Methanolic Extract from Aerial Parts of Artemisia Annua L. Induces Cytotoxicity and Enhances Vincristine-Induced Anticancer Effect in Pre-B Acute Lymphoblastic Leukemia Cells

Background: nowadays, remarkable attention has been drawn towards the effective therapeutic characteristic of natural products targeting cancerous cells. this study aimed to investigate the anti-cancer effect of artemisia annua extract (aae), a chinese herbal medicine alone and in combination with a microtubule binding agent used in all treatment, vincristine (vcr), in b-acute lymphoblastic leukemia (all) nalm-6 and reh cells. materials and methods: cytotoxic activity of aae and vcr was determined using mtt assay in nalm-6, and reh cell lines and synergism was evaluated using the compusyn software. caspase 3 activity and annexin/pi staining were performed for apoptosis assessment. the expression level of apoptosis-related genes, caspase 3, bax and bcl-2 were determined using real time-pcr. one-way anova and post hoc tukey multiple comparisons were used for statistical analysis.results: our findings revealed that a single administration of aae exerted an anti-leukemic effect in both all-derived cells in a time- and dose-dependent manner. interestingly, the growth inhibitory activity of the extract was more potentiated when combined with 0.1 and 1 nm vcr through caspase 3-dependent apoptosis. moreover, real-time pcr analysis showed that vcr-induced cytotoxicity was augmented by aae through alteration of bax, and bcl-2 mrna expression.conclusion: overall, owing to the nontoxic nature of aae and its explicit role in enhancing vcr effectiveness, our study provided new insight into the development of a novel combinatorial approach in all using natural herbs. the practical implication of the research requires further investigation through clinical trials, opening avenues for forthcoming treatment improvements.