
Enhanced Anticancer and Apoptotic Effects of Rhus coriaria Aqueous Extract and Lactobacillus acidophilus on Gastric Cancer Cells (AGS): Synergistic Cytotoxicity and Apoptosis Induction
Fatemeh Bastan 1 ℗, Reyhane Farjadi Kia 1, Maryam Rashidian 1, Mahboobeh Mehrabani Natanzi 2 ©, Zohreh Khodaii 3
Abstract
Introduction: Gastric cancer is among the leading causes of cancer-related deaths globally, with limited treatment options and high recurrence rates. There is growing interest in alternative and complementary treatments, especially natural compounds with low toxicity. Rhus coriaria (sumac), a traditional medicinal plant, and Lactobacillus acidophilus, a well-known probiotic bacterium, have shown individual anticancer and immunomodulatory properties. This study investigates their combined effect on AGS gastric cancer cells. Methods and Materials: Aqueous extract of Rhus coriaria fruit and ethyl acetate extract of L. acidophilus were prepared. AGS cells were cultured and treated with different concentrations of R. coriaria (10, 25, 50, 100, 250, 500, 1000 µg/ml) and L. acidophilus (10, 25, 50, 75, 100, 250, 500, 1000 µg/ml), both individually and in combination. Cell viability was assessed by MTT assay, and apoptosis was evaluated via flow cytometry using Annexin V/PI staining after 24 hours of treatment. IC50 values were calculated for each treatment condition. Results: Both R. coriaria and L. acidophilus significantly reduced cell viability in a dose-dependent manner. When combined, a synergistic effect was observed, with the IC50 of R. coriaria decreasing from 250 µg/ml to 92.07 µg/ml. Apoptosis analysis showed rates of 6.88% for R. coriaria, 12.62% for L. acidophilus, and a significantly higher 42.9% for the combination group (p 0.0001). The morphological changes consistent with apoptosis, including membrane blebbing and chromatin condensation, were more prominent in the combination group. Conclusion and Discussion: The combination of Rhus coriaria and Lactobacillus acidophilus demonstrates a potent synergistic anticancer effect against AGS gastric cancer cells. The reduction in required concentrations to achieve therapeutic effect highlights the potential of this combination as a natural and effective adjunct in gastric cancer therapy. Further in vivo studies are necessary to confirm these findings and evaluate safety profiles in physiological models.
Keywords: Rhus-coriaria, Sumac, gastric cancer, Lactobacillus acidophilus probiotic bacteria