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Abdel-Hamid et al. Antitumor and chemosesitizing efficacy of Kochia indica on human HCC

+ 0.6666 = 0.9966 = 1 in approximately (synergistic which is a lower cytotoxic in comparing with Kochia
effect). Accordingly, when 2 v of Kochia indica extract indica with IC = 120.5 µg/mL which emphasize
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was added to 1 v of 5-FU, there is a synergistic effect the resistance of HepG cells to 5-FU as a
2
on the cell viability of HepG . chemotherapeutic agent. The current work showed
2
also additive synergistic effect when 5-FU combines
DISCUSSION with Kochia indica extract by ratio of 2:1 (v/v) in the
treatment of HepG cultured cells. A previous study
2
The in vitro cytotoxicity test was mainly performed to showed two dual effects when 5-FU enhanced with
screen potentially toxic compounds that affect basic antioxidant such as, Bupleuri Radix that enhanced
cellular functions. This toxicity is measured with cellular 5-FU induced cytotoxicity in HepG hepatoma cells,
2
damage using NR which is a weak cationic dye that and protected normal lymphocytes from 5-FU induced
penetrates and accumulates in the lysosomes of living cytotoxicity. [22]
cells. Therefore, NR assay was used to determine the
cell viability or, in other words, the toxicity of the test Results of IC obtained above showed that the
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compounds. [14] treatment of HCC with either 5-FU or Kochia indica
extract alone can lead to a cytotoxic effect to the target
Data obtained from in vitro study on Kochia indica tumor cells. Instead, the combination between a well-
extract, 5-FU and combination treatment showed a known chemotherapy such as 5-FU and antioxidant
significant cytotoxic effect to HepG cultured cells, with such as Kochia indica extract can ameliorate the toxicity
2
different IC values, when compared to the control. induced by 5-FU as well as enhance the therapeutic
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For example, the value of IC of Kochia indica extract potency of 5-FU toward cancer cells by what is known
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was found to be 120.5 µg/mL. Also, a previous study synergistic effect of both agents. The present results
showed that Kochia indica seeds exerted lethal effect can also suggest that flavonoids found in Kochia indica
on tumor cells IC = 0.147 mg/mL which may indicate extract enhance the physiological properties of the cell
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that the seeds of this plant have serious toxic side membranes facilitating 5-FU entrance into tumor cells
effects than other parts. [8] which were resistant to 5-FU, and hence decrease the
therapeutic dose to be less than 250 µg/mL as shown
Other studies showed different results between in combination therapy. These results are considered
aqueous and alcoholic extracts of Kochia indica where as a first line in studying the possible efficacy of
the anticancer activity of the aqueous extract was 2.88 Kochia indica extract as an anti cancer agent or as
and anticancer activity of the ethanolic extract was adjuvant with 5-FU, however, further in vivo studies are
1.6. It was observed that the aqueous extract is more suggested at experimental animal sessions.
potential than the ethanolic one. [15]
Authors’ contributions
Many studies showed that Kochia indica extract is Study design: N.M. Abdel-Hamid
rich in flavonoids [16] and alkaloids. Therefore, it has Experimental work: W.O. Zeina, G.A. Tabl
[9]
many biological properties about its mode of action Manuscript drafting: Y.E. El-Bolkainy
such as antioxidant, [17] heart tonic and anticancer Manuscript revision: N.M. Abdel-Hamid, W.O. Zeina
[9]
effect. [5,9,17] Many cancers develop resistance to
chemotherapy, thus lowering its anticancer efficacy. As Financial support and sponsorship
current treatments become inadequate, higher doses None.
of anticancer therapies such as 5-FU and other novel
therapies are used in treating cancers. Such higher Conflicts of interest
dose therapies can lead to cytotoxic and genotoxic
side effects in normal cells. [18] There are no conflicts of interest.

According to the above information, 5-FU is a widely Patient consent
used anticancer drug, but the response to it shows Not applicable.
low efficacy, approximately 20%. [19] Thus, many
studies have investigated 5-FU with other anticancer Ethics approval
drugs such as antioxidants. [20] However, cytotoxicity University of Tanta approved the whole work prior to
is nearly inevitable when a combination of 5-FU and any work.
antioxidants is used, which remains a major problem
in chemotherapy. [21] REFERENCES
In the present study, 5-FU showed IC = 237.56 µg/mL 1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo
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154 Hepatoma Research ¦ Volume 3 ¦ July 21, 2017