Tectorigenin alleviates irinotecan-induced intestinal inflammation by activating the Nrf2/Keap1 pathway and synergistically enhances the anti-colon cancer efficacy of irinotecan

Abstract

Background: Gastrointestinal toxicity, primarily manifesting as colitis, is one of the most common adverse events during irinotecan (CPT-11) treatment for colon cancer, significantly impacting therapeutic efficacy and the general condition of patients. Tectorigenin (TEC) is a flavonoid compound extracted from Bupleurum and saponins, which are traditional Chinese medicines with anti-inflammatory properties. Previous experiments have found that it can alleviate CPT-11-induced diarrhoea and synergistically inhibit tumor growth with CPT-11, but the specific mechanisms remain unknown.

Methods: A CPT-11-induced diarrhoea mouse model was used to study the protective effect of TEC on CPT-11-induced diarrhoea in mouse by measuring levels of inflammatory cytokines and intestinal tight junction-related proteins in colon tissues. The chemopreventive effect of TEC was evaluated by measuring levels of inflammatory cytokines and intestinal tight junction-related proteins in Caco-2 cells exposed to CPT-11 and lipopolysaccharide (LPS). Finally, the synergistic effect of TEC combined with CPT-11 on tumor growth was investigated in a mouse model of colon tumors induced by subcutaneous implantation of CT26 colon cancer cells.

Results: TEC inhibited CPT-11-induced intestinal toxicity, as evidenced by reduced weight loss, decreased diarrhoea scores, and less intestinal shortening in mouse. Histological analysis demonstrated that TEC alleviated CPT-11-induced intestinal barrier damage. Additionally, TEC activated the nuclear factor erythroid 2-related factor 2/Kelch-like ECH-associated protein 1 (Nrf2/Keap1) signalling pathway, reduced the expression of inflammatory cytokines both in vivo and in vitro, alleviated intestinal inflammation, and increased the expression of intestinal tight junction proteins, thereby enhancing intestinal barrier function. Furthermore, TEC exhibited a synergistic effect with CPT-11 in anti-tumor therapy.

Conclusions: This study confirmed that TEC alleviates CPT-11-induced intestinal inflammation by activating the Nrf2/Keap1 signalling pathway and enhances the anti-tumor effect of CPT-11 in colon cancer.

Keywords: Colitis; Colon cancer; Irinotecan; Nrf2; Tectorigenin.