In vitro antitumor efficacy of Kochiaindica extract on human hepatocellular carcinoma cell line with or without 5-fluorouracil

Aim: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and the sixth most common cancer worldwide.The resistance to chemotherapy is a major obstacle in the treatment of HCC, necessitating the discovery of additional agents.There is a growing use of anticancer complementary and alternative medicine worldwide.Therefore, the aim of present study was focused on the confirmation of the suitability and validity of the new markers which would be achieved by demonstrating their significant change and reproducible expression during disease and disease management.Methods: HepG 2 cell line was used to provide a source for HCC cells.The cell cultures were divided into 4 groups: control untreated group, 5-fluorouracil (5-FU) treated group as a standard chemotherapy for HCC (positive control) with the following doses (15.625, 31.2, 62.5, 125, 250 µg/mL), Kochia indica extract treated group with the following concentration (12.5, 25, 50, 100, 200 µg/mL) and the group treated with a combination of 5-FU and Kochia indica in different ratios.Results: Treatment with Kochia indica extract, 5-FU and the combined treatment showed a significant cytotoxicity to HepG 2 cells, with different IC 50 values, when compared to the control.Regarding toxic effect, 5-FU showed IC 50 = 237.56µg/mL which is lower cytotoxic in compared to Kochia indica with IC 50 =120.5µg/mL.The results also revealed that tumor cells were more resistant to 5-FU.Alternatively, the co-treatment with Kochia indica extract ameliorated the toxicity induced by 5-FU and enhanced its therapeutic potency, either by synergistic effect of both agents and/or due to its flavonoid components that may enhance the physiological properties of the cell membranes, facilitating 5-FU entrance into tumor cells.This decreased its therapeutic dose to less than 250 µg/mL by combination therapy.Conclusion: Present findings assume that Kochia indica extract co-therapy can ameliorate the side effects of 5-FU on HepG 2 by enhancing its cellular uptake.