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

Purpose: To 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 methods: In 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-1) were measured. RILI and pulmonary function were evaluated at 6 weeks and 6 months after treatment, respectively. Results: Of 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-beta 1 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. Conclusion: Berberine significantly reduced the incidence of RILI, improved PF and decreased the levels of sICAM-1 and TCF-beta 1. The exact mechanisms remain to be further explored. (C) 2008 Elsevier Ltd. All rights reserved.