Protective effects of berberine on radiation-induced lung injury via intercellular adhesion molecular-1 and transforming growth factor-beta-1 in patients with lung cancer

PurposeTo investigate the protective effects of berberine on radiation-induced lung injury (RILI) in non-small cell lung cancer (NSCLC) patients treated with radiotherapy.Patients and methodsIn this randomised, double-blind study, 90 patients with NSCLC were divided into two groups. The trial group received radiation therapy plus berberine, and the control group received radiation therapy plus a placebo for 6 weeks. Soluble intercellular adhesion molecular-1 (sICAM-1) and transforming growth factor-beta-1 (TGF-β1) were measured. RILI and pulmonary function were evaluated at 6 weeks and 6 months after treatment, respectively.ResultsOf the 90 patients enroled, 43 in the control group and 42 in the trial group completed the study. The incidence of RILI was significantly lower in the trial group at 6 weeks and 6 months than that in the control group (45.2% versus 72.1% and 35.7% versus 65.1%, respectively, both P < 0.05). sICAM-1 levels in the trial group were significantly lower at weeks 6 and 12 (373.64 ± 89.33 versus 459.53 ± 123.59 and 447.83 ± 111.21 versus 513.91 ± 150.46, both P < 0.01), and plasma TGF-β1 levels were lower at week 3 and 6 (5.43 ± 1.47 versus 6.22 ± 1.78 and 5.93 ± 2.39 versus 7.67 ± 2.74, P < 0.05 and 0.01, respectively) in comparison with the control group. Significant differences were observed in FEV1 (P = 0.033) and DLCO (P = 0.003) between patients receiving berberine and those receiving placebo. Independent-samples T-test showed reductions from baseline FVC at week 6 (P < 0.05), and FEV1 and DLCO at month 6 (P < 0.05 and 0.01, respectively) in the trial group were significantly smaller than that in the control group.ConclusionBerberine significantly reduced the incidence of RILI, improved PF and decreased the levels of sICAM-1 and TGF-β1. The exact mechanisms remain to be further explored.