title: The Traditional Chinese Medicine DangguiBuxue Tang Sensitizes Colorectal Cancer Cells to Chemoradiotherapy.
abstract: Chemotherapy is an important treatment modality for colon cancer, and concurrent chemoradiation therapy (CCRT) is the preferred treatment route for patients with stage II and III rectal cancer. We examined whether DangguiBuxue Tang (DBT), a traditional Chinese herbal extract, sensitizes colorectal cancer cells to anticancer treatments. The polysaccharide-depleted fraction of DBT (DBT-PD) contains greater amounts of astragaloside IV (312.626 µg/g) and ferulic acid (1.404 µg/g) than does the original formula. Treatment of the murine colon carcinoma cell line (CT26) with DBT-PD inhibits growth, whereas treatment with comparable amounts of purified astragaloside IV and ferulic acid showed no significant effect. Concurrent treatment with DBT-PD increases the growth inhibitory effect of 5-fluorouracil up to 4.39-fold. DBT-PD enhances the effect of radiation therapy (RT) with a sensitizer enhancement ratio (SER) of up to 1.3. It also increases the therapeutic effect of CCRT on CT26 cells. Cells treated with DBP-PD showed ultrastructural changes characteristic of autophagy, including multiple cytoplasmic vacuoles with double-layered membranes, vacuoles containing remnants of degraded organelles, marked swelling and vacuolization of mitochondria, and autolysosome-like vacuoles. We conclude that DBT-PD induces autophagy-associated cell death in CT26 cells, and may have potential as a chemotherapy or radiotherapy sensitizer in colorectal cancer treatment.
authors.affiliation: Department of Chinese Medicine, Buddhist Tzu Chi General Hospital, Taipei Branch, New Taipei City 23142, Taiwan. cst.tp.tw@gmail.com.|Graduate Institute of Traditional Chinese Medicine, School of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan. cst.tp.tw@gmail.com.|Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan. cst.tp.tw@gmail.com.
authors.forename: Shun-Ting
authors.initials: ST
authors.lastname: Chen
authors.affiliation: Graduate Institute of Traditional Chinese Medicine, School of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan. joejoylee@gmail.com.
authors.forename: Tzung-Yan
authors.initials: TY
authors.lastname: Lee
authors.affiliation: Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan. thtsai@ym.edu.tw.
authors.forename: Tung-Hu
authors.initials: TH
authors.lastname: Tsai
authors.affiliation: Department of Medical Research, Mackay Memorial Hospital, Taipei 25160, Taiwan. eric7772330@gmail.com.
authors.forename: Yin-Cheng
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Medical Research, Mackay Memorial Hospital, Taipei 25160, Taiwan. cplin66@gmail.com.
authors.forename: Chin-Ping
authors.initials: CP
authors.lastname: Lin
authors.affiliation: Department of Medical Research, Mackay Memorial Hospital, Taipei 25160, Taiwan. ru123@ms1.mmh.org.tw.
authors.forename: Hui-Ru
authors.initials: HR
authors.lastname: Shieh
authors.affiliation: Department of Medical Research, Mackay Memorial Hospital, Taipei 25160, Taiwan. sabinehsu@gmail.com.
authors.forename: Ming-Ling
authors.initials: ML
authors.lastname: Hsu
authors.affiliation: Department of Medical Research, Mackay Memorial Hospital, Taipei 25160, Taiwan. cwchid48906003@gmail.com.
authors.forename: Chih-Wen
authors.initials: CW
authors.lastname: Chi
authors.affiliation: Department of Research, Buddhist Tzu Chi General Hospital, Taipei Branch, New Taipei City 23141, Taiwan. sardorna@yahoo.com.tw.
authors.forename: Ming-Cheng
authors.initials: MC
authors.lastname: Lee
authors.affiliation: School of Post-Baccalaureate Chinese Medicine, and Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung 40402, Taiwan. tcmchh55@mail.cmu.edu.tw.|Department of Chinese Medicine, China Medical University Hospital, Taichung 40402, Taiwan. tcmchh55@mail.cmu.edu.tw.
authors.forename: Hen-Hong
authors.initials: HH
authors.lastname: Chang
authors.affiliation: Department of Medical Research, Mackay Memorial Hospital, Taipei 25160, Taiwan. chenmdphd@gmail.com.|Department of Chinese Medicine, China Medical University Hospital, Taichung 40402, Taiwan. chenmdphd@gmail.com.|Department of Radiation Oncology, Mackay Memorial Hospital, Taipei 25160, Taiwan. chenmdphd@gmail.com.
authors.forename: Yu-Jen
authors.initials: YJ
authors.lastname: Chen
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000494:pharmacology*; D059248:Chemoradiotherapy; D019008:Drug Resistance, Neoplasm; D004354:Drug Screening Assays, Antitumor; D004357:Drug Synergism; D004365:Drugs, Chinese Herbal / Q000494:pharmacology*; D005472:Fluorouracil / Q000494:pharmacology*; D019073:HT29 Cells; D006801:Humans; D020128:Inhibitory Concentration 50; D011836:Radiation Tolerance / Q000187:drug effects
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D004365:Drugs, Chinese Herbal; C477279:danggui buxue decoction; D005472:Fluorouracil
keywords: DangguiBuxue Tang; chemotherapy; colorectal cancer; radiotherapy