Abstract:Objective To investigate the effects of artesunate (ART) on the reverse of colon cancer cell resistance to 5-fluorouracil by mediating ferroptosis.Methods The inhibitory effects of 5-FU, ART and 5-FU+ART on HT-29/5-FU cells were detected by MTS, and the drug resistance index were calculated. The clone formation ability of HT-29/5-FU cells was detected by clone formation assay. The level of reactive oxygen species (ROS) was detected by flow cytometry. The level of malondialdehyde (MDA) was detected by MDA kit. The protein expression levels of Nrf2 and GPX4 were detected by Western blotting.Results 40 μmol·L-1 ART could reverse the cell resistance to 5-FU, and the resistance index was 2.9. 5-FU combined with ART could inhibit the clone formation ability of HT-29/5-FU cells, and increase the intracellular ROS and MDA levels, and decrease the protein expression levels of Nrf2 and GPX4. These effects could be reversed by ferroptosis inhibitor ferrostatin-1.Conclusion ART could reverse the resistance of HT-29/5-FU cells to 5-FU by inhibiting the expression of Nrf2 and GPx4 and inducing ferroptosis.