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The cooperation of ligustrazine (LI) and borneol was proved to be much better than each of them in treating cerebral ischemia. However, the mechanism of their synergic therapy is unclear till now. Moreover, whether their cooperation brought different degrees of protection among different brain regions was also unclear. In the present study, the effects of LI, borneol, and their mixture were observed in global cerebral ischemia-reperfusion (GCIR) injury by detecting microcirculation, expressions of caspase-3 and p53, levels of IL-1β, IL-6, and TNF-α, and contents of SOD, GSH-Px, and MDA in cortex, hippocampus, hypothalamus, and striatum, respectively. Furthermore, Nissl bodies were scored also. Monotherapy of LI or borneol showed obvious improvements in the four regions, specially in cortex and hippocampus. Interestingly, the cooperation of LI and borneol brought some new improvements, specially in hypothalamus and striatum. Thus, the synergic effect of the two drugs showed region-specificity in GCIR injury except the expressions of caspase-3 and p53.

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The inhibitors for EGF receptor tyrosine kinase (EGFR-TKIs) such as gefitinib have been used as a standard treatment for non-small cell lung cancer (NSCLC), but the increasingly occurrence of drug resistance, the associated adverse effects and the enrichment of cancer stem cells significantly impedes its clinical application. β-elemene is a natural sesquiterpene with potent anti-cancer ability, and also it is renowned for its plant-origin, safety and the additive effect with traditional therapies, which prompt us to explore its potential to co-operate with TKIs to achieve greater therapeutic efficacy. Impressively, our study demonstrates that, elemene, in combination of gefitinib, displayed a significantly higher activity in inhibiting lung cancer cellular proliferation, migration and invasion. More importantly, combinative treatment profoundly impaired the epithelial to mesenchymal transition (EMT), the stem-like properties and the self-renewal capacity of lung cancer cells, and hence impeded the in vivo tumor development. We also reveal that the synergistic anti-tumor effect of elemene and gefitinib was largely mediated their regulation of enhancer of zeste homolog 2 (EZH2), an oncogenic histone methyltransferase and gene transcriptional regulator. Thus, our data indicate that combinative treatment of elemene and gefitinib has greater anti-neoplastic activity and greater efficacies in targeting cancer stem-like properties, mainly through regulating the malignant gene modifier and hence the subsequent effector molecules required for cancer progression. The findings may have potential implications for treating aggressive and resistant lung cancers.

This study aimed to investigate the synergic effects of tetramethylpyrazine phosphate (TMPP) and borneol (BO) for protecting against ischemia in the cortex and hippocampus. A rat model of global cerebral ischemia-reperfusion (GCIR) was induced by four-vessel occlusion. The results showed that TMPP (13.3 mg/kg), BO (0.16 g/kg), and their combination improved the ultrastructure of neurons, reduced the apoptosis index, and reduced the intracellular calcium content in both the cortex and hippocampus. TMPP and the combined treatment increased cortex autophagy by modulating phosphorylated adenosine monophosphate-activated protein kinase (pAMPK) in the pAMPK-mammalian target of rapamycin (mTOR)-Unc-51-like kinase 1 (ULK1) signaling pathway, whereas BO only regulated ULK1. Moreover, BO increased neuron autophagy in the hippocampus by modulating mTOR, whereas TMPP targeted both mTOR and Beclin1. Similarly, the combination targeted both pAMPK and Beclin1. All three treatments decreased the expression of p53 and caspase-3 in the two areas. Additionally, TMPP and the combined therapy regulated Bax and Bcl-2. These results demonstrated the synergic effects between TMPP and BO for treating ischemia-reperfusion injury in the cortex and hippocampus regions. Their neuroprotective effects could be partly attributed to switching from apoptosis to protective autophagy. Additionally, the potential mechanism triggering this switching could be ascribed to the reduction of intracellular calcium content.

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