In our preliminary study, Berbamine (BA), one of the most commonly used traditional Chinese medicines, was effective in inducing the intracellular ROS levels. Since the regulation of cellular antioxidant capacity is crucial to the sensitivity of Ptx, it is feasible to propose that sensitizing cells to Ptx can be achieved through increasing the antioxidant capacity by codelivering BA. Cytotoxicity test demonstrates that either single or combinational treatment of BA and Ptx dose-dependently inhibits the proliferation of U-87 cells. Median-effect analysis clearly proves the synergistic anticancer effect between BA and Ptx. Combinational treatment of both drugs induced more intracellular ROS generation than either of the drugs did. Cotreatment of NAC could partially reverse the ROS generation and ameliorate the cytotoxicity induced by BA plus Ptx. Moreover, sequential activation of ROS-dependent phosphor-Akt expression was dose-dependently inhibited by the combinational application of BA and Ptx, which was more significantly effective than the single treatment of either BA or Ptx. Additionally, the coadministration of BA and Ptx shows the strongest tumor delaying effect in a U87 xenograft model, demonstrating the synergism between two drugs. Therefore, BA is a promising adjuvant to traditional chemotherapy, especially in combination with Ptx, to treat malignant glioma.
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