# Dunhuang Gancao Fuling Xingren decoction and its components alleviate CPT-11 induced intestinal mucositis by regulating gut microbiota related innate immunity and inflammatory response in Drosophila and mice

## TL;DR

A traditional herbal formula called GFXD helps reduce gut damage caused by chemotherapy in flies and mice by balancing gut bacteria and reducing inflammation.

## Contribution

This study identifies GFXD and its active compounds as novel therapeutic agents for chemotherapy-induced intestinal mucositis.

## Key findings

- GFXD improved survival and gut health in Drosophila and mice exposed to CPT-11.
- GFXD restored gut microbiota balance by increasing probiotics and reducing harmful bacteria.
- Three compounds in GFXD—formononetin, kaempferol, and ergosterol—were found to be key in protecting against intestinal injury.

## Abstract

Dunhuang Gancao Fuling Xingren decoction (GFXD) is a traditional formulation derived from the Dunhuang Ancient Medical Prescriptions, has been historically utilized for its immunomodulatory and anti-inflammatory properties. However, the protective effect against irinotecan (CPT-11)-induced intestinal mucositis (CIM) remains poorly elucidated.

To investigate the therapeutic efficacy of GFXD in alleviating CIM and elucidate its underlying mechanism and components using Drosophila melanogaster and C57BL/6 J mouse models.

The therapeutic efficacy of GFXD was assessed in both Drosophila and mouse models by phenotype assay, hematoxylin and eosin (H&E) staining, and Alcian blue-periodic acid schiff (AB-PAS) staining. Transcriptomic profiling combined with 16S rRNA sequencing were employed to identify potential mechanisms of GFXD regulating CPT-11-induced mucositis. Cytokine levels were measured using ELISA, while the expression levels of key signaling pathways, including Toll-Imd and JAK-STAT pathways were analyzed via qRT-PCR, immunofluorescence, fecal microbiota transplantation (FMT) experiment, and antibiotic treatment. Furthermore, functional components of GFXD were characterized via liquid chromatography-mass spectrometry (LC–MS), and their efficacy was validated in CPT-11-treated Drosophila.

GFXD significantly mitigated CPT-11-induced systemic and intestinal damage in Drosophila, evidenced by improved survival rate, restored digestive function, elongated intestinal length, reduced acid–base imbalance, and enhanced epithelial and stem cell proliferation. In mice, GFXD alleviated mucositis symptoms, attenuated histopathological damage, and normalized inflammatory cytokine levels. Mechanistically, GFXD suppressed gut microbiota dysbiosis by enriching probiotics (Lactobacillus, Prevotella) and reducing pathogens (Bacteroides, Enterobacter, Enterococcus and Helicobacter). Transcriptomic and molecular analyses revealed that GFXD inhibited hyperactivation of Toll-Imd pathways and JAK-STAT signaling. Finally, three compounds of GFXD, formononetin, kaempferol, and ergosterol were found to alleviate CPT-11 induced intestinal injury.

GFXD alleviates CPT-11-induced intestinal mucositis by modulating gut microbiota composition, suppressing JAK-STAT and Toll-Imd pathways. Thus, this study demonstrates GFXD and its bioactive constituents as novel therapeutic agents to mitigate CIM.

GFXD alleviates CPT-11-induced intestinal mucositis in flies and mice by improving survival, enhancing gut integrity and reducing inflammation.GFXD exerts its protective effect by restoring gut microbiota balance and suppressing the hyperactivated JAK-STAT and Toll-Imd immune pathways.The key active compounds Formononetin, Kaempferol and Ergosterol were identified as critical components responsible for GFXD's protective effects against mucositis.

GFXD alleviates CPT-11-induced intestinal mucositis in flies and mice by improving survival, enhancing gut integrity and reducing inflammation.

GFXD exerts its protective effect by restoring gut microbiota balance and suppressing the hyperactivated JAK-STAT and Toll-Imd immune pathways.

The key active compounds Formononetin, Kaempferol and Ergosterol were identified as critical components responsible for GFXD's protective effects against mucositis.