Published online Dec 28, 2020. doi: 10.3748/wjg.v26.i48.7633
Peer-review started: August 30, 2020
First decision: October 17, 2020
Revised: October 31, 2020
Accepted: November 12, 2020
Article in press: November 12, 2020
Published online: December 28, 2020
Processing time: 116 Days and 1.5 Hours
According to traditional Chinese medicine, colorectal cancer (CRC) originates from the damp-heat syndrome, while Gegen Qinlian decoction (GQD) is a classical traditional Chinese medicine for the treatment of damp-heat syndrome. We previously showed that GQD had a direct antitumor effect on tumor-bearing mice.
GQD can be used in the treatment of type 2 diabetes and ulcerative colitis (UC). However, the effect of GQD on patients with CRC is not clear.
This study aimed to determine the therapeutic mechanism of GQD in patients with CRC in improving immune function, reducing inflammation and protecting intestinal barrier function.
The patients were divided into the control group and the treatment group. The proportions of T, natural killer (NK), NKT and Treg cells were measured by flow cytometry. The levels of cytokines and serotonin in serum were detected by enzyme-linked immunosorbent assay. The expression of zonula occludens (ZO)-1, occludin, nuclear factor (NF)-κB and tumor necrosis factor (TNF)-α in tumor and normal tissues was measured by immunohistochemistry. The composition of gut microbiota from patients in the treatment group was assessed using 16S rDNA analysis.
There were no adverse events in the treatment group. The proportion of CD4+ T cells and NKT cells in the post-treatment group was significantly higher than that in the pre-treatment and control groups (P < 0.05). The level of TNF-α in the post-treatment group was significantly lower than that in the pre-treatment and control groups (P < 0.05). The concentration of 5-HT in the post-treatment group was significantly lower than that in the pre-treatment group (P < 0.05). The expression of ZO-1 and occludin in tumor tissues in the treatment group was significantly higher than that in the control group (P < 0.05). The expression of ZO-1 in the normal tissues of the treatment group was significantly higher than that in the control group (P = 0.010). Compared with the control group, the expression of NF-κB and TNF-α in the tumor tissues of the treatment group was significantly decreased (P < 0.05). Compared with the pre-treatment group, GQD decreased the relative abundance of Megamonas and Veillonella. In addition, GQD increased the relative abundance of Bacteroides, Akkermansia and Prevotella. The differential genes of gut microbiota between the two groups were enriched by KEGG function and we found functional differences included energy metabolism, immune system, nervous system and cancer.
GQD enhances the immunity and protects intestinal barrier function in patients with CRC by regulating the composition of gut microbiota.
GQD has good clinical application prospects.