CC BY 4.0 · Chinese medicine and natural products 2024; 04(02): e76-e84
DOI: 10.1055/s-0044-1787120
Original Article

Research on the Protective Effects of Different Chinese Medicine Compounds on Gefitinib-Induced Hepatotoxicity

Xiaoting Yin
1   Collaborative Innovation Center for the Whole Industrial Chain of Henan Chinese Medicine, Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, Henan, China
2   School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China
,
Min Li
3   Department of Oncology, Zhengzhou People's Hospital, Zhengzhou, Henan, China
,
Yucheng Li
1   Collaborative Innovation Center for the Whole Industrial Chain of Henan Chinese Medicine, Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, Henan, China
2   School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China
› Author Affiliations
Funding This work was supported by Henan Provincial Science and Technology Research and Development Project (232301420018), Henan Provincial Medical Science and Technology Research Project (LHGJ20230715), and Henan Provincial Natural Science Foundation Project (202300410249).

Abstract

Objective Our objective was to screen drugs with good protective effects on gefitinib-induced hepatotoxicity.

Methods Fifty-four specific pathogen-free-grade male mice of the Institute of Cancer Research were randomly divided into a normal group, gefitinib group, glutathione group, ligustrazine group, silymarin group, glycyrrhizic acid group, baicalin group, paeoniflorin group, and matrine group, with six mice in each group. Except for the normal group, the remaining groups of mice were intragastrically administered 400 mg·kg−1 of gefitinib for 16 days to induce liver injury. Mice in each treatment group were intragastrically administered 100 mg·kg−1 of the corresponding drug 30 minutes after gefitinib administration each day. The normal group and model group mice were intragastrically administered with an equal volume of 0.5% carboxymethylcellulose sodium (CMC-Na), and the administration volume was 10 mg·kg−1. Then, 30 minutes after the last administration, blood was collected from the retro-orbital venous plexus, and the mice were killed by cervical dislocation to obtain liver weight and calculate the liver index. Liver pathological changes were observed by hematoxylin–eosin (HE) staining; the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum were detected using biochemical kits. AML12 cells were cultured in a medium containing drugs for 30 minutes. Except for the normal group, the remaining groups were induced cell damage with 20 μmoL·L−1 gefitinib for 24 hours. Cell viability was detected using a cell counting kit-8, and the levels of ALT, AST, and lactate dehydrogenase (LDH) in the cell culture supernatant were measured using biochemical kits.

Results Animal experiments showed that compared with the gefitinib group, glycyrrhizic acid and baicalin significantly increased the body weight of mice (p < 0.01) and decreased the liver index and levels of ALT and AST (p < 0.05); ligustrazine and silymarin significantly increased the body weight of mice (p < 0.01) and decreased the level of AST (p < 0.05); paeoniflorin and matrine significantly decreased the levels of ALT and AST (p < 0.01). HE staining showed that the liver tissue of mice in the gefitinib group presented a large number of inflammatory cell infiltrations and disordered arrangement of hepatic cords; glutathione, glycyrrhizic acid, baicalin, paeoniflorin, and matrine significantly alleviated pathological damage to mouse liver tissue. Cell experiments showed that all drugs could alleviate gefitinib-induced damage to AML12 cells to varying degrees, among which glycyrrhizic acid, baicalin, and paeoniflorin had better protective effects, with cell survival rates increased to 96.4, 81.1, and 78.2%, respectively. Compared with the gefitinib group, glycyrrhizic acid significantly reduced the levels of ALT, AST, and LDH (p < 0.05); silymarin, baicalin, and paeoniflorin significantly reduced the levels of ALT and LDH (p < 0.05).

Conclusion Glycyrrhizic acid, baicalin, and paeoniflorin all have good protective effects against gefitinib-induced hepatotoxicity, among which glycyrrhizic acid has the best effect.

CRediT Authorship Contribution Statement

Xiaoting Yin: Investigation, methodology, validation, visualization, and writing—original draft. Min Li: Conceptualization, data curation, funding acquisition, supervision, and writing—review and editing. Yucheng Li: Conceptualization, funding acquisition, resources, supervision, and writing—review and editing.




Publication History

Received: 01 January 2024

Accepted: 12 March 2024

Article published online:
27 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Muhsin M, Graham J, Kirkpatrick P. Gefitinib. Nat Rev Drug Discov 2003; 2 (07) 515-516
  • 2 Xu A, Yan H, Bu T. Therapeutic effect of gefitinib on patients with advanced EGFR-mutation NSCLC. Pak J Pharm Sci 2021; 34 (1, Special): 481-486
  • 3 Hsiue EHC, Lee JH, Lin CC, Yang JC. Safety of gefitinib in non-small cell lung cancer treatment. Expert Opin Drug Saf 2016; 15 (07) 993-1000
  • 4 Wu Q, Chen Z, Ding Y, Tang Y, Cheng Y. Protective effect of traditional Chinese medicine on non-alcoholic fatty liver disease and liver cancer by targeting ferroptosis. Front Nutr 2022; 9: 1033129
  • 5 Federico A, Dallio M, Loguercio C. Silymarin/silybin and chronic liver disease: a marriage of many years. Molecules 2017; 22 (02) 191
  • 6 Huo X, Yang S, Sun X, Meng X, Zhao Y. Protective effect of glycyrrhizic acid on alcoholic liver injury in rats by modulating lipid metabolism. Molecules 2018; 23 (07) 1623
  • 7 Wang R, Zhang K, Liu K. et al. Protective effect of baicalin on chlorpyrifos-induced liver injury and its mechanism. Molecules 2023; 28 (23) 7771
  • 8 Chen X, Pan Y, Zhang S. et al. Rechallenge with gefitinib following severe drug-induced hepatotoxicity in a patient with advanced non-small cell lung cancer: a case report and literature review. Oncol Lett 2014; 7 (03) 878-880
  • 9 Pastorino G, Cornara L, Soares S, Rodrigues F, Oliveira MBPP. Liquorice (Glycyrrhiza glabra): a phytochemical and pharmacological review. Phytother Res 2018; 32 (12) 2323-2339
  • 10 Huo X, Meng X, Zhang J, Zhao Y. Hepatoprotective effect of different combinations of 18α-and 18β-glycyrrhizic acid against CCl4-induced liver injury in rats. Biomed Pharmacother 2020; 122: 109354
  • 11 Tian X, Liu Y, Liu X, Gao S, Sun X. Glycyrrhizic acid ammonium salt alleviates Concanavalin A-induced immunological liver injury in mice through the regulation of the balance of immune cells and the inhibition of hepatocyte apoptosis. Biomed Pharmacother 2019; 120: 109481
  • 12 Zou X, Wang Y, Peng C. et al. Magnesium isoglycyrrhizinate has hepatoprotective effects in an oxaliplatin–induced model of liver injury. Int J Mol Med 2018; 42 (04) 2020-2030
  • 13 Yin X, Ma S, Li M. et al. Study on the hepatotoxicity and potential mechanism of gefitinib based on CYP450 in mice and AML12 cells. J Pharm Pharmacol 2023; 75 (03) 407-414
  • 14 Wang L, Ahn YJ, Asmis R. Sexual dimorphism in glutathione metabolism and glutathione-dependent responses. Redox Biol 2020; 31: 101410