Tuoli Xiaodu powder ameliorated 5-fluorouracil-induced intestinal injury by reducing intestinal inflammation, oxidative stress, and intestinal flora imbalance

Ling Jiang; Wanrou Jiang; Wanyi Zhang; Wenjuan Zheng; Hongjie Huang; Yu Xia; Xiuyun He; Chaofu Zhu; Yongjun Wu

Tuoli Xiaodu powder ameliorated 5-fluorouracil-induced intestinal injury by reducing intestinal inflammation, oxidative stress, and intestinal flora imbalance

Files

Wu-41-135-149-2026.pdf(16.68 MB)

Date

2026

Authors

Ling Jiang

Wanrou Jiang

Wanyi Zhang

Wenjuan Zheng

Hongjie Huang

Yu Xia

Xiuyun He

Chaofu Zhu

Yongjun Wu

Publisher

Universidad de Murcia, Departamento de Biologia Celular e Histiologia

Abstract

Chemotherapy-induced diarrhea (CID) is a common adverse event in cancer patients treated with 5-fluorouracil (5-FU). This study aimed to investigate the potential protective effects of Tuoli Xiaodu (TLXD) powder on CID and to explore its possible mechanisms. Mice with CID induced by 5-FU were randomly divided into seven groups: Blank group, CID group, positive drug (loperamide) group, and TLXD powder low, medium, and high groups. The degree of diarrhea, tumor growth, intestinal barrier damage, intestinal inflammation, oxidative stress, and gut microbiota diversity were assessed. The study showed that TLXD powder significantly inhibited diarrhea and tumor growth in 5-FU-induced CID mice. H&E staining and western blot showed that TLXD powder improved the intestinal mucosa and intestinal permeability of 5-FU-induced CID mice. Furthermore, TLXD powder elicited a reduction in the expression of inflammatory factors within the intestinal tract of mice with CID while simultaneously augmenting the expression of anti-inflammatory factors and maintaining a balanced Th17/Treg ratio. TLXD powder decreased intestinal oxidative stress and intestinal epithelial cell ferroptosis and activated the Nrf2/HO-1 signaling axis in CID mice. The results of the gut flora analysis showed that TLXD powder improved the intestinal flora structure of CID mice. TLXD powder significantly reduced the proportion of Proteobacteria, Actinobacteria, Deferribacteres, and TM7 at the phylum level and Desulfovibrio, Mucispirillum, Adlercreutzia, and Odoribacter at the genus level. These findings provide a new therapeutic approach for the management of CID in cancer patients treated with 5-FU

Keywords

Chemotherapy-induced diarrhea , Tuoli Xiaodu powder , Inflammation , Oxidative stress , Intestinal mucosal injury , Intestinal microflora , Colorectal cancer