沙利度胺联合白芍总苷治疗白塞病黏膜损害的疗效及其对TLR2、TLR4mRNA的影响
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摘要
目的:探讨沙利度胺联合白芍总苷对老年人白塞病黏膜损害的疗效及对血MDMs中TLR2、TLR 4m R NA的影响。方法:收集42例白塞病患者,入组条件:临床诊断白塞病,年龄≥60岁,不累及重要内脏器官的损害;予沙利度胺50mg 1/晚联合白芍总苷0.6g/次,3/日,疗程6周,观察治疗效果并采用R T-PCR检测治疗前后TLR 2、TLR 4m R NA变化。结果:42例完全缓解(在治疗期间无口腔及外生殖器溃疡),治疗后BD患者MDMs中TLR2和TLR4 m RNA表达水平较治疗前显著下降(P<0.05)。结论:沙利度胺联合白芍总苷对老年人白塞病的黏膜损害治疗有效,可能通过调节TLR2、TLR4m RNA的表达达到治疗白塞病的作用。
Objective: To assess the efficacy and determine the possible mechanism of thalidomide combined with total paeony glucosides in the treatment of mucocutaneous lesions of Beh觭et disease(BD) in elderly patients and the effect on TLR2 and TLR4 mRNA in blood MDMs. Methods: Totally fourty-two patients aged ≥60 years with BD were collected.Clinical characteristics and mucocutaneous lesions without vital visceral organ involvement in patients were summarized.Thalidomide(50 mg, qn) combined with total paeony glucosides(0.6 g,tid) was given for 6 weeks. The therapeutic effects were evaluated and the changes of TLR2, TLR4 mRNA before and after treatment were detected by RT-PCR. Results: A complete remission was achieved(sustained absence of any oral and genital ulceration during the treatment) in 42 patients.The levels of TLR2 mRNA and TLR4 mRNA were significantly decreased after treatment(P<0.05). Conclusion: Thalidomide combined with total paeony glucosides are effective for treating oral and genital ulcers of elderly patients with BD. The treatment mechanism may be regulation of the levels of TLR2 mRNA and TLR4 mRNA.
Objective: To assess the efficacy and determine the possible mechanism of thalidomide combined with total paeony glucosides in the treatment of mucocutaneous lesions of Beh觭et disease(BD) in elderly patients and the effect on TLR2 and TLR4 mRNA in blood MDMs. Methods: Totally fourty-two patients aged ≥60 years with BD were collected.Clinical characteristics and mucocutaneous lesions without vital visceral organ involvement in patients were summarized.Thalidomide(50 mg, qn) combined with total paeony glucosides(0.6 g,tid) was given for 6 weeks. The therapeutic effects were evaluated and the changes of TLR2, TLR4 mRNA before and after treatment were detected by RT-PCR. Results: A complete remission was achieved(sustained absence of any oral and genital ulceration during the treatment) in 42 patients.The levels of TLR2 mRNA and TLR4 mRNA were significantly decreased after treatment(P<0.05). Conclusion: Thalidomide combined with total paeony glucosides are effective for treating oral and genital ulcers of elderly patients with BD. The treatment mechanism may be regulation of the levels of TLR2 mRNA and TLR4 mRNA.
引文
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[8]Luo J,Jin DE,Yang GY,et al.Total glucosides of paeony for rheumatoid arthritis:A systematic review of randomized controlled trials[J].Complement Ther Med,2017,34:46-56
[9]郑琳颖,潘竞锵,杨以琳,等.白芍总苷下调果糖-高脂诱导大鼠非酒精性脂肪性肝病ERK1/2,TLR4和TLR9蛋白表达的作用[J].中国药学杂志,2014,49(24):2168-2172
[10]陈薇薇,苏晓,沈丕安.沈氏生地芩连土茯苓汤联合沙利度胺治疗白塞病的临床观察[J].上海中医药杂志,2018,52(3):51-54
[11]刘晓丹,金建秋,韩莹,等.350例口腔黏膜病患者龋患及其增龄改变的病例对照研究[J].中华老年口腔医学杂志,2017,15(4):213-220
[2]Reynold N.Vasculitis in Behcet's syndrome:evidence-based review[J].Curr Opin Reumatol,2008,20(2):347-352
[3]Nara K,Kurokawa MS,Chiba S,et al.Involvement of innate immunity in the path ogenesis of intestinal Behcet's disease[J].Clin Exp Immunol,2008,152:245-251
[4]Choi B,Lee ES,Sohn S.Vitamin D3 ameliorates herpes simplex virus-induced Behcet's disease-like inflammation in a mouse model through down-regulation of Toll-like receptors[J].Clin Exp Rheumatol,2011,29:S13-19
[5]Keino H,Watanabe T,Taki W,et al.Effect of infliximab on gene expression profiling in Behcet's disease[J].Invest Ophthalmol Vis Sci,2011,52:7681-7686
[6]Lopalco G,Rigante D,Venerito V,et al.Update on the Medical Management of Gastrointestinal Behcet's Disease[J].Mediators Inflamm,2017,2017:1460491
[7]Hamuryudan V,Mat C,Saip S,et al.Th alidomide in the treatment of the mucocutaneous lesions of the Behcet's syndrome.A randomized,double-blind,placebo-controlled trial[J].Ann Intern Med,1998,128(6):443-450
[8]Luo J,Jin DE,Yang GY,et al.Total glucosides of paeony for rheumatoid arthritis:A systematic review of randomized controlled trials[J].Complement Ther Med,2017,34:46-56
[9]郑琳颖,潘竞锵,杨以琳,等.白芍总苷下调果糖-高脂诱导大鼠非酒精性脂肪性肝病ERK1/2,TLR4和TLR9蛋白表达的作用[J].中国药学杂志,2014,49(24):2168-2172
[10]陈薇薇,苏晓,沈丕安.沈氏生地芩连土茯苓汤联合沙利度胺治疗白塞病的临床观察[J].上海中医药杂志,2018,52(3):51-54
[11]刘晓丹,金建秋,韩莹,等.350例口腔黏膜病患者龋患及其增龄改变的病例对照研究[J].中华老年口腔医学杂志,2017,15(4):213-220