α­Phellandrene enhances the apoptosis of HT­29 cells induced by 5­fluorouracil by modulating the mitochondria­dependent pathway.

α­Phellandrene (α­PA), a natural constituent of herbs, inhibits cancer cell viability and proliferation. 5­Fluorouracil (5­FU) is a frequently utilized chemotherapeutic medicine for the treatment of colon cancer, which works by triggering cancer cell apoptosis. The present study examined how the combination of α­PA and 5­FU affects the suppression of human colon cancer cells by promoting apoptosis. The impact of this treatment on cell viability, apoptosis, and the expression levels of Bcl­2 family members, caspase family members and mitochondria­related molecules in HT­29 cells was assessed by the MTT assay, immunocytochemistry, western blotting and quantitative PCR. The combination of 5­FU and α­PA had a synergistic inhibitory effect on cell viability, as determined by assessing the combination index value. Bax protein expression levels were higher in the 50, 100 or 250 µM α­PA combined with 5­FU groups compared with those in the 5­FU alone group (P<0.05). By contrast, Bcl­2 protein expression levels and mitochondrial membrane potential (MMP, ΔΨm) were lower in the 100 or 250 µM α­PA combined with 5­FU groups than those in the 5­FU alone group (P<0.05). In addition, hexokinase­2 (HK­2) protein expression levels were lower in the 50, 100 or 250 µM α­PA combined with 5­FU groups than those in the 5­FU alone group (P<0.05). Compared with 5­FU alone, after HT­29 cells were treated with 50, 100 or 250 µM α­PA combined with 5­FU, the mRNA expression levels of extrinsic­induced apoptotic molecules, including caspase­8 and Bid, were higher (P<0.05). Treatment with 50, 100 or 250 µM α­PA combined with 5­FU also increased the mRNA expression levels of cytochrome c, caspase­9 and caspase­3, regulating intrinsic apoptosis (P<0.05). These results showed that α­PA and 5­FU had a synergistic effect on reducing the viability of human colon cancer HT­29 cells by inducing extrinsic and intrinsic apoptosis pathways. The mechanism by which apoptosis is induced may involve the intrinsic apoptosis pathway that activates the mitochondria­dependent pathway, including regulating the expression levels of Bcl­2 family members, including Bax, Bcl­2 and Bid, regulating MMP and HK­2 expression levels, and increasing the expression of caspase cascade molecules, including caspase­9 and caspase­3. In addition, it may involve the extrinsic apoptosis pathway that activates caspase­8 and caspase­3 leading to apoptosis.