In vitro (a & c) and ex vivo (b) effects of berbamine (BER) and sera from BER-fed rabbits on the growth of human lung cancer A549 cells and the anticancer activity of anticancer agents against A549 growth. The cells were treated for 24, 48, and 72 h with BER at the concentrations indicated (a) or the sera taken from rabbits (n = 6 for each group at different time points) at 0 (as the control group), 1, 2 and 3 h after oral administration of BER in rabbits (b), respectively. (c) In vitro effects of BER on the anticancer activity of anticancer agents against A549 cell growth. The cells were treated for 48 h with BER at 10–80 μM (BER10, BER20, BER40, BER80) in the absence or presence of the anticancer agents trichostatin A (TSA) at 10 and 20 μg/L (TSA10, TSA20, the histone deacetylase inhibitor) and celecoxib at 10 and 20 μM (S10, S20, the inhibitor of cyclooxygenase-2). The effects on the A549 cell growth were examined by the MTT assay in vitro and ex vivo as described in the section of “Materials and methods”. The data are presented as the mean ± SD (Bar) for each group (n = 6). The figures (a, b and c) are the representative of 3 similar experiments performed. Statistical analysis was carried out using the ANOVA and Bonferroni test. * p < 0.05, ** p < 0.01. Values with different letters (a–e) differ significantly (p < 0.05). c/s, d/s and e/s represent the significant synergistic effects (p < 0.05) compared with the treatment with its individual compound alone. Statistically significant synergistic effects on the growth were observed in A549 cells treated with B10+TSA10, B20+TSA10, B10+TSA20, B20+TSA20, B10+S10, B20+S10, or B20+S20 compared with the individual B10, B20, TSA10, TSA20, S10, and/or S20 treatment alone (c/s: B10+TSA10, p < 0.001, two-way ANOVA; d/s: B20+TSA10, p < 0.001, two-way ANOVA; d/s: B10+S10, p < 0.001, two-way ANOVA; d/s: B20+S10, p < 0.001, two-way ANOVA; d/s: B20+S20, p < 0.001, two-way ANOVA; e/s: B10+TSA20 p < 0.001, two-way ANOVA; e/s: B20+TSA20, p < 0.0001, two-way ANOVA)