三种活血法治疗大鼠慢性萎缩性胃炎癌前病变的作用机理研究
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摘要
目的:复制大鼠CAG癌前病变模型,观察益气活血法、活血化瘀法和理气活血法对大鼠慢性萎缩性胃炎(chronic atrophic gastritis,CAG)癌前病变的治疗效果,并从细胞凋亡及基因水平深入研究大鼠CAG癌前病变的发病机制和三种活血法防治大鼠CAG癌前病变的作用机理。
方法:采用幽门弹簧插入配合高盐热糊灌胃法复制CAG癌前病变模型,从大体标本和光镜病理两方面观察CAG癌前病变大鼠形态学特征,采用流式细胞术检测CAG癌前病变模型大鼠胃粘膜细胞凋亡;应用表达谱基因芯片技术筛选CAG癌前病变大鼠胃粘膜的差异表达基因。CAG癌前病变模型复制成功后,采用代表益气活血法、活血化瘀法和理气活血法的中药进行治疗,从大体标本和光镜病理两方面观察益气活血法、活血化瘀法和理气活血法对CAG癌前病变大鼠胃粘膜形态学的影响;采用流式细胞术检测益气活血法、活血化瘀法和理气活血法对CAG癌前病变大鼠胃粘膜细胞凋亡的影响。应用表达谱基因芯片技术检测益气活血法、活血化瘀法和理气活血法干预后CAG癌前病变大鼠胃粘膜基因的差异表达变化,筛选出差异表达基因,建立三种活血法干预后CAG癌前病变大鼠差异基因表达谱并进行生物信息学分析。
结果:1采用幽门弹簧插入配合高盐热糊灌胃法,于造模第24周随机抽取模型组大鼠8只进行胃粘膜光镜病理检查,其中7只出现轻-中度不典型增生,造模成功。
2流式细胞术检测CAG癌前病变模型大鼠胃粘膜细胞凋亡:CAG癌前病变模型组大鼠胃粘膜细胞早期凋亡率明显高于正常组(P＜0.01)。
3益气活血法、活血化瘀法和理气活血法对CAG癌前病变大鼠治疗12周后,大体标本观察结果显示:益气活血法、活血化瘀法对胃粘膜糜烂或溃疡、皱襞紊乱、粘膜皱襞平坦和增生结节有明显疗效,与自然恢复组比较有显著性差异(P＜0.01或P＜0.05);理气活血组也显示出一定的治疗作用,但与自然恢复组比较,无显著性差异(P＞0.05)。
4益气活血法、活血化瘀法和理气活血法对CAG癌前病变大鼠治疗12周后,光镜病理观察结果显示:益气活血法、活血化瘀法对CAG异型增生的积分有显著的降低效果,与自然恢复组比较有显著性差异(P＜0.01或P＜0.05);理气活血法对对CAG异型增生的积分有降低效果,但与自然恢复组比较无显著性差异(P＞0.05)。
5益气活血法、活血化瘀法和理气活血法对CAG癌前病变大鼠治疗12周后,流式细胞术检测结果显示:CAG癌前病变自然恢复组大鼠胃粘膜细胞早期凋亡率明显高于空白对照组(P＜0.01),益气活血法、活血化瘀法和理气活血法干预各组胃粘膜细胞早期凋亡率均有降低,其中活血化瘀组、理气活血组与自然恢复组比较早期凋亡率的降低有显著性差异(P＜0.01或P＜0.05),益气活血组显示出降低早期凋亡率的趋势,但与自然恢复组比较未见明显差异(P=0.057)。
6聚类分析的结果表明益气活血组的基因表达谱模式与模型组反差最大,提示益气活血组的治疗效果可能较好,热休克蛋白70(heat shock 70kD protein,HSP70)及其相邻的几个基因是模型组和益气活血组反差最大的区域,提示这几个基因可能是益气活血法作用机制较明确的靶标。
7应用表达谱基因芯片技术筛选CAG癌前病变大鼠的差异表达基因:CAG癌前病变大鼠胃粘膜发生显著性差异表达变化的基因有300个,其中上调基因227个,下调基因73个,差异表达基因的功能涉及到多种生物学过程及信号传递调控基因的改变,其中下调基因中包括HSP70基因。
8应用表达谱基因芯片技术检测益气活血法干预后CAG癌前病变大鼠胃粘膜基因的差异表达变化:共筛选出差异表达基因205个,其中上调基因为101个,下调基因104个,共同构成了益气活血法干预大鼠CAG癌前病变的差异表达基因谱,为从基因水平探讨益气活血法防治CAG癌前病变的作用机理提供了有益的实验依据,其中上调基因中包括HSP70基因;活血化瘀组筛选出差异表达基因23个,其中上调基因为0个,下调基因23个,理气活血组筛选出差异表达基因14个,其中上调基因为8个,下调基因6个,活血化瘀组与理气活血组差异基因功能分类特征不显著,未作进一步分析。
结论:1幽门弹簧插入配合高盐热糊灌胃能法成功复制CAG癌前病变大鼠模型,细胞凋亡增强可能是CAG癌前病变的发病机理之一。
2益气活血法和活血化瘀法对大鼠CAG癌前病变有较好的阻断和逆转作用。
3益气活血法、活血化瘀法和理气活血法对CAG癌前病变大鼠胃粘膜细胞凋亡均有抑制作用,可能是其改善或逆转大鼠CAG癌前病变的作用机理之一。
4 CAG癌前病变的发生是一个复杂的病理生理过程,受多种基因调控;差异表达基因谱的建立和研究较全面反映了CAG癌前病变发生的分子生物学概貌,有助于认识CAG癌前病变形成的机制,为进一步寻找特异性诊断和治疗基因提供了有力的实验依据。
5益气活血法对大鼠CAG癌前病变胃粘膜基因表达的影响涉及到多种生物学过程信号传递及基因调控的改变,从基因水平说明中医益气活血法对CAG癌前病变的影响是一个复杂的、多层次的、多靶点的病理生理功能调整的过程。HSP70基因可能是益气活血法防治大鼠CAG癌前病变作用机制的靶标之一,可以进一步做蛋白表达等方面的深入研究。
Objective:Gastric precancerous lesions is the potential benign lesion of gastric carcinoma. Chronic atrophic gastritis(CAG) and intestinal metaplasia (IM) or dysplasia (Dy) due to CAG are the commonest of gastric precancerous lesions. We study the feature of the pathologic picture of precancerous lesion of CAG rats replicated by methods of pylorus spring insertion and hot paste by gavage. And we observe the influence of the therapy of Supplementing Qi and Activating Blood on morphological changes of gastric mucosa in rats with precancerous lesion of CAG. Further more, we lucubrate pathogenesy of precancerous lesion of CAG rats and the pharmaco-mechanism of precancerous lesion of CAG in rats treated with Supplementing Qi and Activating Blood of TCM at apoptosis and gene level.
Methods: We replicate the rat model of precancerous lesion of CAG by methods of pylorus spring insertion and hot paste by gavage .We analysis the feature of the early apoptosis of precancerous lesion of CAG with Annexin V FITC/PI double labeled flow cytometry. The cDNA microarray consisting of 11060 clones of rat genes was used to detect and screen the differentially expressed genes in precancerous lesion of CAG rats and normal rats. The models of rats were randomly divided into five groups: the normal control group , spontaneous recovery group, Activating the blood and resolve blood stasis group, Regulate Qi and Activating the blood group, Supplementing Qi and Activating blood group. After treated with the therapies of Supplementing Qi and Activating blood , Activating the blood and resolve blood stasis and Regulate Qi and Activating the blood, we observe their influence on morphological changes of gastric mucosa in rats with precancerous lesion of CAG. At the same time we analysis all groups' apoptosis of precancerous lesion of CAG with Annexin V FITC/PI double labeled flow cytometry. One step method for extraction of total RNA of rats stomach tissue after administration by gavage of Supplementing Qi and Activating blood of TCM and the stomach tissue of the model group was used. After reverse transcription and fluorescent labeling by Cy3, Cy5, we get two groups of rats stomach cDNA probes and then hybridized with the cDNA gene expression profiles microarray hybridization. The result was scanned by the laser scanner and processed by software for image analysis, standardization, the ratio of value analysis, cluster analysis and Gene Ontology analysis . Results of gene array were authenticated by Real-Time PCR.
Results:
1 The model of precancerous lesion of CAG rats induced by pylorus spring insertion and hot paste by gavage was replicated. Pathologic picture show the rats model of precancerous lesion of CAG is convincing.
2 The ratio of the early apoptosis of the model control group increases more significantly than normal group (P<0.01).
3 In the spontaneous recovery group the result of the light microscope showed that the gastric mucosa was atrophied and thinner, the glands was getting less, the various dysplasia were occurred. After the treating of the therapies of Supplementing Qi and Activating blood and Activating the blood and resolve blood stasis the inflammation of gastric mucosa and dysplasia were all relieved or disappeared.
4 After the treatment the scores of pathomorphology in Supplementing Qi and Activating blood and Activating the blood and resolve blood stasis groups was significantly reduced than the spontaneous recovery group (P<0. 05 or P <0.01).
5 The ratio of the early apoptosis of the model control group increases more significantly than the blank control group(P<0. 01). The ratio of the early apoptosis of the groups treated by three therapies of Activating the blood and resolve blood stasis decreases, Activating the blood and Resolve blood stasis and Regulate Qi and Activating the blood groups decrease more significantly than the model control group(P<0.01). Supplementing Qi and Activating blood group show the tendency of decreasing the ratio of the early apoptosis,but it has not the significant difference comparing with the model control group (P=0.057) .
6 Totally 300 differentially expressed genes were identified in precancerous lesion of CAG rats in comparision with normal rats including 227 up-regulated genes and 73 down-regulated ones according to the designed data filter criteria. These differentially expressed genes belonged to many different functional gene families involving different biological processes.
7 By analyzing the results of three chips, we found 205 differentially expressed genes, among which, there are 101 up-regulated expression genes and 104 down-regulated expression genes. These differentially expressed genes belonged to many different functional gene families involving different biological processes.
8 Real-Time PCR authenticating results were consistent with those of micmarray study.
Conclusion:
1 The model of precancerous lesion of CAG rats induced by pylorus spring insertion and hot paste by gavage was replicated. Increasing the apoptosis may be one of the etiopathogenesis of precancerous lesion of CAG.
2 The therapies of Supplementing Qi and Activating blood and Activating the blood and resolve blood stasis may have a better interrupt and reversal effect on the precancerous lesion of CAG, such as gastric mucosa atrophy and dysplasia.
3 The therapies of Supplementing Qi and Activating blood, Activating the blood and resolve blood stasis and Regulate Qi and Activating the blood show inhibitory action on the early apoptosis of precancerous lesion of CAG rats. Restraining the apoptosis may be one of the effective mechanisms that the Activating the blood and resolve blood stasis on precancerous lesion of CAG rats reverse the gastric mucosa atrophy and dysplasia.
4 A variety of genes involved in the formation of precancerous lesion of CAG rats. The 300 differentially expressed genes comprise the differential gene expression profile of precancerous lesion of CAG rats and describe the general changes in the gene expressions in precancerous lesion of CAG rats at transcriptional level. Further analysis of the identified genes might help reveal the molecular mechanism of precancerous lesion of CAG rats.
5 These differentially expressed genes belonged to many different functional gene families involving different biological processes and gene regulations. Further analysis of the differentially expressed genes might help reveal the pharmaco-mechanism of Supplementing Qi and Activating blood of TCM at genic level.
方法:采用幽门弹簧插入配合高盐热糊灌胃法复制CAG癌前病变模型,从大体标本和光镜病理两方面观察CAG癌前病变大鼠形态学特征,采用流式细胞术检测CAG癌前病变模型大鼠胃粘膜细胞凋亡;应用表达谱基因芯片技术筛选CAG癌前病变大鼠胃粘膜的差异表达基因。CAG癌前病变模型复制成功后,采用代表益气活血法、活血化瘀法和理气活血法的中药进行治疗,从大体标本和光镜病理两方面观察益气活血法、活血化瘀法和理气活血法对CAG癌前病变大鼠胃粘膜形态学的影响;采用流式细胞术检测益气活血法、活血化瘀法和理气活血法对CAG癌前病变大鼠胃粘膜细胞凋亡的影响。应用表达谱基因芯片技术检测益气活血法、活血化瘀法和理气活血法干预后CAG癌前病变大鼠胃粘膜基因的差异表达变化,筛选出差异表达基因,建立三种活血法干预后CAG癌前病变大鼠差异基因表达谱并进行生物信息学分析。
结果:1采用幽门弹簧插入配合高盐热糊灌胃法,于造模第24周随机抽取模型组大鼠8只进行胃粘膜光镜病理检查,其中7只出现轻-中度不典型增生,造模成功。
2流式细胞术检测CAG癌前病变模型大鼠胃粘膜细胞凋亡:CAG癌前病变模型组大鼠胃粘膜细胞早期凋亡率明显高于正常组(P＜0.01)。
3益气活血法、活血化瘀法和理气活血法对CAG癌前病变大鼠治疗12周后,大体标本观察结果显示:益气活血法、活血化瘀法对胃粘膜糜烂或溃疡、皱襞紊乱、粘膜皱襞平坦和增生结节有明显疗效,与自然恢复组比较有显著性差异(P＜0.01或P＜0.05);理气活血组也显示出一定的治疗作用,但与自然恢复组比较,无显著性差异(P＞0.05)。
4益气活血法、活血化瘀法和理气活血法对CAG癌前病变大鼠治疗12周后,光镜病理观察结果显示:益气活血法、活血化瘀法对CAG异型增生的积分有显著的降低效果,与自然恢复组比较有显著性差异(P＜0.01或P＜0.05);理气活血法对对CAG异型增生的积分有降低效果,但与自然恢复组比较无显著性差异(P＞0.05)。
5益气活血法、活血化瘀法和理气活血法对CAG癌前病变大鼠治疗12周后,流式细胞术检测结果显示:CAG癌前病变自然恢复组大鼠胃粘膜细胞早期凋亡率明显高于空白对照组(P＜0.01),益气活血法、活血化瘀法和理气活血法干预各组胃粘膜细胞早期凋亡率均有降低,其中活血化瘀组、理气活血组与自然恢复组比较早期凋亡率的降低有显著性差异(P＜0.01或P＜0.05),益气活血组显示出降低早期凋亡率的趋势,但与自然恢复组比较未见明显差异(P=0.057)。
6聚类分析的结果表明益气活血组的基因表达谱模式与模型组反差最大,提示益气活血组的治疗效果可能较好,热休克蛋白70(heat shock 70kD protein,HSP70)及其相邻的几个基因是模型组和益气活血组反差最大的区域,提示这几个基因可能是益气活血法作用机制较明确的靶标。
7应用表达谱基因芯片技术筛选CAG癌前病变大鼠的差异表达基因:CAG癌前病变大鼠胃粘膜发生显著性差异表达变化的基因有300个,其中上调基因227个,下调基因73个,差异表达基因的功能涉及到多种生物学过程及信号传递调控基因的改变,其中下调基因中包括HSP70基因。
8应用表达谱基因芯片技术检测益气活血法干预后CAG癌前病变大鼠胃粘膜基因的差异表达变化:共筛选出差异表达基因205个,其中上调基因为101个,下调基因104个,共同构成了益气活血法干预大鼠CAG癌前病变的差异表达基因谱,为从基因水平探讨益气活血法防治CAG癌前病变的作用机理提供了有益的实验依据,其中上调基因中包括HSP70基因;活血化瘀组筛选出差异表达基因23个,其中上调基因为0个,下调基因23个,理气活血组筛选出差异表达基因14个,其中上调基因为8个,下调基因6个,活血化瘀组与理气活血组差异基因功能分类特征不显著,未作进一步分析。
结论:1幽门弹簧插入配合高盐热糊灌胃能法成功复制CAG癌前病变大鼠模型,细胞凋亡增强可能是CAG癌前病变的发病机理之一。
2益气活血法和活血化瘀法对大鼠CAG癌前病变有较好的阻断和逆转作用。
3益气活血法、活血化瘀法和理气活血法对CAG癌前病变大鼠胃粘膜细胞凋亡均有抑制作用,可能是其改善或逆转大鼠CAG癌前病变的作用机理之一。
4 CAG癌前病变的发生是一个复杂的病理生理过程,受多种基因调控;差异表达基因谱的建立和研究较全面反映了CAG癌前病变发生的分子生物学概貌,有助于认识CAG癌前病变形成的机制,为进一步寻找特异性诊断和治疗基因提供了有力的实验依据。
5益气活血法对大鼠CAG癌前病变胃粘膜基因表达的影响涉及到多种生物学过程信号传递及基因调控的改变,从基因水平说明中医益气活血法对CAG癌前病变的影响是一个复杂的、多层次的、多靶点的病理生理功能调整的过程。HSP70基因可能是益气活血法防治大鼠CAG癌前病变作用机制的靶标之一,可以进一步做蛋白表达等方面的深入研究。
Objective:Gastric precancerous lesions is the potential benign lesion of gastric carcinoma. Chronic atrophic gastritis(CAG) and intestinal metaplasia (IM) or dysplasia (Dy) due to CAG are the commonest of gastric precancerous lesions. We study the feature of the pathologic picture of precancerous lesion of CAG rats replicated by methods of pylorus spring insertion and hot paste by gavage. And we observe the influence of the therapy of Supplementing Qi and Activating Blood on morphological changes of gastric mucosa in rats with precancerous lesion of CAG. Further more, we lucubrate pathogenesy of precancerous lesion of CAG rats and the pharmaco-mechanism of precancerous lesion of CAG in rats treated with Supplementing Qi and Activating Blood of TCM at apoptosis and gene level.
Methods: We replicate the rat model of precancerous lesion of CAG by methods of pylorus spring insertion and hot paste by gavage .We analysis the feature of the early apoptosis of precancerous lesion of CAG with Annexin V FITC/PI double labeled flow cytometry. The cDNA microarray consisting of 11060 clones of rat genes was used to detect and screen the differentially expressed genes in precancerous lesion of CAG rats and normal rats. The models of rats were randomly divided into five groups: the normal control group , spontaneous recovery group, Activating the blood and resolve blood stasis group, Regulate Qi and Activating the blood group, Supplementing Qi and Activating blood group. After treated with the therapies of Supplementing Qi and Activating blood , Activating the blood and resolve blood stasis and Regulate Qi and Activating the blood, we observe their influence on morphological changes of gastric mucosa in rats with precancerous lesion of CAG. At the same time we analysis all groups' apoptosis of precancerous lesion of CAG with Annexin V FITC/PI double labeled flow cytometry. One step method for extraction of total RNA of rats stomach tissue after administration by gavage of Supplementing Qi and Activating blood of TCM and the stomach tissue of the model group was used. After reverse transcription and fluorescent labeling by Cy3, Cy5, we get two groups of rats stomach cDNA probes and then hybridized with the cDNA gene expression profiles microarray hybridization. The result was scanned by the laser scanner and processed by software for image analysis, standardization, the ratio of value analysis, cluster analysis and Gene Ontology analysis . Results of gene array were authenticated by Real-Time PCR.
Results:
1 The model of precancerous lesion of CAG rats induced by pylorus spring insertion and hot paste by gavage was replicated. Pathologic picture show the rats model of precancerous lesion of CAG is convincing.
2 The ratio of the early apoptosis of the model control group increases more significantly than normal group (P<0.01).
3 In the spontaneous recovery group the result of the light microscope showed that the gastric mucosa was atrophied and thinner, the glands was getting less, the various dysplasia were occurred. After the treating of the therapies of Supplementing Qi and Activating blood and Activating the blood and resolve blood stasis the inflammation of gastric mucosa and dysplasia were all relieved or disappeared.
4 After the treatment the scores of pathomorphology in Supplementing Qi and Activating blood and Activating the blood and resolve blood stasis groups was significantly reduced than the spontaneous recovery group (P<0. 05 or P <0.01).
5 The ratio of the early apoptosis of the model control group increases more significantly than the blank control group(P<0. 01). The ratio of the early apoptosis of the groups treated by three therapies of Activating the blood and resolve blood stasis decreases, Activating the blood and Resolve blood stasis and Regulate Qi and Activating the blood groups decrease more significantly than the model control group(P<0.01). Supplementing Qi and Activating blood group show the tendency of decreasing the ratio of the early apoptosis,but it has not the significant difference comparing with the model control group (P=0.057) .
6 Totally 300 differentially expressed genes were identified in precancerous lesion of CAG rats in comparision with normal rats including 227 up-regulated genes and 73 down-regulated ones according to the designed data filter criteria. These differentially expressed genes belonged to many different functional gene families involving different biological processes.
7 By analyzing the results of three chips, we found 205 differentially expressed genes, among which, there are 101 up-regulated expression genes and 104 down-regulated expression genes. These differentially expressed genes belonged to many different functional gene families involving different biological processes.
8 Real-Time PCR authenticating results were consistent with those of micmarray study.
Conclusion:
1 The model of precancerous lesion of CAG rats induced by pylorus spring insertion and hot paste by gavage was replicated. Increasing the apoptosis may be one of the etiopathogenesis of precancerous lesion of CAG.
2 The therapies of Supplementing Qi and Activating blood and Activating the blood and resolve blood stasis may have a better interrupt and reversal effect on the precancerous lesion of CAG, such as gastric mucosa atrophy and dysplasia.
3 The therapies of Supplementing Qi and Activating blood, Activating the blood and resolve blood stasis and Regulate Qi and Activating the blood show inhibitory action on the early apoptosis of precancerous lesion of CAG rats. Restraining the apoptosis may be one of the effective mechanisms that the Activating the blood and resolve blood stasis on precancerous lesion of CAG rats reverse the gastric mucosa atrophy and dysplasia.
4 A variety of genes involved in the formation of precancerous lesion of CAG rats. The 300 differentially expressed genes comprise the differential gene expression profile of precancerous lesion of CAG rats and describe the general changes in the gene expressions in precancerous lesion of CAG rats at transcriptional level. Further analysis of the identified genes might help reveal the molecular mechanism of precancerous lesion of CAG rats.
5 These differentially expressed genes belonged to many different functional gene families involving different biological processes and gene regulations. Further analysis of the differentially expressed genes might help reveal the pharmaco-mechanism of Supplementing Qi and Activating blood of TCM at genic level.
引文
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