Therapeutic Effect of

Background: Chemotherapy-induced diarrhea (CID), particularly delayed diarrhea, often limits clinical use. Methods: Gas chromatography-mass spectrometry (GC-MS) was employed to explore the components of BJOE. Macro-observation, histology, PCR, immunohistochemistry, and Western blotting were performed to illuminate the potential mechanism of BJOE on irinotecan-induced delayed diarrhea mice model. Results: GC-MS analysis identified linoleic acid (20.67%) as BJOE's main component. BJOE effectively mitigated irinotecan-induced delayed diarrhea in mice, as characterized by attenuation of weight loss, colon shortening, hematochezia, and histopathologic damage. It significantly inhibited the mRNA expression levels of inflammatory mediators TNF-α, IL-1β, IL-6, and iNOS, and upregulated barrier gene expression (ZO-1 and occludin). Furthermore, BJOE markedly enhanced mucin production, and increased PCNA protein expression. Concurrently, BJOE remarkably down-regulated the colonic mRNA levels of cGAS, STING, CXCL10, CCL5, and IFN-β. Activation of the cGAS-STING pathway with agonist DMXAA significantly reduced BJOE's therapeutic, anti-inflammatory, and barrier-protective effects. Similarly, stimulating STING substantially reversed BJOE's inhibition on cGAS-STING pathway. Conclusion: BJOE effectively mitigated inflammation and preserved intestinal barrier function, at least partially, via inhibiting cGAS-STING pathway in irinotecan-induced delayed diarrhea. Active components, long-term safety and pharmacokinetics studies were warranted to facilitate translational application.