| 摘要: |
| 目的 探讨补阳还五汤抑制急性呼吸窘迫综合征（ARDS）病理条件下肺部中性粒细胞炎性活化的作用机制。方法 获取经补阳还五汤治疗及未治疗的ARDS患者的支气管肺泡灌洗液（BALF），采用ELISA检测炎症因子TNF-α、IL-1β、IL-6和IL-4的含量，同时分离中性粒细胞并通过蛋白质印迹法检测IL-4受体α（IL-4Rα）、低氧诱导因子1α（HIF-1α）和caspase 3水解体的表达。给予IL-4Rα沉默的原代中性粒细胞补阳还五汤大鼠药物血清预处理，后通过脂多糖和低氧诱导的方法建立ARDS体外细胞模型，采用ELISA检测细胞培养上清液中炎症因子的含量，采用CCK-8和流式细胞术分别检测细胞增殖活性和凋亡水平。结果 与常规治疗组ARDS患者比较，补阳还五汤治疗组ARDS患者BALF中TNF-α、IL-1β和IL-6含量均降低（P均＜0.01），IL-4含量略有升高但差异无统计学意义（P＞0.05）。与常规治疗组比较，补阳还五汤治疗组ARDS患者BALF来源的中性粒细胞中IL-4Rα和caspase 3水解体表达升高、HIF-1α表达下降（P均＜0.01）。与正常条件培养的中性粒细胞比较，脂多糖和低氧诱导48 h的中性粒细胞培养上清液中TNF-α、IL-1β和IL-6含量增加，细胞增殖活性增强（P均＜0.01）；与ARDS体外模型细胞比较，补阳还五汤药物血清预处理的中性粒细胞培养上清液中上述炎症因子的含量均降低，细胞增殖活性减弱且凋亡率增加（P均＜0.01），而IL-4Rα基因沉默能够逆转补阳还五汤药物血清的上述作用（P均＜0.01）。结论 补阳还五汤能够通过上调IL-4Rα抑制ARDS病理条件下中性粒细胞炎症因子释放。 |
| 关键词: 补阳还五汤 急性呼吸窘迫综合征 中性粒细胞 炎症因子 白细胞介素4受体α |
| DOI：10.16781/j.CN31-2187/R.20211168 |
| 投稿时间：2021-11-17修订日期：2022-09-02 |
| 基金项目:上海市进一步加快中医药事业发展三年行动计划（ZY2018-2020-FWTX-7004）. |
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| Mechanism of Buyang Huanwu decoction in inhibiting pulmonary neutrophil inflammatory activation under acute respiratory distress syndrome by upregulating interleukin 4 receptor α |
| SHEN Zhen-wei1，2,SHI Yi3,CHEN Wei3* |
(1. Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China;
2. Intensive Rehabilitation Ward, Shanghai Taiping Rehabilitation Hospital, Shanghai 201315, China;
3. Department of Critical Care Medicine, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
*Corresponding author) |
| Abstract: |
| Objective To explore the mechanism of Buyang Huanwu decoction in inhibiting pulmonary neutrophil inflammatory activation under the pathological condition of acute respiratory distress syndrome (ARDS). Methods The bronchoalveolar fluid (BALF) of ARDS patients treated and untreated by Buyang Huanwu decoction were obtained, and the contents of inflammatory factors (tumor necrosis factor α［TNF-α］, interleukin ［IL］-1β, IL-6, and IL-4) were detected by enzyme-linked immunosorbent assay (ELISA). Neutrophils were isolated at the same time, and the expression of IL-4 receptor α (IL-4Rα), hypoxia-inducible factor 1α (HIF-1α) and cleaved cysteine aspartic acid specific protease (caspase) 3 was detected by Western blotting. The primary neutrophils with silenced IL-4Rα were pretreated with rats drug serum of Buyang Huanwu decoction, and then ARDS in vitro model was established by lipopolysaccharide (LPS) and hypoxia induction. The contents of inflammatory factors in cell supernatant were detected by ELISA, the cell proliferation activity and apoptosis were detected by cell counting kit 8 and flow cytometry, respectively. Results Compared with the routine treatment group, the contents of TNF-α, IL-1β and IL-6 in the BALF of Buyang Huanwu decoction treatment group were significantly decreased (all P＜0.01), while the content of IL-4 was increased slightly (P＞0.05). Compared with the patients in the routine treatment group, the expression of IL-4Rα and cleaved caspase 3 was significantly increased in the BALF-derived neutrophils of ARDS patients in the Buyang Huanwu decoction treatment group, while the expression of HIF-1α was significantly decreased (all P＜0.01). Compared with neutrophils cultured under normal conditions, the contents of TNF-α, IL-1β and IL-6 were significantly increased in the supernatants of neutrophils cultured under LPS and hypoxia for 48 h, and the cell proliferation activity was also significantly increased (all P＜0.01). Compared with the cells of the ARDS in vitro model, the contents of the above inflammatory factors were significantly decreased in the supernatants of neutrophils pretreated with Buyang Huanwu decoction drug serum, the cell proliferation activity was significantly decreased, the apoptosis rate was significantly increased (all P＜0.01), while IL-4Rα silencing could reverse the above effects of Buyang Huanwu decoction drug serum (all P＜0.01). Conclusion Buyang Huanwu decoction can inhibit the release of inflammatory factors from neutrophils under ARDS by up-regulating IL-4Rα. |
| Key words: Buyang Huanwu decoction acute respiratory distress syndrome neutrophils inflammatory factors interleukin 4 receptor α |
