Grape seed extract protects IEC-6 cells from chemotherapy-induced cytotoxicity and improves parameters of small intestinal mucositis in rats with experimentally-induced mucositis

Mucositis is a common side-effect of high-dose chemotherapy regimens. Grape seed extract (GSE) represents a rich source of proanthocyanidins with the potential to decrease oxidative damage and inflammation within the gastrointestinal tract. We evaluated GSE for its capacity to decrease the severity of chemotherapy-induced mucositis in vitro and in vivo. In vitro: GSE was administered to IEC-6 intestinal epithelial cells prior to damage induced by 5-Fluorouracil (5-FU). Cell viability was determined by neutral red assay. In vivo: Female Dark Agouti rats (130-180g) were gavaged with 1ml GSE (400mg/kg) daily (day 3-11) and received 5-FU (150mg/kg) by intraperitoneal (i.p.) injection on day 9 to induce mucositis. Rats were sacrificed at day 12 and intestinal tissues collected for myeloperoxidase and sucrase activity assays and histological analyses. Statistical analysis was performed by one-way ANOVA. GSE prevented the decrease in IEC-6 cell viability induced by 5-FU (p<0.01). Compared with 5-FU controls, GSE significantly reduced myeloperoxidase activity by 86% and 27% in the proximal jejunum (p<0.001) and distal ileum (p<0.05) respectively; decreased qualitative histological scores of damage (p<0.05) in the proximal jejunum; increased villus height in the proximal jejunum (17%; p<0.05) and distal ileum (50%; p<0.01), and attenuated the 5-FU-induced reduction of mucosal thickness by 16% in the jejunum (p<0.05) and 45% in the ileum (p