title: Complementary and alternative medicine in reducing radiation-induced skin toxicity.
abstract: Radiation therapy-induced acute and late effects, particularly skin toxicities, have significant impact on cancer patients' quality of life and long-term survival. To date, no effective topical agents have been routinely used in the clinical setting to prevent skin toxicity. Using SKH-hr1 hairless mice, we investigated two complementary and alternative medicine in their effects on inflammation and ionizing radiation (IR)-induced skin toxicity: Calendula officinalis (CO) and Ching Wan Hung (CWH). They were applied immediately following each IR dosing of 10 Gy/day for 4 days. Skin toxicity and inflammatory factors were evaluated at multiple time points up to 15 days post-radiation. Serum interleukin (IL)-1α, monocyte chemotactic protein-1 (MCP1), keratinocyte-derived chemokine (KC), and granulocyte colony-stimulating factor (G-CSF) were significantly induced by radiation. Both CO and CWH significantly inhibited IR-induced MCP1 (p < 0.01), KC (p < 0.05), and G-CSF (p < 0.001). IR-induced erythema and blood vessel dilation were significantly reduced by CWH (p < 0.001) but not by CO at day 10 post-IR. Both agents inhibited IR-induced IL-1α (p < 0.01), MCP1 (p < 0.05), and vascular endothelial growth factor (p < 0.05). There were continuous inhibitory effects of CWH on IR-induced skin toxicities and inflammation. In contrast, CO treatment resulted in skin reactions compared to IR alone. Our results suggest that both CO and CWH reduce IR-induced inflammation and CWH reduced IR-induced erythema. In summary, CWH showed promising effects in reducing IR-related inflammation and skin toxicities, and future proof-of-principal testing in humans will be critical in evaluating its potential application in preventing IR-induced skin toxicities.
authors.affiliation: Department of Public Health Sciences, University of Miami School of Medicine, 1120 NW 14th St., CRB 1511, Miami, FL, 33136, USA, jhu@med.miami.edu.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Hu
authors.forename: Tengjiao
authors.initials: T
authors.lastname: Cui
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Rodriguez-Gil
authors.forename: Glenn O
authors.initials: GO
authors.lastname: Allen
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.forename: Cristiane
authors.initials: C
authors.lastname: Takita
authors.forename: Brian E
authors.initials: BE
authors.lastname: Lally
mesh_terms: D043925:Angiogenesis Inducing Agents / Q000378:metabolism; D000818:Animals; D020838:Calendula / Q000737:chemistry; D000529:Complementary Therapies; D003872:Dermatitis / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control; D004365:Drugs, Chinese Herbal / Q000494:pharmacology*; D005260:Female; D051379:Mice; D009369:Neoplasms / Q000150:complications / Q000532:radiotherapy; D011833:Radiation Injuries, Experimental / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control*; D011878:Radiotherapy / Q000009:adverse effects*; D012867:Skin / Q000187:drug effects* / Q000293:injuries / Q000473:pathology / Q000528:radiation effects*
chemical_list: D043925:Angiogenesis Inducing Agents; D004365:Drugs, Chinese Herbal; C000595681:ching wan hung