Title : Protective effect of Chinese herb Prunella vulgaris on esophageal injury caused by bile reflux-induced inflammatory carcinoma transformation
Background: Bile reflux is one of the main risk factors for Esophageal Adenocarcinoma?EAC?. There is almost no effective clinical method to control the reflux type of bile, so early prevention of EAC is still a challenge. This research aimed to investigate the protective effect and mechanism of a commonly used traditional Chinese medicine, Prunella vulgaris, on bile reflux-induced esophageal mucositis and carcinoma transformation in a rat esophageal injury model.
Methods: SD male rats were anesthetized by intraperitoneal injection of 2% sodium pentobarbital. Rats in the Sham group underwent gastric vascular ligation and suturing. The model rats underwent total gastrectomy-esophagoduodenal anastomosis. The modeled rats were randomly divided into the Model group and the traditional Chinese medicine group (i.e., PV group). Esophageal tissues and peripheral blood were taken from rats in the Sham and Model groups at 2, 4 and 8 weeks postoperatively, respectively. Two weeks postoperatively, water decoction of Prunella vulgaris (PV) was given to rats of the PV group by gavage. Gavage was performed for 6 weeks. Then, esophageal tissues were collected for HE staining, CD105 immunohistochemical staining, Ki-67 immunofluorescence staining, and the levels of Inflammatory cytokines or chemokines in peripheral blood were verified. The data are presented as the mean ± SEM, and differences between two groups were compared using one-way ANOVA or Mann-Whitney U test.
Results: In the model rats, the inflammatory response of esophageal tissues became more severe with increasing pathological inflammation scores as the duration of modeling increased. Pathological scores were significantly higher in the Model group at 2, 4, and 8 weeks postoperatively compared to the Sham group at the same time period (P<0.05; P<0.01). PV group which significantly improves pathological inflammation in the esophagus (P<0.05). The overall trend of peripheral blood inflammatory factors and chemokines was increased in the Sham and Model groups of rats at 2, 4 and 8 weeks postoperatively. The concentrations of CXCL1, CXCL10 and VEGF were significantly higher in the Model group than in the Sham group at 8 weeks postoperatively (P<0.05; P<0.01), and in the PV group, the concentrations of VEGF and CXCL1 in the blood(P<0.01). Bile reflux was able to enhance the expression of CD105 and Ki-67 in the esophagus of rats in the Model group significantly (P<0.01), and the expression of CD105 and Ki-67 in the esophagus of the PV group significantly decreased (P<0.05).
Conclusion: Prunella vulgaris can protect esophageal mucosa from bile injury by inhibiting the inflammatory response and angiogenesis-related factors.
Audience Take Away Notes:
- Bile reflux is one of the main causes of gastrointestinal carcinogenesis, and there is a lack of effective drugs for the treatment of bile reflux. Esophageal adenocarcinoma caused by reflux has a rapidly increasing incidence in the global regurgitation and lacks effective means of early prevention, which is a hot spot in digestive system research in recent years.
- This report provides participants with a Chinese herbal medicine Prunella vulgaris that can effectively prevent and treat esophageal inflammatory carcinoma transformation caused by bile reflux, thus providing an alternative method for early prevention of EAC.
- This study was conducted in an esophago-gastro-duodenal anastomosis ( EGDA) rat model. The operative method of the model is definite and clear, which can offer a reference to the other researchers.
- As the process of esophageal inflammatory carcinoma transformation is very complex, this study provides listeners with changes of different pathological factors such as cell proliferation, inflammatory cytokines, and angiogenesis in the process of esophageal inflammatory carcinoma transformation, and provides feasible research directions for other researchers.