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
We previously showed, using the Traditional Chinese Medicine System Pharmacology Database, that Gegen Qinlian decoction (GQD) had a direct antitumor effect, and was combined with programmed cell death protein (PD)-1 inhibitors to treat microsatellite stable (MSS) tumor-bearing mice. However, the effect of GQD on patients with colorectal cancer (CRC) is not clear.
To determine the therapeutic mechanism of GQD in improving immune function, reducing inflammation and protecting intestinal barrier function.
Seventy patients with CRC were included in this study: 37 in the control group and 33 in the treatment group. The proportions of CD4+ T, CD8+ T, natural killer (NK), NKT and T regulatory cells were measured by flow cytometry. Levels of the cytokines tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-2, IL-6, IL-10 and serotonin (5-hydroxytryptamine; 5-HT) in serum were assessed by enzyme-linked immunosorbent assay (ELISA). The expression of zonula occludens (ZO)-1, occludin, nuclear factor (NF)-κB and 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 normal tissues of the treatment group was significantly higher than that in the control group (P = 0.010). Compared with the control group, expression of NF-κB and TNF-α in 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.
GQD enhances immunity and protects intestinal barrier function in patients with CRC by regulating the composition of gut microbiota.
Core Tip: On the basis of our previous study, this study revealed that Gegen Qinlian decoction (GQD) repaired intestinal barrier function in patients with colorectal cancer (CRC) by regulating gut microbiota, thereby improving immune status and reducing inflammation. Our findings highlight the therapeutic potential of GQD in modulating the gut microbiota and protecting intestinal barrier function in CRC patients.