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| Clinical observation of Kushen Injection for radiation-induced esophagitis injury |
| Hits 22 Download times 11 Received:May 11, 2026 |
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| DOI
10.11656/j.issn.1673-9043.2026.09.05 |
| Key Words
Kushen Injection;ROS/PINK1-Parkin;radiation-induced esophagitis;mitophagy |
| Author Name | Affiliation | E-mail | | ZHENG Xiao | Third Department of Oncology, Handan Hospital of Integrated Traditional Chinese & Western Medicine, Handan 056002, China | | | LI Guijun | Third Department of Oncology, Handan Hospital of Integrated Traditional Chinese & Western Medicine, Handan 056002, China | ctuqdrzq6t@163.com | | WANG Yuanyuan | Third Department of Oncology, Handan Hospital of Integrated Traditional Chinese & Western Medicine, Handan 056002, China | | | ZHANG Jianhua | Sixth Department of Oncology, Handan Hospital of Integrated Traditional Chinese & Western Medicine, Handan 056002, China | | | LI Jingmin | Third Department of Oncology, Handan Hospital of Integrated Traditional Chinese & Western Medicine, Handan 056002, China | |
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| Abstract
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| [Objective] To investigate whether Kushen Injection（KS） protects the epithelial barrier via the reactive oxygen species（ROS）/PTEN-induced kinase 1（PINK1）-Parkin-mediated mitophagy pathway，thereby intervening in radiation esophagitis（RE） injury. [Methods] This randomized，double-blind，controlled trial enrolled 70 patients with esophageal/lung cancer receiving radical thoracic radiotherapy（≥50 Gy）. Patients were randomly divided into the KS group（intravenous infusion of 20 mL Kushen Injection） and the RE group（intravenous infusion of an equal volume of normal saline）. Esophageal inflammatory tissues were sampled via gastroscopy，snap-frozen in liquid nitrogen，and stored. Clinical efficacy was evaluated using the Visual Analog Scale（VAS） pain score and the Radiation Therapy Oncology Group（RTOG） dysphagia grade，and mucosal healing time was recorded. Specimens underwent HE staining；tissue morphology was examined by transmission electron microscopy；ROS levels were detected using a dihydroethidium（DHE） fluorescent probe；and related protein expression was analyzed by Western blotting. [Results] Compared with the RE group，the KS group showed decreased VAS scores，reduced dysphagia grades，and shortened mucosal healing time（P<0.001）. The RE group displayed hyalinization，vascular dilation，and increased inflammatory cells，whereas these pathological changes were markedly improved in the KS group. Compared with the RE group，the KS group exhibited increased protein expression of PINK1 and Parkin，an increased microtubule-associated protein 1 light chain 3（LC3）-II/LC3-I ratio（P<0.001），and decreased p62 protein（P<0.001）. Moreover，mitochondria in the RE group showed swelling，blurred structure，loss or fragmentation of cristae，decreased matrix electron density，and vacuolization，while mitochondrial swelling and structural blurring were not obvious in the KS group. Compared with the RE group，the KS group had reduced ROS levels（P<0.001） and increased zonula occludens-1（ZO-1） and Occludin expression（P<0.001）. ROS level was significantly negatively correlated with ZO-1 expression（r=-0.82，P=0.001），and PINK1 expression was strongly positively correlated with the number of mitophagosomes（r=0.78，P=0.001）. [Conclusion] The protective effect of Kushen Injection（KI） on radiation esophagitis（RE） is closely associated with its role in reducing reactive oxygen species（ROS） levels and activating the PINK1-Parkin pathway，suggesting that it may have a potential cascade mechanism of “enhancing mitophagy and rebuilding the epithelial barrier by eliminating toxic ROS”，which provides new experimental evidence and ideas for the prevention and treatment of RE. |
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