Metformin Attenuates Radiation-Induced Pulmonary Fibrosis in a Murine Model.

While radiotherapy continues to be a major cancer treatment option, its dose-limiting side effects, such as pulmonary fibrosis, severely impair the quality of life in these patients. In this study, we evaluated the radioprotective effects of metformin, a commonly used biguanide antidiabetic medication, in a murine model of pulmonary damage. Sprague Dawley® rats received whole lung 20 Gy irradiation with or without metformin treatment. Computed tomography (CT) was performed and Hounsfield units (HU) were determined during the observation period. Histological analysis and evaluation of fibrosis/inflammatory markers by Western blot were performed at 12 weeks postirradiation. CCK-8 and colony formation assays were used to explore the effects of metformin on non-small cell lung cancer cells A549 and H460. Results of this study showed that metformin reduced radiological and histological signs of fibrosis, inflammatory infiltration, alterations to alveolar structures and radiation-induced HU lung density. In addition, metformin was found to significantly decrease collagen 1a and TGF-β expression and inhibit p-Smad2 and p-Smad3 expression compared to that of the irradiated group alone. Moreover, metformin reduced A549 and H460 cell growth and clonogenic survival. In conclusion, metformin exerted a protective effect on normal tissues from radiation-induced pulmonary injury, and shows promise as a radioprotective agent in the treatment of lung cancer.