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Contents lists available at ScienceDirect

Journal of Ethnopharmacology
journal homepage: www.elsevier.com/locate/jethpharm

1 In vitro anti-inflammatory and anti-cancer activities of Cuscuta reflexa Roxb.

2 Q1 V. Suresh a , V. Sruthi b , B. Padmaja c , V.V. Asha a,∗
3 Q2 a
Bioprospecting and Molecular Pharmacology Lab, Rajiv Gandhi Centre for Biotechnology Thiruvananthapuram, Kerala 695014, India
b
4 School of Biotechnology, Chemical & Biomedical Engineering VIT University, Vellore, Tamilnadu, India
c
5 Ayurveda Research Institute for Mother and Child Health Care, Thiruvananthapuram, India
6

7 a r t i c l e i n f o a b s t r a c t
8
9 Article history: Ethnopharmacological relevance: Cuscuta reflexa Roxb. is used in folk medicine of Bangladesh and Tripura Q3
10 Received 25 March 2010 to treat various ailments related to inflammation and cancer.
11 Received in revised form Aim of the study: To determine anti-inflammatory and anti-cancer activities of Cuscuta reflexa in cell lines
12 14 December 2010
(in vitro).
13 Accepted 25 January 2011
Materials and methods: Anti-inflammatory activity of the water extract was analysed in vitro using
Available online xxx
lipopolysaccharide (LPS) induced inflammatory reactions in murine macrophage cell line RAW264.7.
14
The expression of COX-2 and TNF-␣ genes involved in inflammation was analysed by SQ RT-PCR. EMSA
15 Keywords:
16 Cuscuta reflexa Roxb.
was conducted to analyse the influence of the extract on NF-␬B signalling. Anti-cancer activity was anal-
17 Inflammation ysed on Hep3B cells by MTT assay, DAPI staining, annexin V staining and SQ-RT PCR analysis of BAX,
18 Cancer Bcl-2, p53 and survivin.
19 RAW264.7 Results: The extract down regulated LPS induced over expression of TNF-␣ and COX-2 in RAW264.7 cells;
20 Hep3B blocked NF-␬B binding to its motifs and induced apoptosis in Hep3B cells as evidenced from MTT, DAPI
staining and annexin V staining assays. The extract up regulated pro-apoptotic factors BAX and p53, and
down regulated anti-apoptotic factors Bcl-2 and survivin.
Conclusions: The study showed that Cuscuta reflexa inhibits LPS induced inflammatory responses
in RAW264.7 cells through interplay of TNF-␣, COX-2 and NF-␬B signalling. It induced apo-
ptosis in Hep3B cells through the up regulation of p53, BAX and down regulation of Bcl-2 and
survivin.
© 2011 Published by Elsevier Ireland Ltd.

21 1. Introduction tremendous potential in the management, prevention and treat- 32

ment of cancer (Aggarwal et al., 2006a,b). If a drug could interfere 33

22 Recent studies have shown that chronic inflammation can pro- with the inflammatory reactions and induce apoptosis at the same 34

23 gressively lead to cancer and the role of inflammatory reactions time in cancer cells, it could be useful in both cancer prevention 35

24 leading to neoplasia is also well documented (Aggarwal et al., and therapy (Aggarwal et al., 2006b). 36

25 2006b). The progression of cancer from a single cell involves the Cuscuta reflexa Roxb., commonly known as dodder, belongs 37

26 interplay of numerous inflammatory modulators (Coussens and to the family Convolvulaceae. Interestingly, the folk medicine of 38

27 Werb, 2002). These complex set of reactions decide the fate of a Bangladesh uses this herb to cure tumours (Costa-Lotufo et al., 39

28 cell-malignancy or normal growth. Chronic inflammation has been 2005). The Tripura tribe of Bangladesh and Satar tribes of Nepal 40

29 reported to be linked with steps involved in tumorigenesis and has attributed a multitude of functions to this plant – for the treat- 41

30 metastasis (Coussens and Werb, 2002; Mantovani, 2005). Com- ment of oedema and body ache, as an aphrodisiac, maintenance of 42

31 pounds that can block or alter inflammatory reactions can have hepatic system, for alleviation of skin infections and also for cur- 43

ing jaundice (Siwakoti and Siwakoti, 1999; Hossan et al., 2009). 44

Based on this tribal information, this plant was analysed for its anti- 45

inflammatory and anti-cancer activities in vitro. Since this plant is 46

Abbreviations: DMEM, Dulbecco’s modified Eagle medium; TNF-␣, tumour
necrosis factor ␣; COX-2, cyclooxygenase-2; dNTPs, di nucleotide triphosphates;
used to cure inflammation, cancer and liver disorders, we have used 47

EMSA, electrophoretic mobility shift assay; NF-␬B, nuclear factor ␬B; DTTD, di thio- in vitro models for hepatic inflammation and hepatic cancer for 48

thretol; DAPI, 4 ,6-diamidino-2-phenylindole; G3PDH, glyceraldehyde 3 phosphate the study. The macrophages in liver (also called Kupffer cells) have 49
dehydrogenase; BAX, Bcl2 associated X protein; LPS, lipopolysaccharide; HEPES, important roles in mediating the inflammatory response in liver 50
4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid; MTT, 3-(4,5-dimethylthiazol-
(Knolle and Gerken, 2000). We have used the macrophage cell line 51
2-yl)-2,5-diphenyltetrazolium bromide.
∗ Corresponding author. Tel.: +91 471 2529457; fax: +91 471 2348096. as a model in inflammatory studies and hepatocellular carcinoma 52

E-mail addresses: vvasha@rgcb.res.in, ashavv@rediffmail.com (V.V. Asha). cell lines for anti-cancer studies. 53

0378-8741/$ – see front matter © 2011 Published by Elsevier Ireland Ltd.

doi:10.1016/j.jep.2011.01.043

Please cite this article in press as: Suresh, V., et al., In vitro anti-inflammatory and anti-cancer activities of Cuscuta reflexa Roxb. J. Ethnopharmacol.
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54 2. Materials and methods The final concentration of DMSO in the medium was adjusted 109

to 0.1% in all cases. After 30 min of the treatment with extract, 110

55 2.1. Cell lines and reagents LPS (lipopolysaccharide, 10 ␮g/ml) was added and incubated for 111

4 h. The total RNA was then isolated from different treatment 112

56 RAW264.7, an immortalised murine macrophage cell line, and groups by Trizol method (Suresh and Asha, 2008; Sheeba and 113

57 human hepatocellular carcinoma cell line Hep3B were obtained Asha, 2009). The RNA was quantified using a spectrophotometer 114

58 from American Type Culture Collection (ATCC), Manassas, USA. (Perkin Elmer, USA) at 260 nm. cDNA was prepared from the total 115

59 DMEM, Antibiotic–antimycotic mixture and HEPES were obtained RNA (2 ␮g) by reverse-transcription using an oligo (dT) 18 mer as 116

60 from Gibco – BRL, USA. Trypsin, ethidium bromide, FBS, DEPC, a primer and M-MLV reverse transcriptase. The expression lev- 117

61 glycerol, bromophenol blue, xylene cyanol, primers, lipopolysac- els of COX-2, TNF-␣ and ␤-actin (internal control) were analysed 118

62 charide, dithiothretol, nonidet P40, phenyl methane sulphonyl by PCR amplification of these genes by using specific primers 119

63 fluoride (PMSF), ficoll 400, bradford reagent, labelled primer and at specific annealing temperatures (Supplementary Table 1) in a 120

64 SDS were obtained from Sigma, USA. DMSO, hexane, chloroform, thermal cycler (iCycler, Biorad, USA). The PCR reactions (25 ␮l) 121

65 isopropanol, acetic acid are from Merck India pvt. Ltd. Oligo dT, RT were carried out in 2 mM MgCl2 , 10 mM dNTPs, PCR buffer and 122

66 buffer, dNTPs, RNase inhibitor, AMV-RT enzyme, PCR master mix, 2 units of Taq DNA polymerase in the thermal cycler. After ampli- 123

67 agarose, poly (dI-dC), and T4 kinase were from Promega, Madison, fication, the amplicons were electrophoresed in 1.2% agarose gel 124

68 USA. TRIzol, Na2 EDTA·2H2 O and EDTA were from Invitrogen, Carls- stained with ethidium bromide. The bands were quantified by 125

69 bad, USA. NaHCO3 , KH2 PO4 , and NaH2 PO4 from Himedia, Mumbai, densitometry on Gel documentation System using quantity one 126

70 India. NaCl, MgCl2 , EGTA and KCl from Qualigen’s, Mumbai, India. software (Biorad, USA). Values were normalised by calculating the 127

densitometry ratio with that of internal control ␤-actin as base 128

71 2.2. Collection of the plant and extraction line. 129

72 The plant Cuscuta reflexa Roxb., was collected from the outskirts 2.3.4. Electrophoretic mobility shift assay (EMSA) for NF-B 130

73 of Trivandrum, Kerala, India. A voucher specimen was kept in the binding 131

74 institute herbarium (Ethno 31). It was dried in shade, powdered and The assay was performed as described previously (Sheeba 132

75 sieved. 10 g of the powder was extracted with 300 ml of double dis- and Asha, 2009). Briefly RAW264.7 cells were seeded into 6 133

76 tilled water in room temperature. The decoction is then lyophilized well plates and incubated with various concentrations of CR (25, 134

77 (Model Freezone, Labconco Corporation, MO, USA) at a very low 50 and 100 ␮g/ml) for 1 h along with untreated normal control 135

78 temperature (−45 ◦ C) and pressure (30 psi). The powdery residue and DMSO control. The cells were then treated with 10 ␮g/ml 136

79 obtained was stored at −20 ◦ C and used for the experiments. of LPS for 1 h. The nuclear extract from the cells were pre- 137

pared using a high-salt detergent buffer (totex buffer). Cells 138

80 2.3. Anti-inflammatory assays were harvested by centrifugation, washed once in ice cold PBS 139

and re-suspended in four cell volumes of totex buffer. The cell 140

81 2.3.1. Cell culture lysate was incubated on ice for 30 min and then centrifuged at 141

82 Murine macrophage cell line RAW264.7 was used for the anti 13,000 rpm at 4 ◦ C for 5 min. NF-␬B oligonucleotide was labelled 142

83 inflammatory assays. The cells were cultured and maintained on using [32 P] ATP (3000 Ci/mmol). Equal amounts of protein was 143

84 DMEM with 10% fetal calf serum and 1% antibiotic–antimycotic in (10–20 ␮g) added to a reaction mixture containing 20 ␮g of bovine 144

85 a humidified atmosphere of 5% CO2 at 37 ◦ C in an incubator (Sheeba serum albumin, 2 ␮g of poly (dI-dC), 2 ␮l of buffer D, 4 ␮l of 145

86 and Asha, 2009). buffer F and 100,000 cpm (cerenkov) of [32 P] – labelled oligonu- 146

cleotide, made up to a final volume of 20 ␮l with distilled water. 147

87 2.3.2. Cytotoxicity assay Samples were incubated at room temperature for 25 min. The elec- 148

88 The cytotoxicity of the extract to RAW264.7 cells was analysed trophoresis was performed in a non-denaturant polyacrylamide 149

89 by MTT assay (Liu and Schubert, 1998; Sheeba and Asha, 2009). gel (4%) in TBE buffer at pH 8.0, which was then developed 150

90 Briefly, the cells were seeded in to 96 well culture plates and treated using a Kodak XAR-5 film (Kodak Corporation, Rochester, NY, 151

91 with different concentrations of CR (100, 200, and 300 ␮g/ml) and USA). Only active NF-␬B can bind to the DNA, therefore, disap- 152

92 Silymarin (50 ␮g/ml) for 24 and 48 h. After the treatment, the pearance of the band indicates inhibition of DNA binding by the 153

93 cells were rinsed with PBS and incubated in 5 mg/ml MTT reagent drug. 154

94 dissolved in PBS for 4 h. Cells were then permeabilized by the addi-

95 tion of SDS (10% in DMSO). The absorbance at 570 nm was read 2.4. Anticancer assays 155

96 on a microplate reader (Biorad Model 680; Bio-Rad Laboratories,

97 Hercules, CA, USA) after 10 s of vigorous machine shaking. The per- 2.4.1. Cell culture 156

98 centage of cell viability was calculated as: The hepatocellular carcinoma cell line, Hep3B was used for 157

the anticancer assays. This cell line was maintained in DMEM as 158
99 Percentage growth inhibition = 100 described above for the RAW264.7 cells. 159

100 − (mean OD of individual test group × 100)

101 2.4.2. MTT assay for the analysis of growth inhibition by the 160
Mean OD of the control: extract 161

102 Percentage cell viability = 100 − percentage inhibition Hep3B cells were seeded on to 96 well micro plates and were 162

treated with different concentrations of water extract of CR (25, 50, 163

and 100 ␮g/ml) for 24 and 48 h. The cytotoxicity was analysed and 164

103 2.3.3. PCR amplification and quantification (SQ-RT-PCR) the percentage of growth inhibition was calculated as described 165

104 The study was conducted in 6 well plates and were divided above. 166

105 into control, DMSO control, LPS control, LPS + CR (25, 50 and
106 100 ␮g/ml) treatment groups in triplicates. The normal group was 2.4.3. Visual detection of apoptosis by DAPI staining 167

107 kept untreated and DMSO was added in DMSO group. The extract The assay was performed on Hep3b cells treated with dif- 168

108 treatment groups were treated with respective doses of the CR. ferent concentration of the extracts (CR 20, 50, and 100 ␮g/ml), 169

Please cite this article in press as: Suresh, V., et al., In vitro anti-inflammatory and anti-cancer activities of Cuscuta reflexa Roxb. J. Ethnopharmacol.
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Fig. 1. (A) Expression levels of TNF–␣, COX-2 and ␤-actin in LPS inflammatory study in RAW264 cells. (B) Densitometry ratio graph of TNF-␣ and COX-2 with that of ␤-actin.
(N – untreated, D – 0.1% DMSO, L – 10 ␮g/ml of LPS, M – 100 bp marker, 25 – 25 ␮g/ml of CR, 50 – 50 ␮g/ml of CR, 100–100 ␮g/ml of CR); Tukey post hoc analysis: † values are
not significant comparing to normal; *values are significant when compared to normal P ≤ 0.05.

170 DMSO (50 ␮l/ml) and Silymarin (50 ␮g/ml) at different incuba- Germany) and the images were recorded using Leica TCS SP2 186

171 tion periods (24 h, and 48 h). Further cell staining was done as camera. 187

172 described by Song et al. (2005). The cells were then observed
173 under a fluorescence microscope (Leica Microsystems AG, Wetzlar, 2.4.5. Analysis of the expression of genes involved in apoptosis by 188
174 Germany). SQ-RT-PCR 189

The analysis was carried out as described above. The study 190

175 2.4.4. Visual detection of apoptosis by annexin V-FITC assay groups involved normal, DMSO, CR (CR 50 ␮g/ml) and the positive 191

176 This was done as described earlier (Wills and Asha, 2009). control Silymarin (50 ␮g/ml). The genes analysed were BAX, Bcl-2, 192

177 Briefly, cells treated with different concentrations of CR (100, p53 and survivin. The primer sequences and other details are given 193

178 50 and 25 ␮g/ml) or DMSO 0.1% (v/v) were washed in PBS and in Supplementary Table 1. GAPDH was used as the internal control 194

179 suspended in 1× binding buffer (500 ␮l) containing Annexin V- (base line) to normalise the samples by densitometry as previously 195

180 FITC (1.25 ␮l) and incubated for 15 min at room temperature in described. 196

181 dark. The cells were then washed with 1X binding buffer. The
182 buffer was removed and the cells were suspended in phenol red 2.5. Statistical analysis 197

183 free media for microscopic examination. The cells were exam-
184 ined under both fluorescence and differential interference contrast All values were expressed in mean ± SE (n = 6) and Tukey’s 198

185 (DIC) imaging (Leica DMIRE2, Leica Microsystems AG, Wetzlar, post hoc test was done to analyse significance of difference 199

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Fig. 2. The graphical representation of the growth inhibition by different doses of the extract in Hep3 B cells. Values are mean ± SD, n = 3. (Normal – untreated, CR25 –
25 ␮g/ml of CR, CR50 – 50 ␮g/ml of CR, CR100 – 100 ␮g/ml of CR, Sily – 50 ␮g/ml of Silymarin). Tukey post hoc analysis: *values are significant when compared to normal
P ≤ 0.05.

200 between different groups. Values with P ≤ 0.05 were considered as vast array of genes involved in inflammation and tumorigenesis 233

201 significant. (viz TNF, interleukins, COX-2, 5-LOX, etc.) are influenced by NF-␬B 234

which exists in its inactive state and gets easily activated by inflam- 235

202 3. Results and discussion matory stimuli and carcinogens (Shishodia and Aggarwal, 2004). 236

Activated NF-␬B binds to its binding motif and initiates transcrip- 237

203 3.1. Effect of the extract on RAW264.7 cell viability tion. The down regulation of TNF-␣ and COX-2 by the treatment 238

with extract could be related to inhibition of NF-␬B activation or 239

204 The cell viability analysis of CR with RAW 264.7 cells have shown binding of activated NF-␬B to its respective motif. 240

205 that concentrations of CR up to 300 ␮g have no significant cytotox-

206 icity compared to untreated control. 3.4. Effect of the extract on the proliferation of Hep3B cells 241

207 3.2. Effect of the extract on LPS-induced inflammatory responses Fig. 2 shows percentage of growth inhibition of Hep3B cells by 242

208 in RAW264.7 cells different doses of the extract. It can be noted that CR induced apo- 243

ptosis in Hep3B cells dose dependently. As explained above, the 244

209 The expression levels of various genes and its densitometry extract does not have any significant toxicity in the other cell line 245

210 analysis are given in Fig. 1. The analysis of COX-2 and TNF-␣ expres- we have used, i.e. RAW264.7, which suggests that the cytotoxicity 246

211 sion levels in different treatment groups of RAW264.7 cells has of the extract is specific to cancer cells. 247

212 shown that, LPS has induced an over expression of these genes
213 as compared to control. TNF-␣ is a cytokine that is involved in 3.5. Induction of apoptosis by the extract 248

214 systemic inflammation and has different effects on both inflam-

215 mation and cancer progression (Tracey and Cerami, 1994; Gabay 3.5.1. DAPI staining 249

216 and Kushner, 1999; Balkwill, 2002). It induces other inflammatory Supplementary Fig. 2 (see supplementary information) has 250

217 mediators and proteases that create the inflammatory response depicted the details of DAPI staining of Hep3B cells. It should be 251

218 (Aggarwal et al., 2006b). Similarly cycloxygenase has important noted that the number of cells showing signs of apoptosis (cells 252

219 role in cancer progression and also in maintaining tumorigenecity that have brightly fluoresced and fragmented nucleus) are more in 253

220 (Goulet, 2003). The COX-2 expression is controlled by TNF-␣ and extract treated groups than the control group. It is clearly evident 254

221 hence the two genes act synergistically (Subbarayan et al., 2001). that different doses of CR have induced apoptosis and DNA conden- 255

222 Treatment with CR extract has resulted in the normalization of sation in cells with varying intensity depending up on the dosage 256

223 the over expression of these two genes, indicating its efficacy in and time of exposure. 257

224 protecting the cells from acute inflammation.

3.5.2. Annexin V-FITC binding assay 258

225 3.3. Effect of the extract on the activation of NF-B in RAW264.7 Changes occur on the dynamics of phosphatidyl serine as 259

226 cells a part of early events in apoptosis. It is normally located on 260

the inner face of the cell membrane and get exposed on the 261

227 The result of NF-␬B signalling analysis is depicted in outer surface when apoptosis progresses. Annexin V is a Ca2+ 262

228 Supplementary Fig. 1. LPS treatment has activated an enhanced dependent, phospholipid binding protein with a high affinity for 263

229 binding of NF-␬B to its binding motifs (Supplementary Fig. 1, Lane phosphatidyl serine. Its detection by annexin V–FITC has shown 264

230 2) as compared to control (Lane 1) which was blocked by different that more number of cells have been stained in groups treated 265

231 doses of the extract (Lane 3–5). NF-␬B is a transcription factor which with the extract (Supplementary Fig. 3) than those belonging to 266

232 regulates many signalling pathways in inflammation and cancer. A normal and DMSO controls. This experiment further substanti- 267

Please cite this article in press as: Suresh, V., et al., In vitro anti-inflammatory and anti-cancer activities of Cuscuta reflexa Roxb. J. Ethnopharmacol.
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Fig. 3. (A) Expression levels of the various genes analysed in Hep3B cells treated with CR. (B) Its densitometry ratio with that of the internal control gene GAPDH. Values are
mean ± SD, n = 3 (N – normal or untreated, D – 0.1% DMSO, S – 50 ␮g/ml of Silymarin, Cus – 50 ␮g/ml of CR).

268 ated that the extract dose dependently induces apoptosis in Hep3B group in Fig. 3). Treatment with CR or Silymarin has resulted in the 285

269 cells. down regulation of these genes. It is over expression can inhibit the 286

activation of BAX, there by inhibiting apoptosis (Gross et al., 1998). 287

270 3.5.3. Effect of the extract on the expression of genes involved in This indicates that the extract enables BAX activation through inhi- 288

271 apoptosis bition of Bcl-2. 289

272 Fig. 3 shows the expression levels of different genes in Hep3B Similarly, high expression levels of survivin are necessary for 290

273 cells treated with CR. The graphical representations of the densito- a cancer cell to maintain its proliferative nature. Down regulation 291

274 metry ratio of different genes are shown in Fig. 3b. The expression of this gene will force the cell to undergo apoptosis (Caldas et al., 292

275 levels of BAX shows that its level is over expressed in CR treated 2005; Sah et al., 2006). The analysis of the levels of survivin on 293

276 groups. BAX (Bcl2 associated X protein) plays significant role in p53 various treatment groups showed that its level was down regulated 294

277 mediated apoptosis (Bates and Vousden, 1999). The over expres- in groups treated with water extract of CR or Silymarin (Fig. 3). By 295

278 sion of this gene is indicative of the fact that, the mechanism of reducing the survival signals like Bcl-2 and survivin, the extract as 296

279 induction of apoptosis by the extract is through activation of p53 well as Silymarin induced apoptotic cell death in cancer cells. 297

280 mediated apoptotic pathway. In accordance with the same result,

281 the expression levels of p53 on the groups treated with CR has 4. Conclusions 298

282 shown a sharp over expression compared to other groups.

283 BCl-2 is a major anti apoptotic protein and its expression levels The present investigation has clearly shown that the water 299

284 in cancer cells are generally high (as shown in control and DMSO extract of Cuscuta reflexa possesses anti-inflammatory and anti can- 300

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301 cer activities. Cell viability assay on murine macrophage cell line, Coussens, L.M., Werb, Z., 2002. Inflammation and cancer. Nature 420, 860–867. 338

302 RAW264.7 cells did not show any significant toxicity. Treatment Demma, M., Wong, S., Maxwell, E., Dasmahapatra, B., 2004. CP-31398 restores DNA- 339
binding activity to mutant p53 in vitro but does not affect p53 homologs p63 340
303 with the extract resulted in the down regulation of TNF-␣ and COX- and p73. Journal of Biological Chemistry 279, 45887–45896. 341
304 2 genes in LPS treated RAW 246.7 cells. Also, the water extract was Gabay, C., Kushner, I., 1999. Acute-phase proteins and other systemic responses to 342

305 able to block the binding of NF-␬B to its DNA binding motifs, mak- inflammation. New England Journal of Medicine 340, 448–454. 343
Goulet, A., 2003. Analysis of cyclooxygenase 2 (COX-2) expression during malignant 344
306 ing it evident that the extract down regulates TNF-␣ and COX-2 via melanoma progression. Cancer Biology and Therapy 2, 713–718. 345
307 NF-␬B inhibition. The extract induced apoptosis in Hep3B cells by Gross, A., Jockel, J., Wei, M., Korsmeyer, S., 1998. Enforced dimerization of BAX results 346
308 influencing the expression of BAX, p53, Bcl2 and survivin and also in its translocation, mitochondrial dysfunction and apoptosis. The EMBO Journal 347
17, 3878–3885. 348
309 by controlling NF-␬B signalling. With all these results, it can be
Hossan, M., Hanif, A., Khan, M., Bari, S., Jahan, R., Rahmatullah, M., 2009. Ethnob- 349
310 safely said that, the water extract of Cuscuta reflexa is a promissory otanical survey of the Tripura tribe of Bangladesh. American-Eurasian Journal of 350
311 candidate for further studies in anti-cancer drug development. Sustainable Agriculture 3, 253–261. 351
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317 ment of Biotechnology and Council for Scientific and Industrial biology of survivin. Cancer Letters 244, 164–171. 364
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319 Appendix A. Supplementary data 39–44. 368

Shishodia, S., Aggarwal, B., 2004. Nuclear factor-␬B: a friend or a foe in cancer? 369
Biochemical Pharmacology 68, 1071–1080. 370
320 Supplementary data associated with this article can be found, in Siwakoti, M., Siwakoti, S., 1999. Ethnomedicinal uses of plants among the satar tribe 371

321 the online version, at doi:10.1016/j.jep.2011.01.043. of Nepal. Journal of Economic and Taxonomic Botany 23, 103–105. 372
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Please cite this article in press as: Suresh, V., et al., In vitro anti-inflammatory and anti-cancer activities of Cuscuta reflexa Roxb. J. Ethnopharmacol.
(2011), doi:10.1016/j.jep.2011.01.043