Guizhi Fuling capsule, an ancient Chinese formula, attenuates endometriosis in rats via induction of apoptosis

Objective The Guizhi Fuling (GZFL) capsule has been a traditional Chinese medicine for the treatment of gynecological inflammation for the past thousands of years. However, as a formula, its therapeutic mechanism has not been clearly elucidated. The aim of this study is to investigate the role of apoptosis during GZFL capsule therapy for the treatment of endometrial hyperplasia. Methods The rat model of endometriosis was established, and the rats were given different doses of GZFL capsule. Uterine histomorphometric analysis, real-time quantitative PCR (qPCR) and Western blotting were performed. The terminal deoxynucleotidyl transferase (TdT)-mediated dUTP biotin nick end labeling (TUNEL) method was performed to analyze the apoptosis induced by the GZFL capsule. Results The TUNEL assay showed that different doses of GZFL capsule were able to induce apoptosis in rat endometriotic cells. qPCR and Western blot analysis showed that the GZFL capsule can inhibit the mRNA levels of the survivin gene. In addition, the GZFL capsule can inhibit the mRNA level of the mitochondrial apoptotic pathway-related apoptosis-inhibiting factor Bcl-2 but increases the mRNA level of apoptosis-promoting factor Bax. Conclusions These results indicate that the GZFL capsule can induce apoptosis of endometriotic cells and inhibit cell proliferation and metastasis of endometriotic cells through the mitochondrial apoptotic pathway.