N-CWS promotes the repair of radiation-induced skin injury by enhancing angiogenesis

PURPOSE: Radiation-induced skin injury is a common complication that seriously affects the follow-up treatment and life quality of tumor patients. Nocardia rubra cell-wall skeleton (N-CWS) has been reported to have pro-angiogenesis effects, and its role on RISI remains unclear. The aim of this study was to investigate its effect on repair of radiation induced skin injury. MATERIALS AND METHODS: After exposure to 45 Gy X-rays, the irradiated areas of SD rats were treated by N-CWS every 3 days. The radioprotective effects of N-CWS were evaluated by body weight changes, skin scores, H&E staining and TUNEL staining. Microvascular monitoring system and immunofluorescence staining of CD31 were performed to assess angiogenic capacity in vivo. In vitro, the activity and apoptosis of HUVECs were measured by CCK8 and flow cytometry. The angiogenic capacity of HUVECs was evaluated by tubule formation assay and Transwell assay. Western blot was performed to verify the possible mechanisms of the protective effect of N-CWS against radiation-induced skin damage. RESULTS: N-CWS was demonstrated to have low toxicity and radioprotective effects, maintained cell activity and attenuated radiation-induced apoptosis. In addition, N-CWS attenuated radiation-induced vascular injury in vivo and in vitro. Furthermore, P38 MAPK was shown to be associated with the radiation protection capability of N-CWS in HUVECs. CONCLUSIONS: N-CWS promoted the repair of radiation-induced skin injury by enhancing angiogenesis, and the mechanism was related to the activation of P38 MAPK.