Calcium-activated chloride channel is involved in the onset of diarrhea triggered by EGFR tyrosine kinase inhibitor treatment in rats - 03/09/21
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Abstract |
EGFR tyrosine kinase inhibitors (TKIs) are mainly used to treat non-small cell lung cancer; however, adverse effects such as severe diarrhea represent a major obstacle towards the continuation of EGFR-TKIs therapy. Chloride channels, which control the fluid flow in the intestinal lumen, are proposed as an important target to remediate EGFR-TKIs-induced diarrhea, but the mechanism remains unclear. The aim of this study was to clarify the mechanism underlying EGFR-TKIs-induced diarrhea with a particular focus on the role of intestinal chloride channels. Here, we show that osimertinib-treated rats exhibit diarrhea and an increase in fecal water content without showing any severe histopathological changes. This diarrhea was attenuated by intraperitoneal treatment with the calcium-activated chloride channel (CaCC) inhibitor CaCCinh-A01. These findings were confirmed in afatinib-treated rats with diarrhea. Moreover, treatment with the Japanese traditional herbal medicine, hangeshashinto (HST), decreased fecal water content and improved fecal appearance in rats treated with EGFR-TKIs. HST inhibited the ionomycin-induced CaCC activation in HEK293 cells in patch-clamp current experiments and its active ingredients were identified. In conclusion, secretory diarrhea induced by treatment with EGFR-TKIs might be partially mediated by the activation of CaCC. Therefore, blocking the CaCC could be a potential new treatment for EGFR-TKI-induced diarrhea.
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Highlights |
• | Diarrhea is a major obstacle in treatment with EGFR tyrosine kinase inhibitors. |
• | Calcium-activated chloride channel inhibitor attenuated EGFR-TKI-induced diarrhea. |
• | The Kampo medicine Hangeshashinto restored diarrhea by blocking CaCC. |
• | Colonic CaCC could be a potential therapeutic target for EGFR-TKI-induced diarrhea. |
Abbreviations : CaCC, HST, TKI, TMEM16A
Keywords : CaCC, EGFR-TKI, Diarrhea, Therapy, Hangeshashinto
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Vol 141
Article 111860- septembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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