In Vitro Assessment of the Apoptotic and Anti-oxidant Effects of Pomegranate Extract on Tongue Squamous Cell Carcinoma Cell Line (In Vitro Study)

Abstract

Background: Oral squamous cell carcinoma is a very dangerous type of cancer, especially those appearing on the tongue. Recently, natural compounds are considered an important method of anticancer drug therapy. Pomegranate extract (PE) has a wide range of pharmacological and therapeutic aspects including reactive oxygen species (ROS) scavenging, anti-inflammatory and anti-hypertensive effects. Moreover, the anticancer effects of PE have been studied in many cancers such as human bladder and breast cancer and showed cytotoxic and anti-proliferative effects against these cancer cell lines.

Aim: To identify the possible anti-cancer and antioxidant effects of PE on Tongue Squamous Cell Carcinoma cell line and compare it with the chemotherapeutic drug Cetuximab and their combination together.

Methods: Tongue squamous cell carcinoma cell line was divided into four groups; group I: untreated control group, group II: treated with pomegranate extract, group III: treated with Cetuximab and group IV: treated with a combination of Pomegranate extract and Cetuximab. Determination of the anticancer and antioxidant effects of these agents on the tongue squamous cell carcinoma cell line was done using Methyl Thiazole Tetrazolium assay, Nuclear Morphometric Analysis, Microscopic Examination, Polymerase Chain Reaction and Immunofluorescence.

Results:  PE succeeded to decrease the percentage of viable and proliferating cells. Also, it increased the levels of caspase-3 and Nrf2 expression. Moreover, combination of PE with Cetuximab produced better effects at markedly lower doses than when used individually.

Conclusion: Pomegranate Extract has a strong anticancer effect against squamous cell carcinoma compared to that of Cetuximab. Moreover, combining PE with Cetuximab has synergistic effect.