Evaluating the Indigenous Probiotic Lactococcus lactis D4 as an Adjuvant to Capecitabine: Modulation of NF-κB in a Colorectal Carcinogenesis Model

Authors

  • Arli Suryawinata Department of Surgery, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  • M Iqbal Rivai Department of Surgery, Division of Digestive Surgery, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  • Rini Suswita Department of Surgery, Division of Digestive Surgery, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  • Irwan Department of Surgery, Division of Digestive Surgery, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  • Avit Suchitra Department of Surgery, Division of Digestive Surgery, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  • Raflis Rustam Department of Surgery, Division of Vascular and Endovascular Surgery, Faculty of Medicine, Universitas Andalas, Padang, Indonesia

DOI:

https://doi.org/10.37275/bsm.v10i5.1572

Keywords:

Capecitabine, Colorectal cancer, NF-κB, Lactococcus lactis D4, Tumor microenvironment

Abstract

Background: Chronic inflammation driven by the nuclear factor kappa-B (NF-κB) signaling pathway is a fundamental driver of colorectal cancer (CRC) pathogenesis, promoting tumor survival, mucosal proliferation, and profound chemoresistance. Capecitabine is a standard first-line fluoropyrimidine chemotherapy; however, its clinical utility is frequently compromised by dose-limiting toxicities and the activation of inflammatory feedback loops. Lactococcus lactis D4, a novel probiotic strain isolated from traditional Indonesian fermented buffalo milk (dadih), possesses well-documented immunomodulatory properties.  

Methods: A randomized controlled experimental study was conducted utilizing male Sprague-Dawley rats (n=37). Colorectal carcinogenesis was chemically induced via intraperitoneal administration of 1,2-dimethylhydrazine (DMH). Following strict histopathological confirmation of malignancy, the cohort was randomized into five distinct groups: Negative Control, Positive Control, L. lactis D4 monotherapy, Capecitabine monotherapy, and Combination therapy. Interventions were administered daily for 14 days. Outcomes included NF-κB protein expression assessed via immunohistochemistry (IHC) and targeted gene expression quantification via RT-qPCR.  

Results: Immunohistochemical analysis demonstrated that the positive control group exhibited significantly elevated NF-κB protein expression (35.87 ± 13.53%). Capecitabine monotherapy significantly reduced this expression to 16.07 ± 3.79% (p=0.003). The Combination therapy achieved a profound reduction in NF-κB protein expression down to 12.99 ± 4.92%; however, this was not statistically superior to Capecitabine alone (p=1.000). Conversely, RT-qPCR analysis revealed no statistically significant difference in NF-κB mRNA levels among the experimental groups (p=0.094).  

Conclusion: The combination of L. lactis D4 and Capecitabine effectively reduces NF-κB protein expression in a preclinical CRC model, achieving suppression levels comparable to primary chemotherapy. The distinct discordance between the significant protein suppression and the sustained mRNA expression levels suggests potential post-transcriptional or post-translational regulatory mechanisms that warrant further targeted molecular investigation.

Authors

  • Arli Suryawinata1*
  • M Iqbal Rivai2
  • Rini Suswita2
  • Irwan2
  • Avit Suchitra2
  • Raflis Rustam3
  1. 1Department of Surgery, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  2. 2Department of Surgery, Division of Digestive Surgery, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  3. 3Department of Surgery, Division of Vascular and Endovascular Surgery, Faculty of Medicine, Universitas Andalas, Padang, Indonesia

Corresponding author Arli Suryawinata — suryawinataarli@gmail.com

Article history

  1. Submitted
  2. Accepted
  3. Published

Downloads

Published

2026-03-03

Article metrics

184Abstract views
134PDF downloads

How to Cite

1.
Arli Suryawinata, M Iqbal Rivai, Rini Suswita, Irwan, Avit Suchitra, Raflis Rustam. Evaluating the Indigenous Probiotic Lactococcus lactis D4 as an Adjuvant to Capecitabine: Modulation of NF-κB in a Colorectal Carcinogenesis Model. Bioscmed [Internet]. 2026 Mar. 3 [cited 2026 Aug. 4];10(5):1670-87. Available from: https://bioscmed.com/index.php/bsm/article/view/1572

Most read articles by the same author(s)

<< < 1 2