Anti-inflammatory Effects of "Sanliangsan" on Gefitinib Induced Skin Rash via Modulation of Macrophages

Gefitinib induced rash is a common sequellae during cancer treatment. The mechanism and treatment of these rashes are unclear, therefore we investigated the anti-inflammatory effect of Sanliangsan on gefitinib induced rashes. Brown Norway (BN) rats were randomly selected and divided into five groups: control group, gefitinib rash model control group(model group), Sanliangsan model groups of low-dose, medium-dose, and high-dose(low,medium and high dose). Gifitinib was administered in the morning and Sanliangsan in the afternoon on the same day for 4 weeks .The BN model rats in the low-dose, medium-dose and high-dose groups were given 2 mg/kg/day, 4 mg/kg/day and 8 mg/kg/day of Sanliangsan respectively. The control group was given pure water. Macrophages were classified by flow cytometry. Protein expression was detected by immunohistochemistry. Protein chip array was used to detect the signaling pathways and inflammatory factors associated with inflammation. The results showed that the expressions of macrophage inflammatory protein (MIP) -1, MIP-2, myelocyte triggered receptor-1 (TREM-1) and IL-17A were significantly increased in the gefitinib rash model control group compared with the control group. The expressions of MIP-1, MIP-2, TREM-1 and IL-17A were significantly reduced in the Sanliangsan groups compared with the gefitinib rash model control group. It was also discovered that the anti-inflammatory effect of Sanliangsan on gefitinib-induced rash was closely related to the signaling pathway of IL-17A.