title: A multi-component herbal preparation, STW 5, shows anti-apoptotic effects in radiation induced intestinal mucositis in rats.
abstract: OBJECTIVE
  Intestinal mucositis is a common adverse effect in patients undergoing radiotherapy and constitutes a treatment-limiting condition. Since no agents are yet known that can adequately guard against its development, the search continues to find safe and effective measures. The present study was intended to investigate whether the herbal preparation, STW 5, could offer a potentially effective agent in this respect.
  
  
  METHODS
  Intestinal mucositis was induced in rats by exposing them to whole body gamma-irradiation (6 Gy). Rats were treated orally with STW 5 (5 or 10 ml/kg) for five days before and two days after irradiation. One day later, rats were sacrificed and segments of small intestine were examined histologically. Intestinal homogenates and serum samples were used to assess relevant parameters for apoptosis and different markers for inflammation and oxidative stress.
  
  
  RESULTS
  Exposure to radiation produced dose-dependent extents of intestinal injury associated with apoptotic changes with high radiation levels. Apoptosis was associated with an increase in cytosolic calcium, depletion of mitochondrial cytochrome c, B-cell lymphoma-2 and complex I. Oxidative stress parameters (reduced glutathione, thiobarbituric acid reactive substance and total nitrate/nitrite) were deranged. Inflammation markers (tumor necrosis factor and myeloperoxidase) and indices of intestinal damage (serum diamine oxidase) were increased. STW 5 protected to a large extent against histological changes and counteracted the deranged parameters.
  
  
  CONCLUSIONS
  The findings provide experimental evidence for the potential beneficial use of STW5 in protecting against the development of radiation-induced intestinal mucositis and associated changes in tissue biomarkers.
authors.affiliation: Department of Pharmacology, Faculty of Pharmacy, Cairo University, Egypt. Electronic address: mtkhayyal@gmail.com.
authors.forename: Mohamed T
authors.initials: MT
authors.lastname: Khayyal
authors.affiliation: Department of Drug Radiation Research, National Centre for Radiation Research and Technology, Atomic Energy Authority, Egypt.
authors.forename: Doaa H
authors.initials: DH
authors.lastname: Abdel-Naby
authors.affiliation: Scientific Department, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany.
authors.forename: Heba
authors.initials: H
authors.lastname: Abdel-Aziz
authors.affiliation: Department of Drug Radiation Research, National Centre for Radiation Research and Technology, Atomic Energy Authority, Egypt.
authors.forename: Mona A
authors.initials: MA
authors.lastname: El-Ghazaly
mesh_terms: D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D005720:Gamma Rays / Q000009:adverse effects; D007249:Inflammation / Q000473:pathology; D007421:Intestine, Small / Q000187:drug effects / Q000473:pathology*; D008297:Male; D052016:Mucositis / Q000188:drug therapy*; D018384:Oxidative Stress / Q000187:drug effects; D010936:Plant Extracts / Q000627:therapeutic use*; D011837:Radiation-Protective Agents / Q000627:therapeutic use*; D017208:Rats, Wistar; D014916:Whole-Body Irradiation / Q000009:adverse effects
chemical_list: D010936:Plant Extracts; D011837:Radiation-Protective Agents; C039964:iberogast
keywords: Apoptosis; Gamma radiation; Mucositis; STW 5 (Herbal Formula)