Keywords | 
  
  
    | Anti-inflammatory agents, Antineoplastic agents, Herbal medicine, Plant roots | 
  
  
    Introduction | 
  
  
    | Medicinal herbs used in traditional oriental medicine are
      attractive sources for developing novel therapeutics or
      preventives
      since they have been used for thousands of
      years in clinics [1]. The radix of Asiasarum heterotropoides
      var. mandshuricum F. Maekawa (A. radix) is called seshin
      in Korean, saishin in Japanese, xì xin in Chinese and
    Chinese wild ginger in English and is widely used to treat various diseases [2]. A. radix has been used for its antiinflammatory,
    antiallergy, antibacterial, and anticancer
    effects [1, 3-5]. | 
  
  
    | Inflammatory responses are recognized as natural defense
      mechanisms critical for the recruitment of a variety of
      immune cells and molecules to sites with infectious
      microbes or injured tissues [6]. Inflammation is a complex
    process characterized by the contributions of mediators, including nitric oxide (NO) and free radicals [7]. Blocking
    the expression of cyclooxygenase-2 (COX-2) and
    inducible nitric oxide synthase (iNOS) can restrain the
    production of high-output NO, and inhibiting COX-2 and
    iNOS expressions have been used as functional criteria for
    developing anti-inflammatory agents [6, 7]. | 
  
  
    | In cancer, mutations in progenitor cells most likely undergo
      uncontrolled proliferation [8]. Apoptosis is important for
      controlling cell numbers and proliferation, but cancer
      cells do not undergo apoptosis [9]. Thus, drugs and agents
      that can restore the normal apoptotic pathway may have
    potential for treating cancers. | 
  
  
    | The aim of this study was to determine the dose-dependent
      anti-inflammatory and anticancer effects using methanol,
      ethanol and water extracts of A. radix. To our knowledge,
      this investigation is the first to elucidate the comparative
      effects of methanol, ethanol and water extracts of A. radix
      on mouse leukaemic monocyte macrophage cell lines
      (RAW 264.7) and human lung carcinoma cell lines (A549
    cells). | 
  
  
    Materials and Methods | 
  
  
    Chemicals and Reagents | 
  
  
    | All chemicals and reagents used in this study were
      purchased from Sigma (St. Louis, MO, USA) unless
    otherwise specified. | 
  
  
    Plant Material and Preparation of the Extracts | 
  
  
    | The dry roots of Asiasarum heterotropoides were obtained
      from Chungju Hospital of Korean Medicine (Jecheon,
      Korea). The roots of A. radix were chopped to a small
      size of 0.5 cm long, dried in the shade and powdered in a
      mechanical grinder. The pulverized roots were extracted
      for absolute ethanol, 70% ethanol, absolute methanol,
      70% methanol, water and boiling water for 3 hours, and
      finally the extractions were dried under a vacuum rotary
      evaporator (CCA-1110, Eyela, Tokyo, Japan). Twenty
      grams of dry roots in each group were used, and 1.544,
      3.704, 1.575, 3.852, 4.105, and 5.181 g were obtained for
      the absolute ethanol extract, 70% ethanol extract, absolute
      methanol extract, 70% methanol extract, water extract, and
      boiling water extract, respectively. The yields were 7.72,
    18.52, 7.88, 19.26, 20.53, and 25.91% (w/w), respectively. | 
  
  
    Anti-inflammatory Assay | 
  
  
    Cell line and cell culture | 
  
  
    | A RAW 264.7 cell line was purchased from the Korean
      Cell Line Bank (Seoul, Korea). RAW 264.7 cells were
      maintained in RPMI 1640 medium supplemented with
      10% FBS, 100 U/ml of penicillin, and 100 μg/ml of
      streptomycin. The cells were incubated at 37°C in a
    humidified atmosphere of 95% air and 5% CO2. | 
  
  
    Cytotoxicity assay | 
  
  
    | The cytotoxicity of samples of RAW 264.7 cells was
    tested. Cells were seeded into 96-well plates at a density of 1 Ã 105 cells/well. After incubation for 18 h, cells
    were exposed to medium along with samples at different
    concentrations for 24 h. The supernatant was removed
    from each well, and 10 μl of MTT solution (5 mg/ml in
    phosphate-buffered saline) and 90 μl of FBS-free medium
    were added to each well and incubated for 4 h at 37°C.
    Then, the supernatant was sucked out and 200 μl of
    DMSO were added to each well. The plate was vibrated
    slightly for 10 min, and the amount of MTT formazan was
    quantified by measuring the absorbance at 490 nm using
    an enzyme-linked immunosorbent assay (ELISA) plate
    reader (ELx800TM, Bio-Tek, Winooski, VT, USA). The
    optical density of formazan formed in the control cells was
    considered 100% viability. Cell viability was expressed as
    a percentage of the control culture value. | 
  
  
    Quantification of NO production in lipopolysaccharide
    (LPS)-induced RAW 264.7 cells | 
  
  
    | The inhibitory effect of NO production in LPS-induced
      RAW 264.7 cells was determined according to the method
      of Jiang et al. [10]. RAW 264.7 cells were plated in 96-
      well cell plates and incubated for 18 h. Then, cells were
      stimulated with LPS (2 μg/ml) in the presence or absence
      of samples with various concentrations for 24 h. Aliquots
      of 100 μl of cell culture medium were mixed with 100
      μl of Griess reagent [0.1% aqueous solution of naphthylethylenediamine
      dihydrochloride, 50 μl; 1% sulfanilamide
      (in 5% phosphoric acid), 50 μl]. The absorbance was
      determined at 550 nm using an ELISA plate reader
    (ELx800TM). | 
  
  
    Reverse transcription-polymerase chain reaction (RTPCR)
    analysis | 
  
  
    | RAW 264.7 cells (1 Ã 106) were grown in 6-well plates for
      18 h. Then, cells were treated with various concentrations
      of samples for 30 min, and LPS (2 μg/ml) was added. After
      incubation for 24 h, the total RNA of the cells was isolated
      with a Trizol RNA isolation kit (Invitrogen, Carlsbad, CA,
      USA). The total RNA was reverse-transcribed to cDNA
      and used as the template for PCR amplification. The
    iNOS, IL-1β, and COX-2 primers (Table 1) were used in the PCR. The amplified PCR products were separated
    on 1% agarose gel, and the gel was stained with ethidium
    bromide. The gel was photographed with a Mini BIS
    Image Analysis System (DNR Bio-Imaging Systems Ltd.,
    Jerusalem, Israel). | 
  
  
      | 
  
  
    Anticancer Assay | 
  
  
    Cell line and cell culture | 
  
  
    | A lung cancer A549 cell line was purchased from the Korean
      Cell Line Bank (Seoul, Korea). Cells were maintained in
      DMEM medium supplemented with 10% FBS, 100 U/ml
      of penicillin, and 100 μg/ml of streptomycin. The cells
      were incubated at 37°C in a humidified atmosphere of
    95% air and 5% CO2. | 
  
  
    Cytotoxicity assay | 
  
  
    | The cytotoxicity of samples on A549 cells was detected
      by MTT assay. Cells were seeded into 96-well plates
      and incubated with samples for 24, 48 or 72 h. Then, the
      supernatant was removed and 100 μl of MTT solution
      were added to each well and incubated for 4 h at 37°C. The
      supernatant was sucked out, and 200 μl of DMSO were
      added to each well. The amount of MTT formazan was
    quantified by measuring absorbance at 550 nm. | 
  
  
    RT-PCR analysis | 
  
  
    | A549 cells (1 Ã 106) were grown in 6-well plates for 24
      h. Then, cells were treated with samples for different
      amounts of time (0, 3, 6, 12, 24 and 48 h). The total
      RNA of the cells was isolated with a Trizol RNA isolation
      kit (Invitrogen, Carlsbad, CA, USA). The total RNA
      was reverse-transcribed to cDNA and used as the template
      for PCR amplification. The forward and reverse
      primers were as follows: 5?-TGTTACCAACTGGGACGACA-
      3? and 5?-CTCTCAGCTGTGGTGGTGAA-3?
    for β-actin; 5?-TGGTGGAGAACCCAAAGG-3? and 5?-GTCAAAGGAACCAAAGTCACG-3?for superoxide
    dismutase-2 (SOD-2); and 5?AGTGGAGGCCGACTTCTTGT-
    3? and 5?-CTGTTGCCACCTTTCGGTTA-
    3? for caspase-3. The amplified PCR products
    obtained by PCR were separated on 1% agarose gel
    electrophoresis, and the gel was stained with ethidium
    bromide. The gel was photographed with a Mini BIS
    Image Analysis System (DNR Bio-Imaging Systems
    Ltd.). | 
  
  
    Statistical Analysis | 
  
  
    | The data are represented as means ± standard deviations
      of the experiments. A one-way analysis of variance
      (ANOVA) with a post hoc test was performed to
      determine the differences between the groups using
      a commercially available program (SPSS 12 for
      Windows, SPSS Inc., Chicago,mIL, USA). The level of
    significance was 0.05. | 
  
  
    Results | 
  
  
    Anti-inflammatory Assay | 
  
  
    | Cytotoxicity assay: The effects of A. radix on RAW 264.7
      cells are presented in Figure 1. The results showed that
      the 70% ethanol extract and the boiling water extract
      did not exhibit any statistically significant toxicity on
      RAW 264.7 cells (P>0.05). The absolute ethanol extract
      at concentrations of 25, 50, 100, and 200 μg/ml reduced
      cell viability to 90.3 ± 1.3%, 80.3 ± 1.4%, 73.8 ± 0.9%,
      and 71.8 ± 0.2 %, respectively, when the control was
    considered 100% (100.0 ± 0.8 %) (P<0.05). | 
  
  
    | Quantification of NO production in LPS-induced RAW
      264.7 cells: Stimulation with LPS for 24 h led to a robust
      increase in NO production. However, A. radix significantly
      suppressed NO in the LPS-stimulated RAW 264.7 cells in
    all groups (70% ethanol, ethanol, 70% methanol, methanol, water and boiling water extracts) (Figure 2A). The boiling
    water extract showed an 80.9 ± 0.8 % reduction of NO
    production at 25 μg/ml. The highest reduction of NO
    production was achieved in the ethanol extract group at
    200 μg/ml with 98.9 ± 0.4 %. | 
  
  
      | 
  
  
    Figure 1. Cell viability of RAW 264.7 cells after incubation in the presence of different extracts from A. radix for 24 h. Each value
      is expressed as the mean ± SD (n=3) 
      # A statistically significant difference was seen when compared with the control (non-treated group) at 24 h (P<0.05) 
      * There was a statistically significant difference when compared with the 25 μg/ml group for each extraction method 
      EtOH: ethanol 
    MeOH: methanol | 
  
  
      | 
  
  
    Figure 2. (A) Nitric oxide (NO) inhibition of different extracts from A. radix on LPS-stimulated RAW 264.7 cells. Each value is
      expressed as the mean ± SD (n=3) 
      #A statistically significant difference was seen when compared with the control at 24 h (P<0.05) 
      * A significant difference was seen when compared to the control (nonloaded group) (P<0.05) 
      EtOH: ethanol 
      MeOH: methanol 
      (B) Effects of absolute ethanol extract of A. radix (AHE) on nitric oxide synthase (iNOS), interleukin 1β (IL-1β), interleukin 6 (IL-6) and cyclooxygenase-2 (COX-2) mRNA expression in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells | 
  
  
    RT-PCR analysis | 
  
  
    | The iNOS, IL-1β, IL-6 and COX-2 mRNA expressions in
      the unstimulated RAW 264.7 cells were minimal, but their
      mRNAs were profoundly induced after the treatment with
      LPS (Figure 2B). Pretreatment with the absolute ethanol
      extract of A. radix suppressed the LPS-stimulated iNOS,
      IL-1β, IL-6 and COX-2 expression. The suppression of
      inflammatory-related genes increased with the increasing
    concentration of A. radix extract. | 
  
  
    Anticancer assay | 
  
  
    | Cytotoxicity assay and RT-PCR analysis: The results
    of cell viability of A549 cells after incubation in the presence of different extracts from A. radix for 24 h, 48
    h and 72 h are shown in Figures 3A-3C. The results at
    24 h showed that A. radix extracts significantly reduced
    cellular viability when compared with the untreated
    control (P<0.05) (Figure 3A). The results at 48 h and
    72 h showed similar trends with 24 h data (Figures 3B
    and 3C). The absolute ethanol extract showed the most
    powerful effects of 42.3 ± 0.1%, 36.1 ± 1.0%, and 28.5
    ± 1.5% with concentrations of 50, 100, and 150 μg/ml,
    respectively, at 72 h when the control was considered
    100 (100.0 ± 2.7)% (P<0.05). The expression of SOD-2
    and caspase-3 increased with the increase of exposure
    time to the absolute ethanol extract (Figure 3D). | 
  
  
    Discussion | 
  
  
    | In this study, we examined the effects of different
      extracts of A. radix on RAW 264.7 and A549 cells under
      predetermined concentrations. The absolute ethanol extract
    showed the highest anti-inflammatory and anticancer effects in these experimental settings. | 
  
  
      | 
  
  
    Figure 3. (A) Cell viability of A549 cells after incubation in the presence of different extracts from A. radix for 24 h. Each value
      is expressed as the mean ± SD (n=3) 
      #A statistically significant difference was seen when compared with the control (nontreated group) at 24 h (P<0.05) 
      * There was a statistically significant difference when compared with 25 μg/ml group in each extraction method. 
      EtOH: ethanol 
      MeOH: methanol 
      (B) Cell viability of A549 cells after incubation in the presence of different extracts from A. radix for 48 h. Each value is expressed
      as the mean ± SD (n=3) 
      #A statistically significant difference was seen when compared with the control (nontreated group) at 48 h (P<0.05). 
      *There was a statistically significant difference when compared with 25 μg/ml group in each extraction method. 
      (C) Cell viability of A549 cells after incubation in the presence of different extracts from A. radix for 72 h. Each value is expressed
      as the mean ± SD (n=3) 
      #A statistically significant difference was seen when compared with the control (nontreated group) at 72 h (P<0.05) 
      *There was a statistically significant difference when compared with 25 μg/ml group in each extraction method. 
      (D) A549 cancer cells were plated in 6-well plates and then exposed to absolute ethanol extract (AHE) for the indicated times. 
      Caspase-3 and superoxide dismutase-2 (SOD-2) mRNA levels in A. radix-stimulated cells were detected by reverse transcriptionpolymerase
    chain reaction (RT-PCR) | 
  
  
    | The RAW 264.7 macrophage model is considered a useful
      model for evaluating anti-inflammatory agents because
      a number of different inflammatory mediators, including
      NO, prostaglandin E2 and tumor necrosis factor-a,
      are generated by the macrophages upon stimulation
      with LPS (a primary component of the Gram-negative
      bacteria cell wall) [6]. Increased anti-inflammatory
      effects of the ethanol extract may be explained by the
      phenolic and flavonoid compounds in A. radix because
      with typical extraction procedures phenolic compounds
      are mostly carried out using organic solvents [11,12].
      These compounds have reportedly shown various healthpromoting
      biological actions, including anti-inflammatory,
      anticarcinogenic, and anti-atherosclerotic functions [7]. It
      was unclear whether the A. radix-mediated inhibition of
      NO production was the consequence of inhibiting iNOS,
      COX-2, IL-1β, and IL-6 at the transcriptional level or due
      to some other mechanism. This study clearly suggested
      that the suppressive activity of A. radix extracts on iNOS,
      COX-2, IL-1β and IL-6 was mediated via transcriptional
    levels. | 
  
  
    | Caspases are crucial mediators of programmed cell
      death (apoptosis), and caspase-3 is a frequently activated
      protease in mammalian cell apoptosis [13]. Cytotoxic
      effects on lung carcinoma cell lines are partly explained
      by the expression of caspase-3. The transcriptional level
      of caspase-3 was increased with longer exposure to
      A. radix extracts in this study. Additionally, this study
      showed that the transcriptional level of SOD-2 was greater
      with an increase in exposure time. The role of SOD in
      carcinogenesis has been widely studied but remains
      ambiguous and controversial [16]. A major intracellular
      form of the SOD enzyme is considered a tumor suppressor
      [9,14]. A previous report showed that increased manganese
      SOD expression suppresses the malignant phenotype of
    human melanoma cells [15]. | 
  
  
    | Within the limits of this study, A. radix showed antiinflammatory
      effects using a RAW 264.7 cell line and
      anticancer effects on A549 cells. These effects were
      influenced by extraction methods. The absolute ethanol
      extract showed the highest anti-inflammatory and
    anticancer effects in these experimental settings. | 
  
  
    Acknowledgement | 
  
  
    | The authors report no conflicts of interest related to this
      study. The author does not have any financial interest
      in the companies whose materials are included in the
    article. | 
  
  
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