The herbal preparation, STW 5, protects against radiation induced intestinal mucositis
Intestinal mucositis is a common adverse effect in cancer patients undergoing radiotherapy and is associated with apoptotic processes. The condition has been simulated in rats by exposing them to acute radiation from a Cesium 137 source. The extent of intestinal injury was dependent on the radiation dose level and histological evidence of apoptosis was shown at an exposure of 8 Gray. Apoptotic changes were associated with a marked increase in cytosolic calcium, depletion of mitochondrial cytochrome c, B-cell lymphoma-2 and complex 1. Serum diamine oxidase and lactate dehydrogenase as well as intestinal tumor necrosis factor were also markedly increased. STW 5 (Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany) is an herbal preparation consisting of 9 components which is effectively used clinically in functional dyspepsia (1) and irritable bowel syndrome (2) and found to be effective in DSS induced colitis (3). It was also previously shown to have good anti-inflammatory and anti-ulcerogenic activity. The drug was given orally at 2 different dose levels for 5 days before exposure to radiation and continued for 2 days after exposure. Treatment was shown to protect to a large extent against the histological changes induced by radiation and to counteract dose-dependently the derangement in nearly all relevant parameters. The good anti-apoptotic effects of STW 5 and general protective effects against intestinal radiation damage could pave the way to discovering new measures for avoiding the occurrence of mucositis following radiation exposure.
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