清温并用法对慢加急性肝衰竭大鼠调节性T淋巴细胞/辅助性T淋巴细胞17表达的影响  

Effect of the warming and heat-clearing method on the percentage of regulatory T lymphocytes/T helper 17 cells in rats with acute-on-chronic liver failure

作　　者：陈斌[1] 张涛[1] 朱文芳[1] 彭杰[1] 张茜茜[1] 黎运芳 丁秀丽 CHEN Bin;ZHANG Tao;ZHU Wenfang(Department of Liver Diseases/Infectious Diseases,The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学第一附属医院肝病/感染病科,长沙410007

出　　处：《临床肝胆病杂志》2018年第12期2642-2647,共6页Journal of Clinical Hepatology

基　　金：国家自然科学基金(81673959)

摘　　要：目的观察清温并用法对慢加急性肝衰竭(ACLF)大鼠调节性T淋巴细胞(Treg)/辅助性T淋巴细胞(Th) 17表达的影响,探索其抗肝衰竭的作用机制。方法 SD大鼠140只随机分为正常组、模型组、清法组、温法组及清温并用法组。采用牛血清白蛋白致敏建立免疫性肝纤维化大鼠模型,然后以D-氨基半乳糖+脂多糖攻击建立ACLF模型。观察24 h内各组大鼠血清肝功能(ALT、TBil)、肝组织病理学改变及外周血Treg、Th17细胞数,并计算Treg/Th17比值。计量资料多组间比较釆用One-Way ANOVA比较,进一步两两比较选用LSD-t法检验。结果与正常组比较,模型组大鼠ALT、TBil在各时间点明显升高(P值均<0. 01),肝小叶结构被破坏,肝细胞见桥接及片状坏死,汇管区可见炎细胞浸润,外周血Treg、Th17细胞比例明显升高(P <0. 01),且Th17高于Treg,Treg/Th17比值明显降低(P <0. 01)。与模型组比较,清法组、温法组、清温并用法组ALT、TBil明显降低(P <0. 05),肝小叶结构较完整,肝细胞可见小片状、点状坏死,门区少量纤维组织增生,外周血Treg、Th17比例明显降低(P <0. 05),且Th17降低趋势高于Treg,其中以清温并用法组降低最明显(分别与清法组、温法组比较,P <0. 05)。结论清温并用法具有调节ACLF大鼠Treg/Th17失衡的作用,是其抗肝衰竭的作用机制之一。Objective To investigate the effect of the warming and heat-clearing method on the percentage of regulatory T(Treg)/T helper 17(Th17)cells in rats with acute-on-chronic liver failure(ACLF)and the mechanism of its anti-liver failure activity.Methods A total of 140 Sprague-Dawley rats were randomly divided into normal group,model group,heat-clearing group,warming group,and warming+heat-clearing group.A rat model of immune liver fibrosis was established by sensitization with bovine serum albumin,and then an ACLF model was established by D-galactosamine+lipopolysaccharide attack.Serum liver function parameters[alanine aminotransferase(ALT)and total bilirubin(TBil)],liver pathological changes,and number of peripheral Treg and Th17 cells were observed within 24 hours,and Treg/Th17 ratio was calculated.One-way ANOVA was used for comparison of continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups.Results Compared with the normal group,the model group had significant increases in ALT and TBil at each time point(all P<0.01),with the damage of lobular structure,bridging and piecemeal necrosis in hepatocytes,and inflammatory cell infiltration in the portal area.Compared with the normal group,the model group also had significant increases in the percentage of peripheral Treg and Th17 cells(P<0.01),and the percentage of Th17 cells was higher than that of Treg cells;there was a significant reduction in Treg/Th17 ratio in the model group(P<0.01).Compared with the model group,the heat-clearing group,the warming group,and the warming+heat-clearing group had significant reductions in ALT and TBil(P<0.05),with a more complete lobular structure,patchy and spotted necrosis in hepatocytes,and mild fibrous tissue hyperplasia at the portal area;these three groups also had significant reductions in the percentage of peripheral Treg and Th17 cells(P<0.05),and Th17 cells had a greater reduction than Treg cells;the warming+heat-clearing group had significantly g

关 键 词：肝功能衰竭 T淋巴细胞 调节性 T淋巴细胞 辅助诱导 温法 清法 

分 类 号：R575.3[医药卫生—消化系统]