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A Caco-2 and Bifidobacterium bifidum co-culture model to assess lapatinib’s effects on intestinal microbiota and cell viability

Nur Syafina Hisham 1
Wan Nor I’zzah Wan Mohamad Zain 1, * ORCID logo
Nur Ain Najiha Ridzuan 2 ORCID logo
Narimah Abdul Hamid Hasani 1 ORCID logo
Hassanain Al-Talib 1 ORCID logo
  1. Faculty of Medicine, Universiti Teknologi MARA, Sg Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia
  2. National Public Health Laboratory Sungai Buloh Lot 1853, Kampung Melayu 47000 Sungai Buloh, Selangor Malaysia
Correspondence to: Wan Nor I’zzah Wan Mohamad Zain, Faculty of Medicine, Universiti Teknologi MARA, Sg Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia. ORCID: https://orcid.org/0000-0002-4761-2472. Email: [email protected].
Volume & Issue: Vol. 12 No. 12 (2025) | Page No.: 8100-8112 | DOI: 10.15419/87e7y739
Published: 2025-12-31

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This article is published with open access by BioMedPress. This article is distributed under the terms of the Creative Commons Attribution License (CC-BY 4.0) which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. 

Abstract

Background: Lapatinib (LAP), a tyrosine kinase inhibitor (TKI) used to treat ErbB2-overexpressing breast cancer, is frequently associated with diarrhoea reported in 58–78 % of patients. Decreased Bifidobacterium spp. levels in TKI-treated patients have been observed, suggesting a link between LAP and gut microbiota alterations, but the underlying interactions remain unclear. The present study established a Caco-2/Bifidobacterium bifidum (BB) co-culture model to examine the effects of LAP on intestinal epithelial cell viability, bacterial viability, and bacterial adhesion.

Methods: BB morphology was confirmed by Gram staining and scanning electron microscopy. Caco-2 cells, representing the intestinal epithelium, were co-cultured with BB at different bacterial concentrations and treated with LAP. Caco-2 cell viability was assessed using an MTS assay; BB viability was determined with a bacterial viability assay, while bacterial adhesion was quantified by recovering adhered BB following LAP treatment and enumerating colony-forming units (CFU).

Results: LAP reduced Caco-2 cell viability at all bacterial concentrations, although differences were not statistically significant (p > 0.05). Although not statistically significant, a higher BB concentration (1 × 10^8 CFU/mL) was associated with slightly greater cell viability (86.60 % ± 2.73). While LAP initially decreased BB viability, bacterial proliferation subsequently increased, reaching 115.66 % ± 6.25 by 96 hours. A high number of viable, adhered BB was recovered from Caco-2 cells even after LAP treatment, indicating that bacterial-host interactions persisted despite drug exposure.

Conclusions: LAP suppresses epithelial cell viability and transiently reduces BB growth, but BB rapidly recovers and maintains adhesion to Caco-2 cells. LAP may induce epithelial stress that modifies surface properties, thereby favouring adhesion without preserving barrier integrity. Further studies assessing tight-junction proteins and permeability are needed to confirm whether BB adhesion mitigates LAP-induced epithelial disruption.

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