [DOI: 10.1016/j.biopha.2016.04.063] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/28/2016] [Accepted: 04/28/2016] [Indexed: 12/29/2022] Open
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Boussabbeh M, Ben Salem I, Belguesmi F, Neffati F, Najjar MF, Abid-Essefi S, Bacha H. Crocin protects the liver and kidney from patulin-induced apoptosis in vivo. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:9799-9808. [PMID: 26856859 DOI: 10.1007/s11356-016-6195-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/27/2016] [Indexed: 06/05/2023]
Abstract
Patulin (PAT) is a mycotoxin mainly produced by Aspergillus, Penicillium, and Bissochlamys. Given the high risk associated with this mycotoxin, its potential effects have been investigated by many studies. It is known to be teratogenic, mutagenic, and genotoxic, and it has been shown to induce damages in several organs in experimental animals. Our aim was to investigate the preventive effect against PAT-induced apoptosis in vivo using natural carotenoid, Crocin (CRO). Mice were divided into six groups: a control group, a "PAT alone" group, a "CRO alone" group, and a "PAT plus CRO" groups (pre-treatment conditions). Our results showed that CRO restored the normal levels of biochemical parameters in the liver and kidney. The analysis of the protein expression in these organs revealed that PAT-induced toxicity promotes the induction of apoptosis via the increase in P53, Bax, and cytochrome C and the decrease in Bcl2 expressions. We also found that PAT triggered caspase 3 activation and DNA fragmentation. However, pre-treatment with CRO demonstrated a reduction in the induction of apoptosis via the regulation of all tested biomarkers demonstrating that CRO is effective in the protection against PAT hazards. This could be relevant, particularly with the emergent demand for natural products which may counteract the detrimental toxic effects and therefore prevents multiple human diseases.
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Affiliation(s)
- Manel Boussabbeh
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, Monastir University, Rue Avicenne, 5019, Monastir, Tunisia
- Faculty of Sciences of Bizerte, Carthage University, Tunis, Tunisia
| | - Intidhar Ben Salem
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, Monastir University, Rue Avicenne, 5019, Monastir, Tunisia
- Faculty of Sciences of Bizerte, Carthage University, Tunis, Tunisia
| | - Faicel Belguesmi
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, Monastir University, Rue Avicenne, 5019, Monastir, Tunisia
| | - Fadwa Neffati
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monaster, Tunisia
| | - Mohamed Fadhel Najjar
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monaster, Tunisia
| | - Salwa Abid-Essefi
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, Monastir University, Rue Avicenne, 5019, Monastir, Tunisia.
| | - Hassen Bacha
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, Monastir University, Rue Avicenne, 5019, Monastir, Tunisia
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Ben Salem I, Boussabbeh M, Graiet I, Rhouma A, Bacha H, Abid Essefi S. Quercetin protects HCT116 cells from Dichlorvos-induced oxidative stress and apoptosis. Cell Stress Chaperones 2016; 21:179-186. [PMID: 26476661 PMCID: PMC4679746 DOI: 10.1007/s12192-015-0651-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 01/24/2023] Open
Abstract
The present study was designed to assess the possible protective effects of Quercetin (QUER), a flavonoid with well-known pharmacological effects, against Dichlorvos (DDVP)-induced toxicity in vitro using HCT116 cells. The cytotoxicity was monitored by cell viability, reactive oxygen species (ROS) generation, anti-oxidant enzyme activities, malondialdehyde (MDA) production, and DNA fragmentation. The apoptosis was assessed through the measurement of the mitochondrial transmembrane potential (ΔΨm) and caspase activation. The results indicated that pretreatment of HCT116 cells with QUER, 2 h prior to DDVP exposure, significantly decreased the DDVP-induced cell death, inhibited the ROS generation, modulated the activities of catalase (CAT) and superoxide dismutase (SOD), and reduced the MDA level. The reductions in mitochondrial membrane potential, DNA fragmentation, and caspase activation were also attenuated by QUER. These findings suggest that dietary QUER can protect HCT116 cells against DDVP-induced oxidative stress and apoptosis.
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Affiliation(s)
- Intidhar Ben Salem
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, Rue Avicenne, 5000, Monastir, Tunisia
- Faculty of Sciences of Bizerte, Carthage University, Tunis, Tunisia
| | - Manel Boussabbeh
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, Rue Avicenne, 5000, Monastir, Tunisia
- Faculty of Sciences of Bizerte, Carthage University, Tunis, Tunisia
| | - Imen Graiet
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, Rue Avicenne, 5000, Monastir, Tunisia
| | - Asma Rhouma
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, Rue Avicenne, 5000, Monastir, Tunisia
| | - Hassen Bacha
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, Rue Avicenne, 5000, Monastir, Tunisia.
| | - Salwa Abid Essefi
- Laboratory for Research on Biologically Compatible Compounds, Faculty of Dental Medicine, Rue Avicenne, 5000, Monastir, Tunisia
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Boussabbeh M, Ben Salem I, Rjiba-Touati K, Bouyahya C, Neffati F, Najjar MF, Bacha H, Abid-Essefi S. The potential effect of patulin on mice bearing melanoma cells: an anti-tumour or carcinogenic effect? Tumour Biol 2015; 37:6285-95. [DOI: 10.1007/s13277-015-4474-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 11/18/2015] [Indexed: 12/14/2022] Open
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12
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Boussabbeh M, Ben Salem I, Neffati F, Najjar MF, Bacha H, Abid-Essefi S. Crocin Prevents Patulin-Induced Acute Toxicity in Cardiac Tissues via the Regulation of Oxidative Damage and Apoptosis. J Biochem Mol Toxicol 2015; 29:479-488. [DOI: 10.1002/jbt.21718] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 05/14/2015] [Accepted: 05/20/2015] [Indexed: 12/23/2022]
Affiliation(s)
- Manel Boussabbeh
- Laboratory for Research on Biologically Compatible Compounds; Faculty of Dental Medicine; Rue Avicenne Monastir 5019 Tunisia
- Faculty of Science of Bizerte; University of Carthage; Tunisia
| | - Intidhar Ben Salem
- Laboratory for Research on Biologically Compatible Compounds; Faculty of Dental Medicine; Rue Avicenne Monastir 5019 Tunisia
- Faculty of Science of Bizerte; University of Carthage; Tunisia
| | - Fadwa Neffati
- Laboratory of Biochemistry-Toxicology; Monastir University Hospital; Tunisia
| | | | - Hassen Bacha
- Laboratory for Research on Biologically Compatible Compounds; Faculty of Dental Medicine; Rue Avicenne Monastir 5019 Tunisia
| | - Salwa Abid-Essefi
- Laboratory for Research on Biologically Compatible Compounds; Faculty of Dental Medicine; Rue Avicenne Monastir 5019 Tunisia
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Antioxidant properties of cluster rhenium compounds and their influence of erythropoiesis of rats with Guerin carcinoma. UKRAINIAN BIOCHEMICAL JOURNAL 2015. [DOI: 10.15407/ubj87.01.099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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14
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Li SG, Chen HY, Ou-Yang CS, Wang XX, Yang ZJ, Tong Y, Cho WC. The efficacy of Chinese herbal medicine as an adjunctive therapy for advanced non-small cell lung cancer: a systematic review and meta-analysis. PLoS One 2013; 8:e57604. [PMID: 23469033 PMCID: PMC3585199 DOI: 10.1371/journal.pone.0057604] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 01/22/2013] [Indexed: 12/14/2022] Open
Abstract
Many published studies reflect the growing application of complementary and alternative medicine, particularly Chinese herbal medicine (CHM) use in combination with conventional cancer therapy for advanced non-small cell lung cancer (NSCLC), but its efficacy remains largely unexplored. The purpose of this study is to evaluate the efficacy of CHM combined with conventional chemotherapy (CT) in the treatment of advanced NSCLC. Publications in 11 electronic databases were extensively searched, and 24 trials were included for analysis. A sum of 2,109 patients was enrolled in these studies, at which 1,064 patients participated in CT combined CHM and 1,039 in CT (six patients dropped out and were not reported the group enrolled). Compared to using CT alone, CHM combined with CT significantly increase one-year survival rate (RR = 1.36, 95% CI = 1.15–1.60, p = 0.0003). Besides, the combined therapy significantly increased immediate tumor response (RR = 1.36, 95% CI = 1.19–1.56, p<1.0E−5) and improved Karnofsky performance score (KPS) (RR = 2.90, 95% CI = 1.62–5.18, p = 0.0003). Combined therapy remarkably reduced the nausea and vomiting at toxicity grade of III–IV (RR = 0.24, 95% CI = 0.12–0.50, p = 0.0001) and prevented the decline of hemoglobin and platelet in patients under CT at toxicity grade of I–IV (RR = 0.64, 95% CI = 0.51–0.80, p<0.0001). Moreover, the herbs that are frequently used in NSCLC patients were identified. This systematic review suggests that CHM as an adjuvant therapy can reduce CT toxicity, prolong survival rate, enhance immediate tumor response, and improve KPS in advanced NSCLC patients. However, due to the lack of large-scale randomized clinical trials in the included studies, further larger scale trials are needed.
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Affiliation(s)
- Shi Guang Li
- Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Oncology and Hematology, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong Province, China
| | - Hai Yong Chen
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Chen Sheng Ou-Yang
- Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Oncology and Hematology, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong Province, China
| | - Xi-Xin Wang
- Shanxi Province Hospital of Traditional Chinese Medicine, Taiyuan, Shanxi Province, China
| | - Zhen-Jiang Yang
- Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Oncology and Hematology, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong Province, China
| | - Yao Tong
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- * E-mail: (YT); (WCSC)
| | - William C.S. Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China
- * E-mail: (YT); (WCSC)
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