In October 2024, the team of Associate Professor Ming Li from the School of Radiation Medicine and Protection, Soochow University, and Professor Ye Tian from The Second Affiliated Hospital of Soochow University collaborated to publish a research paper online in the journal *Radiother Oncol* (commonly known as "Green Journal", Impact Factor: 4.9) entitled "EGCG protects intestines of mice and pelvic cancer patients against radiation injury via the gut microbiota/D-tagatose/AMPK axis" (DOI: 10.1016/j.radonc.2024.110608).
Radiotherapy plays a crucial role in the treatment of pelvic malignancies; however, radiation-induced intestinal injury (RIII) severely hinders its clinical application, and there is currently a lack of effective clinical strategies to conquer RIII. Epigallocatechin Gallate (EGCG), the main component of tea polyphenols, exhibits multiple biological functions such as antiviral, antioxidant, and antitumor activities. Previous work by the research team has shown that EGCG pretreatment can significantly prolong the survival time of mice exposed to lethal-dose irradiation, alleviate intestinal structural damage in mice, and promote intestinal regeneration. To explore the clinical feasibility of EGCG in protecting against RIII, the research team conducted a prospective clinical trial in this study, where patients undergoing pelvic radiotherapy were given EGCG orally. The results demonstrated that EGCG significantly reduced the severity of RIII in patients, decreased the number of moderate-to-severe cases, and improved patients' quality of life during radiotherapy. In terms of mechanism exploration, using techniques such as 16S rRNA sequencing and metabolomic analysis, the research team found that EGCG can regulate the gut microbiota and enrich the metabolite D-tagatose. D-tagatose can activate the AMPK signaling pathway to exert intestinal protective effects. This study comprehensively reveals the protective effect and mechanism of EGCG against RIII at both the animal and human levels for the first time. EGCG is expected to become a safe and effective protective agent against radiation-induced intestinal injury. This achievement provides a novel strategy and potential drug for the clinical prevention and treatment of RIII, and is of great significance for improving the quality of life of patients undergoing radiotherapy for pelvic tumors and enhancing the efficacy of radiotherapy.
Figure 1. Schematic diagram of the mechanism by which EGCG protects the intestine against radiation injury.
Master's candidate Haiyan Lu, Ph.D. candidate Liwei Xie, and Chief Physician Liangsheng Guo from The Second Affiliated Hospital of Soochow University are the co-first authors of this paper. Associate Professor Ming Li from the School of Radiation Medicine and Protection, Soochow University, Professor Ye Tian, and Associate Chief Physician Shang Cai from The Second Affiliated Hospital of Soochow University are the co-corresponding authors. This research work was supported by the National Natural Science Foundation of China, the Jiangsu Provincial Science and Technology Program, and other funding sources.