Establishment of Coloproctitis Cancer Model in Mice and Evaluation of Therapeutic Effect of Chinese Medicine

Published: October 13, 2023

doi:

Dongxing Lyu, Weifang Wang, Hanying Xu, Pengfei Li, Wenyuan Zhang, Xiangyue Meng, Shixin Liu

¹College of Traditional Chinese Medicine,Changchun University of Chinese Medicine, ²School of Clinical Medicine,Changchun University of Chinese Medicine, ³Department of Radiotherapy,Jilin Provincial Cancer Hospital

Summary

This protocol provides a mouse model of ulcerative coloproctitis-associated colorectal cancer induced by azomethane combined with dextran sulfate sodium. The model was used to evaluate the efficacy of traditional Chinese medicine compounds in the prevention and treatment of colorectal cancer.

Abstract

Colorectal cancer (CRC) is a common malignancy of the digestive system and has become the third most common malignancy worldwide and the second leading cause of malignancy-related death. Ulcerative coloproctitis (UC) is a precancerous lesion, and UC-associated CRC (UC-CRC) is the most common subtype of CRC. Therefore, a reasonable UC-CRC model is the cornerstone and guarantee of new drug development. Traditional Chinese medicine (TCM) has been widely used in the treatment of UC-CRC due to its good efficacy. As a classic tonic prescription of TCM, Liujunzi decoction (LJZD) has been widely used in the treatment of UC-CRC. In this study, a UC-CRC model was established by combining azomethane and dextran sulfate sodium, and the LJZD was administered. The data confirmed that LJZD can effectively inhibit cancer transition in UC-CRC by using mouse body weight, colorectal length, pathological and inflammatory factors, colorectal barrier function, and cancer markers. This protocol provides a system for evaluating the efficacy of TCM in the prevention and treatment of UC-CRC.

Introduction

Colorectal cancer (CRC) is a common gastrointestinal malignancy, the third most common malignancy, and the second most common cause of death in the world, accounting for 10% of the global cancer incidence and 9.4% of the total cancer-related death¹^,². Genetic factors, chronic inflammation, high-fat diet, diabetes, and abnormal intestinal flora are risk factors for CRC³^,⁴. Among them, inflammatory bowel disease, especially ulcerative coloproctitis (UC), is a clear risk factor for CRC⁵^,⁶. UC-associated CRC (UC-CRC) is a transition process of inflammation, atypical hyperplasia, and cancer based on chronic inflammation of the colorectum, which is different from the typical adenoma-adenocarcinoma development model of CRC⁷^,⁸. Compared with the general population, the risk of CRC is approximately 10-40 times higher in patients with inflammatory bowel disease⁹.

Currently, surgery is still the standard treatment for CRC, and depending on the location and stage of the tumor, radiation therapy, systemic drug therapy, or a combination of both are possible¹⁰. Although these traditional treatment modalities have made great progress, due to the high heterogeneity and recurrence rate of CRC, the prognosis is poor, and the treatment effect is not ideal¹¹^,¹². Therefore, early detection, early diagnosis, and comprehensive treatment are key to improving the survival rate of CRC patients, and it is particularly important to pay attention to the transformation of UC to CRC. Over the years, traditional Chinese medicine (TCM) has attracted much attention in the treatment of UC-CRC or chronic gastritis due to its limited side effects and significant efficacy. Based on dialectical treatment, famous Chinese medicine practitioners of various generations have created a large number of classic prescriptions, such as Huangqi Jianzhong decoction¹³, Sijunzi decoction¹⁴, and Sishen pill¹⁵.

Liujunzi decoction (LJZD) originated from the works of Yi Xue Zheng Zhuan compiled in the Ming Dynasty and is a classic prescription in TCM¹⁶. As shown in Table 1, LJZD consists of six traditional herbs, including Codonopsis pilosula (Franch.) Nannf. (Dangshen), Poria cocos (Schw.) Wolf (Fuling), Atractylodes macrocephala Koidz. (Baizhu), Glycyrrhiza uralensis Fisch. (Gancao), Citrus reticulata Blanco (Chenpi) and Pinellia ternata (Thunb.) Breit (Banxia), which has the effect of replenishing qi and strengthening the spleen, drying dampness, and resolving phlegm. In modern clinical practice, it is often used to treat chronic gastritis, gastric ulcers, and duodenal ulcers. Modern pharmacological research has shown that LJZD and modified LJZD have high application value in the adjuvant treatment of UC and digestive tract cancer¹⁷^,¹⁸^,¹⁹.

At present, there are many ways to construct UC-CRC mouse models, but the azoxymethane (AOM)/dextran sulfate sodium (DSS) induced mouse model is the most widely used UC-CRC model; the clinical symptoms, morphological, and pathological observations have proved that the model is very similar to human UC-CRC²⁰^,²¹. The basic principle is to first induce carcinogenesis with chemical carcinogen AOM and then continuously expose mice to the inflammatory stimulation environment of DSS to simulate the continuous damage and repair of intestinal mucosal epithelium, thereby constructing a UC-CRC mouse model²². The aim of this study is to establish a mouse model of UC-CRC by intraperitoneal injection of AOM and cyclic stimulation of DSS in the short term and to evaluate the effect of the drug and the molecular mechanism of LJZD on UC-CRC in order to provide a scientific basis for the treatment of UC-CRC.

Protocol

The animal procedure has been approved by the Ethics Committee of Changchun University of Chinese Medicine (Record number: 2021214). Specific pathogen-free C57BL/6J mice (8-10 weeks, weight 18-22 g), male and female, were housed in independently ventilated cages at 22 °C and 65% relative humidity. The mice began the experiment after 7 d of adaptive feeding, during which they had free access to water and diet. 1. Drug preparation Preparation of LJZD &#82…

Representative Results

The decoction of LJZD was prepared according to the composition ratio of drugs in Table 1 and the decoction method of TCM in Figure 1A. According to the time point indicated in Figure 1B, mice were intraperitoneally injected with 1 mg/mL AOM on the 7th day, and mice were given free access to drinking water containing 2% DSS in the 3rd, 6th, and 9th weeks. The UC-CRC mouse model was successfully establi…

Discussion

CRC is one of the most common cancers worldwide, with approximately 1,148,000 new cases and more than 576,000 deaths each year. CRC can be divided into three types according to different causes, including hereditary, sporadic and UC-CRC³¹. The incidence of CRC in patients with inflammatory bowel diseases such as UC is significantly higher than that in the general population. UC stimulates the development of CRC through the inflammatory-cancer pathway, which differs from the typical adenoma-adenoca…

Disclosures

The authors have nothing to disclose.

Acknowledgements

This work was supported by the Jilin Provincial Department of Science and Technology (YDZJ202201ZYTS181).

Materials

Azoxymethane	Sigma	A5486
5-amino salicylic acid	Kuihua Pharmaceuticals Group Jiamusi Luling Pharmaceutical Co., Ltd	3819413
C57BL/6J mice	Liaoning Changsheng Biotechnology Co., Ltd	NO 210726210100853716
Cover slip	Jiangsu Shitai Experimental Equipment Co., Ltd	10212432C
DAB color development kit	Jiangsu Shitai Experimental Equipment Co., Ltd	2005289
Dewatering machine	Wuhan Junjie Electronics Co., Ltd	JJ-12J
Dextran sulfate sodium	Dalian Meilun Biotechnology Co., Ltd	MB5535
Embedding machine	Wuhan Junjie Electronics Co., Ltd	JB-P5
Hematoxylin-eosin dye	Wuhan Hundred Degree Biotechnology Co., Ltd	B1000
IL-6	Jiangsu Meimian Industrial Co., Ltd	MM-0163M2
Isoflurane	RWD Life Science Co., Ltd	R510-22-10
KI67 primary antibody	Google Biotechnology Inc	GB121141
Neutral gum	Wuhan Hundred Degree Biotechnology Co., Ltd	10004160
Object slide	Jiangsu Shitai Experimental Equipment Co., Ltd	10212432A
Occludin primary antibody	Affnity	DF7504
Orthostatic optical microscope	Nikon	Nikon Eclipse CI
Pathological microtome	Shanghai Leica Instrument Co., Ltd	RM2016
ZO-1 primary antibody	Abcam	ab221547

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Lyu, D., Wang, W., Xu, H., Li, P., Zhang, W., Meng, X., Liu, S. Establishment of Coloproctitis Cancer Model in Mice and Evaluation of Therapeutic Effect of Chinese Medicine. J. Vis. Exp. (200), e66045, doi:10.3791/66045 (2023).