新风胶囊对强直性脊柱炎患者疗效及血清免疫球蛋白亚型、外周血淋巴细胞自噬的影响  

Effect of Xinfeng Capsule on AS Patients and Their Serum Immunoglobulin Subtypes and Peripheral Lymphocyte Autophagy

作　　者：叶文芳[1,2] 刘健[3] 万磊[3] 曹云祥[3] 汪四海[3] 王亚黎[1] 阮丽萍[1] 

机构地区：[1]安徽中医药大学研究生部,合肥230038 [2]安徽人口职业学院,安徽247099 [3]安徽中医药大学第一附属医院风湿科,合肥230038

出　　处：《中国中西医结合杂志》2016年第3期310-316,共7页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81173211);国家中医药重点学科中医痹病学建设项目(No.国中医药发[2009]30号);安徽省科技厅科研计划(No.09-020304046)

摘　　要：目的观察新风胶囊(XFC)对强直性脊柱炎(AS)患者的症状体征、血清免疫球蛋白、外周血淋巴细胞自噬蛋白、自噬基因的影响,探讨其作用机制。方法将59例AS患者按随机数字表法分为2组,治疗组(39例)和对照组(20例),治疗组给予XFC治疗,每次3粒,每日3次;对照组给予柳氮磺胺吡啶(SASP)治疗,每次4片,每日2次。治疗3个月。统计Bath强直性脊柱炎疾病活动指数(BASDAI)及Bath强直性脊柱炎功能指数(BASFI);采用ELISA法检测两组血清免疫球蛋白(Ig G1、Ig G2、Ig G3、Ig G4、Ig A、SIg A、Ig M)水平,采用Western blot检测两组的淋巴细胞自噬蛋白Beclin1、LC3-Ⅱ、PI3K、Akt、m TOR水平,采用聚合酶链式反应(Polymerase Chain Reaction,PCR)方法检查血清自噬相关基因Atg1、Atg5、Atg12、Atg13、Atg17表达改变。采用Spearman相关分析方法比较AS患者免疫球蛋白亚型与细胞自噬基因的相关性。结果与治疗前比较,治疗组治疗后BASDAI、Ig G1、Ig G3、Ig A水平下降(P<0.01),PI3K、Akt、m TOR蛋白表达下降(P<0.01),ATG1、ATG12、ATG13、ATG17 mRNA表达下降,ATG5 mRNA表达升高(P<0.01);对照组BASDAI、Ig G1、Ig A水平下降(P<0.05,P<0.01),PI3K、Akt、m TOR蛋白表达下降(P<0.05),ATG1、ATG13mRNA表达下降(P<0.05,P<0.01)。与对照组比较,治疗组BASDAI、Ig G1、Ig A水平下降(P<0.05),PI3K、Akt、m TOR蛋白表达水平下降(P<0.01),ATG12、ATG17 mRNA表达下降,ATG5 mRNA表达升高(P<0.01)。相关分析结果显示,AS患者Ig G1、Ig G2、Ig G3、Ig A、SIg A、Ig M与ATG17呈负相关,Ig G4与ATG17呈正相关(P<0.05,P<0.01)。结论 XFC提高AS患者临床疗效,其增强AS患者细胞自噬的机制可能为作用于PI3K/Akt/m TOR信号,影响自噬基因和自噬蛋白的表达,参与调节B淋巴细胞的增殖和分化,加强体液免疫。Objective To observe the effect of Xinfeng Capsule（ XFC） on ankylosing spondylitis（ AS） patients＇ symptoms and signs,serum immunoglobulin levels,peripheral blood lymphocyte autophagy protein,autophagy gene,and to explore its mechanism. Methods Totally 59 AS patients were assigned to the treatment group（ 39 cases） and the control group（ 20 cases） according to random digit table. Patients in the treatment group received XFC,0. 5 g each pill,three pills each time,3 times per day,while those in the control group received sulfasalazine（ SASP）,0. 25 g per tablet,4 tablets each time,twice per day. Three months consisted of one therapeutic course. Bath Ankylosing Spondylitis Disease Activity Index（ BASDAI） and Bath Ankylosing Spondylitis Functional Index（ BASFI） were statistically calculated. Serum immunoglobulins（ Ig G1,Ig G2,Ig G3,Ig G4,Ig A,SIg A,and Ig M） were detected using ELISA. Changes of Beclin1,LC3-Ⅱ,phosphatidylinositol 3-kinase（ PI3K）,Akt,the mammalian target of rapamycin（ m TOR） were detected using Western blot. Serum autophagy related genes such as Atg1,Atg5,Atg12,Atg13,and Atg17 were detected using the polymerase chain reaction（ PCR）. The correlation between immunoglobulin subtypes and autophagy gene in AS patients using Spearman correlation. Results Compared with before treatment,BASDAI,Ig G1,Ig G3,and Ig A decreased（P 〈0. 01）; PI3 K,Akt,and m TOR protein expressions decreased（P 〈0. 01）; ATG1,ATG12,ATG13,and ATG17 mRNA expressions decreased,ATG5 mRNA expression increased（P〈 0. 01） in the treatment group. But BASDAI,Ig G1,and Ig A levels decreased（P 〈0. 05,P〈 0. 01）; PI3 K,Akt,and m TOR protein expressions decreased（P 〈0. 05）; ATG1 and ATG13 mRNA expressions decreased（P 〈0. 05,P 〈0. 01） in the control group. Compared with the control group,BASDAI,Ig G1,and Ig A levels decreased（P〈 0. 05）; PI3 K,Akt,m TOR protein expressions decreased（P〈 0. 01）; ATG12 and ATG17 mRNA expression decreased,ATG5 mRNA expression i

关 键 词：强直性脊柱炎 免疫球蛋白 自噬蛋白 自噬基因 自噬通路 新风胶囊 

分 类 号：R259[医药卫生—中西医结合]