三叶人字草对IgA肾病的治疗作用及其机制研究
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摘要
目的:
     通过复制IgA肾病小鼠模型,观察邓老验方中三叶人字草对IgA肾病模型小鼠肾皮质血小板衍化生长因子(PDGF-B)及其mRNA表达的影响,测定IgA肾病模型小鼠血清中肌酐(SCR)、尿素氮(BUN)、一氧化氮(NO)水平,探讨其治疗IgA肾病的作用机理,并对三叶人字草治疗IgA肾病的相关药效学实验进行探索,观察其对免疫系统、血压、血液功能、肠胃功能四个方面的影响。为临床治疗IgA肾病提供实验研究依据,提升中医药在此领域的研究水平,为探索中医药高效低毒治疗方案提供新思路。
     方法:
     采用牛血清白蛋白(BSA)、葡萄球菌肠毒素B (SEB)成功复制IgA肾病小鼠模型,通过观察对模型小鼠的一般情况、测定蛋白尿、血尿量及血清中SCR, BUN、NO水平;半定量RT-PCR测定IgA肾病小鼠肾皮质PDGF-B、PDGFR-B mRNA的表达;并观察其肾脏病理组织切片,考察三叶人字草IgA肾病模型小鼠的作用机制。
     采用碳粒廓清法,考察人字草对小鼠免疫系统的影响;采用大鼠灌服三叶人字草提取液,考察其对血压的影响;采用玻片法、毛细管法,考察三叶人字对小鼠凝血、出血时间以及其对血小板聚集等影响;采用半固体灌胃法,考察三叶人字草对小鼠胃肠功能的作用,探讨其治疗IgA肾病的相关药效学作用。
     以上实验的供试药品三叶人字草水提液采用正交试验法,以总黄酮含量为指标,考察不同影响因素和水平对提取工艺条件的影响,筛选出最优工艺。
     结果:
     (1)三叶人字草对IgA肾病模型小鼠的药理作用及机制:
     三叶人字草作用于IgA肾病小鼠后,能明显改善模型小鼠的生活状态,减轻IgA肾病模型小鼠的蛋白尿尿血量,三叶人字草高剂量组(12.34 g/kg)能降低IgA肾病小鼠血清中SCR、BUN含量,提高IgA肾病小鼠全血中NO活力(P<0.05),能降低模型小鼠肾组织PDGF-B、PDGFR-B mRNA的表达。IgA肾病模型小鼠PDGF-B、PDGFR-B基因RT-PCR产物进行琼脂糖凝胶电泳结果显示:各组均在193bp处可见PDGF-B mRNA的表达,相比模型组,各组条带逐渐变暗,半定量分析提示三叶人字草高剂量组PDGF-B mRNA的表达下降26.8%,与模型组相比,具有显著性差异(P<0.05);各组均在206bp处可见PDGFR-B mRNA的表达,相比模型组,各组条带逐渐变暗,半定量分析提示三叶人字草高剂量组PDGF-B mRNA的表达下降18.5%,与模型组相比,具有显著性差异(P<0.05)。
     (2)三叶人字草治疗IgA肾病的相关药效学研究:
     高剂量(12.34 g/kg)、中剂量(6.17 g/k     (3)正交实验筛选出三叶人字草最佳提取工艺为:以水为提取溶剂,16倍料液比,煎煮0.5h,提取3次。
     结论:
     三叶人字草能减少IgA肾病小鼠尿蛋白和血尿,降低IgA肾病小鼠血清中BUN、SCR含量,改善IgAN症状;能显著提高小鼠体内NO活力,能降低IgA肾病小鼠肾皮质中PDGF-B、PDGFR-B mRNA的表达,减少因PDGF-B及受体持续过度表达刺激系膜细胞增生及基质积累而导致肾脏疾病进行性发展,并能增强免疫,降压,止血,对胃肠功能有促进作用。三叶人字草对IgAN模型小鼠具有治疗作用,其表现出的肾脏保护效应,可能与抑制肾组织中PDGF-B、PDGFR-B mRNA的表达有重要作用,为其治疗IgA肾病的机制之一。
Objective:
     Observe the effect of Kummerowia Striata from Denglao experience prescription on the expression of platelet-derived growth factor (PDGF-B) and its mRNA in IgA nephropathy model mouse. Determine the serum level of SCR、BUN、NO in IgA nephropathy model mice. Study the Kummerowia Striata's treatment on IgA nephropathy and the IgA nephropathy mechanism of pathogenesis. Besides, explore the pharmacodynamics of Kummerowia Striata treatment on IgAN and observe its effect on the immune system、blood pressure、blood function and gastrointestinal function etc. Provide experimental foundation for the clinical treatment of IgAN and promote the research level of traditional Chinese medicine in the nephritis research area. Advance the treatment of low toxicity and efficient of traditional Chinese medicine and provide a new method of treatment.
     Method:
     The extraction conditions were optimized by orthogonal test method. Investigated by orthogonal test method and level of different factors on the extraction rate, Preparation of this selection process with the Kummerowia Striata extract as the experimental drugs tested.
     Using bovine serum albumin (BSA) and staphylococcal enterotoxin B (SEB) replicate IgA nephropathy mouse model. Observe the general situation of mice, serum SCR, BUN, NO level; determinate the expression of PDGF-B, PDGFR-B mRNA in IgA nephropathy mouse renal cortex by Semi-quantitative RT-PCR. Study the renal histopathology of Kummerowia Striata's treatment on IgA nephropathy model mice.
     Effect of Kummerowia Striata on the immune system in normal mice was used by carbon clearance method. To study its effects on blood pressure by slide method. Study trefoil clotting and bleeding time and its platelet aggregation and other hemostatic factor by capillary method. Study the effects on gastrointestinal function to promote its treatment on IgA nephropathy pharmacodynamic by semi-solid method.
     Results:
     (1) pharmacological effects of Kummerowia Striata on IgA nephropathy model mice and its mechanism
     As the Kummerowia Striata effect on IgA nephropathy model mice, the living conditions of mice significantly improved while proteinuria and the amout of hematuria reduced. The content serum of SCR, BUN decreased and the whole blood NO activity (P<0.05) increased in the high dose group(12.34 g/kg).The expression of mice renal cortex PDGF-B、PDGFR-B mRNA also reduced in the high dose group. Agarose gel eletrophoresis of products from PDGF-B、PDGFR-B mRNA gene RT-PCR of IgAN model mice showed that:193bp in each group were observed at the expression of PDGF-B mRNA,the other groups gradually darkened strip compared with model group. Semi-quantitative analysis showed that the expression of PDGF-B mRNA decreased 26.8% in KS high dose group with significant differences (P<0.05) compared with model group; 203bp in each group were observed at the expression of PDGFR-B mRNA, the other groups gradually darkened strip compared with model group. Semi-quantitative analysis showed that the expression of PDGF-B mRNA decreased 18.5% in KS high dose group with significant differences(P<0.05) compared with model group.
     (2) Effect of Kummerowia Striata on IgA nephropathy model mice and its pharmacodynamics research
     The mice peritoneal macrophage phagocytic clearance capacity and speed were significantly increased(P<0.01) in KS high dose group (12.34 g/kg) and medium dose group (6.17g/kg). The spleen of mice were significantly improved in KS high dose group and medium dose group. KS high dose could increase the normal mouse peritoneal macrophage phagocytosis (P<0.01). KS high、medium and low dose might have an effect on the rats blood pressure decreasing but have no significant difference compared with the former administration. KS high and medium dose could significantly shorten clotting time (slide method, capillary method) (P<0.01); KS high dose group mice have significantly effect of shorten the bleeding time (P<0.01) and increase platelet count (PLT) (P<0.01). But on the red blood cell count (RBC), hemoglobin (HGB), hematocrit (HCT) have no obvious indicators of the role of trend. KS high dose could significantly promote gastric emptying (P<0.01) and intestinal propulsiving (P<0.01).
     (3)The best extraction of orthogonal filtering out KS:Water as extraction solvent,16 times the ratio of solid to liquid, boiling 0.5h, extract 3 times.
     Conclusion:
     KS could reduce proteinuria and the amout of hematuria in IgAN model mice, lower serum content of BUN, SCR and heal the symptoms of IgAN; significantly increase NO activity and reduce the renal cortex expression of PDGF-B and PDGFR-B mRNA in IgAN model mice;reduce the development of renal disease which is due to PDGF-B and its receptor stimulation sustained progressively over-expression of mesangial cell proliferation and matrix accumulation. KS also can enhance immunization, blood pressure, bleeding, promote gastrointestinal function. The protective effect of KS on IgAN model mice could be interrelated with the expression of PDGF-B and PDGFR-B mRNA that they might play an important role in IgAN and that may be one of the mechanisms of KS effect on IgAN.
引文
[1]侯贵传,徐立.鸡眼草的综合利用[J].中国野生植物,1990,9(2):31-33.
    [2]国家中医药管理局《中华本草》编委会.中华本草:第4册[M].上海:上海科学技术出版社,1998:3239-3241
    [3]Rikuchi M, et al.CA,1991,114:98212r
    [4]Kancta M, et al.CA.1980,93:91880w
    [5]Yoshida T, et al.Phytochemistry,1977,16(1):131
    [6]南药《中草药学》编写组.中草药学(中册).第一版.南京:江苏人民出版社.1976:480
    [7]江苏新医学院.中药大辞典(上册).第1版.上海科学技术出版社.1977:1216
    [8]唐人九.人字草黄酮类化学成分研究.华西药学杂志,1995,1(11):5-10
    [9]周玖瑶、陈蔚文、黄桂英,等.三叶人字草止血作用研究.中国实验方剂学杂志,2007,13(3):65-66.
    [10]周玖瑶、黄桂英、韩坚.三叶人字草抗炎镇痛作用研究.中国医药导报,2007,4(2):155-156.
    [11]周玖瑶、王霞、余应嘉,等.三叶人字草对IgA肾病模型大鼠的治疗作用,中药新药与临床药理,2009,20(6):39-42
    [12]王霞、周玖瑶、孙毅东,等.三叶人字草对IgA肾病模型大鼠的影响,广州中医药大学学报,2010,28(2):132-136
    [13]Hsu SI, Ramirez SB, Winn MP,et al. Evidence for genetic factors in the development and progression of lgA nephropathy. Kidney Int,2000,57(5):1818-1835
    [14]Johnson RJ, Feebally J. Comprehensiv Clinical Nephrology [M]. London:Mosby, 2000,5.26.1-5.26.10.
    [15]Appel GB and Glassoek RJ. IgA nephropathy[J]. Neph SAP,2002,1(1):11-19
    [16]Ibels LS, Gyory AZ, Caterson RJ, et al. Primary IgA nephropathy:natural history and factors of importance in the progression of renal impairment[J]. Kid Int,1997,61(8): 67-70.
    [17]Barrett J, Feehally J. IgA nephropathy[J]. J Am Soc Nephrol,2005.16(7):2088-2097.
    [18]Radford, Donadio, Bergstralh. Predicting renal outcome in IgA nephropathy [J]. J Am Soc Nephrol,1997,8(2):199-207.
    [19]D'Amico G. Natural history of idiopathic IgA nephropathy and factors predictive of disease outcome[J]. Semin Nephrol,2004,24(3):179-196.
    [20]Nair R, Walker PD. Is IgA nephropathy the commonest primary glomerulopathy among young adults in the USA. Kidney Int,2006,69(8):1455-1458
    [21]孙建实.IgA肾病中医病因病机新探[J].中医药学报,2006,34(2):1-2
    [22]Efstathios Alexopoulos. Treatment of primary IgA nephropathy [J]. Kidney Int,2004, 65(1):341-355
    [23]李文歌,IgA肾病的病理分级与临床表现,临床肾脏病杂志,2009,9(7):292-293
    [24]Nogaki F, M uso E, Kobayashi I, et al. Alert me when:new articles cite this article. Download to Citation M anager. Nephrol Dial Transplant,2000,15:1146-1154.
    [25]Julian BA, Tomana M, Novak J, Mestecky J. Progress in the pathogenesis of IgA nephropathy. Adv Nephrol Necker Hosp.1999,29:53-72.
    [26]Leung JC, Tang SC, Lam MF, Chan TM, Lai KN. Charge-dependent binding of polymeric IgAl to human mesangial cells in IgA nephropathy.Kidney Int. 2001,59(1):277-85.
    [27]Lu JC, Zhang H, Chen YQ, et al. Uteroglobin G38 A polymorphism is associated with the progression of Igh nephropathy in Chinese patients Zhonghua Nei Ke Za Zhi.2004,43(1):37-40.
    [28]Lued ecking EK, DeKosky ST, Mehdi H, et al. Analysis of genetic polymorphisms in the transforming growth factor-betal gene and the risk of Alzheimer's di8ease. Hum Genet,2000,106(5):565-69.
    [29]Sato F, NaritaI, Goto S, etal. Transforming growthfactor-betal gene polymorphism lnodifies the histological and clinical manifestations in Japanese patients with IgA nephropathy. Tissue Antigens,2004,54(1):35-42
    [30]Sato F, Narita I, Goto S, etal. Transforming growth factor-betal gene polymorphism inodifies the histological and clinical manifestations in Japanese patients with IgA nephropathy[J]. Tissue Antigens,2004,64(1):35-42.
    [31]Cederholm B, Wieslander J, Bygren P, et al. Circulating complexes containing IgA and fibronectin in patients with primary IgA nephropathy[J]. Proc Natl Acad Sci,1988,(85):4865-4868.
    [32]Demaine AG, Rambausek M, Katsutani J, et al. Relation of mesangial IgA glomerulonephritis to polymorphism of immunoglobulin heavy chain switch region. [J]. J Clin Invest,1998,81:611-614.
    [33]Endo Y. IgA nephropathy human disease and animal model[J]. Renal Fail,1997, 19(3):347-371.
    [34]魏林,刘桂馨,王海燕,等.血清IgA-纤维连接蛋白聚合物在IgA肾病诊断中的意义[J].中华内科杂志,1997,36(2):83-86.
    [35]Schettini J, Salamone G, Trevani A, Raiden S, Gamberale R, Vermeulen M, Giordano M, Geffner JR. Stimulation of neutrophil apoptosis by immobilized IgA[J]. J Leukoc Biol. 2002,72(4):685-691.
    [36]张丽芬.黄文政教授治疗IgA肾病的经验[J].天津中医学院学报,2004,23(1):31.
    [37]黄国东,禹长杰.IgA肾病中医辩证分型研究概况.广西中医学院学报[J],2007,10(2): 82-84
    [38]孔薇,王钢教授对IgA肾病中医药辨治规律研究,中国中西医结合肾病杂志,2005,6(2):67-69
    [39]刘玉宁,邓跃毅,王立红.陈以平教授治疗IgA肾病的临证经验[J].中国中医药信息杂志,2003,6(4):314-315.
    [40]傅文录,石显方.石景亮老中医治疗IgA肾病的经验[J].四川中医,2002,20(8):1-2.
    [41]胡仲仪,张立艳,曲环汝,等.辨治IgA肾病经验[J].陕西中医,2003,23(4):331
    [42]郑春燕,琚玮,黄生生.郑建民教授治疗IrA肾病经验[J].中医研究,2006,19(2):44-45
    [43]郑平东.IrA肾病辨证论治经验与体会[J].上海中医药杂志,2006,40(4):9-10.
    [44]林启展,马育鹏,潘碧琦,等.张琪教授辨治IgA肾病尿血证经验[J].广州中医药大学学报,2006,23(3):234-236
    [45]Clarkson AR, Woodroffe AJ, Bannister KM, et al. The syndrome of IgA nephropathy. Clin Nephrol,1984,21(1):7-14.
    [46]Nishikawa Y, Shibata R, Ozono Y, et al. Streptococcal Mprotein enhances TGF-beta prod-uction and increases surface lgA-positive B cells in vitro in IgA nephropathy. Nephrol Dial Transplant,2000,15(6):772-777.
    [47]Del Prete D, Gambaro G, Lupo A, et al. Precocious activation of genes of the rennin-angiotensin system and the fibrogenic cascade in IgA glomerulonephritis. Kidney Int,2003,64(1):149-159.
    [48]叶任高,刘慧,黄玉玺,等.中西医结合治疗IgA肾病疗效观察[J].中国中西医结合杂志,1992,12(1):17
    [49]周文祥.中西医结合防治IgA肾病的体会[J].湖北中医学院学报,2000,2(3):35
    [50]王丽彦,刘娜,张佩青.张佩青治疗伴有扁桃体异常IgA肾病经验[J].上海中医药杂志,2008,42(6):10.
    [51]中华中医药学会肾病分会.IgA.肾病的诊断、辨证分型和疗效评定(试行方案)[J].上海中医药杂志,2007,41(5):9.
    [52]霍光旭.王耀献从三焦论治IgA肾病经验[J].中医药临床杂志,2005,17(1):76.
    [53]杜兰屏,陈以平.中药治疗IgA肾病经验[J].辽宁中医杂志,2001,28(4):2042-2051
    [54]严志林,朱为媛.益肾和络汤为主治疗IgA肾病30例临床观察[J].四川中医,2005,23(11):56.
    [55]孙虎生.三炭益肾汤治疗IgA肾病46例临床观察[J].四川中医,2006,24(1):61.
    [56]傅贵平,王政华.益肾凉血抗敏汤治疗儿童IgA病54例[J].上海中医药杂志,2006,40(7): 54.
    [57]费梅,熊佩华,陈爱平,等.活血养阴方治疗IgA肾病及对TGF-β 1水平的影响[J].陕西中医,2007,28(4):407
    [58]李小伟,朱红柳,吕长鑫,等.血尿饮治疗IgA肾病血尿22例[J].四川中医,2007,25(12): 63.
    [59]陶志虎,卢玲. “滋肾活血Ⅰ号”对IgA肾病患者CD4/CD8调节与TGF-β 1表达的影响[J].江苏中医药,2008,40(1):33.
    [60]刘晓渭,许国双,陈威,等.正清风痛宁片辅助治疗单纯血尿性IgA肾病52例[J].第四军医大学学报,2007,28(8):709.
    [61]李素敏,严静霞,杨林,等.黄芪注射液对IgA肾病患者肾小管功能的影响[J].中国中西医结合杂志,2006,26(6):504.
    [62]饶家珍,吴立友,蒙向欣,等.芪黄饮对IgA肾病红细胞免疫功能影响的临床研究[J].时珍国医国药,2007,18(6):1495.
    [63]Namikoshi T, Satoh M, Horike H, et o2. Implication of peritubular capilarylossan daltered expresion of vascular endothelial growthfactorin IgA nephropathy[J]. Nephron Physiol,2006,102(1):9-16.
    [64]Lai KN, Chan LY, Leung JC Mechanisms of tubulointerstitial injury in IgA nephropathy[J]. Kidney Int Suppl,2005, (94):s110-s115.
    [65]Jia Q. Pestka JJ. Role of cyclooxygenase-2 in deoxynivalenol induced immunoglobulin a nephropathy[J]. Food Chem Toxicol,2005,43(5):721-728.
    [66]Chen A, Ding SL, Sheu LF, et al. Experimental IgA nephropathy Enhanced deposition of OmeⅢlar IgA immune complex in proteinuric states[J]. Lab Invest,1994,70(5):6397.
    [67]Koyama A, Sharmin S, Sakurai H, et al. Staphylococcus aureus cell envelope antigen is a new candidate for the induction of IgA nephropathy[J]. Kidneylnt,2004,66(1): 121-132.
    [68]Suzuki S, Gejyo F, Nakatomi Y, et al. Role of IgA, IgG, and IgM antibodies against Haemophilus parainfluenzae antigens in IgA nephmpathy[J]. Clin Nephrol,1996,46(5): 287-295.
    [69]1 Sharufin S, Shimizu Y, Hagiwara M, et al. Staphylococcus aureus antigens induce IgA type gmerulonephritis in Balb/c mice[J]. Nephrol,2004,17(4): 504-511.
    [70]Amore A, Roccatello D, Picciotto G, et al. Processing of IgA aggregatesin a rat model of chronic liver disease[J]. Clin Immunol lmmunopathol,1997,84(2):107-114.
    [71]Narita I, Goto S, Saito Netal. Interaction between ACE and ADD1 gene polymorphisms in the progression of IgA nephropathy in Japanese patients[J]. Hypertension,2003,42(3):304-309.
    [72]Imai H, Nakamoto Y, Asakura K, et al. Spontaneous Omerul. dr IgA deposition in ddY mice:an animal model of IgA nephritis[J]. Kidheylnt,1985,27(5):756-761.
    [73]程军,张雯,陶筱娟,等.IgA肾病小鼠肾组织鞘氨醇激酶、内皮分化基因表达及意义.细胞与分子免疫学杂志,2008.24(1):64-66
    [74]毕晓黎,黄志军,陶君彦,等.实时荧光定量PCR筛选和评价清热解毒中药抗炎活性的研究.中药材,2008年.31(7):1033-1036
    [75]杜晓刚、甘华.PDGF在肾脏疾病中的研究进展[J].医学综述,2001,(1):30-40.
    [76]陈美香,谢院生.重视延缓IgA肾病进展的基础和临床研究[J].中华肾脏病杂志,2004,4(3):235
    [77]Reiss M. TGF-βand cancer. Microbes and Infect,1999,1(15):1327-1347.
    [78]Nishikawa Y, Shibata R, Ozono Y, et al. Streptococcal Mprotein enhances TGF-beta prod-uction and increases surface lgA-positive B cells in vitro in IgA nephropathy. Nephrol Dial Transplant,2000,15(6):772-777.
    [79]Del Prete D, Gambaro G, Lupo A, et al. Precocious activation of genes of the rennin-angiotensin system and the fibrogenic cascade in IgA glomerulonephritis. Kidney Int,2003,64(1):149-159.
    [80]国家中医药管理局, 《中华本草》编委会[S],一部,上海:上海科学技术出版社,1999:3238-3240
    [81]胡浩斌,简毓峰,曹宏,等.正交试验法优选东紫苏中黄酮类化合物的提取工艺[J]中药材,2006,3,29(3):296-298

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