Gopika AG, Sachdeva N. New insights into the mechanisms of modified Pulsatilla decoction in alleviating chemotherapy-induced intestinal mucositis. World J Gastroenterol 2025; 31(12): 105162 [DOI: 10.3748/wjg.v31.i12.105162]
Corresponding Author of This Article
Naresh Sachdeva, PhD, Professor, Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India. sachdeva.naresh@pgimer.edu.in
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Mar 28, 2025; 31(12): 105162 Published online Mar 28, 2025. doi: 10.3748/wjg.v31.i12.105162
New insights into the mechanisms of modified Pulsatilla decoction in alleviating chemotherapy-induced intestinal mucositis
Ajitha G Gopika, Naresh Sachdeva
Ajitha G Gopika, Naresh Sachdeva, Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Author contributions: Gopika AG drafted the manuscript; Sachdeva N reviewed and edited the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Naresh Sachdeva, PhD, Professor, Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India. sachdeva.naresh@pgimer.edu.in
Received: January 14, 2025 Revised: February 21, 2025 Accepted: March 5, 2025 Published online: March 28, 2025 Processing time: 71 Days and 23 Hours
Abstract
Chemotherapy-induced intestinal mucositis (IM) is a prevalent complication affecting up to 80% of cancer patients undergoing treatment. Current therapies focus on symptomatic relief rather than addressing the underlying mechanism. Recent advances in integrative medicine highlight the potential of traditional Chinese medicine formulations as alternatives or adjuncts to existing therapies. In this context, this editorial discusses the recent results of a study published by Qiu et al, which investigates the multifaceted potential of modified Pulsatilla decoction (PD), a formulation of PD with licorice (Glycyrrhiza uralensis) and Ejiao (Colla corii asini), on 5-fluorouracil-induced IM in mice to alleviate clinical symptoms including diarrhea, weight loss, and intestinal damage. A series of histological, biochemical, bioinformatic, and microbiological assays evaluated body weight, diarrhea scores, inflammatory cytokine profiles, oxidative stress modulation, and microbiota composition. The findings indicated a reduction in diarrhea and oxidative stress, as well as an improvement in body weight and intestinal histopathology. Furthermore, the modified PD suppressed the TLR4/MyD88/nuclear factor kappa-B inflammatory pathway and down-regulated key pro-inflammatory cytokines. Moreover, the study underscores the role of gut microbiota in IM pathogenesis. Modified PD treatment reshaped microbial diversity by promoting beneficial genera such as Bacteroides acidifaciens while suppressing pathogenic species like Salmonella. These findings suggest that the therapeutic effects of the modified PD extend beyond inflammation modulation to encompass microbiome reprogramming and mucosal barrier repair. Although the study provides significant insights, several limitations still prevail. The broader implications of modified PD in gastrointestinal disorders and integrative oncology need further exploration.
Core Tip: The modified Pulsatilla decoction could be a promising treatment option for chemotherapy-induced intestinal mucositis, where inflammation, oxidative stress, and alteration of gut microbiota are targeted.
