颞下颌关节滑膜细胞对应力的分子应答机制及丹皮中具有滑膜细胞保护作用的化合物筛选
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摘要
第一部分应力作用对大鼠滑膜细胞形态学的影响
     颞下颌关节(temporomandibular joint,TMJ)是人体内保持较强终身改建能力的负重关节。颞下颌关节紊乱病(temporomandibular disorders,TMD)是口腔外科临床的常见病,关节盘前移位(anterior disc displacement,ADD)是其中最常见的类型。因为局部力学环境的改变,关节盘移位后,作为关节运动的两个主要承力区的髁突和关节盘可以发生一系列的适应性改建以适应新的盘突关系。并且滑膜的过量炎症反应被认为是TMD的起始因素之一。然而,临床研究发现一些有症状的关节盘移位患者在不恢复关节盘正常解剖位置的情况下进行保守治疗亦可达良好的疗效。生物力对影响骨关节形态、功能以及软骨生成的重要因素之一。但目前生物力学研究多集中在大骨关节上,对于TMJ盘移位后髁突以及双板区的力学研究较少。
     实验一无菌条件下取Sprague-Dawley大鼠双侧TMJ髁突关节盘后区平滑光亮的滑膜组织,用组织块法处理滑膜组织,将培养瓶倒置37℃,5%CO_2培养箱内培养2-3 hrs,使其贴壁。然后翻转继续培养。待有滑膜细胞爬出组织块后,去除组织块,继续培养。3d后可见有梭形细胞贴壁生长。为鉴定分离得到的原代滑膜细胞,分别用巨噬细胞标记物CD68和纤维原细胞标记物vimentin对培养的细胞进行免疫染色。同时设计加载应力模式为静水压力(hydrostatic pressure,HP)0kPa,30kPa,60kPa和90kPa 12 hrs。
     结果显示:培养的滑膜细胞贴壁生长,分布均匀,形态均一,呈短梭状,有两个或多个突起,细胞核呈卵圆性,位于细胞中央,核仁明显。培养的原代细胞达铺满状态所需的时间,与分离细胞的存活率和细胞接种密度等有关系,存活率越高,接种密度越大,到达铺满状态所需的时间越短。所有培养的滑膜细胞均对vimentin蛋白表达阳性,CD68蛋白表达阴性,说明该细胞来源于中胚层,并具有成纤维细胞的特点,是滑膜细胞B型细胞,即滑膜成纤维细胞(synovial fibroblasts,SFs)。
     实验二分别用MTT法、流式细胞术、超微电镜、免疫染色等方法来检测不同程度的HP对SFs增殖、细胞周期、超微结构以及细胞骨架的影响。
     结果显示:MTT结果显示受到不同HP的各组SFs增殖率间不存在显著差异。运用流式细胞术分析细胞周期所得的结果也表明应力组和正常组细胞G2期与G1期细胞数目大致相同。而在不同强度的HP下SFs的F-actin呈现较为不同的变化。正常情况下,F-actin在细胞间呈现大量有序排列的突起,在应力情况下,细胞外形被拉伸,呈现较强的应力纤维染色特征。
     不同HP下SFs的超微结构也呈现不同程度的改变。30kPa应力下细胞胞浆和胞核轻度皱缩,在致密的胞浆中可以辨认线粒体等细胞器,核仁明显,较0kPa时变化不大;60kPa作用后发现胞体进一步皱缩,胞膜及其内侧空泡形成,胞核更加致密,但仍可见完整的核膜结构及边聚的染色质,呈新月形或驼峰状;90kPa时SFs的超微结构主要表现为核膜结构不完整,细胞器变性,核内结构少量溶解;胞浆内空泡形成,染色质凝集成块,与核膜分离,残留网状或颗粒状的染色。
     当TMJ髁突受到机械负重,关节腔内的应力就会改变。HP就作为一个机械因素,来维持关节腔的稳定性,并且高的HP能够影响细胞结构和细胞分化,干扰细胞膜的流动性和细胞膜的结构以及一些内部的细胞器。SFs作为近些年来对关节组织的研究靶点,能够对机械的、离子的和渗透性的信号有较好的敏感性和传导性;并根据周围环境、激素和基因等因素对所收到的信号做出相应的反馈,进而调节代谢活动。
     第二部分应力对滑膜细胞TGF-β、BMP-2和SOX-9表达的影响
     迄今为止,应力作用下TMJ软骨重建的机制还未能完全阐明。众多研究表明,双板区滑膜组织内压力的提高主要是由关节盘移位造成,可能引起双板区软骨化生过程和关节的重建。转化生长因子-beta(transforming growth factor beta,TGF-β)和骨形态发生蛋白(bone morphogenetic proteins,BMPs)在骨及软骨的修复,成骨细胞和破骨细胞的分化、增殖过程中都发挥着极其重要的作用:同时TGF-β与BMP-2与其各自的受体结合后能通过细胞内信号系统将信号传递到细胞核内而起到多种不同的生理调节作用。SOX-9基因则是软骨化生的重要指标之一。上一章研究已发现应力作用下,SFs的细胞骨架会发生一定的变化,但应力对SFs生长相关蛋白表达的研究还较少。因此我们通过观察SFs在不同HP作用下TGF-β、BMP-2和SOX-9的表达情况,对应力作用下TMJ的改建机理进行探讨
     实验三SFs原代培养和应力加载方式同第一部分实验一。分别用免疫细胞化学和Western Blot法检测不同强度HP作用下的SFs中TGF-β、BMP-2和SOX-9表达情况。对免疫细胞化学结果进行灰度测定,用t检验和单因素方差分析对灰度值进行统计学分析。Western Blot结果用Biosense 300 software软件进行信号分析,以GAPDH蛋白的光密度值进行标准校正,计算TGF-β、BMP-2和SOX-9蛋白产物的相对量。
     结果显示:TGF-β和BMP-2在正常细胞表达不高,在HP作用下表达明显增强,但随着HP强度增高,该变化并不明显。SOX-9在30kPa时染色高于正常培养的细胞染色,60kPa时表达增加,90kPa时表达又稍有降低。Western Blot结果与免疫细胞化学的结果一致。
     关节负重是维持关节软骨正常组成和功能的基本要求。尽管TMD的发病机理尚不完全清楚,但关节软骨承受的局部生物力对于TMD的发生发展有潜在的促进作用。关节盘移位后,髁突在前移位关节盘的机械刺激下可以发生一系列的改建。关节盘移位后,局部滑膜组织增厚,表明局部有炎性刺激,其受到前移位关节盘的持续存在的牵拉作用,使得双板区应力环境发生改变,滑膜组织的代谢加快达到新的平衡。因而我们有理由认为关节盘移位后TGF-β和BMP-2的表达的升高更多是由于双板区组织受到的机械应力刺激的直接结果。SOX-9的表达在软骨形成早期变化明显,可以成为TMD发生发展过程早期的重要标记。
     第三部分应力对滑膜细胞MAPK通路蛋白表达的影响
     MAPK信号通路参与多种细胞外刺激引起的细胞反应,在细胞的多项生命活动及对细胞外环境变化引起的适应性改建中发挥重要的调控作用。但对于MAPK通路是否在髁突软骨表达以及在骨组织改建中的作用尚不明确。有实验发现在人滑膜组织的纤维位点发现炎症细胞浸润和TGF-β的过表达,TGF-β的过表达不仅会引起组织纤维化的病理过程,还会影响正常器官的功能。本章对SFs在不同程度HP作用下MAPK通路上三个重要蛋白ERK、JNK和p38的表达及其活化情况进行了检测,初步探讨了上述三个通路在异常应力下的作用。并且加入ERK特异阻断剂PD98059后,观察不同时间点TGF-β的变化。
     实验四将原代培养的SFs加载应力后,用Western Blot方法对不同HP作用下MAPK通路上三个重要蛋白ERK、JNK和p38在SFs表达及其活化情况进行检测,初步探讨上述三个通路在异常应力下的作用。
     结果显示:与正常细胞相比,30 kPa HP作用显著抑制了ERK蛋白表达,60 kPa时恢复到正常组水平,但90 kPa时又有所降低;而ERK的活化水平在30 kPa时最高,在90 kPa时最低;30 kPa应力作用同时也提高了JNK蛋白的表达,在60 kPa和90 kPa时,JNK的表达依次明显降低;而应力作用对p38的表达以及JNK、p38的磷酸化水平基本无影响。
     实验五在原代培养的SFs中加入15μM PD 98059在30kPa HP作用下分别培养5 mins,30 mins,1 hr,2 hrs,4 hrs,8 hrs和12 hrs,以同等应力同等时间点未加入PD 98059收集的细胞作对照。ERK的阻断剂PD98059按照说明书用DMSO溶解,对照组细胞在加载应力前用PD98059孵育1 hr。空白组细胞用0.04%的DMSO孵育。收集细胞培养液并ELISA试剂盒检测在加载应力前加入ERK阻断剂PD98059探讨在ERK/MAPK通路调节应力下TGF-β的作用。
     结果显示:SFs在应力作用下TGF-β的分泌量增加,尤其在30kPa作用下分泌量增加较多,而在加入ERK特异抑制剂PD98059后,TGF-β的活性得到了显著抑制。提示在一定的应力作用下SFs可通过提高TGF-β的活性,导致MAPK通路的激活,从而启动自适应性改建过程。
     本部分内容侧重分析了SFs在HP作用下三种MAPK亚型,ERK,JNK和p38的表达和活化情况。ERK通路在HP作用下起着重要的调节作用,JNK和p38作用不明显。在30kPaHP作用下加入ERK通路抑制剂PD98059后,SFs分泌TGF-β的活性得到了显著抑制。进一步证明TGF-β介导的ERK通路在SFs受到应力作用下引发的自我适应和调节的过程中起着一定作用。而p38和ERK在成骨过程中起着相反的调节作用,分化活性通过介导黏附分子的表达在前软骨阶段的后期来调节成骨,在本试验中p38的作用较小。
     第四部分丹皮中具有滑膜细胞保护作用的化合物筛选
     滑膜的过量炎症反应被认为是TMD的起始因素之一。SFs在应力作用下会加大TNF-α等炎症因子的分泌量,以启动后续的病理生理过程。因此可推测,具有抗炎活性的化合物可用于治疗早期的TMD。中药在治疗复杂性疾病、慢性疾病、免疫疾病等方面具有独特的疗效和优势。丹皮提取物能够抑制ROS堆积,并具有自由基清除能力,另一种与丹皮具有类似化学组成的中药材—芍药的提取物,能够在抑制关节炎大鼠的炎症反应,并改变SFs的超微结构。然而,丹皮药材中具有抗炎活性的化合物及其活性,至今少见报道。本部分内容通过活性追踪的方式筛选并鉴定有效成分,确定丹皮提取物及组分的抗炎活性。
     实验六运用制备液相色谱分离丹皮提取物得到22个组分,采用实验一介绍的原代培养SFs,加入10 ng/mL的IL-1β刺激后,ELISA法检测培养液中TNF-α含量。并运用液相色谱—质谱联用法对具有活性的组分进行鉴定并分离。
     结果显示:分离得到的6个组分能够显著抑制IL-1β刺激后的SFs分泌TNF-α。通过对活性组分的鉴定从中发现8种化学成分。进一步研究分离得到的三种化学成分芍药苷、丹皮酚和五没食子酰葡萄糖对于抑制SFs合成TNF-α和IL-6时均呈现明显的量效关系。
     近年来,大量临床和实验研究表明许多中药提取物和中药活性成分是一类安全、有效的骨关节炎和风湿性关节炎治疗药物。研究者通过比较姜黄科的中药材在关节炎小鼠模型上的抗炎活性,找出了一系列有活性的中药提取物。由此可见,有望从中药提取物中找出治疗TMD的药物。以往,TMD常采用保守治疗,也有研究者尝试采用关节内注射超氧化物岐化酶和透明质酸钠的方法进行补充治疗。本部分研究结果表明,丹皮提取物中的一些具有抗炎活性的有效化合物通过控制TMD患者的炎症反应来达到预防和治疗的目的。
     结论
     1.滑膜细胞在应力作用下形态学和超微结构会发生变化,且这种变化程度与应力大小有关。
     2.静水压力能够引起滑膜细胞骨形成相关蛋白的变化,这种改变与力学的大小呈现不同趋势的变化,说明TGF-β、BMP-2和SOX-9对于滑膜细胞在应力作用下起到不同的调节作用。
     3.静水压力能引起MAPK通路上ERK、JNK、P38等重要信号分子的改变并引起ERK的活化,提示ERK1/2通路的作用发挥着重要作用。并且TGF-β介导的ERK通路在滑膜细胞应力作用下的自我适应和调节过程中起着信号传导的作用。
     4.从丹皮药材中纯化得到的三种活性化合物芍药苷、丹皮酚和五没食子酰葡萄糖能够抑制颞下颌关节滑膜细胞的炎症反应。
Part one:Effects of hydrostatic pressure on cytoskeleton in rat temporomandibular synovial fibroblasts
     Temporomandibular disorders(TMD)are common syndromes in dental.clinic and are characterized by orafacial pain,joint sounds,and limited mandibular movement.Several studies have demonstrated that the increased pressure in synovium of the bilaminar zone, chiefly caused by disc displacement,may be contributed to the progression of chondrogenesis in bilaminar zone and remodeling in joint.As a physiological factor,the pressure in joint cavity takes an important role in keeping intra-articular fluid and maintaining the stability of the join.
     In part one of this study,the double condyles of 3 months old Sprague-Dawley rats(~200 g)were excised.Surface parts of synovial tissues were isolated from TMJ of rats,followed by washing extensively with phosphate-buffered saline,then minced into 1mm~3 pieces and plated onto tissue culture dishes with DMEM supplemented with 15%fetal calf serum.SFs were confirmed by immunocytochemical staining to detect marker proteins CD68 and vimentin,which are macrophage marker and fibroblasts marker,respectively.SFs were seeded onto the culture dishes at a concentration of 2×10~6 cells/dish.When the cells reached 70%confluence,the culture dishes were transferred to a columned stainless-steel vessel.The vessel was then placed in the cell-culture incubator.HP was applied at levels of 30 kPa,60 kPa,90 kPa for 12 hrs.
     Our results showed that the primary cultured cells were found to proliferate with a fibroblastic character,whilst no spontaneous changes in shape were found even in repeated culture.When grown to confluence,the cells looked spindly and polygonal.The cells were confirmed by immunocytochemical staining.All cells were negative for CD68.Moreover, they were all positive for vimentin,a fibroblasts marker and confirmed to be synovial fibroblasts(SFs).
     In part two of this study,Changes of proliferation,cell cycle,ultrastructure and cytoskeleton were observed by MTT assay,flow cytometry transmission electron microscope and fluorescent microscope after loading different HP.
     Our results showe that the proliferation rates in HP treated groups were lower than 100%, but there were no statistical differences in comparison of cells in normal condition.The result of cell cycle of SFs is the similar.The ultrastructure of SFs at 0kPa was normal and intact.At 30 kPa,the ultrastructure of SFs mostly shows that the chromatin was condensated lightly and ruptured to the nuclear margin.At 60 kPa,the karyon takes on crescent and the mitochondria seem varicose.At 90 kPa,the apoptosis-like body was wrapped by membrane and embedded in the high density chromatin.Compared with the untreated control,the cellular actin configuration of SFs became elongated and more intense F-actin stress fiber staining was observed after HPloading.
     The SFs primary cell culture and HP loading were successfully established in this study. Our results suggested that HP could impact on the change of ultrastucture and cytoskeleton of SFs.Meanwhile,SFs could response the HP and might be occurring some molecular eventswhich relative to the new biomechanicai environment.
     Part two:Effects of hydrostatic pressure on BMP-2,TGF-βand SOX-9 production in rat temporomandibular synovial fibroblasts
     Recent experimental evidence has suggested that pressure may play an important role in the pathogenesis of arthritic diseases such as temporomandibular disorders,rheumatic diseases and osteoarthritis.This study examines the effects of hydrostatic pressure(HP)on the protein production of BMP-2,TGF-βand SOX-9 in SFs of rat TMJ.The primary SFs culture and loading profile were the same as the part one.Production of TGF-β,BMP-2 and SOX-9 was examined by immunocytochemical assay and Western blot.
     Exposure of SFs to HP for 12 hrs resulted in significant up-regulation of BMP-2 by 46%,54%,66%at 30,60,90 kPa,whilst TGF-βincreased by 11%,19%and 28%at 30,60, 90kPa.HP also induced the increase of SOX-9 by 72%at 30 kPa and 83%at 60 kPa,but only 54%at 90 kPa.
     The obtained data suggests that HP induced the alteration of cytoskeleton and bone-morphogenetic-related proteins production of SFs,which may influence the pathological condition of temporomandibular disorders.
     Part three:Effects of hydrostatic pressure on MAPK and TGF-βin rat temporomandibular synovial fibroblasts
     Various data obtained mitogen-activated protein kinases(MAPKs)in many types of cells argue that activation of a pathway occurs after loading stimulation.The purpose of the present work is to detect the relationship between ERK,JNK and p38 activation and the magnitude of HP by SFs culture,and examine the change of TGF-βwith or without ERK inhibitor(PD 98059)with time.
     The primary SFs culture and loading profile were the same as described before.The first part in this study,protein extracts were analyzed by western blot for the activation of ERK,JNK and p38.
     Our results showed that the production and activation of ERK,JNK and p38 were changed with the magnitude of HP.SFs exposured to 30kPa HP showed low expression of ERK,and then returned to normal.Finally,the expression of ERK decreased.On the other way,the activation of ERK shows highest on 30kPa and shows lowest on 90kPa. Meanwhile,30 kPa HP can also change the expression of JNK.But HP has less effect on the activation of JNK and p38.
     The second part in this study,SFs were cultured in the HP for a constant time point such as 5 mins,30 mins,1 hr,2 hrs,4 hrs,8 hrs and 12 hrs with or without 15μM PD 98059, an inhibitor of ERK.Cells were pre-incubated with PD 98059 for 1 hr before the mechanical stimulation began.The inhibitor was reconstituted in dimethylsulphoxide (DMSO),and control cells were pre-incubated with equivalent amounts of 0.04%DMSO alone.The TGF-βconcentration was tested by ELISA method.The assay procedure was performed accordi ng to the manufacturer's instructions.
     Our results showed that HP especially 30 kPa HP could increase the expression of TGF-β,But the ERK inhibitor PD98059 suppressed HP-induced expression of TGF-β.
     These results demonstrate that mechnical pressure induced by HP involved activation of ERK,JNK and p38 with different level.Mechanical stimulation induced a rapid activation of ERK,resulting in a visible phosphorylation at 30 kPa.On contract,the production of JNK and p38 changed along with the different HP,but the change of both phosphorylations is not visible.It indicates that JNK and p38 are not sensitive to the HP. There is a relationship between ERK and TGF-βassociated with HP.which may be play a key rolein remodeling of injured SF.
     Part four:screening of Moutan Cortex for anti-inflammatory activities and chemical constituents
     Moutan Cortex,a widely used traditional Chinese medicine for the treatment of various diseases,is the root bark of Paeonia suffruticosa Andrews(Paeoniaceae).Most of the pharmacological investigations of Moutan Cortex have been addressed to its central nervous system activities,antioxidant and sedative actions.Otherwise,there are few reports about the active compounds with anti-inflammatory activity of Moutan Cortex.The aim of the present study was to screen and identify bioactive compounds with anti-inflammatory effect from Moutan Cortex.
     With the aid of preparative HPLC technique,ethyl acetate and ethanol extract of Moutan Cortex were isolated into twenty-two fractions.Bioactivities of these fractions were evaluated by measuring expression of tumor necrosis factor-alpha(TNF-α)on rat synovial fibroblasts subjected to interleukin-1beta(IL-1β).Eight compounds were isolated from six active fractions and identified by HPLC/MS~n.Purified compounds,paeoniflorin,paeonol, and pentagalloylglucose resulted in dose-dependent inhibition of TNF-αand IL-6 synthesis in synoviocytes treated with proinflammatory mediator.
     Traditionally,temporomandibular disorder(TMD)is treated with conservative therapy. Some alternative and complementary therapy for TMD patients have also been introduced, including intra-articular injection of superoxide dismutase(SOD)and sodium hyaluronate (SH).Evaluation of cell viability indicated that incubation of synoviocytes with fractions of Moutan Cortex for 1 d at concentration of 10~(-5)g/ml dose not reduce the percent of viable cells.These results suggested that paeonol,paeoniflorin,glycosides and pentagalloylglucose has potential to be used as anti-inflammatory drug for patients with TMD.
     Condusion:
     1.HP could impact on the change of cytoskeleton and ultrastructure of SFs after exposure in HP,and the direct proportion along with HP.
     2.TGF-βand BMP-2 might regulate the remodeling of the mandibular condyle induced by the mechanical stimulation during the disc displacement.SOX-9 would be a valuable parameter of cartilage regeneration
     3.The production and activation of ERK1/2 could be changed by different magnitude of HP and HP has less effect on activation of JNK and p38.ERK1/2 plays an important role in SFs suffering HP and transfer the signal by TGF-β.
     4.Paeonol,paeoniflorin,glycosides and pentagalloylglucose contribute to the anti-inflammatory effect of Moutan Cortex to SFs.
引文
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